I want my teeth yesterday!

Dr. Justin Moody discusses a time saving technology in a fast paced world

(left to right) Figure 1: Duplicated denture used as surgical guide; Figure 2: Placement of the multiunit abutment; Figure 3: Titanium pickup copings; Figure 4: Lower denture conversion

In the ever-changing world of implant dentistry, we are finding ourselves in a battle with our patients over the amount of time needed to provide their care. With national ad campaigns discussing teeth in an hour and teeth in a day, we often find ourselves backed into a corner in respect to time and credibility. When our patients ask questions regarding TV or print advertisements, they are really trying to find out if we do those procedures. We usually try to answer them in an educated manner based on proper clinical techniques and evidence-based dentistry; however, patients perceive anything contrary to the advertisement as an excuse. We must strive to be proactive with our own treatment plans particularly in the field of immediately loaded dental implants.

Figure 5: Final i-CAT pano
Figure 5: Final i-CAT pano

I recently mentored a live surgery at the Rocky Mountain Dental Institute where this was indeed the case. The doctor treatment planned an immediately loaded lower denture case using BioHorizons’ TeethXpress™ protocol.   The problem was not with the procedure but in the expectation of the final product. The immediately converted denture is not the definitive restoration but merely a transitional appliance on the way to the final prosthesis. The ultimate final prosthesis is based on many variables such as a screw-retained denture, a locator-retained denture or any number of full fixed appliances. These choices come with different price tags as well as different treatment time frames.

This case was treatment planned for six dental implants using Tx STUDIO and a CBCT from the i-CAT® FLX (Imaging Sciences International) machine. A duplicate denture was fabricated to use as a surgical guide for implant placement and positioning and six BioHorizons’ Laser-Lok Tapered dental implants were placed, and the anterior four implants were used to convert the denture chairside following the TeethXpress protocol. The simplicity and quality of the BioHorizons’ multiunit abutment makes these kinds of cases very predictable. The doctor’s plan is for 4 months of integration prior to fabrication of the final restoration, which is treatment planned for a screw-retained full fixed prosthesis. This resulted in a wonderful treatment for the patient and an even better experience for the dentist. By avoiding the excuses and being proactive with patient education, we can win this battle. I will part with a quote from one of my mentors, Dr. John Kois, “Dentists should not be viewed as the hitman, but rather as the healer.”

Dr. Justin Moody is a Diplomate with the American Board of Oral Implantology and with the International Congress of Oral Implantologists, Fellow and Associate Fellow of the American Academy of Implant Dentistry, Adjunct Professor at the University of Nebraska Medical College, and Founder and Director of the Rocky Mountain Dental Institute. He is an international speaker and is in private practice at The Dental Implant Center in Rapid City, South Dakota. He can be reached at justin@rockymountaindentalinstitute.com or at drjustinmoody.com.

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