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An interview with P-I Brånemark
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Dr. Patrick Palacci answers several questions from the audience pertaining to narrow implants, such as the risk of food impaction with narrow implants and whether or not narrow, one-piece implants should be placed in the posterior.
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Dr Bertil Friberg relates his experiences with NobelGuide as part of an eight-center pilot study, which included 52 patients with edentulous maxillae. Of the 312 implants placed, only 2 were lost, resulting in a CSR of 99. 4%. He believes NobelGuide planning is especially effective in compromised situations.
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Dr. Patrick Palacci demonstrates the flexibility of NobelGuide for flapped surgeries. He believes that retaining as much soft tissue as possible is the easiest way to ensure soft tissue integration around the implants and produce excellent esthetics.
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The panel examines the topic of immediate loading as related to primary stability. Everyone agrees that insertion torque can be seen as an indicator of primary stability, but whether to immediately load is best determined based on the clinical situation and user experience.
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Dr. Oliver Hugo explains the advantages of CAD/CAM prosthetics in indications of limited space between teeth and situations when the implant must be angled. He recalls that before NobelProcera, zirconia abutments came as blanks, which needed to be ground down by hand before placing.
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Dr. Oliver Hugo discusses his experiences with NobelProcera, explaining the advantages of shaded zirconia for esthetics, without any degradation in flexural strength. He also displays several examples of how NobelProcera can be used to restore existing teeth.
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The moderators and expert panel answer questions from the audience including. Questions regarding the correlation of initial stability, the insertion torque and CSR as well as the possibility of specific implants for specific indications were discussed.
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Dr. Patrick Palacci gives a detailed account of his many years of using narrow implants, and his recent extension to placing narrow implants posterior of the lateral incisors. Furthermore, he has never experienced implant or prosthetic fractures of any kind.
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Dr. David Nisand contends that the concepts for narrow implants are nearly identical as for short implants. Dr. Oliver Hugo explains his three part concept for using narrow implants, which includes occlusal, loading and emergence profile parameters.
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