Introduction to Stranger Implants
Lately, there is a lot of buzz around Stranger Things tv show. For those who were just kids growing during the ’80s, like me, this TV show is a throwback to a lot of memories that brings some nostalgia: Walkie-talkies, BMX bikes, corded telephones, and much more other things.
In this TV show exists “The upside-down world” which is an alternate dimension existing in parallel to the human world. In this parallel world, there are predatory creatures: The Demogorgons.
I tried to make some kind of analogy between this tv show and some cases that I´ve seen during the last year on social media. Some of them look like they came from the upside-down world and other cases are frightening as Demogorgons. Let´s analyze some of the weirdest cases seen on social media and try to explain what happened in this “Stranger Implants” cases.
#1. The JICI (Just In Case Implants) Case.
This case was shared by @gsanllehivallejonajera and we really don´t know where it came from. The thing about this case is that the dentist who did this placed 6 implants for a partial fixed restoration to restore 4 lost teeths. We have to say he was quite honest because there was room enough for another implant.
From a biomechanical point of view using 7 implants would be the best option to restore 4 lost teeths.
#2. The Teeth-to-Pin implant case.
No explanation for this one. I cannot even imagine the surgical protocol to place this Pin-Implants. I only can speculate that the teeths were removed, pins were placed at the apex, and then placed into the bone.
If you tell me that this is Demorgogons mouth, I´ll buy it.
#3. The “Up-Side-Down Implant”.
This is one of my favorite cases of the year. This case was originally posted on Facebook by Dr. Simone Vaccari @drsimonevaccari and it´s for sure a case from the “Up-Side-Down World”.
The best theory to describe what happened, in this case, is the one posted by Dr. Frank Caputo @fcaputodds:
It´s the best explanation I found for this case. Another interesting thing is this case is the Bluetooth connection on the first molar. Can´t wait to see the results from the Zipprich tests on this connection type. I´m sure there will be no micromotion inside that wireless connection.
#4. War of the Worlds Implant.
It can be a bit strange this sort of needle implant, but it was invented back in the 60´s by a French doctor named Jacques Scialom.
The funniest part of this case is the analogy between this implants and the Martian Tripod ship from the film War of the Worlds.
Thanks, Blogdodentista for sharing this Stranger Implants case with the dental community.
#5. Only-One-Kenobi Implant Case.
All-on-four is a well known and recognized option to treat edentulous patients with four implants that are loaded with a full denture, and it seems a reliable option with an acceptable outcome in the long term (Malo 2011). I´m not going to dive deep into the scientific background around some treatment options because this post is not so much about the science but more about curious and weird things that we can see in our daily practice.
The thing is that it seems All-on-four has escalated and someone came up with the only-on-implant option. I named it Only-One-Kenobi treatment approach in honor to Obi-Wan Kenobi (yes, I´m a Star Wars freak).
I guess I´ll wait for a publication with a long-term follow up to try this. Meanwhile, I´ll stick to the All-on-four and All-on-six option.
Thanks, @Dr.Smile for sharing this “great” Strange Implant case.
#6. Nail Implant.
Not too much to say about this case. I really can´t imagine a dentist hammering a nail into the bone of someone´s jaw.
I hope at least the definitive prosthesis is a CAD/CAM restoration.
#7. The Healing Abutment Implant
Ok, I know, this one could happen to anyone. Sometimes when we are uncovering an implant during a two-stage procedure, we do small flaps to place the healing abutment.
This healing abutment missed the implant connection and was directly screwed to the bone. I hope at least it had a nice insertion torque.
#8. WTF Implant.
The only explanation here is that the implant perforated the lingual cortical and migrated toward the sublingual region. I could not find any report of a case in the scientific literature that could justify this case.
After placing the implant into the “Up-Side-Down World”, the dentist placed another wider implant in previously prepared neo-alveolus.
The other option is just this is another Photoshoped x-ray.
#9. The Dick-Implant
Not much to say about this phallic shaped single implant restoration. This is something that happens all the time when we do an x-ray to some frameworks, but most of the time we don´t even notice these strange shapes.
Thanks, @odonto_logia for this funny post.
#10. The Sinus with Healing Abutment and Implant.
This case is not so strange. We often see this kind of case where the implant is aspirated into the sinus. This complication is mainly due to the lack of implant primary stability when it is placed in the posterior maxilla where the bone quality is low (Norton 2001, Damlar 2015).
It can happen to everyone. It didn´t happen to me yet, mainly because when I´m not sure about the implant primary stability during a sinus floor augmentation (low torque and ISQ below 60), I prefer to perform the two stages approach. First I regenerate and then I place the implants.
Also, I use wide neck implants or conical implants, although there is no literature that supports this statement, it makes sense that a conical implant or a wide neck implant are less likely to disappear into the sinus than a straight implant.
In this case, I think two mistakes were committed:
- The implant was placed with no primary stability
- It was used a healing abutment, which may cause a pseudo-loading that lead to the loss of implant stability.
Thanks Matteo_negri for sharing this case.
Shit can happen to those who perform implant dentistry. Anyone. It doesn’t matter the expertise or how cautious you may be.
There are a lot of factors we cannot control, but in all these cases posted, at least 9 out 10 could be avoided (the sinus one is more common).
Today I wrote about other´s shit, but soon I´ll write about my shit also, and below one of my favorite “messy-case” that I´m still trying to solve.
Until then, I wish you a Merry Christmas and a Happy new year (2018). Let´s hope Netflix launch the third season of Stranger Things, and of course, here in Periospot, we will launch Stranger Implants II- The Revenge.
Written by Francisco Teixeira Barbosa
Periospot cofounder. Implant dentistry and digital dentistry. Passionate about music and digital social media.