That statement in title is not correct. Imagine bicortical implant in maxilla all-on-4. Sometimes you need some pressure on implant to go through nasal floor.
So, when it comes to placing my implants, I have a little trick up my sleeve. Instead of going into the nose, I actually like to position them at the bottom of the osteotomy. And let me tell you, I use this awesome type 4 fully fuided system that guarantees the implant gets super close to the ideal spot, like within a few hundred micros.
Oh, wow, the U.K. is just the absolute genius behind sarcasm, isn't it? Thank you so much for your incredibly kind words. They really mean the world to me. And guess what? I'll be lecturing on the four cornerstones of implant success in London in May, just in case you're interested.
As a guy who has TONS of experience with nuts and bolts and screws and tap and die sets and drilling pilot holes..Im inclined to think placing implants arent that difficult to master.. Its Just a scaled down version of basic hand tools Like self tapping screws and ratchet drivers....You have your Jig, your stops, your drills and self tapping screws....Its all very basic..
Omg! This scares the H out of me!! If a dentist doesn't have enough common sense to understand this without you having to explain this, we're all in big trouble!! Since you're making a video about this, it tells me that this should be emphasized during implant training if it isn't already. I'm not a dentist, but I would understand this just on common sense alone. This will make for a great convo with whatever dentist I choose to have do my implants.
These are certainly the types of things to ask your potential implantologist about-and make sure you're clear on whether your dentist will be the one actually performing the surgery. There is often a disconnect between dentist and surgeon with very different priorities for both! Choosing a dentist who simply has a plan and uses a prosthetic-driven protocol is your best bet!
Until I watched the video I must admit I pretty much thought the implant was like a regular screw which you would simply screw into the jawbone until it's where it needs to be. And that the drilling into the bone was supposed just to facilitate the process a bit. Now I certainly understand it's more complicated than that.
Also an engineer here. I am watching to understand more about dental implants. I really like how you try to explain important engineering principles to dentists so they can install implants in the best way possible. The one thing the animation is missing when discussing increasing the depth of the hole is that the cone of the screw will be biting into new material since the diameter is now larger at each depth. I have not watched all the videos yet, I imagine two more, (1) my implant is at the right height without reaching desired torque, (2) implant driven lower than planned, what do I do now?
Titanium has a long track record of being arguably the most biocompatible material available to mankind. Remember, humans cannot live without metal in them. Sodium, potassium, iron etc.
As a mechanic of 15 years, it's absolutely insane to me that this guy has to make a video about how to not strip out a bolt for fucking dentist. But thank God he's doing it
It’s not their fault. Years ago, the dental industry was misled about the concept of torque being a reliable indicator of implant stability. This concept gained widespread acceptance among early adopters of implants, who then passed it on to the general public. Consequently, when dentists encounter low insertion torque, they often assume that additional revolutions of the implant will result in higher torque. However, in many cases, this approach actually leads to the creation of a stripped implant (spinner). My goal is to share a different biomechanical understanding that can help doctors achieve better outcomes for their patients.
So this applies mainly to immediate loading , but if u have a spinner and the plan is to just submerge the implant this wouldn’t be a problem since there would be no forces applied on the implant and it will be integrated 4 months later right ?
That's correct. Since a spinner just means there is no resistance to rotational loads, that doesn't mean you don't have primary stability. Even if the implant has zero torque (a spinner), but it's immobile in the bone, there is a chance for integration. Clinically, I have been successful with this approach!
Yes, Isaac Newton originally published his three laws of motion in his seminal work titled "Philosophiæ Naturalis Principia Mathematica" (Mathematical Principles of Natural Philosophy), commonly referred to as the Principia. The first edition was published in 1687. This work laid the foundations for classical mechanics and introduced the laws of motion as part of Newton’s broader theories on the motion of objects and universal gravitation. In the Principia, the laws were not called "Newton's laws" at the time; instead, they were presented as basic principles or "axioms" of motion. I hope this helps.
The titanium implant is not designed to cut any depth.. like CNC machining bottoming tap or form tap its designed to cut within specified drill tolerance diameter and blind hole depth you bottom out say goodbye tap
As an Implant guy, I would like to share details of my practice. Thanks for explanation, but I would like to add that there are 2 factors, where this law doesn,t work.... First in case of narrow and aggresive implant, that implant will go deeper if we push harder. Secondly the bone density. If we have d3 d4 bone even in bad drilled bad implant will screw in. So I think it will be better to mention that this case is for d1 and mostly for d2 bone. Thanks again
This is true. If you are completely in spongy bone you could likely continue to advance apically. However, that rarely happens since the compact bone sounds the spongy bone so eventually you hit compact bone.
Dr. I had an implant case , which I couldnt performed the osteotomy as I planned as the implant motor didnt work properly and I couldnt reach the working length. I couldnt placed the implant as I wanted in depth, I had 40 Ncm but not fully seated( 2 threads are showing ,on B side). Do you think from your experience that there is going to be problem?
Hey doc. Sorry to hear that. The good news is a lot of shallow implants do just fine. Especially if the patient has good home care. When that happens what one can do is remove the implant. Make sure it remains sterile by not letting it touch anything. Extend the osteotomy two millimeters and place the implant again. Of course this is dependent on have room apical to extend the osteotomy. Hope this helps
Dr. Hello Please i want to ask a question, I put inplant on torque 35 on motor .. then 3/4 of inplant lenght went inside then stopped amazing means good Then i continued manual by wernch the last 1/4 of remaining implant i found torque from 20-25 ncm .. could u explain to me why? Isn’t supposed to by manual=handpeice
Hello Doc. This is a common scenario that many clinician encounter. The likely reason for the loss of stability as you drove the implant deeper was the fact the implant struck some D1 compact bone. Either a focal sclerosis or cortical plate. When this happens the implant can not advance any deeper which turns the implant into an auger. This subsequently strips the bone around the threads with each subsequent rotation. I hope this helps.
Hello Dr. Robert, I had a case of the second stage the other day but when I touched the covering cap, the patient felt much pain. On unscrewing it, the implant spun and the blood came out. Would you leave it there or extract it? thanks
I’m sorry to hear about your unfortunate situation. If the implant was in for 3months prior to second stage uncovery it will not integrate now. I would remove it and degranulate the tissue. If all of the bony walls are intact I would allow it to heal and attempt another implant in a few months. Stay positive and if I can help let me know.
I tend to not be limiting in my statements. “Only siths speak in absolutes”. In general, the risks associated with a sharp tip verses a blunt tip out weigh any preserved advantage. Did you see the radiograph of the implant that went into the patients eye? If so you will notice that the tip of the implant is pointed. If it had been blunted the tragic outcome might have been avoided.
Thank you sir .. i appreciate it.. well undertood implantology from ur side I want to ask a question,. Until now what make me fear from implants is not to get torque from i implants or initial stability,.. so please when i am inserting implants how to put it by handpeice or by manual ? This make me scare the inplant will sink inside and cant retake it … Please answer me … Thank you sir
I like to use my motor to drive the implant to depth. The reason is I create less off-axis loads using a motor verses using a manual hand wrench. If one creates off-axis loads then loss of primary stability increases.
@@Stanleyinstitute today i follow ur soul instructions when i was putting implant .. ur voice and eyes infront of my face when i was putting and seein primary stability
Why are everyone so scared of spinners? Like it is a sin or something. If you have a spinner, and it is in or below the bone level, just suture it under the mucosa and it will integrate.
You are correct, doc! Having a spinner doesn’t necessarily mean lack of primary stability, but that is the subject of an upcoming episode. Might I recommend our video "Bone level doesn't exist," and there would be no need to obtain primary closure in this case. (Also an upcoming episode;-) ) Stay tuned!
That's not what the patient will feel like..I'm really tired of doctors thinking clients mouths are just dummies and they don't have any biological reaction to bacteria or complications.
@@TheDenizxo What is the relevancy to the topic? Are you a clinician? Having no primary stability is no complication. In fact all of them I had are now healed and working normally
Really helpful and amazing graphics thanks for sharing this videos
Keep going doc!❤️
So glad this helped and thanks so much for your kind words 🙌 More to come!
Video title : How to unnecessarily complicate a relatively simple topic.
Could've explained in 20 seconds.
I’m always looking to improve. Please share your solution.
That statement in title is not correct. Imagine bicortical implant in maxilla all-on-4. Sometimes you need some pressure on implant to go through nasal floor.
So, when it comes to placing my implants, I have a little trick up my sleeve. Instead of going into the nose, I actually like to position them at the bottom of the osteotomy. And let me tell you, I use this awesome type 4 fully fuided system that guarantees the implant gets super close to the ideal spot, like within a few hundred micros.
As an implant guy from the U.K. I only have one criticism of your uploads. You aren’t doing enough of them!
Oh, wow, the U.K. is just the absolute genius behind sarcasm, isn't it? Thank you so much for your incredibly kind words. They really mean the world to me. And guess what? I'll be lecturing on the four cornerstones of implant success in London in May, just in case you're interested.
As a guy who has TONS of experience with nuts and bolts and screws and tap and die sets and drilling pilot holes..Im inclined to think placing implants arent that difficult to master.. Its Just a scaled down version of basic hand tools Like self tapping screws and ratchet drivers....You have your Jig, your stops, your drills and self tapping screws....Its all very basic..
I agree 💯. The real challenge for many folks is proper planning. The execute is all mechanics.
Glad i only had one done...seems fine...except food always stuck..in-between..😅
That can happen from time to time
Omg! This scares the H out of me!! If a dentist doesn't have enough common sense to understand this without you having to explain this, we're all in big trouble!! Since you're making a video about this, it tells me that this should be emphasized during implant training if it isn't already. I'm not a dentist, but I would understand this just on common sense alone. This will make for a great convo with whatever dentist I choose to have do my implants.
These are certainly the types of things to ask your potential implantologist about-and make sure you're clear on whether your dentist will be the one actually performing the surgery. There is often a disconnect between dentist and surgeon with very different priorities for both!
Choosing a dentist who simply has a plan and uses a prosthetic-driven protocol is your best bet!
Until I watched the video I must admit I pretty much thought the implant was like a regular screw which you would simply screw into the jawbone until it's where it needs to be. And that the drilling into the bone was supposed just to facilitate the process a bit. Now I certainly understand it's more complicated than that.
Also an engineer here. I am watching to understand more about dental implants. I really like how you try to explain important engineering principles to dentists so they can install implants in the best way possible.
The one thing the animation is missing when discussing increasing the depth of the hole is that the cone of the screw will be biting into new material since the diameter is now larger at each depth.
I have not watched all the videos yet, I imagine two more, (1) my implant is at the right height without reaching desired torque, (2) implant driven lower than planned, what do I do now?
excellent suggestions. Thank you.
A sinus lift....is used..and takes months to heal.......lots of implants cannot be good..for the bone and body...especially for elderly...
Please elaborate.
Titanium has a long track record of being arguably the most biocompatible material available to mankind. Remember, humans cannot live without metal in them. Sodium, potassium, iron etc.
As a mechanic of 15 years, it's absolutely insane to me that this guy has to make a video about how to not strip out a bolt for fucking dentist. But thank God he's doing it
It’s not their fault. Years ago, the dental industry was misled about the concept of torque being a reliable indicator of implant stability. This concept gained widespread acceptance among early adopters of implants, who then passed it on to the general public. Consequently, when dentists encounter low insertion torque, they often assume that additional revolutions of the implant will result in higher torque. However, in many cases, this approach actually leads to the creation of a stripped implant (spinner). My goal is to share a different biomechanical understanding that can help doctors achieve better outcomes for their patients.
So this applies mainly to immediate loading , but if u have a spinner and the plan is to just submerge the implant this wouldn’t be a problem since there would be no forces applied on the implant and it will be integrated 4 months later right ?
That's correct. Since a spinner just means there is no resistance to rotational loads, that doesn't mean you don't have primary stability. Even if the implant has zero torque (a spinner), but it's immobile in the bone, there is a chance for integration. Clinically, I have been successful with this approach!
?? articles confirming all this?
Yes, Isaac Newton originally published his three laws of motion in his seminal work titled "Philosophiæ Naturalis Principia Mathematica" (Mathematical Principles of Natural Philosophy), commonly referred to as the Principia. The first edition was published in 1687. This work laid the foundations for classical mechanics and introduced the laws of motion as part of Newton’s broader theories on the motion of objects and universal gravitation.
In the Principia, the laws were not called "Newton's laws" at the time; instead, they were presented as basic principles or "axioms" of motion. I hope this helps.
The titanium implant is not designed to cut any depth.. like CNC machining bottoming tap or form tap its designed to cut within specified drill tolerance diameter and blind hole depth you bottom out say goodbye tap
👍👍👍
Your videos are soooo good!!! Thank you for uploading
Thanks for watching 🙌 Glad you're enjoying them!
As an Implant guy, I would like to share details of my practice. Thanks for explanation, but I would like to add that there are 2 factors, where this law doesn,t work.... First in case of narrow and aggresive implant, that implant will go deeper if we push harder. Secondly the bone density. If we have d3 d4 bone even in bad drilled bad implant will screw in. So I think it will be better to mention that this case is for d1 and mostly for d2 bone. Thanks again
This is true. If you are completely in spongy bone you could likely continue to advance apically. However, that rarely happens since the compact bone sounds the spongy bone so eventually you hit compact bone.
Dr. I had an implant case , which I couldnt performed the osteotomy as I planned as the implant motor didnt work properly and I couldnt reach the working length. I couldnt placed the implant as I wanted in depth, I had 40 Ncm but not fully seated( 2 threads are showing ,on B side). Do you think from your experience that there is going to be problem?
Hey doc. Sorry to hear that. The good news is a lot of shallow implants do just fine. Especially if the patient has good home care. When that happens what one can do is remove the implant. Make sure it remains sterile by not letting it touch anything. Extend the osteotomy two millimeters and place the implant again. Of course this is dependent on have room apical to extend the osteotomy. Hope this helps
Dr. Hello
Please i want to ask a question,
I put inplant on torque 35 on motor .. then 3/4 of inplant lenght went inside then stopped amazing means good
Then i continued manual by wernch the last 1/4 of remaining implant i found torque from 20-25 ncm .. could u explain to me why?
Isn’t supposed to by manual=handpeice
Hello Doc. This is a common scenario that many clinician encounter. The likely reason for the loss of stability as you drove the implant deeper was the fact the implant struck some D1 compact bone. Either a focal sclerosis or cortical plate. When this happens the implant can not advance any deeper which turns the implant into an auger. This subsequently strips the bone around the threads with each subsequent rotation. I hope this helps.
Hello Dr. Robert,
I had a case of the second stage the other day but when I touched the covering cap, the patient felt much pain. On unscrewing it, the implant spun and the blood came out. Would you leave it there or extract it? thanks
I’m sorry to hear about your unfortunate situation. If the implant was in for 3months prior to second stage uncovery it will not integrate now. I would remove it and degranulate the tissue. If all of the bony walls are intact I would allow it to heal and attempt another implant in a few months. Stay positive and if I can help let me know.
So from your perspective
Implant with cutting tip should be never used?
I tend to not be limiting in my statements. “Only siths speak in absolutes”. In general, the risks associated with a sharp tip verses a blunt tip out weigh any preserved advantage. Did you see the radiograph of the implant that went into the patients eye? If so you will notice that the tip of the implant is pointed. If it had been blunted the tragic outcome might have been avoided.
pushing is always a no. be exceedingly careful and allow the drill to apply itself. this goes for dyi as well. the power of slow
Slow is smooth and smooth is fast!
Thank you sir .. i appreciate it.. well undertood implantology from ur side
I want to ask a question,. Until now what make me fear from implants is not to get torque from i implants or initial stability,.. so please when i am inserting implants how to put it by handpeice or by manual ? This make me scare the inplant will sink inside and cant retake it …
Please answer me …
Thank you sir
I like to use my motor to drive the implant to depth. The reason is I create less off-axis loads using a motor verses using a manual hand wrench. If one creates off-axis loads then loss of primary stability increases.
@@Stanleyinstitute today i follow ur soul instructions when i was putting implant .. ur voice and eyes infront of my face when i was putting and seein primary stability
Is this instruction is mean to be for the dentist or for the patient ?
The dentist.
This can put people off implants...
Implants are an amazing solution for replacing missing teeth.
Great video !!!!!
Glad you enjoyed it
Keep goingggg
Thanks
😂😂😂❤❤
No one likes a spinner!
Why are everyone so scared of spinners? Like it is a sin or something. If you have a spinner, and it is in or below the bone level, just suture it under the mucosa and it will integrate.
You are correct, doc! Having a spinner doesn’t necessarily mean lack of primary stability, but that is the subject of an upcoming episode. Might I recommend our video "Bone level doesn't exist," and there would be no need to obtain primary closure in this case. (Also an upcoming episode;-) ) Stay tuned!
That's not what the patient will feel like..I'm really tired of doctors thinking clients mouths are just dummies and they don't have any biological reaction to bacteria or complications.
@@TheDenizxo What is the relevancy to the topic? Are you a clinician? Having no primary stability is no complication. In fact all of them I had are now healed and working normally
@@martinchrom4444 👍