Jack E. Wasserstein, DDS, Inc. » case report

Mini implants used to stabilize a temporary denture

Jack Wasserstein, DDS — Thu, 22 Apr 2010 18:45:43 +0000

In this case, mini dental implants (Dentatus Atlas system) are placed along with the permanent dental implants (Nobelbiocare Tapered Groovy system). The mini dental implants are used for the purpose of stabilizing the temporary denture. By using this technique the temporary denture can be modified by removing the palatal aspect as well as decreasing the denture flanges. This modification of the temporary denture is typically performed by the restoring dentist. Some of these aspects were performed at the time of surgery just to get initial stabilization. Guided implant surgery was also used for the placement of the permanent implants. The following slide carousel demonstrates the procedures performed and will be update as more photos are available.

Gum graft with simultaneous root coverage

Jack Wasserstein, DDS — Sun, 14 Mar 2010 06:58:50 +0000

In this case, we are adding a new method to the standard procedure by advancing the gingival collar coronally to cover the root surface at the same time we are adding the graft to increase the zone of attached gingiva. Note the difference in root coverage before and just one week after the procedure.

Placing the graft directly over the root surfaces at the time of surgery typically doesn’t work, as there is no blood supply to nourish the graft over the root surfaces.

With this technique, the gingival collar that we are advancing maintains its blood supply from the adjacent gingival papillae, and is supported in its new position by the donor tissue.

Gingingival graft with simultaneous root coverage

Jack Wasserstein, DDS — Sat, 13 Mar 2010 21:27:58 +0000

Placing the graft directly over the root surfaces at the time of surgery typically doesn’t work, as there is no blood supply to nourish the graft over the root surfaces.

With this technique, the gingival collar that we are advancing maintains its blood supply from the adjacent gingival papillae, and is supported in its new position by the donor tissue.

Guided implant surgery single tooth

Jack Wasserstein, DDS — Mon, 08 Mar 2010 02:07:14 +0000

Guided implant surgical case – minimal bony dimensions for dental implant placement.

This case is in progress, but it involves implant placement in minimal bony dimensions. This case would be extremely difficult to do without guided surgery. It would be very easy to perforate the alveolar housing. Using guided surgery though the implant can be meticulously placed, minimizing the risk of bony perforation ………

Semilunar graft

Jack Wasserstein, DDS — Sun, 07 Mar 2010 08:26:31 +0000

This type of graft is used to try to cover an exposed root surface. A moon shaped incision is made in the gingiva. The two corners are left attached. The attached corners allow blood to flow through the graft. The center section of the graft is moved toward the crown of the tooth to cover the root surface. Pressure is applied for four minutes. There must be an adequate zone of attached gingiva prior to performing this procedure, if not a connective tissue graft is done initially. This is a fairly predictable procedure and typically you can achieve root coverage up to the height of the adjacent gum papillae. This series of pictures shows images from start to two weeks post operatively.

Gingival prosthetic

Jack Wasserstein, DDS — Sun, 07 Mar 2010 06:48:15 +0000

This patient presented with maxillary alveolar ridge atrophy. The large air space below the bridge was creating a phonetic problem as it was allowing air to pass through, creating a lisp. The patient was also concerned about the gingival aesthetics of the area.

While ridge augmentation using soft and or hard tissue is also a treatment consideration, a very simple approach involved the use of a gingival prosthetic to mask the area. This prosthetic was fabricated chair-side and its intended purpose was to demonstrate its function and see how the patient would tolerate it.

The patient was ecstatic with this temporary device. It immediately solved his phonetic problem and he was happy with the improved aesthetics. He asked if he could keep it and of course we let him.