I have replaced some maxillary canines with regular platform implants.
I establish a progressive anterior disclussion with the lateral inicisor and first premolar before restoring the implant in the maxillary canine position. I then insure that the canine does not function in guiding the mandible. Has anybody had success using a single, free-standing implant in the maxillary canine position to function in canine guidance?
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The problem with canine guidance is the off axis loading of the implant. This promotes screw loosening and stress hardening of the anti-roational elements and screws and can lead to screw or implant fracture. If you use an implant with a frictional fit abutment or a one piece implant/abutment then I see no reason that canine guidance can’t be maintained with a good long fixture.
I have an implant at #11. It is still temporized after about 2 years(sheesh, if all of our patients were like us…), and was placed via hand tightening at that time. It has not loosened so I can notice it. Implant and temp abutment are 3i. I see no reason not to maintain this occlusion when I have the porcelain done.
yes, I have arround 12 canine implants with canine guidance, even over 2 years of loading, I personally found that internal hex implants work better in bone resortion,(more in this case that there is a lot stress) and also in the cases that the vestibular bone is more thick the results is better
If you read the classic Pros lit ~1958 (D’amico et al.) you will find that the experiments were actually perfomed on canine guidance and the conclusion derived was that when canine guidance was present and used in function, the electrical activity of the muscles of mastication dropped very quickly. This is the scientific basis for canine and anterior progrssive guidance. There is no reason to load a lateral instead of the canine. A single canine implant works very well. The type of implant is unimportant, however, I would personally prefer the longer connection of the internal systems. However, I have placed mostly external hexes in that position with no notable problems.