Thin Ridge Implant Placement

Good morning, 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. 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. We’re going to take our explorer and we’re going to sound the boning. You see this tissue is very loose but the bridge is right there, the ridge is right there. So in order to put the implants in I’m going to use my fingers rather than the stent to place it initiative. So I’ll put the stent back on. I’m going to look at 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 buckling. So what I want to do is I want to put this in and see the angle that’s going to clip 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 buckle lingual plate. I’m going to be using a 213 MDL 213 to place that in. We could have that now I’ll put the stent back on. I found the pilot hole that I made right in the center. I’m going to place the implant, place that one to place.

Now what I’m going to do is show you how to make a pre pilot hole with a 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. It’s a very thin area. Put a number twelve bur on there. I use a very small number twelve diamond bur 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 stack, take the pilot drill going to see that angulation hold that tight and my pilot drill should go right back into that hole that I made with the diamond. Now, to ensure that I’m in complete ball 360 degrees around the pilot drill, I will take my periodontal probe and I’ll put it in there and seal around and 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 fence. Okay, hold that. We know that it’s solid in bone, doesn’t move, not moving back and forth bucklinguals.

So we’ll place it the rest of the way using the hand piece. That’s an alternative way to actually place the mini good lynch plant on a very thin bridge using the guy and also your finger and thumb as the guy for Lean maker pilot hole. Thanks for joining us on this Monday morning minute. We’ll see you next week.