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Merrill Lynch Highlights OsseoNews.com
In a recent research report on Nobel Biocare over at Merrill Lynch, analyst Michael K. Jüngling referenced the OsseoNews.com blog. Mr. Jüngling called OsseoNews.com, "one of the world’s largest dental implant resource sites."
Mr. Jüngling's analysis of Nobel, which was based on many industry resources, including responses on the OsseoNews.com dental implant blog, concluded that, "Unlike market consensus, we believe the uncertainties surrounding NobelDirect are far from resolved. In our view, a positive decision from the Swedish MPA is vital for NOBE’s shares not to come under pressure."
May 30, 2006 in Dental Implant News | Permalink | Comments (1)
Total Graft Failure and Teeth in Day
Dana from Florida asks us:
My wife has been undergoing treatment to place dental implants in her entire upper mouth. She had bone grafts in the back of her mouth 18 months ago to place bone while she still had front her front teeth.
8 months ago she had her front upper teeth removed and that area was grafted also. The periodontist used bovine in both procedures with a pcp mix (I believe).
However, recent CAT Scan shows total failure of the graft in the rear and success in the front. The doctor wants to place dental implants in the front and use a fixed denture. He wants to try grafts in the rear again at a later date. The doctors blames the failure of the graft on smoking.
We then went to see an eminent prosthodontist in Philadelphia. He says he can fix this in a day. The Periodontist in Florida totally disagrees. He says micro movement of the dental implants (teeth in a day procedure) combined with the failure of the grafts and smoking will not work. The Prosthodontist in Philadelphia says it will work and Periodontist in Florida is using old techniques and being overly cautious. What do we do? Who is right here? Thanks for any advice?
May 30, 2006 in Bone Grafting, Immediate Loading | Permalink | Comments (38)
Bone Loss to the Third Thread
Dr. Marcus asks us:
One of my patients has had 5 maxillary 3i dental implant fixtures placed by a periodontist. On checking for the seat of the dental implant abutments, I noted that the 3 anterior fixtures have bone loss, already down to the third thread.
They have never been loaded, just submerged beneath the transitional upper, so I guess there could have been some lateral force on them, but enough to cause this much loss in less than 6 months? Any thoughts? What should I be looking to do? What can happen here? Thanks.
May 30, 2006 in Treatment Planning & Complications | Permalink | Comments (13)
One Stage Implant Problems
Dr. Cutnei from Brazil asks us:
At our practice when we are working with a one stage dental implant
system, we notice some limitations in the esthetic zone.
Specifically, when working with ITI Straumann dental implants in anterior region of mandible, where we all know we have a very nonkeratinized and thin mucoso in the lingual section of anterior mandible, we are always confronted with a thin and tearable and non attached mucosa in the lingual aspect of dental implant. This situation could predispose the patient for bone loss in the area. What should I do? Should I move to a 2 Stage implant process in the anterior of mandible and make a bucal flap instead of crestal flap? Thanks for any help.
May 29, 2006 in Treatment Planning & Complications | Permalink | Comments (8)
Oral Bisphosphonates
Dr. Jeffries asks us:
I'm trying to get a barometer on the prevailing opinion for dental implant placement on patients taking oral bisphosphonates (Fosamax, Actonel, etc.)
I've placed them in a number of these patients and have seen no problems, nor have I seen any published reports of osteonecrosis associated with dental implant placement in these patients. What are some other surgeons' philosophy when it comes to this controversial topic?
May 29, 2006 in Dental Implant Contraindications, Oral Bisphosphonates | Permalink | Comments (4)
Dental Implants and Bruxism
Dr. Abrams asks us:
I am planning on placing two dental implants to replace the lower right first and second molars in a patient with a long history of bruxism.
The history bruxism has resulted in a completely flat occlusal plane, i.e. the curve of Monson is flat. Would a screw-retained or cement -retained superstructure be better? I am aware that an occlusal nightguard is imperative. Any advice would be appreciated.
May 29, 2006 in Dental Implant Complications, Dental Implant Contraindications, Treatment Planning & Complications | Permalink | Comments (2)
Use of Surgical Guides
Dr. Tsanis asks us:
I have a couple of questions regarding the use of surgical guides in dental implantology.
To start with do you routinely use surgical templates when dealing with edentulous patients? What is your opinion of computer guided surgical guides, as their costs seem to be increasing. Finally, in terms of practical applications, I have an edentulous patient that needs 6 or 7 dental implants and I want to construct a conventionally made surgical guide (not computer guided). What concerned me was how I will be able to fit that template in the mouth after I have raised the flaps, given the interference? Any usefull tips or advice?
May 29, 2006 in Treatment Planning & Complications | Permalink | Comments (8)
Saving on Surgical Guide Stents
Dr. Klein asks:
I am trying to conserve my expenses for dental implants in my practice. Dental implantology is just not turning out to be as profitable as I expected.
Therefore, I would like to start making my own surgical guide stents instead of paying my lab upwards of $250. I would like to use .020 inch suck-down shells for dental implant cases where I am having a maxillary central incisor replaced. I would like the long axis of the dental implant to be thru the incisal-edge cingulum area. How do I build this into the stent? Do you think my plan of making my own stents is a good idea? Any other suggestions?
May 29, 2006 in Treatment Planning & Complications | Permalink | Comments (9)
Fosamax Lawsuits
Fosamax was touted as a wonder drug for osteoporosis. More than 30 million prescriptions were written last year. But now some say the drug has ruined their lives.
Stella Poe took Fosamax for about eight years to help strengthen her aging bones.
"I have no bone in my jaw, I've lost all my teeth, and there's nothing they can do for me." She said. "I didn't know I was going to lose all my teeth. No one told me."
Poe is one of dozens of former patients suing pharmaceutical giant Merck, the maker of Fosamax.
"It's a contradiction. It's supposed to build bones yet it, of course, deteriorates the jawbones in, primarily, the elderly," Attorney Tim Maloney said.
Maloney says he's ready to file almost two dozen lawsuits because of Fosamax related osteonecrosis (ONJ) of the jaw. This is when the bone literally dies. This disease has been linked to bisphoshonates, the active ingredient in drugs used to build bones.
The majority of cases are seen when the drug is given intravenously to cancer patients, but in the last few years, ONJ began to show up in Fosamax users.
Merck, already facing 15 lawsuits over ONJ, issued a statement about its $13 billion a year drug. They say their trials, including more than 17,000 patients they never saw one case of ONJ.
Dr. Steven Milam heads the maxillofacial surgical department at The University of Texas Health Science Center in San Antonio.
"About 350 cases, approximately, have been reported and we're pretty sure those constitute a very small percentage of the actual cases."
Milan agrees with Merck's claim that most cases of ONJ are caused by intravenous bisphoshonates users, but with 36 million prescriptions of Fosamax last year, he says it's only a matter of time.
"It wouldn't surprise me if within five years we're not looking at, potentially, well over 100,000 or 200,000 patients that suffer from these conditions," Milan said.
In an interview with Dr. Robert Heaney of Creighton University provided to the I-Team by Merck, Heaney says the chances of getting ONJ are one in a million.
"The benefit from receiving oral bisphoshonates treatment for osteoporosis far, far outweigh any risk of anything associated with ONJ."
Maloney says the trial will prove Merck with knew information about the problem before the drug hit the market and they rolled the dice.
Poe says she is not a gambler.
"If there was a warning, I wouldn't have taken it. ... I wouldn't have taken it," she said.
When Poe began taking Fosamax, her attorney says there was no mention of ONJ under the warning label. In 2005, the FDA requested Merck include that in their warning. It has been there ever since, but patients like Poe say they were never told.
Source:
May 26, 2006 in Dental Implant News | Permalink | Comments (2)
Bleeding from Dental Implants
Sara, a dental implant patient from Texas, asks us:
My dental implant is about 9yrs old. Lately I've been having some bleeding around the back of the dental implant.
My dentist has sinced moved, so my question is why is it bleeding? I'm a flosser 3 to 4 times a day and brush my teeth the same way I did before I got the dental implant. I try to keep the area clean and healthly, so what could it be? Thanks for any information.
May 23, 2006 in Treatment Planning & Complications | Permalink | Comments (3)
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