Self-Tapping Implants: Thoughts?

Now a days every implant is selftapping in its design. Now to tap or not the receptor site with bone tap drill is really a clinical decision that depends on the bone quality of the site. For instance in lower anterior sites with a thick cortical layer, Types 1 or 2, you may nedd to tap anyhow, regardless of the selftapping design of the implant

Dr Nac, I would suggest that you take a surgical course or two if you desire to start placing implants. Your question sounds like a statement made by a manufacturer. ie: no need to tap with our implants. You will save yourself a lot of misery by learning from people who have been there before you. Misch surgical course is fantastic. I took Carl's course 10 years ago and it has saved me from making mistakes and learning the hard way. Why reinvent the wheel. Learn from your peers. Trust me, you will never regret taking this course and it will actually make you a better dentist. Good luck. Dr D.

Dr.Nac your question is too wide... Gps are now going back to expertise doctors because they realize easy was not it!...even if the implants are self-tapping implants or whatever....

dont tap bone best of luck

To tap or not to tap...this is the question. Before making this decision, one must evaluate the type of bone the implant (s) are to be placed into. In my experience, if the implants are going into the symphyis, which is Type 1, very dense bone; you will probably break you taps attempting to do so. In softer bone, first drill to the correct depth with a narrow diameter pilot drill to feel the bone for its density.If the bone is malable, I would proceed with Osteotomes to stretch the bone with each size before preceding with a wider diameter instrument, or tapping screw.....if excessive force is required, I would suggest drilling with a wider diameter drill, and then go back to manual osteotomes or tapping to finish the site. Dr.O. Hilt Tatum jr. who now lives in France, is a master at bone manipulation, and listening to him or reading his articles is the best source of information. Tapping +/or using osteotomes, or just plain stretching and manipulating bone, has the advantage of not removing and losing bone cells......just "bending" the bone to accomodate the tapered "screw in type" implant......bear in mind, that over pressuring the osteotomy site could lead to "pressure necrosis" a phenomenon that many experienced implantologists do not believe exists....just ask the patient who has felt the effects of too much force....it can be painful, and lead to the sloughing of the implant. Dr. Gerald Rudick, Montreal

The type of implant matters but it depends on the prosthetic demands which will dictate the surgical techniques and materials. Are you considering soft tissue profiles, bone type, positioning relative to other teeth, emmergence profile, will buccal plate exist, is graft needed???. When you understand the above concepts the answer to your question will be instinctive.