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Pete
Posted: Sun May 27, 2007 8:07 pm
Guest
le huart wrote:
Quote:
The difference with the laser and the tissue punch? Maybe $20,000?

He just got a new laser the night before my torus removal. They were
working on the old one while I was talking to him during my consult - we had
to move for the repair tech. I could tell the guy wasn't going to be able
to fix it - lol . Anyway I asked him how much the new machine cost the next
day, and he said $55,000 if I recall. Was he bullshitting me, do you think.


Quote:

Most patients say they were sorry that they didn't do the implant
sooner. I have been using 1 stage implants since 1990 with no
problems. They are made by Straumann. No second surgery. They have
essentially same results as the 2 step implants. AAMOF, Nobel Biocare
is pushing their 2 stage, bone level implant, as a 1 step implant -
just have to use a thicker healing screw. And lastly, some implant
dentists are doing immediate placement of an abutment and a temporary
crown, waiting the 4 months to torque the abutment and make a final
crown.

He told me you can't do one stage implants on the molars, only the forward
teeth (obviously they are better since they are one piece and can't come
apart) due to the pressure when chewing while you are waiting the 4 months.
I don't quite understand the one step (I know it is an implant and abutment
combined into one piece. If you do a one step, then how would you chew with
the damn abutment sticking up and wouldn't that mess up the healing and
knitting of tissue with the implant for the next four months. What tooth
numbers do you do with the one step (ie how far back do you go).

In other words why were (and still are, I believe) most implants of the two
stage type (especially for the back teeth). It makes sense to me, although
I recognize the single piece is better because it can't separate or work
loose, like a screwed abutment could. And the force fit abutments are
stronger and less likely to come apart but Zimmer doesn't make them. Do you
also recommend going with the Zimmer.

Thanks le huart - do you have a nickname or first name I can use...Pete
le huart
Posted: Sun May 27, 2007 8:28 pm
Guest
I'm sorry, Pete. I didn't explain it correctly. One stage means only one
surgery. Instead of placing the implant flush with the bone, then
covering it with the gum, then reopening it to place a healing screw or
abutment, a 1 stage implant is placed to be flush with the gum, exposed
to the oral environment, but no abutment is placed, unless an immediate
load crown is the Tx plan. In the front, they can be placed
subgingivally with a thicker healing screw that allows access to the
implant platform for abutment placement. In the molar area, we use an
implant with a 4.8mm body and a 6.5mm platform that allows for a more
molar-like final crown.

Zimmer has a very good success rate and an excellent reputation. It is
the dentist's clinical judgement and clinical experience as to what
system is used. I'm sure that you will be very happy with your implant
and final restoration.

I hope that I clarified things for you.
Pete
Posted: Sun May 27, 2007 9:06 pm
Guest
le huart wrote:
Quote:
I'm sorry, Pete. I didn't explain it correctly. One stage means only
one surgery. Instead of placing the implant flush with the bone, then
covering it with the gum, then reopening it to place a healing screw
or abutment, a 1 stage implant is placed to be flush with the gum,
exposed to the oral environment, but no abutment is placed, unless an
immediate load crown is the Tx plan. In the front, they can be placed
subgingivally with a thicker healing screw that allows access to the
implant platform for abutment placement. In the molar area, we use an
implant with a 4.8mm body and a 6.5mm platform that allows for a more
molar-like final crown.

Huart...I didn't misunderstand you that bad. I think the misunderstanding
is in the healing screw (or cap), which I will address in the next
paragraph. Perhaps I should have used the word one piece or one step. The
way he explained it to me is (and he showed my pictures) - the one piece
consists of the implant post and the abutment in one solid piece, and there
is no healing cap or healing screw (I believe he called it a healing cap).

In the two piece or two step, the first piece is the implant post and the
second piece is the abutment that the crown fits over (the abutment doesn't
go on until after the four months waiting period). And I thought he said
that when he puts the implant post in, he immediately puts the healing cap
in the hole (the hole that is for the future abutment to screw into). I
understand the healing cap to be nothing more than a plug to keep stuff out
of the hole in the implant, that the abutment will be screwed into later.
And I thought he said he would stitch the skin over the healing cap the same
day as the implant. Then four months later, he would cut the skin (or flap)
again and remove the healing cap, and screw in the abutment, then take an
impression for the crown.

Is this close enough, and we are on the same track. Thanks again. You are a
kind person...Pete

PS - you didn't address my question about him saying you can't use the
single piece implants on the back teeth. I explained it in detail in my
last post and asked you how far back you go with the single piece. Could
you please take another look and give me your opinion on this. I would
appreciate it. Thanks.


Quote:

Zimmer has a very good success rate and an excellent reputation. It is
the dentist's clinical judgement and clinical experience as to what
system is used. I'm sure that you will be very happy with your implant
and final restoration.

I hope that I clarified things for you.
le huart
Posted: Sun May 27, 2007 10:14 pm
Guest
I have never used a 1 piece combination abutment/implant. Nobel Biocare
makes one and it is supposed to be used for areas like the lower incisors.

Your dentist talked about 1 piece implants he did not talk about 1 stage
(i.e. 1 surgery visit) implants. Go to Straumann.com and Zimmer.com and
compare the implants.
Pete
Posted: Sun May 27, 2007 11:22 pm
Guest
le huart wrote:
Quote:
I have never used a 1 piece combination abutment/implant. Nobel
Biocare makes one and it is supposed to be used for areas like the
lower incisors.
Your dentist talked about 1 piece implants he did not talk about 1
stage (i.e. 1 surgery visit) implants. Go to Straumann.com and
Zimmer.com and compare the implants.

Thanks Huart...I went to both sites and couldn't find anything specific (by
searching "single stage" and "one stage". No need to respond anymore. I
think the one piece combination is also a 1 surgery visit (its obvious by
what I wrote before). I will ask the dentist about one piece versus one
stage when I see him. I think they are kind of the same thing.

I will post a new post about all this when everything shakes down. If the
damn torus doesn't get better, there will be no implant. I can't wait to
hear what he has to say about the stitches, that he will not be able to
remove because they are gone Smile .

You have been very kind, and I thank you again...Pete
ahuangdds2@gmail.com
Posted: Mon May 28, 2007 7:38 am
Guest
On May 27, 11:22 pm, "Pete" <p...@nospam.net> wrote:
Quote:
le huart wrote:
I have never used a 1 piece combination abutment/implant. Nobel
Biocare makes one and it is supposed to be used for areas like the
lower incisors.
Your dentist talked about 1 piece implants he did not talk about 1
stage (i.e. 1 surgery visit) implants. Go to Straumann.com and
Zimmer.com and compare the implants.

Thanks Huart...I went to both sites and couldn't find anything specific (by
searching "single stage" and "one stage". No need to respond anymore. I
think the one piece combination is also a 1 surgery visit (its obvious by
what I wrote before). I will ask the dentist about one piece versus one
stage when I see him. I think they are kind of the same thing.

I will post a new post about all this when everything shakes down. If the
damn torus doesn't get better, there will be no implant. I can't wait to
hear what he has to say about the stitches, that he will not be able to
remove because they are gone Smile .

You have been very kind, and I thank you again...Pete

Pete:
Le Huart and both Dr. Steve have given you great
info......Here is the Bony spurs phtos you can look at after lower
molar extraction............
http://www.docere.com/MessageBoard/thread.aspx?s=2&f=173&t=81886&r=1229691#Post1229691
I think implants are great.......You must get an experience
restorative dentist to plan and design the case....Then an experience
and skillful surgeon to place the implant at where the implant need to
be at......Restorative and surgical goes hand in hand..........Implant
is now restorative driven, not surgical. There are plenty of GP can
can place and restore implants. But few can truely replace the success
of team approach implant dentistry.
Best wishes...........Albert
ahuangdds2@gmail.com
Posted: Mon May 28, 2007 7:43 am
Guest
On May 27, 11:22 pm, "Pete" <p...@nospam.net> wrote:
Quote:
le huart wrote:
I have never used a 1 piece combination abutment/implant. Nobel
Biocare makes one and it is supposed to be used for areas like the
lower incisors.
Your dentist talked about 1 piece implants he did not talk about 1
stage (i.e. 1 surgery visit) implants. Go to Straumann.com and
Zimmer.com and compare the implants.

Thanks Huart...I went to both sites and couldn't find anything specific (by
searching "single stage" and "one stage". No need to respond anymore. I
think the one piece combination is also a 1 surgery visit (its obvious by
what I wrote before). I will ask the dentist about one piece versus one
stage when I see him. I think they are kind of the same thing.

I will post a new post about all this when everything shakes down. If the
damn torus doesn't get better, there will be no implant. I can't wait to
hear what he has to say about the stitches, that he will not be able to
remove because they are gone Smile .

You have been very kind, and I thank you again...Pete

Sorry...I forget you may need to sign up into dental town in order to
view that thread..............
Steven Fawks
Posted: Mon May 28, 2007 8:14 am
Guest
I bought a Waterlase about 3 years ago. I use it almost every
day for something.

I didn't say that I did not like the machine. It is great for
anterior cavity preps and gumline fillings. I use it a lot on
kids' teeth too. Nice clean preps with less soft tissue
bleeding.

IME, it does not live up to the promise of 'needle free' dentistry.
It is less painful than a 'drill' for most work, but it is not
'pain free' for most treatment unless I add anesthetic.

Soft tissue work is pretty good too, but not without anesthetic.

Most people who spend $50K for a laser fall for all of the hype,
or get rid of the machine. The truth is somewhere in the middle.

JMO,
Steve

Quote:
I have a Waterlase in the office, and I agree with
Dr. Bornfeld.

:-)
Steve


I am sorry Steve...forgive my ignorance. This may be an inside joke - I
told you I just joined here today. If you don't like Waterlase, then why
did you buy (or rent) one. Please explain...Pete

ahuangdds2@gmail.com
Posted: Mon May 28, 2007 8:30 am
Guest
On May 28, 8:14 am, Steven Fawks <tuthjoc...@myturbonet.com> wrote:
Quote:
I bought a Waterlase about 3 years ago. I use it almost every
day for something.

I didn't say that I did not like the machine. It is great for
anterior cavity preps and gumline fillings. I use it a lot on
kids' teeth too. Nice clean preps with less soft tissue
bleeding.

IME, it does not live up to the promise of 'needle free' dentistry.
It is less painful than a 'drill' for most work, but it is not
'pain free' for most treatment unless I add anesthetic.

Soft tissue work is pretty good too, but not without anesthetic.

Most people who spend $50K for a laser fall for all of the hype,
or get rid of the machine. The truth is somewhere in the middle.

JMO,
Steve



I have a Waterlase in the office, and I agree with
Dr. Bornfeld.

:-)
Steve

I am sorry Steve...forgive my ignorance. This may be an inside joke - I
told you I just joined here today. If you don't like Waterlase, then why
did you buy (or rent) one. Please explain...Pete- Hide quoted text -

- Show quoted text -

The only laser I have is a periolase......It does not do hard
tissue...It does not even remove soft tissue effectively like
electrosurge.......But I love the result of LANAP and biostimulation.
Many dentist buy into waterlase MD and using waterlase to remove
decay, treating gum disease, doing crown lengthening..........and
expose implant. I don't think waterlase MD can treat gum disease as
well as periolase because the different in wavelength. The cost of
periolase is $68K with periolase trainning. My service for LANAP is
$5500 full mouth..........In my humble opinion the result is better
than traditional flap surgery to treat periodontal pockets. I average
about 3-4 full lanap cases per month. I use the periolase daily on
Biostimulation and crown impression......... So Dr. Steve check out
the periolase.......You can find used waterlase for sell on ebay or by
other dentist.....But you will not find any used periolase on the
market.........There is only 4-500 out there now........
Albert
Steven Bornfeld
Posted: Mon May 28, 2007 11:10 am
Guest
Steven Fawks wrote:
Quote:

I bought a Waterlase about 3 years ago. I use it almost every
day for something.

I didn't say that I did not like the machine. It is great for
anterior cavity preps and gumline fillings. I use it a lot on
kids' teeth too. Nice clean preps with less soft tissue
bleeding.

IME, it does not live up to the promise of 'needle free' dentistry.
It is less painful than a 'drill' for most work, but it is not
'pain free' for most treatment unless I add anesthetic.

Soft tissue work is pretty good too, but not without anesthetic.

Most people who spend $50K for a laser fall for all of the hype,
or get rid of the machine. The truth is somewhere in the middle.

JMO,
Steve

Thanks for the balanced and concise critique.

Steve


Quote:

I have a Waterlase in the office, and I agree with
Dr. Bornfeld.

:-)
Steve


I am sorry Steve...forgive my ignorance. This may be an inside joke -
I told you I just joined here today. If you don't like Waterlase,
then why did you buy (or rent) one. Please explain...Pete
Pete
Posted: Mon May 28, 2007 10:28 pm
Guest
Steven Fawks wrote:
Quote:
I bought a Waterlase about 3 years ago. I use it almost every
day for something.

I didn't say that I did not like the machine. It is great for
anterior cavity preps and gumline fillings. I use it a lot on
kids' teeth too. Nice clean preps with less soft tissue
bleeding.

IME, it does not live up to the promise of 'needle free' dentistry.
It is less painful than a 'drill' for most work, but it is not
'pain free' for most treatment unless I add anesthetic.

Soft tissue work is pretty good too, but not without anesthetic.

Most people who spend $50K for a laser fall for all of the hype,
or get rid of the machine. The truth is somewhere in the middle.

JMO,
Steve

Thanks for the info Steve...Pete


ve a Waterlase in the office, and I agree with
Quote:
Dr. Bornfeld.

:-)
Steve


I am sorry Steve...forgive my ignorance. This may be an inside joke
- I told you I just joined here today. If you don't like Waterlase,
then why did you buy (or rent) one. Please explain...Pete
Pete
Posted: Mon May 28, 2007 11:00 pm
Guest
ahuangdds2@gmail.com wrote:
Quote:
On May 27, 11:22 pm, "Pete" <p...@nospam.net> wrote:
le huart wrote:
I have never used a 1 piece combination abutment/implant. Nobel
Biocare makes one and it is supposed to be used for areas like the
lower incisors.
Your dentist talked about 1 piece implants he did not talk about 1
stage (i.e. 1 surgery visit) implants. Go to Straumann.com and
Zimmer.com and compare the implants.

Thanks Huart...I went to both sites and couldn't find anything
specific (by searching "single stage" and "one stage". No need to
respond anymore. I think the one piece combination is also a 1
surgery visit (its obvious by what I wrote before). I will ask the
dentist about one piece versus one stage when I see him. I think
they are kind of the same thing.

I will post a new post about all this when everything shakes down.
If the damn torus doesn't get better, there will be no implant. I
can't wait to hear what he has to say about the stitches, that he
will not be able to remove because they are gone Smile .

You have been very kind, and I thank you again...Pete

Pete:
Le Huart and both Dr. Steve have given you great
info......Here is the Bony spurs phtos you can look at after lower
molar extraction............
http://www.docere.com/MessageBoard/thread.aspx?s=2&f=173&t=81886&r=1229691#Post1229691
I think implants are great.......You must get an experience
restorative dentist to plan and design the case....Then an experience
and skillful surgeon to place the implant at where the implant need to
be at......Restorative and surgical goes hand in hand..........Implant
is now restorative driven, not surgical. There are plenty of GP can
can place and restore implants. But few can truely replace the success
of team approach implant dentistry.
Best wishes...........Albert

Thanks Albert...I already have enough usernames and passwords, and I don't
want to go through another registration process right now, but I would have
loved to see the photo. I do not understand what you mean by I must get a
"restorative dentist" to plan and design the case. That is the first
mention of that I have received in here (you are the fourth dentist to reply
I believe). With all due respect that sounds like total overkill and just
kind of further makes me want to forget the implant. Hell my regular
dentist is an experienced restorative dentist (and so is the laser dentist I
am going to now, who also does implants and torus surgery- he better be, he
is 53 years old).

I thought all dentists were restorative dentists - ie that is what they do
for a living. Do you mean a restorative dentist just for implants - if you
do, then I am sorry but that is overkill. I have been to approx 75 doctors
in my life (with not much to show for it), and I can not make a big deal out
of this. I will either let this guy do the job or forget it. Hell I could
spend $200 a clip getting a bunch of consultations and I would still never
know who would do the best job. The best referral is by word of mouth and I
don't know anybody like that, and this doctor is the only "quasi" oral
surgeon (I told you his boss is an oral surgeon) that takes my insurance (my
insurance at least covered the $800 torus surgery). He has been doing laser
assisted implants for six years now - that is good enough for me. I know my
insurance will not cover the implant, and I will have to pay for that in
full - approx $2,600 for implant, abutment and crown.

But I certainly appreciate your comments. This is a great group and all of
you are very kind to volunteer your time, and I appreciate it very much.
Thank you again...Pete
ahuangdds2@gmail.com
Posted: Tue May 29, 2007 6:38 am
Guest
On May 28, 11:00 pm, "Pete" <p...@nospam.net> wrote:
Quote:
ahuangd...@gmail.com wrote:
On May 27, 11:22 pm, "Pete" <p...@nospam.net> wrote:
le huart wrote:
I have never used a 1 piece combination abutment/implant. Nobel
Biocare makes one and it is supposed to be used for areas like the
lower incisors.
Your dentist talked about 1 piece implants he did not talk about 1
stage (i.e. 1 surgery visit) implants. Go to Straumann.com and
Zimmer.com and compare the implants.

Thanks Huart...I went to both sites and couldn't find anything
specific (by searching "single stage" and "one stage". No need to
respond anymore. I think the one piece combination is also a 1
surgery visit (its obvious by what I wrote before). I will ask the
dentist about one piece versus one stage when I see him. I think
they are kind of the same thing.

I will post a new post about all this when everything shakes down.
If the damn torus doesn't get better, there will be no implant. I
can't wait to hear what he has to say about the stitches, that he
will not be able to remove because they are gone Smile .

You have been very kind, and I thank you again...Pete

Pete:
Le Huart and both Dr. Steve have given you great
info......Here is the Bony spurs phtos you can look at after lower
molar extraction............
http://www.docere.com/MessageBoard/thread.aspx?s=2&f=173&t=81886&r=12...
I think implants are great.......You must get an experience
restorative dentist to plan and design the case....Then an experience
and skillful surgeon to place the implant at where the implant need to
be at......Restorative and surgical goes hand in hand..........Implant
is now restorative driven, not surgical. There are plenty of GP can
can place and restore implants. But few can truely replace the success
of team approach implant dentistry.
Best wishes...........Albert

Thanks Albert...I already have enough usernames and passwords, and I don't
want to go through another registration process right now, but I would have
loved to see the photo. I do not understand what you mean by I must get a
"restorative dentist" to plan and design the case. That is the first
mention of that I have received in here (you are the fourth dentist to reply
I believe). With all due respect that sounds like total overkill and just
kind of further makes me want to forget the implant. Hell my regular
dentist is an experienced restorative dentist (and so is the laser dentist I
am going to now, who also does implants and torus surgery- he better be, he
is 53 years old).

I thought all dentists were restorative dentists - ie that is what they do
for a living. Do you mean a restorative dentist just for implants - if you
do, then I am sorry but that is overkill. I have been to approx 75 doctors
in my life (with not much to show for it), and I can not make a big deal out
of this. I will either let this guy do the job or forget it. Hell I could
spend $200 a clip getting a bunch of consultations and I would still never
know who would do the best job. The best referral is by word of mouth and I
don't know anybody like that, and this doctor is the only "quasi" oral
surgeon (I told you his boss is an oral surgeon) that takes my insurance (my
insurance at least covered the $800 torus surgery). He has been doing laser
assisted implants for six years now - that is good enough for me. I know my
insurance will not cover the implant, and I will have to pay for that in
full - approx $2,600 for implant, abutment and crown.

But I certainly appreciate your comments. This is a great group and all of
you are very kind to volunteer your time, and I appreciate it very much.
Thank you again...Pete- Hide quoted text -

- Show quoted text -

Pete:
The most important thing in dentist/patient relationship is
trust, and this trust is difficult to built and maintain. Your
investment in a dental implant replacement take a lots of your time
and money. In addition your relationship with your dentist doesn't
stop after he place the implant and restore the crown. Implant require
regular recalls to maintain. So this relationship is like a marriage
once implant is involved. From reading your last post......You trust
your dentist because of his experience, skill, and
reputation........So why worry and second doubt him..........He should
be the one to answer all your questions............Good luck
Sincerely.......Albert
 
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