Ridge Lap over Implant

[JKraver]

My 2 cents, always advice against bad practice and bad ideas, document and give the Dr. what they are requesting. They are the responsible party. When McDonalds gets sued for crappy food, they cant blame their suppliers. Unless they were uninformed of their choices.

 

[edwarddental]

Most of the doctors going to restorative part without making temps and custom impression copings to manage tissue . It is why we end up with the tissue overlap .

 

[lcmlabforum]

Making the guide is sometimes just for the restorative DDS to try to influence outcome.
Sometimes the surgeon cannot use it because clinically, there is just no bone.
Many time, the surgeon just do not use it faithfully . . . or completely ignore it.
Sigh.
LCM

 

[CreDes]

I have seen plenty of poorly positioned implants using guided surgery. Guides are not the answer to all the problems faced utilizing implants.
Diagnostic work ups allow all involved to see the challenges that must be met. Full DX in occlusion an proper function gives the opportunity
to see the possible outcome and make the best decisions regarding placement before a scalpel is even picked up.

"Free-hand" is for ego maniacs and old dogs who can't learn new tricks. Times are changing for surgeons as well, not just technicians and clinicians.

I was thinking the same thing. I have seen a couple of guided cases that did not turn out very well. Diagnostics were not implemented which would have helped tremendously.

 

[JKraver]

Just witnessed a surgery with 15mm of bone removed, I can now see how the implants can get a little wonky.

 

[JMN]

Just witnessed a surgery with 15mm of bone removed, I can now see how the implants can get a little wonky.

That can be planned for if the OS and GP communicate anything about the plan before surgery to the lab. You can still make a useful guide with that knowledge. It is really rare to remove bone all the way back to the notches, and you can design to have the guide sit there after flapping and removing bone.