This is why you should NEVER push on a dental implant

Рет қаралды 19,591

Stanley Institute for Comprehensive Dentistry

Күн бұрын

Yep, we're talking about spinners. If you've ever gotten a dental implant very close to depth, only to have it stop going in and start spinning in the hole, you know the agony. In this video, we'll cover why spinners happen, how to avoid them, and what to do if your implant stops going deeper in the osteotomy.
As usual, physics is the culprit! Implants aren't designed to drill their own way through bone (and there are some good reasons for that!). Watch the video to find out all about spinners and how to avoid them.
Check out the Stanley Institute's full continuum at stanleyinstitute.com.

Пікірлер: 52

@hasanalkhateeb4350 2 жыл бұрын

Really helpful and amazing graphics thanks for sharing this videos Keep going doc!❤️

@Stanleyinstitute 2 жыл бұрын

So glad this helped and thanks so much for your kind words 🙌 More to come!

@forunonein 8 ай бұрын

Also an engineer here. I am watching to understand more about dental implants. I really like how you try to explain important engineering principles to dentists so they can install implants in the best way possible. The one thing the animation is missing when discussing increasing the depth of the hole is that the cone of the screw will be biting into new material since the diameter is now larger at each depth. I have not watched all the videos yet, I imagine two more, (1) my implant is at the right height without reaching desired torque, (2) implant driven lower than planned, what do I do now?

@neelkothari1802 4 ай бұрын

As an implant guy from the U.K. I only have one criticism of your uploads. You aren’t doing enough of them!

@Stanleyinstitute 4 ай бұрын

Oh, wow, the U.K. is just the absolute genius behind sarcasm, isn't it? Thank you so much for your incredibly kind words. They really mean the world to me. And guess what? I'll be lecturing on the four cornerstones of implant success in London in May, just in case you're interested.

@frostedfiresmods2059 2 жыл бұрын

Your videos are soooo good!!! Thank you for uploading

@Stanleyinstitute 2 жыл бұрын

Thanks for watching 🙌 Glad you're enjoying them!

@NY-cg6fd 10 ай бұрын

Great video !!!!!

@Stanleyinstitute 10 ай бұрын

Glad you enjoyed it

@xmpl100 25 күн бұрын

As an Implant guy, I would like to share details of my practice. Thanks for explanation, but I would like to add that there are 2 factors, where this law doesn,t work.... First in case of narrow and aggresive implant, that implant will go deeper if we push harder. Secondly the bone density. If we have d3 d4 bone even in bad drilled bad implant will screw in. So I think it will be better to mention that this case is for d1 and mostly for d2 bone. Thanks again

@Stanleyinstitute 15 күн бұрын

This is true. If you are completely in spongy bone you could likely continue to advance apically. However, that rarely happens since the compact bone sounds the spongy bone so eventually you hit compact bone.

@powerofknowledge7771 Жыл бұрын

Omg! This scares the H out of me!! If a dentist doesn't have enough common sense to understand this without you having to explain this, we're all in big trouble!! Since you're making a video about this, it tells me that this should be emphasized during implant training if it isn't already. I'm not a dentist, but I would understand this just on common sense alone. This will make for a great convo with whatever dentist I choose to have do my implants.

@Stanleyinstitute Жыл бұрын

These are certainly the types of things to ask your potential implantologist about-and make sure you're clear on whether your dentist will be the one actually performing the surgery. There is often a disconnect between dentist and surgeon with very different priorities for both! Choosing a dentist who simply has a plan and uses a prosthetic-driven protocol is your best bet!

@inquisitivenessandcontempl9918 Жыл бұрын

Until I watched the video I must admit I pretty much thought the implant was like a regular screw which you would simply screw into the jawbone until it's where it needs to be. And that the drilling into the bone was supposed just to facilitate the process a bit. Now I certainly understand it's more complicated than that.

@hasansaleh6232 Жыл бұрын

So this applies mainly to immediate loading , but if u have a spinner and the plan is to just submerge the implant this wouldn’t be a problem since there would be no forces applied on the implant and it will be integrated 4 months later right ?

@Stanleyinstitute Жыл бұрын

That's correct. Since a spinner just means there is no resistance to rotational loads, that doesn't mean you don't have primary stability. Even if the implant has zero torque (a spinner), but it's immobile in the bone, there is a chance for integration. Clinically, I have been successful with this approach!

@carmentseng27 Жыл бұрын

Hello Dr. Robert, I had a case of the second stage the other day but when I touched the covering cap, the patient felt much pain. On unscrewing it, the implant spun and the blood came out. Would you leave it there or extract it? thanks

@Stanleyinstitute Жыл бұрын

I’m sorry to hear about your unfortunate situation. If the implant was in for 3months prior to second stage uncovery it will not integrate now. I would remove it and degranulate the tissue. If all of the bony walls are intact I would allow it to heal and attempt another implant in a few months. Stay positive and if I can help let me know.

@janejohnstone5795 7 ай бұрын

Glad i only had one done...seems fine...except food always stuck..in-between..😅

@Stanleyinstitute 14 күн бұрын

That can happen from time to time

@broken1965 Жыл бұрын

The titanium implant is not designed to cut any depth.. like CNC machining bottoming tap or form tap its designed to cut within specified drill tolerance diameter and blind hole depth you bottom out say goodbye tap

@megenberg8 Жыл бұрын

pushing is always a no. be exceedingly careful and allow the drill to apply itself. this goes for dyi as well. the power of slow

@Stanleyinstitute Жыл бұрын

Slow is smooth and smooth is fast!

@drshadykhalifa4839 Жыл бұрын

Thank you sir .. i appreciate it.. well undertood implantology from ur side I want to ask a question,. Until now what make me fear from implants is not to get torque from i implants or initial stability,.. so please when i am inserting implants how to put it by handpeice or by manual ? This make me scare the inplant will sink inside and cant retake it … Please answer me … Thank you sir

@Stanleyinstitute Жыл бұрын

I like to use my motor to drive the implant to depth. The reason is I create less off-axis loads using a motor verses using a manual hand wrench. If one creates off-axis loads then loss of primary stability increases.

@drshadykhalifa4839 Жыл бұрын

@@Stanleyinstitute today i follow ur soul instructions when i was putting implant .. ur voice and eyes infront of my face when i was putting and seein primary stability

@anastasiapaschalidou1067 7 ай бұрын

Dr. I had an implant case , which I couldnt performed the osteotomy as I planned as the implant motor didnt work properly and I couldnt reach the working length. I couldnt placed the implant as I wanted in depth, I had 40 Ncm but not fully seated( 2 threads are showing ,on B side). Do you think from your experience that there is going to be problem?

@Stanleyinstitute 7 ай бұрын

Hey doc. Sorry to hear that. The good news is a lot of shallow implants do just fine. Especially if the patient has good home care. When that happens what one can do is remove the implant. Make sure it remains sterile by not letting it touch anything. Extend the osteotomy two millimeters and place the implant again. Of course this is dependent on have room apical to extend the osteotomy. Hope this helps

@drshadykhalifa6300 Жыл бұрын

Dr. Hello Please i want to ask a question, I put inplant on torque 35 on motor .. then 3/4 of inplant lenght went inside then stopped amazing means good Then i continued manual by wernch the last 1/4 of remaining implant i found torque from 20-25 ncm .. could u explain to me why? Isn’t supposed to by manual=handpeice

@Stanleyinstitute Жыл бұрын

Hello Doc. This is a common scenario that many clinician encounter. The likely reason for the loss of stability as you drove the implant deeper was the fact the implant struck some D1 compact bone. Either a focal sclerosis or cortical plate. When this happens the implant can not advance any deeper which turns the implant into an auger. This subsequently strips the bone around the threads with each subsequent rotation. I hope this helps.

@anthonyloveanthonylove2159 6 ай бұрын

Is this instruction is mean to be for the dentist or for the patient ?

@Stanleyinstitute 6 ай бұрын

The dentist.

@najichahni 11 ай бұрын

So from your perspective Implant with cutting tip should be never used?

@Stanleyinstitute 11 ай бұрын

I tend to not be limiting in my statements. “Only siths speak in absolutes”. In general, the risks associated with a sharp tip verses a blunt tip out weigh any preserved advantage. Did you see the radiograph of the implant that went into the patients eye? If so you will notice that the tip of the implant is pointed. If it had been blunted the tragic outcome might have been avoided.

@dr.ahmedelmekaty6479 11 ай бұрын

Keep goingggg

@Stanleyinstitute 11 ай бұрын

Thanks

@craigslistrro709 10 ай бұрын

As a guy who has TONS of experience with nuts and bolts and screws and tap and die sets and drilling pilot holes..Im inclined to think placing implants arent that difficult to master.. Its Just a scaled down version of basic hand tools Like self tapping screws and ratchet drivers....You have your Jig, your stops, your drills and self tapping screws....Its all very basic..

@Stanleyinstitute 10 ай бұрын

I agree 💯. The real challenge for many folks is proper planning. The execute is all mechanics.

@janejohnstone5795 7 ай бұрын

A sinus lift....is used..and takes months to heal.......lots of implants cannot be good..for the bone and body...especially for elderly...

@EL-yi6df 4 ай бұрын

Please elaborate.

@Stanleyinstitute 14 күн бұрын

Titanium has a long track record of being arguably the most biocompatible material available to mankind. Remember, humans cannot live without metal in them. Sodium, potassium, iron etc.

@tomaszkazmierczak1378 10 ай бұрын

That statement in title is not correct. Imagine bicortical implant in maxilla all-on-4. Sometimes you need some pressure on implant to go through nasal floor.

@Stanleyinstitute 9 ай бұрын

So, when it comes to placing my implants, I have a little trick up my sleeve. Instead of going into the nose, I actually like to position them at the bottom of the osteotomy. And let me tell you, I use this awesome type 4 fully fuided system that guarantees the implant gets super close to the ideal spot, like within a few hundred micros.

@janejohnstone5795 7 ай бұрын

This can put people off implants...

@Stanleyinstitute 14 күн бұрын

Implants are an amazing solution for replacing missing teeth.

@MdRipon-jc3xy Жыл бұрын

😂😂😂❤❤

@Stanleyinstitute Жыл бұрын

No one likes a spinner!

@martinchrom4444 2 жыл бұрын

Why are everyone so scared of spinners? Like it is a sin or something. If you have a spinner, and it is in or below the bone level, just suture it under the mucosa and it will integrate.

@Stanleyinstitute 2 жыл бұрын

You are correct, doc! Having a spinner doesn’t necessarily mean lack of primary stability, but that is the subject of an upcoming episode. Might I recommend our video "Bone level doesn't exist," and there would be no need to obtain primary closure in this case. (Also an upcoming episode;-) ) Stay tuned!

@TheDenizxo Жыл бұрын

That's not what the patient will feel like..I'm really tired of doctors thinking clients mouths are just dummies and they don't have any biological reaction to bacteria or complications.

@martinchrom4444 Жыл бұрын

@@TheDenizxo What is the relevancy to the topic? Are you a clinician? Having no primary stability is no complication. In fact all of them I had are now healed and working normally

@TheDenizxo Жыл бұрын

@@martinchrom4444 👍