SINGLE PIECE BASAL IMPLANTS VS ACTIVE THREADED TTPHIL™ BICORTICAL BASAL ANCHORED IMPLANTS

WHAT ARE THE DIFFERENCES BETWEEN SINGLE PIECE BASAL IMPLANTS VS  ACTIVE THREADED TTPHIL™ BICORTICAL BASAL ANCHORED IMPLANTS?

This post is not to support one particular technique. Each technique has its own pros and cons. We need to decide which is the best for your particular case. Every case is different. Every patient is different. Each one has their own priorities.. You need to take a call based on the presentation below. But before taking the decision you need to read this article.  

In this post we would like to tell the advantages of our technique and not to criticize the other techniques. We do both Single piece implants and Two piece Implants in our practice. We decide which implant technique to be used based on the patient location, Budget, treatment planning, number of teeth missing, location of the teeth missing- Front / Back, Upper Jaw/ Lower Jaw.

The first and foremost thing one should note is that Single piece implants have abutments and Implant fixture in one piece, hence needs to be cemented. There is no option for screw retention at all. In TTPHIL ™ Technique the restorations ( Implant Supported Crowns and Bridges ) can be either cement retained or screw retained depending on the case. Watch the video below to understand what are Single piece implants and two piece implants.

The other thing one should understand is that whether we are doing immediate loading or delayed loading. In Immediate loading we need to splint  or connect the bridges if multiple teeth needs to be replaced for equal force distribution in either of the techniques.  Because of this reason we prefer screw retention when we are replacing many teeth.  If one of the implant for suppose has a problem in future cement retained implant crown and bridges retrievability is impossible. We cannot repair the bridge. We need to cut the whole bridge which is traumatic. If you are planning to get a single implant replaced you can choose cement or screw retained option in case of front tooth missing. In case of back tooth missing it is advised to go for screw retained restorations because it is not located in the esthetic region. Now the recent developments in case of front tooth/ teeth replacements we are using pre angulated abutments.

screw retained restoration(Why we at THE DENTAL SPECIALISTS prefer cemented restorations is because  in these situations having a screw access in a visible area is unacceptable. When screw access to the implants are in aesthetic areas, the screw access can be re directed at times with use of pre angled abutments or the restoration should be retained with custom-made  CADCAM abutments and cement retained Implant supported restorations can be attached to implants with screws or can be cemented to abutments which are secured to implants with screws.)

This article will be written from this perspective and the advantages and disadvantages of each method of retention. It will be discussed under the following 10 headings:

1.Aesthetics

2.Retrievability

3. Retention

4. Immediate Implant placement

5. Passivity

6. Provisionals

7. Occlusion

8.Immediate loading

9. Impression procedures

10.Long term treatment planning

This post is mainly regarding Single Visit Dental Implant treatment. In most of the cases we at THE DENTAL SPECIALISTS  place Flap less or Pinhole or Key hole Implants ( without opening the gums) based on the clinical and radiographic guide assessment. But sometimes when the bone availability is less we prefer to open the gums and place the implants and bone grafts for better visibility and safety and long term results. Both the flapless ( Less when compared to Flap Opening) and flap opening procedures lead to gum shrinkages when we load immediately. Usually we replace the crowns and bridges immediately with in 2 days to week depending on the case. We used to do single piece implants for multiple and full mouth rehabilitations for Single Visit Dental Implants before, but because of three reasons we are now preferring screw retained restorations- gum shrinkage in cement retained implant restorationsFirst reason: We can expect some gum shrinage which cannot be  repaired in cemented bridges. In screw retained bridges with multi unit abutments  and CAD CAM MLS and ZIRCONIA technology we can repair it by sending it to the ceramic  laboratory Though screw retained restorations are more expensive they can be maintained and repaired. Second reason: In Cemented retained restorations the cement gets entrapped in the gums which leads to gum shrinkage leading to inflammatory changes because of the left out cement particles in the gum sulcus which  later leads to bone loss.

cutting the bridge cement retained restoration

Third reason: We need to cut the whole restoration or the bridge if any issue comes. If it is one single tooth replacement it is easy to cut but if multiple teeth replacements or full mouth replacements have to be done cutting the bridge is not easy. The only advantage of cement retained restoration is that the bridge will not come out but what if there are any issues in the implants. We should expect those and get the implants done.  We are getting them done once for all. Now its you to choose whether to go for cement or screw retained restorations based on the above article.

Aesthetics is better in cement retained restorations  but now with the Pre Angulated abutments with Micky Mouse screw this also has a solution. But very expensive..

Retrievability – Screw retained better than Cement retained. In case of any complication the bridge can be removed and can diagnose the situation easily.

Retention: In case of less mouth opening less than 7 mm abutments are used screw retained is always better when compared to cement retained restortions

Immediate implant placement: Screw retained restoration better because of repairability and maintenance.

Passivity and provisionals( Temporary teeth): Both are good

Occlusion: In screw retained restoration you can get it removed and add ons can be done later after osseous integration of the implants. Progressive loading is possible in screw retained restorations.

Immediate loading: Both cement and screw retained can be done.

Impression procedure: Its easy to do cement retained restorations. The doctor should be a Prosthodontist or skilled dental surgeon to take accurate impressions.

Long term Planning: Screw retained restoration is always better than cement retained restoration.

These are the prosthetic advantages why we choose ACTIVE THREADED TTPHIL™ BICORTICAL BASAL ANCHORED IMPLANTS?

We wish you to read the below articles which are more interesting about the TTPHIL™ technique.

Single Piece Implants- Disadvantages

TTPHIL Technique – Permanent Teeth in 2-9 Days


Still have doubts please feel free to call us on 00919963511139/ 00919959448800/ +919177671117. Its important for our team to clarify your doubts before you take a decission. The best way is to email us your  X-rays, OPG, CBCT and Intra Oral photos to dentalspecialistsindia@gmail.com. Our team will call you or email you which ever you are comfortable.