A series of case studies are being published by Palmeri Publishing, commencing in the January 2010 issue of Spectrum Dialogue and TeamWork. They are Implant and Non-Implant supported surgical and restorative cases that represent some of the services offered in the Fox Mentorship Program. These full cases and others will be made available online in conjunction with the Journal publications.

 

			CASE #1 Four Immediately Placed Implants For Single Crowns With Two Veneers
			CASE #2 Space Regaining Prior To Implant Placement
			CASE #3 Bilateral Maxillary Anterior Implant Supported Bridges and Natural Crowns

Below are Prosthetic Styles from Dr. Fox's Case Loads.

 

	STYLE #1 12 Single Crowns Implant Supported	STYLE #2 4 Single Implant Supported Crowns & 2 Implant Supported Bridges
	STYLE #3 Style Changed From Locators To Custom Abutments For Fixed Bridge	STYLE #4 Five Locators For Over Denture

Sinus Tenting: Six Cases Reviewed

Certain considerations need to be made while planning to augment compromised sites in the posterior maxilla, specifically:

1. need a good diagnostic x-ray (minimum 5 mm residual bone) confirm height by measuring lengths of adjacent roots;),
2. need to stay 1 to 2 mm. short of the sinus cortex (during rotary preparation),
3. need good osteotomes which must be used in sequence. Use condensing/cutting osteotomes progressively from 2mm to final implant diameter,
4. use a MFDBA (mineralized freeze-dried bone allograft) in order to add more cell attachment sites and to maintain volume of bone fill with Accell Connexus, and so it shows up radiographically,
5. tease the sinus membrane gently with a sinus membrane elevator that has up to a 90 degree angulation in order to release the Schneiderian Membrane, rather than ‘lifting’ it. Condense and allow graft material to act as buffer. Condense material with large osteotome and pack until resistance is felt,
6. Place fixture.

 

	SINUS TENTING CASE #1 This case could have succeeded without augmentation as well.	SINUS TENTING CASE #2 Good results in a staged augmentation bilaterally, with several prep holes for a wider range of access. This case took 2 years to complete.
	SINUS TENTING CASE #3 Four year post op reveals excellent mineralization	SINUS TENTING CASE #4 Particularly outstanding results in the upper left quadrant
	SINUS TENTING CASE #5 Watch for follow up image in 3 to 6 months	SINUS TENTING CASE #6 Prosthetic view is one year later, with fully torqued abutments.
	SINUS TENTING CASE #7

Below are a series of Implant Failures/Difficulties from Dr. Fox's Case Loads.

	IMPLANT FAILURE #1 Fractured Implant - Retreated	IMPLANT FAILURE #2 Severe Bone Loss - Patient Was Heavy Smoker
	IMPLANT DIFFICULTY #3 Do Not Always Rely On One X-Ray	IMPLANT FAILURE #4 Idiopathetic Failure - Observe 6 Month Decline
	IMPLANT FAILURE #5 Minimal Crestal Bone Loss Can Be Repaired