Couple of decades ago there was the osseointegration revolution. Then there was the bone grafting one. The last decade has been all about two topics: Soft tissue management in the esthetic zone and Guided implant placement. Guides are pretty common place today but not ubiquitous, although they should be. Of course implants can be and are placed without guides. But if given a chance everyone would like to have a guide for ease of placement and greater accuracy. Then why don’t they? Mainly due to the additional cost and the complexity of working up the case using software. Well instead of having simplant or other CAD/CAM type guides made. Here is a guided case done with a local lab. The guide was made to the size of the final drill (nobel 4.5mm in this case). The telescoping pieces slide in and out to make the drill hole 2mm and 3.5mm in diameters for the intermediate drills. The precision placement allowed me to place this implant and immediately load it with a screw retained temporary crown for ideal soft tissue contours. The cost of the guide – $100. The two telescoping pieces are autoclavable and reusable for multiple cases. No need for the guided kits from nobel or straumann, etc. You can just use your normal surgical kit.
Where will today’s implant companies be tomorrow?
This may not be absolutely critical to torquing down your implant practice today… but maybe tomorrow!! While we look for the right surface, taper, strength, and alloy research is producing some very interesting results. I always thought that stem cell application would start by creating a graft site and then seating the cells within, then guiding the tooth to occlusion orthodontically. It appears that at least some research has taken a different approach. Dr. Jeremy Mao of Columbia University has developed a tooth shaped scaffold which can be impregnated with stem cells resulting in a completely formed tooth in nine months. It’s in alpha testing now but makes me think of where the implant companies of today will be tomorrow? Read the full story here…