Immediate loading Implants with TTPHIL ™ Technique
What is TTPHIL ™ technique?
- T – Tall implants measuring 16 to 57.5 mm depending on the engagement of the Bicortical Basal bone support
- T – Tilted implants placed at an angulation of 15 to 70 degrees.
- PH – PinHole – Flapless procedure
- IL – Immediate Loading (Provisional Prosthesis in 2 hrs and Permanent Prosthesis in two days)
WHY TTPHIL- ALL TILT TM Technique? Rationale: Set of reasons and logical basis. A Justification…
Surgical Phase Advantages
1.Immediate Loading- Permanent CAD CAM Ceramic teeth in just 2 days.
2.Avoid Sinus Lifting procedures and other Bone Augmentation procedures unless really needed for aesthetic reasons. – Secondary Morbidity Invasive procedures- Avoidance of additional surgical risks.
3.Local Anesthesia procedure – Minimal Anesthesia
5.Can be done in Heart Patients/ Smokers/ Diabetic Patients/ Gum diseases
6.High success rates
7.Low cost to the patient and time saving ( Avoids bone grafting procedures)
8.No healing time required- Immediate function the same day- Permanent prosthesis in 2 days
9.Less post operative pain
10.Most advanced system
11.High success rate in patients with less bone height
12.Employs cortical bone areas which are resistant to infection and resorption.
Prosthetic Phase Advantages
Latest CAD CAM Abutments which are customised have a Q- lock Morse connection when torqued at 25 Newton centimeter becomes cold welded. This cold welding property prevents screw loosening.
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. The main advantage of screw retention is retrievability – In case of any complication ( For eg: Gums shrinkage: Most common in immediate Implantation and loading) we can remove the ceramic prosthesis simply and add ceramic where required.
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.
8 DIFFERENCES BETWEEN TTPHIL IMPLANT TECHNIQUE AND CONVENTIONAL IMPLANT TECHNIQUE. 8 REASONS WHY WE CHOOSE TTPHIL TECHNIQUE at THE DENTAL SPECIALISTS: ADVANCED DENTAL IMPLANT CENTRE
1.Load Transmission is in the basal Cortical Bone – Because these implants are Tall and Tilted beyond 16mm to engage the cortical basal bone which is highly resistant to resorption. This cortical bone is highly mineralized and more resistant to infections as well as its ready from day 1 to take the loads. Conventional implants the load transmission is in crestal cortical plate leading to crestal bone loss. In thus area it leads to bacterial attack.
2.Polished collar in the crestal region: No penetration of bacteria. No source of Infection and Peri– implantitis – Hence No bone losS
3. TTPHIL™ Implants require only patients own, residual bone for anchorage and primary stability.
4. No risky augmentation procedures required- No time delay for augmentation Graft to take up- No secondary morbidity chances
5. Immediate loading- No edentulous phase- No waiting period. 2nd day permanent teeth- Direct Metal Laser Sintered CAD CAM teeth- Improves quality of life..
6. Simple and easy Surgical Phase- No bleeding- Flapless technique- No sutures- Minimal anesthesia- Just 0.2ml. Minimal bleeding- Minimal medication- Minimal discomfort during and after – It will not take more than 30 minutes for full mouth implant placement. Simple Single implant cases takes just 5 minutes. Post operative pain minimum.
7.Extractions and Implants are done on the same appointment. Same Anesthesia- Same Post Operative medications. Even if the teeth have periodontal infection, the teeth are removed, bone
curettage is done and TTPHIL™implants are placed at the same time. Patients are never with out the teeth. Immediate provisional are given in 2 hours. Permanent CAD CAM DMLS teeth are given on the second day.
8. The Implant Design will allow better bone healing and osteonal remodeling.
10 reasons why we at THE DENTAL SPECIALISTS stopped using single piece Implants
1.Narrow Diameter Implants: Very thin Implants. Hence more number (Minimum 10-12 in each Jaw) of Implants are required to restore full mouth rehabilitation.
2.Bone Implant Contact(BIC): BIC ratio is very less- No Osseointegration. Polished Surface all over- Thin Implants- Less Surface area- less osseo integration
3. Implant retention: because it engages only the cortical bone. Threads only in tip: leads to spinning or failure of Implant.
4. Need to load the implants for sure if there is no primary stability also (Because it is Single Piece- Implant and Abutment is connected)- leads to failure.
5. Can not be tilted beyond 15 degrees. Abutment breaks and the implant becomes useless.
6. Neck Connection: Implant and Abutment connection is very thin and can break while tightening at high torques or tilting the abutment to make it parallel to the adjacent implant.
7. No US FDA approval
8. Cannot be loaded individually. Needs to be connected to the other implant or tooth which is not suggested. Need to place 2 implants instead of one especially in the load bearing areas.
9. Tilting of the implants is not possible because the implant and abutment is in one piece. Especially in upper anteriors and when there is no bone tall and tilted implants are necessary to engage the cortical bone- Nasal floor.
10. Palatal placement of the implant is not possible because it cannot be bent. The abutment when bent can break at the neck of the implant.
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