April 12, 2023

The ISI Complete™ ,

TSI, and Soon Be Released ERI Immediate Load

Dental Implant System

OCO Biomedical introduced the next generation of endosseous implants:

Patent pending

Diagnosis and treatment planning

1. Medical and dental history2. How did the patient loose the tooth or teeth3. Pano or cone-beam cat scan x-ray4. Study models5. Model mapping on areas to be treated if needed6. Identify bone type and density7. Evaluate available bone in areas to be treated8. Inform before you perform9. Evaluate the patient expectations10.Can you meet those expectations11.Can anyone achieve the expectations12.Encourage the patient to get a second or third opinion and estimate

Evaluate study model for ridge width, alignment of adjacent teeth, if a dental implant can be placed using uncomplicated techniques.

Section the model through the edentulous area and after estimating gingival thickness, map it.

Mount study models, mounted. A must for treatment planning and Case Presentation

Mount study models, mounted. A must for treatment planning and Case Presentation

April 12, 2023

Edentulous MandibleAn immediate denture placed 17 yrs ago

Pantographic X=Ray, a must for any implant case. Is there abundance of bone?

Model of lower, sectioned at the center and mapped

April 12, 2023

Bone Densities

Anterior Bone Qualities

Lekholm and Zarb’s four bone qualities for the anterior region of the jaws:– Quality 1: Composed of homogenous compact

bone – Quality 2: Thick layer of cortical bone

surrounding dense trabecular bone. – Quality 3: Thin layer of cortical bone

surrounded by dense trabecular bone of favorable strength.

– Quality 4: Thin layer of cortical bone surrounding a core of low-density trabecular bone.

D1

D3

D2

D4

General Bone Densities

Bone Density Classification by Misch & Judy

Bone Density Description Tactile Analog Typical Anatomical Location

D1 Dense Cortical Oak or maple wood Anterior mandible

D2 Porous cortical and coarse trabecular

White pine or spruce wood Anterior mandiblePosterior mandibleAnterior maxilla

D3 Porous cortical (thin) and fine trabecular

Balsa wood Anterior maxillaPosterior maxillaPosterior mandible

D4 Fine trabecular Styrofoam Posterior maxilla

D2D1 D4D3

Basics for fixed: 4 Main buttresses for fixed or implant supported teeth

Ideal minimumImplant diameter

Minimum implant length 10 to 12 mm

A Dental Implant is not a natural tooth root

Vertical tooth movement: 25 to 100 mµ

Vertical Implant movement: 0 to 10 mµ

Proprioception: Tooth – yes

Implant - no

Horizontal flex: Tooth –yes

Implant - no

So, if not following the buttress parameters and ignoring the physical properties:

Edentulous upper left quadrant:

Ideal implant placement

4.0mm bicuspid areas

5.0 mm 1st molar area4 or 5mm 2nd molar

Bi-Lateral lower edentulous: R- normal ridge, L- narrow ridge Treatment

R- Ideal, 5.0mm at Molar, 4mm for bicuspids

L- Narrow ridge- compromise, 2 3.25 At molar.

3.25 in bicuspidAreas.Prosthesis, splinted crownsNo wider than bicuspids, Lighter occlusion and no Lateral interferences.

Edentulous upper and lower Treatment: Stabilize lower denture

Economy: I-Mini Implants

4 on the floor4 3.0mm I-Mini implantsPlaced between mental foramina

X XFOR A SIMPLEOVERDENTURENEVER PLACEIMPLANTS IN THE POSTERIOR REGION

To maximise

To maximize A-P place markers in the denture, take a pano and establish the location of the mental foramina

O I I O

Implants placed and at least 3mm anterior to the mental foramina

Edentulous upper and lower Treatment: Stabilize lower denture

Or, if the residual ridge Permits: moderate height, Wide ridge

4 to 6 standard sized 3.25 or 4mm Implants placed between the mental foramina,

2 - 4.0 mm

2 – 3.25 mm

Never!2 Implants in Cuspid Areas

Crates a fulcrumThe denture will rock

Edentulous upper and lower Treatment: Stabilize lower denture

Or, if the residual ridge Permits: Tall, med width

OR:

5 or 6 3.25 mm implants between the mental foramina

Five implants placed comfortably in the safety zone by placing markers in denture first

Post- Op Pano

In less than 2 weeks the healing looks great and he’s ready for a reline and the final female attachments

Flanges are trimmed and the size of the denture is minimized

April 12, 2023

IMMEDIATE PLACEMENT PROTOCOL AND PROCEDURE

ISI Complete™ One-piece and

TSI Two-piece Dual Stabilization™ Implants

Establishing the path of implant insertion after removing the tooth or tooth roots

With a high speed drill, always break through the cortical bone lining the socket wall in the direction of implant alignment

Use a # 8 surgical or XXL straight fissure burr/ watercooling only, no air

Use the pilot drill in the surgical HP aligned to the final depth

Select the implant diameter by placing the final drill into the socket. It must not drop more that half the selected length

Drill with osteotomy former to the final depth established by the pilot Drill

Implant placed with grafting material, if dual stabilization is present, ISI can be used. If not, a TSI must be used

Thank YouQuestions?

Q&A

OCO Biomedical is a debt-freeCompany serving the dental

Implant Community since 1976