Topic

[Surgery]  Immediate Locator


Ho - Young,

 

I've done a few immediate locators since your course and have had great success thus far. 

 

Following surgery patients are instructed not to remove the denture until the 2 week-post op/suture removal. 

 

What is your reccomendation protocol beyond the 2 weeks for the patient as far as removal?

Does it change based on the number of implants 2/3/4?

 

Thanks,

 

Stefano


by Stefano Storey at Tue, Sep 13, 2016 1:26 AM

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Ho-Young Chung Replied at Tue, Sep 13, 2016 3:33 PM

The reason that I don't place 2 implants is that it's never enough. Best location is canine areas but if they are not satisfied enough with 2 (and likely they won't be), then you have to likely place 3 more and that's only if you left enough space distal to the 2 implants and in front of the mental foramen and anterior loop. once patient sees value in getting 4 implants, they will ask you to place 4 rather than 2 or 3. I know you work with denturists and many denturists are use4d to pitching 2-3 implants. This is not their fault but due to their previous experience with surgeons and periodontists who are placing 2-3 implants. Don't sell yourself or your patients short by placing 2-3 implants. that's just my opinion mind you. Ho-Young



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Ho-Young Chung Replied at Tue, Sep 13, 2016 2:48 PM

Hey Stefano, Good to hear from you! You are absolutely correct about 2 weeks PO/SR and lower denture in 24/7 for 2 weeks. Make sure patient if edentulous on top then takes out CUD nightly for 2 weeks. After 2 weeks it's the reverse. Lower denture out every night. Upper denture they can do whatever they wish (most females will not go to bed without their CUD). Take off CLD at least twice a day to clean and brush denture. salt water rinse only in the mouth is fine as tissue will still be fragile. I see them at 2 months for final check. the locator abutments are torqued to 20Ncm at day of surgery. most patients won't loosen up abutment although I get the occasional patient who does. retorque it to 30Ncm at 2 months. Do ISQ if you have Osstell andI recommend that you do. Soft foods for 2 months! this means nothing harder than fish or soft-cooked pasta. Anything they can EASILY cut with a FORK (AND NOT KNIFE) is a good rule to follow. I rarely do 2 implants. I don't refuse work typically but I don't give them much choice either. 99% of the times I'm placing 4 implants and occasionally 6! Also something new that I have started doing is using Tissue Level (Osstem SS implants) implants. The protocol is slightly different as far as countersinking implant depth and height of abutment. I'll be introducing it at my next locator course in Edmonton and Toronto (both scheduled in May). Cheers, Ho-Young