Embrace Complications in Order to Avoid Them
Whether you’re a seasoned pro or you’re new to the world of restoring smiles with implant-retained overdentures, we all know that issues can and will arise. That is why it is important to understand how to manage complications when they inevitably occur. Facing complications does not mean you’re any less skilled of a practitioner. In fact, the most-skilled of us are ones who have faced and overcome complicated cases and problem-solved practical and effective outcomes. After all, they say you learn more from your failures than you do from your successes, right?
Dr. Eva Anadioti of Wellnox Studio is one such highly skilled clinician who has pretty much seen it all. She is a wealth of knowledge when it comes to thinking of creative ways to secure implant-retained overdentures that leave patients happy, healthy, satisfied, and feeling confident – which is, of course, the ultimate goal! We had the privilege of hosting Dr. Anadioti for a recent webinar on overdenture complications where she let us in on her tried and true techniques on how to avoid implant-retained overdenture complications.
The biggest takeaway? You must first learn to manage overdenture complications before you can start to avoid them. That is to say, once you have hands-on experience with fixing overdenture issues, you can better understand how to plan for success.
To get all the nitty gritty details, be sure to watch her full webinar by registering here. It’s free for a limited time, so be sure to get access before that window closes. If you’re too late, don’t worry, you can always register for the next one by joining our email list here.
If you fail to plan, you plan to fail!
The best case scenario when it comes to treating implant overdenture patients, is avoiding complications altogether, but smooth seas don’t make strong sailors. However, by educating yourself on what can happen with improper treatment planning, you’ll be able to set yourself up for the best chance of success while also being ready for whatever curve balls may come your way. Got your pen and paper ready? Dr. Anadioti breaks it down into three main questions you should always ask yourself when going into any treatment plan:
1. What is missing?
It may seem elementary, but by asking yourself “what is missing?” you’ll be able to fine tune your approach to your patient’s needs and goals rather than just their wants. For example, does your patient have all of their soft tissue and alveolar bone while only missing their teeth? Or is their alveolar bone starting to resorb vertically? Maybe they have alveolar bone resorption both vertically and horizontally. Or are you dealing with severe bone loss? Determining the answers to these questions will dictate whether your patient would be best served with a fixed prosthesis, a hybrid prosthesis like LOCATOR FIXED®, or even a removable denture.
Instead of just letting the patient drive the conversation based on their preconceived notions of what procedure they think they want, it is important to ask yourself these questions to judge what treatment may be best suited for your patient.
2. How much restorative space is there?
Another key question to ask yourself is whether or not there is enough restorative space for the procedure you are trying to do. There will always be a struggle between biology and prosthetics as the more bone that remains, the better the outcome, but this also means less room for the restoration. Conversely, less bone means you’ll have plenty of room for the prosthetic, but then strategically placing implants becomes crucial. Having enough room for the prosthetic is extremely important as you want to build a strong prosthetic that will last as opposed to a thin restoration that barely fits in the space available.
So how do we plan for this? If you have a patient with strong bone, but not enough restorative space, you could always remove some bone, but you don’t want to compromise the structure too much. So essentially, the task at hand is to determine whether your patient has enough room to support a full prosthetic that will last.
Proper measurements are going to be your best friend here. If you’re not already, be sure to measure using cross sections of your impression putty! Don’t simply put your trust in a flat measurement taken straight on from the front or back. Take a cross section of your putty matrix, turn it to the side, and measure from the mandibular or maxillary crest, where the implant will be placed, up to the incisal edge at a diagonal to really see how much restorative space is actually available.
Of course, the above advice only applies if the implants have not yet been placed. If you are not involved in the treatment planning of placing the implants, then you know that “creative” placement of implants can lead to problematic angulation that you will have to solve for down the line. Luckily, products like LOCATOR R-Tx are designed for issues with angulation. R-Tx can correct up to 60º of angulation!
3. Do you have enough support?
Once you’ve determined what is missing and accurately measured the available restorative space, it’s time to build a strong prosthetic that will feel equally secure and comfortable to the patient. Dr. Anadioti’s advice? When in doubt, add a metal framework! She says that she always adds a metal mesh framework to the maxillary prosthetic, and sometimes adds one to the mandibular denture too. It’s always better to be safe than sorry! When you plan to add a framework from the get-go, you can create an aesthetically pleasing prosthetic that is as comfortable as it is strong.
If you’re in doubt, talk to your patient about realistic expectations for their dentures. While it may make you nervous to talk about their new denture potentially failing, it’s better to be upfront and plan for that possibility rather than sweeping it under the rug and hoping for the best. We aren’t used car salespeople, we are in the business of restoring smiles and confidence, and for that to be successful you need your patients to trust you. Your patients will be grateful for the honesty and transparency and will be more likely to say yes to your future recommendations. Remind them that you’re in this together and that teamwork leads to success. Assure them that you will be building them the best prosthetic possible, but that they have a part to play in maintaining it as well.
What complications have you faced?
Have you or your team dealt with any implant overdenture complications recently? Or if you’ve faced any issues with any other restorative or cosmetic procedures, we would love it if you would share your experiences with us! Feel free to join the conversation by posting a picture of your case using the hashtag #ZestCaseReview and tag us on Instagram, LinkedIn, or Facebook. We know that there is power in knowledge and we can all become better clinicians by sharing what works and what doesn’t with our community. As always, if you have any questions for us, we would love to hear from you. Simply reach out by contacting us online and a member of our team will happily help.
