Missing teeth 3,4. Two bicon implants placed. 5x5 implant in 3 region is subcrestal in medial side and supra crestal in distal side. Implant covered with prf membrane and primary closure achieved. Plan to splint the crowns so the implant in 3 region will be stable in long run. I am interested in expert opinions on prosthesis part. Thanks.
Aqman comments:Why would you choose this system? From all the screw retained options. Being that they are off angle I have no idea how you will splint them good luck.
Sureshkannan comments:It can be done with angled abutments. I like to use Bicon implants because it's easy, short implant available. Only implant with proven bone formation around the implant abutment junction as far as I know
GregKammeyer comments:Although not ideal, these generally work out just fine, since you are not into the PDL. Inform the patient and watch it monthly w radiographs. If you note any change/radiolucency then remove it.
GregKammeyer DDS MS DABOI comments:I wonder what your plan is with the molar that has a grade 3 furcation? Certainly the bacterial count in that area will be higher if you leave it.
Sureshkannan comments:It will go for extraction. I have to restore lower and upper multiple missing teeth. Implants done for other sites too. Retained the molar so will have an idea to establish VD
Dr.Mahijeet Singh Puri comments:How old are the implants. Is it extraction and immediate placement.
Sureshkannan comments:Implant in tooth 4 region is 2 months old. In tooth 3 region placed 2weeks back.
Junaid comments:Anterior implant is in perfect position for a Bicon. Distal implant may be problematic. Ideally should be 2 mm subcrestal. The oeriodontally challenged UR7 will be a issue and further bone loss may compromise the implant further. Bicon implants do not need to be splinted. May be an idea to restore the anterior implant with a single unit crown only. Distal implant leave buried and monitor or explant. In my experience, it is highly likely it will fail over time.
mwjdds, ms comments:As others have asked, why did you use these implants? Very difficult to correct your poor angulation with bicon as opposed to custom abutments of other systems. Also, why so short? Can't see the sinus floor in this PA so easily could have used longer implants. Lastly, implant restorations should be planned from the restoration down. That means get your restorative plan FIRST, then figure out implant placement from there. A surgical guide would have been handy for you as well to align the implants. So, you have made your restoration more difficult than you needed to do since you placed the implants without a plan. That being said, align the abutments as best you can then splint the crowns. Next time, measure twice, cut once i.e., plan restoration, then place implants.
Sureshkannan comments:I do follow prosthetic driven approach. This case I have restore the complete upper and lower arch except for the right upper canine and first premolar and lower lateral and canine. Bone height was only 3mm in tooth 3 region. So I did sinus lift with bone transportation using bicon bone expanders. Usually I place 2-3mm subcrestal. For this particular implant in tooth 3 I was afraid there may be a sinus perforation so I didn't push it inside. Anyways thanks for the comment
dr.g@celinafamilydentistr comments:I use Bicon implants on regular basis. Great system. If you send the impression to Bicon lab they do great work and they will be able to plan it for you. However it appears that distal implant should have been placed more sub crestal. I will graft it before restotring it. you want your Bicon implans to be placed 2-3 mm subcrestal for better long term results, and it appers that this implant could be placed deeper ( at least from this radiograph) I will also do something with perio evolved molar and bifurcation area distal to your implants. you may want to extract it and place another Bicon there too.