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Dental Implant Interview with Dr. Thomas Balshi
We recently had a chance to talk with Dr. Thomas Balshi about immediate loading protocols for dental implant placement. In the first interview, Dr. Balshi discusses the use of computer software for immediate loading dental implant protocols. In the second interview, some of the techniques used in implant restoration are described. In the third interview, Dr. Balshi discusses Determining Primary Stability.
A few quick excerpts:
From Interview I:
OsseoNews: Could you explain how you have encorporated computer software into your protocols.
Dr. Balshi: We make a CT scan of the dental implant patient to generate a three dimensional virtual replication of the bone, soft tissue and alignment of teeth. We feed this data into our software program to generate a surgical guide, which selects the most advantageous dental implant sites and angulations. The surgical guide will have three guide pins, which will securely stabilize the guide stent during the drilling and placement of the implants. The stent will first be used as a guide to drill a hole for each of the guide pins. The guide pins will then be inserted through the stent and into the bone. The advantage of this technique is that the drilling and placement of the dental implants is very precise and accurate. The dental implants end up exactly where you want them, at the desired angulation and the desired occlusogingival height.
From Interview II:
ON: Your orientation appears to favor fixed partial or complete dentures and fixed-detachable partial and complete dentures as opposed to overdentures.
Dr. Balshi: We have found over time, and again after decades of collecting data on our completed cases, that the fixed alternative is to be preferred over the removable. In the long term we have found that overdentures require far more maintenance and are prone to many problems. A screw-retained fixed-detachable partial or complete prosthesis is far more stable.
From Interview III:
ON: Could you describe your protocol for determining primary stability?
Dr. Balshi: In the majority of current treatment applications insertion torque generally provides the stability quantification. However in research cases we use Resonance Frequency Analysis (RFA). This provides an accurate, quantitative assessment of the quality of the implant fixture to bone interface. In essence we transmit mechanical vibrations to the implant to bone interface. We then monitor changes in resonance frequency. This provides a very accurate assessment of the stability of the implant in the bone.
You can read the first interview by clicking here.
You can read the second interview by clicking here.
You can read the third interview by clicking here.
Please feel free to add your comments below.
January 2, 2006 in Dental Implant Interviews | Permalink
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Comments
what is your protocol for
single tooth immediate placement and immediate
loading?
Posted by: | Jan 3, 2006 1:41:52 PM
This was a good overview. I am looking forward to the next part of this interview. I would love to hear some specifics as relates to a single, anterior, immediate load crown; also referencing the cosmetics and soft tissue architecture.
Posted by: | Jan 3, 2006 10:16:34 PM
What is the cost diference for the pacient of the all treatment including CAT scans? In what materials you do the final prosthesis? what are the advantages for the pacient but the time they don´t wait? Those the gengiva heals in the better position? In the Xray is there 100% adjustment of the prosthesis? What is for you The best treatment: "precoce" loading (3 to 5 weeks later) or imediate loading? Those any pacient fits in this protocol? (...)
Posted by: Rui Pinto Cardoso | Jan 4, 2006 7:06:27 AM
Please see Dr. Balshi´s second interview by
going to: http://www.osseonews.com/store/webpage.aspx?SID=3&Webpage_ID=495&Category_ID=141
It may answer some of your questions.
Posted by: OsseoNews | Jan 10, 2006 3:39:36 AM
Single tooth protocol has evolved to the point where with rare exception (no bone available to stabilize the implant) these implants are immediately restored with a provisional crown. The occlusion is hypo.
If the remaining dentition is healthy and there is no anticipation of additional implants in the near future, then we enjoy the benefits of NobelPerfect implants, especially in extraction sites.
If additional implants are anticipated, then the traditional Branemark implant is used with a cera-one abutment. This allows that implant to be incorporated into a future larger implant supported prosthesis.
Hope this is helpful.
TJ BALSHI
Posted by: T J BALSHI | Jan 10, 2006 7:46:52 AM
a spinner is a spinner. that means its not holding firm in bone. i would always prefer to bury it and uncover it after 6 months. if you incorporate this spinner into your prosthesis that's being supported by other immediate load implants, where's the benefit?no matter how rigid your prosthesis is, even in hypo-occlusion when the pt puts a load on this area you're still beating it up. i think your first suggestion is more sound(bury).
Posted by: Dr. R Mosery | Jan 10, 2006 3:39:40 PM
The term "spinner" a specialized term coined by Roland Meffert 20 or more years ago. It applied to HA coated cylenders. The HA coating remained integrated to the bone while the cylender body spun within the HA. That's a spinner. Part of the history as of today.
Posted by: Steven Silberg | Jan 11, 2006 6:49:36 PM
Where does one acquire a radio frequency analysis (RFA) unit?
DAS
Posted by: Dave Salmassy | Jan 31, 2006 3:01:49 PM
I attended an ICOI meeting in December where Dr. Trisi showed that the RFA tests could not correlate very well with the primary stability and the bone to implant contact. I don't remember the details of his research very well but i think he proved that RFA is not as useful as most of us think.
Posted by: yianni | Jan 31, 2006 9:49:38 PM
This was a good overview. I am looking forward to know Dr.Balshi opinion about the new studies to use low modules of elasticity implant material (polymer implant) in poor quality of bone and to minimize the stress in implant to bone interface.
Posted by: Ballo Ahmed | Feb 3, 2006 1:19:35 PM
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