Dr. Doug Smail is back this week with another clinical tip that will help every dentist who offers dental implants as a part of his or her treatment mix.
Watch the video below to see Dr. Smail's tip. You can also learn more about CDOCS.
Video transcript
"Now you can see from this case in front of you that we're trying to do tooth #3 for an implant. But the problem is, we know as much as we try to place the implants fully guided so that they can align with both the relationship with the bone and to the future prosthesis, when we're putting implants in the molar region, sometimes that's very difficult. So how do you find out before surgery that you've got a problem?
"Well, really, right during the implant consult, you can go ahead and place the drill in there. It seems a little awkward, but it's a great way to find out before you even do the guide. If you find that you're close, but you just can't quite make it, then you can do some things during the digital design phase. So one of the ways to do this, as many of you know, is using this CEREC Guide 2. In the CEREC Guide 2, as you see here, you could do a side slot to help the drill get in easier. You can also move the D2 all the way down through the gingiva to just over the bone. That'll get you a couple of extra millimeters. Of course, you know you're going to have to do a full flap, but that's OK. You've gained a couple millimeters that way.
"But there's another way to do it as well. And you can do this during the digital design part, especially with Astra EV implants. Because as you see, here we've replaced or planned an 11-mm implant. Well, that's the same drill as what you use for the 9-mm implant. And when we take a look at that and we say, 'Well, what are my other options here for a shorter drill?' The problem is, is that when you're using the 9- to 11-mm drill, a 21-mm D2. So when you're doing that planning, you've got a 21 mm.
"Now, how much will I save if I use, if I plan for an 8-mm implant instead of an 11? So if you plan for an eight, as you see here, then when you go ahead and look at the sleeve, because you're using the six to eight drill, you see that you have 18 mm as a D2. So just by switching that drill 1 mm from a nine, let's say, to an eight, you pick up 3 mm of D2. In other words, three extra millimeters of room to get your drill in there.
"So that's great. So we were able to change that plan and do the case. I was able to do the sinus bump with graft and get the case completed as you see here and that worked out beautiful."
