How To Use The Stent On Thin Ridges

Good morning and welcome to this Monday morning minute. I’m Dr. David Powers and I’m here to give you guys a little tip on how to use the stent on very thin ridges. Sometimes the pilot drill can tend to go off to the buckle or lingual into the soft tissue. And I’m going to give you a tip to show you how you can keep that from happening.

My patient here is a very thin ridge in this area and we’re going to be using a stent to place this. So we’re going to place the stent in first and we’re going to sound the bone in the area. We’re going to mark with the Thompson marking sticks the area of the thin ridge, those two areas right there. Then we’re going to take our explorer and we’re going to sound the bone here. You see this tissue is very loose but the bridge is right there. The ridge is right there. So in order to put the implant in I’m going to use my fingers rather than the stent to place it in.

So I’ll put the stent back on. I’m going to look at the let me have the pilot drill guide, please. I’m going to take a look at the angulation we have here. This does have a little play in it. It can go bucklingual. So what I want to do is I want to put this in and see the angle that it’s going to put me at. I can see that angle. I got an idea. I will remove this and I will actually use my fingers to find the ridge, the center of that ridge and the angulation that I’m going to make because that is a very thin ridge.

I will then drill between my two fingers staying inside the bucklingual plate. I’m going to be using a 213 MDL 213 to place that in. I can have that. Now I’ll put the stem back on. I found the pilot hole that I made right in the center and I placed the implant. Place that one in place. Now what I’m going to do is show you how to make a pre tiler hole with the diamond bird. We’re going to do the same thing. We marked it with the Thompson marking stick. I’m going to do it again in that same area. I’m going to remove the scent and then I’m going to sound the bone here.

You can see there’s a lot of loose tissue and the ridge is right there. Right in between my fingers there’s a very thin area. Put a number twelve burn on there. I use a very small number twelve diamond burr to make my initial pilot hole. That way we have a way to have the pilot drill have a purchase point on the very thin ridge. So I’ll take this and I’ll just make a small pilot hole for the pilot drill.

Then take the stint. Take the pilot drill going to see that Angulation? Hold that tight. My pilot drill should go right back into that hole that I made with a diamond. Now, to ensure that I’m in complete bone, 360 degrees around the pilot drill, I will take my periodontal probe, and I’ll put it in there and seal around to make sure that I have 360 degrees of bone around it. And I do.

Now, we’re going to place the implant in that hole through the stand. Okay, hold that. We know that that solided bone doesn’t move, not moving back and forth bucklingual. So we’ll place it the rest of the way using the hand piece. Now, that’s an alternative way to actually place the mini good lynch plant on a very thin ridge using the guy and also your finger and tongue as the guy for when you make your pilot hole.