DentaltownUK April 2017 - 64

Prosthodontics
Message Board

drjk
Member Since: 09/14/04
Post: 7 of 25

First, I haven't done any big cases as these with implants, or any All-on-4. I don't understand
the logic of loading only four if you have more implants. Is it for ease of restorability or some
other reason? n

11/23/2016

toofache32

Fewer implants are much easier for the immediate prosthesis. n

Member Since: 08/10/04
Post: 8 of 25

GocubsGo
Member Since: 10/19/16
Post: 9 of 25

11/23/2016

Toof, Bifid, do you guys charge the patient more when you do five or six? In my practice,
I treatment plan for four and charge for four. Only once I've thrown in an extra for stability
since I didn't feel great, but if the others torque at >50 and I feel good, then I just leave the four
regardless of bone. Just curious how others do it.
And I agree: four, five six-doesn't matter. Just load those up for him immediately and give
him a great result. n
11/24/2016

6D1R3
Member Since: 03/02/06
Post: 10 of 25

Where would you put the implants in this case? Assuming we don't graft then you have to
place the implants at the #6 and #8 positions on the right and have the options of #9, #10, #11,
#12 on the left. If we do a hybrid, then it doesn't really matter and can place two on the right and
2-3 on the left and call it a day. This should work really well but I want to build for long-term
complications if in the next 60 years one implant fails. I guess you can do the sinus lifts and
grafting then if/when the issue occurs. n
11/24/2016

Calvin Bessonet
Member Since: 12/17/03
Post: 11 of 25

Personally I would want to give this very young patient the option of socket fit bridges (three
segments). I would feel better not removing a ton of bone to make room for a hybrid (assuming
his smile line will show transition). Let him choose but at least offer the best. n

11/24/2016

GocubsGo

Why would you consider your option the best? n

Member Since: 10/19/16
Post: 12 of 25

resadent
Member Since: 11/08/14
Post: 13 of 25

11/24/2016

Good point about transition zone-that was my first thought too. I think he definitely
needs some bone removed to account for materials at the very least. What are socket fit bridges?
Haven't heard of them!
Also, while planning for an immediate provisional, how do you determine tooth position
and occlusal plane in a case like this? Looks like he has limited interarch space anteriorly and
posteriorly. Could you walk us through that process please? n

11/24/2016

Bifid Uvula
Member Since: 05/17/06
Posts: 14 & 15 of 25

64

Flat fee to get the job done. Most of my cases are four, some need more and they get it. My
goal is to load the case, and sometimes that means adding an implant somewhere else. If my
prostho tells me he really needs five or six for the case, then I make it happen. I charge more
if it's a really complicated case that may involve some zygomatics, but not substantially more.
If I need to do some crazy grafting with BMP or something out of the ordinary, I'll charge
more. But 99% of these cases are just flat fee.
That is a perfectly acceptable option ... but it doesn't mean it's the best option. This is much
more technically demanding when it comes to landing the implants in to "perfect position" and
"perfect depth" and "perfect angulation."
Assuming that you are able to land 6-8 implants for a "socket-fitted bridge," and the case

APRIL 2017 // dentaltownuk.com


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Table of Contents for the Digital Edition of DentaltownUK April 2017

Cover
Meet the Team
Mike Gow
Industry News
Howard Speaks
International Dental Show
Through the Keyhole: Surgery—Home and Away
What's on Dentaltown
Golden Nuggets
Continuing Education
BACD: Rise of Cosmetic Dentistry
3-D Printing
Google: Leading Cause of Truth Decay
General Practice: Message Board
Time Out
Probing Report
Eating Disorders
Physiotherapy in the Treatment of Craniomandibular, Craniofacial and Craniocervical Disorders
Prosthodontics: Message Board
Plan Z
Online Marketing
Product Profile
Finance: Message Board
Lifestyle Section
Student Section
Poll
The European Society of Hypnosis
Wish List
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DentaltownUK April 2017 - What's on Dentaltown
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DentaltownUK April 2017 - Continuing Education
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DentaltownUK April 2017 - Google: Leading Cause of Truth Decay
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