by Brady Frank, DDS
My view of the implant field is that the coming five years will be the next golden age of dentistry due to the rapid expansion of patient education with regard to implants. Implants are currently the highest fee per procedure according to the ADA codes, and minimally invasive implant procedures are geared toward the busy general practice.
I am introducing three procedures that can transform your practice if you choose to dig deeply into them. The No-drill Implant Procedure: Immediately after extracting a tooth an OsteoconverterTM is inserted with a spiraling motion into the socket, which achieves two important tasks. One, the PDL is scored in roughly 2 mm increments allowing blood flow and highly bone forming cells to enter the site. Two, the unique curvature of the root is "converted" to a cylindrical shape which allows for an implant worthy osteotomy. The Osteoconverter is a hybrid between a bone condenser and osteotomb, and is also approved for use as a conventional dental implant as well.
FIG. 1 -- No-drill Implant ProcedureTM
1. Unrestorable tooth necessitating an extraction. Applicable for any tooth in the mouth
2. The Osteoconverter™ is threaded into the socket. Completing the task of both an osteotomb and bone condenser
3. The socket is prepared for an implant three ways:
1. Converts socket curves and irregularities into a suitable implant site
2. Scores the internal socket wall in 1mm increments providing optimal blood flow for implant healing
3. Expands bone to provide ideal initial implant stability (45Ncm to 65Ncm on average)
4. The Osteoconverter™ is also an implant. It may be left in the socket as the final implant, or you may place an appropriate size implant of your choosing.
The second procedure is called the 3 in 1 Implant ProcedureTM. Due to the ease and efficiency of this procedure, many dentists call this the five-minute implant, abutment, and crown procedure. To the benefit of the patient, three steps are now able to be accomplished efficiently in a single dental appointment. It is a huge plus to your patients because there is less time investment in the dental office and there is typically much less discomfort associated with the procedure. Remember, bone is not innervated, nerves may travel through the bone but do not directly innervate. Any discomfort related to an implant procedure post-surgically is caused by soft tissue.
The 3 in 1 Implant Procedure is applicable for almost any edentulous area in the mouth that is suitable. The final osteotomy is created and the implant is placed. Immediately after implant placement, a final impression is taken after customizing a straight stock abutment, placing wax in the top of the abutment, and taking a standard check bite or full tray impression. Please view the adjacent animated diagram to fully comprehend the technique.
1. Traditional multiple drill sequence for Osteotomy not needed.
2. Multi-drill technique used for final Osteotomy pioneered in the Orthodontic surgery filed. (Replacing the use of separate drill sizes)
3. Implant insertion completed using the 3 in 1 implant procedure
4. Prep abutment and refine the margins before moving on to the final impression
The third and final procedure that is transforming GP practices around the nation is the 1-Drill Implant ProcedureTM. Instead of the clinician going through a series of four or five drills to complete the osteotomy, one drill is used to complete the final osteotomy. The drill is called a Multi-drillTM and has the widths of four to five drills built into the drill. This procedure is transforming the versatility of implants in the GP practice. View the adjacent schematic to comprehend the physical steps of the procedure. The 1-Drill procedure relies on two important variables: one, the drill used must be end cutting, side/axial cutting, and have a modified taper (6% is ideal) or have multiple steps (see diagram). Two, the implant used with the 1-Drill procedure should ideally have aggressive threading, a 6% taper, and be self-tapping. By utilizing a tapered drill the osteotomy is wider toward the coronal aspect (more dense cortical plate bone) and more narrow apically (generally softer type 2/3 bone). If the site has been edentulous for over six weeks, then an impression for the final crown may be taken immediately after the implant is placed. The typical implant placed with this procedure takes less time to complete that an occlusal composite. That gives dentists the opportunity to provide this outstanding service for a much more reasonable fee for those in need. Do yourself and your patients a favor and learn the 1-Drill implant technique.
The foundation of the three procedures are tried and tested techniques to prevent peri-implantitis and allow for optimal osseointegration. The three procedures are simplified, efficient approaches easily integrated into the general practice routine. To view a video of the procedures and for more information, go to www/OsteoReady.com.
Brady Frank, DDS Having placed thousands of implants, Dr. Frank developed OsteoReady implants to better meet the needs of his patients. A frequent speaker on implant education. Dr. Frank is an active member of the International Congress of Oral Implantology. Reach him at [email protected].
The 1-drill procedure relies on two important variables:
One, the drill used must be end cutting, side/axial cutting and have a modified taper (6% is ideal) or have multiple steps (see diagram).
Two, the implant used with the 1-drill procedureTM should ideally have aggressive threading, a 6% taper and be self-tapping.
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