Tuesday, January 27, 2015

My First Implant



I have a lot of admiration for the early pioneers of dental implants, such as Leonard I. Linkow, Carl E. Misch,  Gerald A. Niznick, and too many others to mention.  They had the intelligence and the courage to work with less resources and knowledge than we have presently, and learn at the same time.  It is because of their accomplishments that we have our implant practices today.


It was actually Dr. Niznick who introduced me to the surgical placement of implants in the late 1980’s with his Screwvent  implant, a part of the Corevent system. 


It is easy to show your best cases, but I am going to show you my first implant, done in the late 1980’s when implants were not as popular as they are today and our knowledge about them more limited.


My patient was an elderly gentleman that lost a maxillary canine which served as an abutment for a three-unit bridge.  I did not feel that a four or five unit bridge would be as good a service to him as a smaller three unit bridge if I could use an implant as the anterior abutment, so that is what I did.  
Here are the pre-op and post-op periapical radiographs:



 

Today of course, we prefer not to join implants and natural teeth, but it seemed a great idea at the time, and the bridge served him well for many years.  I lost contact with the patient, so I cannot give you more details about its longevity.

Introducing implants in my practice has allowed me to provide a higher level of care for my patients.  I can honestly say that I haven’t had a single implant patient that hasn’t  liked them.  Compared to other treatment alternatives, implants are usually the best solution.
If we can help you with implant related questions or services, please call us at (561) 968 6022.

West Palm Beach Dentist
Carlos Boudet, DDS DICOI
website:  http://www.boudetdds.com
Implant Blog:  http://www.palm-beach-implants.com
Spanish website:  http://palmbeachdentist.net



 

Thursday, January 15, 2015

ALL PORCELAIN CROWNS – THE CAD/CAM WAY



When some of my dentists colleagues learn that I use the Cerec system  to create all-porcelain crowns for my patients, one of the first questions I get is if they are good looking enough to be used in front teeth.  I tell them that after placing a great number of these crowns, I would not want to go back to placing a conventional porcelain fused to metal crown. 
Porcelain fused to metal crowns have served our patients well over many decades, just like silver amalgam fillings, but just like silver fillings, I don’t use them anymore.  The all porcelain crowns that I fabricate using the CAD/CAM system are translucent and let the light through just like the natural teeth.  They don’t  darken the tooth and look opaque like  porcelain fused to metal crowns.  Let me show  you how I used Cad/Cam crowns in a case involving some poorly designed crowns to completely change the smile of a patient.
This is the way the patient came to our office.  The two central incisors had crowns that were mismatched in shape and size and canted.  The ill-fitting margins had caused a chronic gingivitis.



The case required a small amount of osseous crown lengthening for the right central incisor and a diagnostic wax-up to place temporaries that were correctly designed and fine-tune their anatomy and occlusion.  The post-op picture is shown below, and the patient was very happy with the results.





These results are not extraordinary, but they are very typical of the quality of the restorations  that are routinely done with present Cad/Cam systems.
For any questions or to schedule an appointment please call our office at (561) 968 6022.

Carlos Boudet, DDS
Dentist in West Palm Beach Florida