Blimey!?

[Toto]

Patient came from other Dentist with a problem. She has a lower full denture over 4 mini implants which the dentist trimmed the implant balls to fit the denture -so now it has no retention.Should have attached the female part in situ . Same situation as photo.
They are an all in one type implant so no unscrewing as the whole implant will come out. These implants are also tooth pick thin in diameter.
Was thinking to wax a framework over all 4 implants and make some attachments for a new denture ?

 

[TheLabGuy]

The Dentist ground on the implant...oh boy!!!

 

[Mohammad Khair]

Patient came from other Dentist with a problem. She has a lower full denture over 4 mini implants which the dentist trimmed the implant balls to fit the denture -so now it has no retention.Should have attached the female part in situ . Same situation as photo.
They are an all in one type implant so no unscrewing as the whole implant will come out. These implants are also tooth pick thin in diameter.
Was thinking to wax a framework over all 4 implants and make some attachments for a new denture ?

Make a denture and make a few millimeter deep holes where the implants are located, provide those holes with undercut to hold soft reline material. and let your dentist fill those holes with soft reline material and fit it on the patient mouth, hopefully there will be a little deference in the path of insertion of those implants to act like undercut holders, utilizing of course the high tear resistance and the high flexibility of the soft reline material.
its not a perfect implant treatment, but it may success with easy effort.
by the way your doc have done a big mistake by reducing the implant clinical part.

best wishes

 

[rkm rdt]

Good idea Toto,

maybe even a telescopic coping mesiostructure.

 

[Mohammad Khair]

Good idea Toto,

maybe even a telescopic coping mesiostructure.

Again you show a lack of knowledge and experience about implants and dentures,
so again i will advice you to leave it for the experts to handle it for you and just relax and learn.

Those ball posts have not been designed to have a rigid connection to the denture, there must be a flexible intermediate between them and the denture, otherwise they will fracture rather soon because of the lever action of the free-end saddle denture, that if we assume that the implant it self can withstand such a lever action.
the flexible intermediate will absorb the lever force by its flexibility and allow for a limited movement with no harm forces on the implant and the post(the denture will be supported by the saddle tissue rather than being supported by the implant itself ),
while the rigid connection will absorb lever forces by micro-bending the ball-post and the implant ,,,then they will fail to withstand the lever forces very soon.

best wishes

 

[rkm rdt]

I disagreed with you because I didn't want to give your profile a dumb rating which it truly deserves.

Your fragile ego has become embarrassing to witness.

Kiss my Bootyshake

 

[CoolHandLuke]

girls, girls, youre both pretty.

resolution to this case is simple. tell the patient to save the money for the funeral. sell them a blender.

 

[KentPWalton]

You must listen to Luke....he's the Chosen One! Even blind he sees everything.

 

[CoolHandLuke]

well its easier than putting the previous dentist into a malpractice suit for trimming the implants.

this only serves to discourage people like me who are actively engaged in engineering my own implant catalogue. if the dentist is just going to trim it out of ignorance and a sense of apathy then i shouldn't even bother.

i mean you could tell the patient to go back to the dentist and take the case to a judge, with the intent to show the ignorance but i think the case would be lost in the technical dental terminology and details. if it came down to a "this [allowance for customization] was given to me by the implant provider" then it would fall on all of us repercussively.

this would be an attempt to thwart some malpractice but it could end up biting us all in the butt.

so save yourself the time and hassle, and save my neck, and sell the patient a blender. as i see it the only other option is to remove and place 4 new proper size implants and not trim the goddang attachments. you know, do it right, albeit the second time.

 

[rkm rdt]

No need to remove the implants if they have ossiointegrated. Adding a couple more conventional implants would help.

 

[Mohammad Khair]

I disagreed with you because I didn't want to give your profile a dumb rating which it truly deserves.

Your fragile ego has become embarrassing to witness.

Kiss my Bootyshake

In technical threads wise guys should always give technical rating, not a personal or emotional rating.
however, i really don't care about rating, feel free to give the rate you like emotional or technical as you wish, the problem is the opinion that follow the negative rating.
misleading opinions is not acceptable, bring a better technical opinion(or at least acceptable technical opinion) after your disagree or stop right at your rating, and if you bring a better technical opinion i will be the first to give you a good rating and the first to thank you.

regarding the ego, i just follow the advice i just gave it to you, when i don't have enough information i just relax and learn, so my technical opinions always stand on solid and strong technical and logical ground and that's called self-trust.

you should ask your self why you are following my posts to disagree on no technical or logical ground ??? is it just because your fragile ego have been broken, rethink and answer your self.
at the end its shame to offer your Bootyshake to the public keep it in private for your mate.

Regarding other negative comments or ratings, you can mock at anyone who ask a question and you can mock also at anyone who try to help and answer, but at the end those negative comments and ratings will never answer the question and will never solve the problem.

best wishes

 

[rkm rdt]

Your solution is a waste of time and money.


Is that technical enough for you?

 

[Mohammad Khair]

Your solution is a waste of time and money.


Is that technical enough for you?

Too late, incorrect, impractical, and also misleading again.
bring a better solution to the problem Mr. disagree,,,,,,or try to make some experiments or at least think a little before releasing such a comment.
from your comment a logical thinking technician may conclude that you never use a soft reline material before.

 

[Toto]

You must listen to Luke....he's the Chosen One! Even blind he sees everything.

I agree with Luke - he is right. Bananas and soup I tell them. Had one old dentist tell me that the patient was complaining about his new denture - hurts when I eat , this complaint , that complaint etc - doc then asked patient - when you're reading are they ok? Answer - yes -Well at least they're good for reading.

 

[CoolHandLuke]

Again you show a lack of knowledge and experience about implants and dentures,
so again i will advice you to leave it for the experts to handle it for you and just relax and learn.

Those ball posts have not been designed to have a rigid connection to the denture, there must be a flexible intermediate between them and the denture, otherwise they will fracture rather soon because of the lever action of the free-end saddle denture, that if we assume that the implant it self can withstand such a lever action.
the flexible intermediate will absorb the lever force by its flexibility and allow for a limited movement with no harm forces on the implant and the post(the denture will be supported by the saddle tissue rather than being supported by the implant itself ),
while the rigid connection will absorb lever forces by micro-bending the ball-post and the implant ,,,then they will fail to withstand the lever forces very soon.

best wishes

mohammad what you describe is ball attachments i think, or locators. these are mini implants, they are made to snap together like the domes of a shirt. they were made to be flush with the ginigva and be at slightly differing angles to encourage the snap together. an all on 8 per arch solution. certainly not 4, like the original post, nor yet ground down and undo the snap fit. here: http://www.cornerstonesmiles.com/Mini-Dental-Implants-Anderson-SC.asp

a bar with locators ground down would be just as bad. they are precision designed, not to be tampered with. and yes they have plastic caps to allow room to flex.

there are reasons we as a community have a large pool of parts to use; for instance a large and wide assortment of denture attachment designs, to accommodate the many kinds of prosthetics that are possible.

but when dentists throw curveballs or start playing engineer, we have to go back to the beginning and reteach them that this kind of thinking is no longer necessary. the parts exist. theres no need to made modifications. the array is wide, and its guaranteed that the attachment this dentist wanted was already available. but he chose to grind it and that all by itself shows us that if you fix this case as it is, you encourage the dentist to do this bad practice over and over again.

so while a flexible intermediate between the implant and the denture may work, it will not solve the fundamental problem, and worse, this may occur again. more than twice and if even 1 of those patients decides it will be worth the cost of the lawyers, it will be your head on the pike at the end of the day because you knew, and you didnt say anything.

a safe fix in this scenario is to fix and give no warranty at all. charge for every reline and remake that this denture will get, if you arent prepared to accept this lackadaisical work then gouge your little heart out until the doc starts asking himself why this work has no warranty.

it wasn't right to begin with, it shouldnt get right going out the door.

fixing it is more trouble than it is worth. the doc wanted no retention he should have used a non engaging implant. its very simple.

 

[Mohammad Khair]

mohammad what you describe is ball attachments i think, or locators. these are mini implants, they are made to snap together like the domes of a shirt. they were made to be flush with the ginigva and be at slightly differing angles to encourage the snap together. an all on 8 per arch solution. certainly not 4, like the original post, nor yet ground down and undo the snap fit. here: http://www.cornerstonesmiles.com/Mini-Dental-Implants-Anderson-SC.asp

a bar with locators ground down would be just as bad. they are precision designed, not to be tampered with. and yes they have plastic caps to allow room to flex.

there are reasons we as a community have a large pool of parts to use; for instance a large and wide assortment of denture attachment designs, to accommodate the many kinds of prosthetics that are possible.

but when dentists throw curveballs or start playing engineer, we have to go back to the beginning and reteach them that this kind of thinking is no longer necessary. the parts exist. theres no need to made modifications. the array is wide, and its guaranteed that the attachment this dentist wanted was already available. but he chose to grind it and that all by itself shows us that if you fix this case as it is, you encourage the dentist to do this bad practice over and over again.

so while a flexible intermediate between the implant and the denture may work, it will not solve the fundamental problem, and worse, this may occur again. more than twice and if even 1 of those patients decides it will be worth the cost of the lawyers, it will be your head on the pike at the end of the day because you knew, and you didnt say anything.

a safe fix in this scenario is to fix and give no warranty at all. charge for every reline and remake that this denture will get, if you arent prepared to accept this lackadaisical work then gouge your little heart out until the doc starts asking himself why this work has no warranty.

it wasn't right to begin with, it shouldnt get right going out the door.

fixing it is more trouble than it is worth. the doc wanted no retention he should have used a non engaging implant. its very simple.

Cool, the situation here is not about to choose the best implant treatment indication for this patient, and its not about to blame someone or to claim a patient rights.

you have a patient came from hocus bocus country, with this problem and ask you for a cure to it, and as you a doc you ask your technical expert for the best technical solution for this problem at the best and least pain, time and money cost.

The best answer is mine, not because i have an ego as somebody claim but because it is really the best practical solution so far at virtually no cost. the denture is exist the implant clinical part is partially trimmed, this will need 10 minutes in the lab and the same in the clinic.
the soft reline is extremely flexible and extraordinary tear and deform resistance + its made to serve for long time in the patient mouth + its easy for direct use and can be repeated as much as you wish and at the end its very cheap, however, even if there is no enough retention the doc may create a little of undercuts on the ball-post, and if failure no problem as no harm done.

so given it a try on the patient own risk will be a very wise thing to do because it will cost everyone nearly nothing at a reasonable short-term success rate.

best wishes.

 

[aqdental]

Cool, the situation here is not about to choose the best implant treatment indication for this patient, and its not about to blame someone or to claim a patient rights.

you have a patient came from hocus bocus country, with this problem and ask you for a cure to it, and as you a doc you ask your technical expert for the best technical solution for this problem at the best and least pain, time and money cost.

The best answer is mine, not because i have an ego as somebody claim but because it is really the best practical solution so far at virtually no cost. the denture is exist the implant clinical part is partially trimmed, this will need 10 minutes in the lab and the same in the clinic.
the soft reline is extremely flexible and extraordinary tear and deform resistance + its made to serve for long time in the patient mouth + its easy for direct use and can be repeated as much as you wish and at the end its very cheap, however, even if there is no enough retention the doc may create a little of undercuts on the ball-post, and if failure no problem as no harm done.

so given it a try on the patient own risk will be a very wise thing to do because it will cost everyone nearly nothing at a reasonable short-term success rate.

best wishes.

Finding a solution, of course. Report the dentist to the dental board, at least make him/her take responsability for his/her moment of "genius " (sorry for the sarcasm) . Just wondering if the patient was informed of what was going to happen to her "balls" before they got chopped.
Once authority are informed, than go ahed and try a temporary fix ( your sounds good Mohammad).
Has this dentis just washed his/ her hands clean? I'm sure most clinicians would be horrified hearing this story.

 

[KentPWalton]

well its easier than putting the previous dentist into a malpractice suit for trimming the implants.

this only serves to discourage people like me who are actively engaged in engineering my own implant catalogue. if the dentist is just going to trim it out of ignorance and a sense of apathy then i shouldn't even bother.

i mean you could tell the patient to go back to the dentist and take the case to a judge, with the intent to show the ignorance but i think the case would be lost in the technical dental terminology and details. if it came down to a "this [allowance for customization] was given to me by the implant provider" then it would fall on all of us repercussively.

this would be an attempt to thwart some malpractice but it could end up biting us all in the butt.

so save yourself the time and hassle, and save my neck, and sell the patient a blender. as i see it the only other option is to remove and place 4 new proper size implants and not trim the goddang attachments. you know, do it right, albeit the second time.

I was talking about your picture Neo!! Haha.

 

[rkm rdt]

If it is temporary then it is not a fix.

Mini implants are not too invasive so placing new tissue level rp's may be a solution depending on the positions.

 

[Mohammad Khair]

Finding a solution, of course. Report the dentist to the dental board, at least make him/her take responsability for his/her moment of "genius " (sorry for the sarcasm) . Just wondering if the patient was informed of what was going to happen to her "balls" before they got chopped.
Once authority are informed, than go ahed and try a temporary fix ( your sounds good Mohammad).
Has this dentis just washed his/ her hands clean? I'm sure most clinicians would be horrified hearing this story.

Its really complicated, i don't think it would be considered as a practice intentionally mistake, as the only way to reduce retention on those implant's balls is to polish them down(after trying to use the low retention matrix),well that must be right at least in the court hall i think.
however, i prefer to consider the real situation on the patient's mouth before any farther judgement.

If it is temporary then it is not a fix.

Mini implants are not too invasive so placing new tissue level rp's may be a solution depending on the positions.

Depending on the situation on the patient's mouth and the technical procedures by the tech and the doc this technique might serve for years.
however, if not work well for a reasonable period of time because of any reason, your solution might be the next to consider.