22 Implants in the Maxilla and 18 in the Mandible: Any Ideas?

Last Updated: Sep 25, 2011

Dr. D. asks:
I have a new patient who presented with this large number of dental implants. I have never seen this many implants in one patient. It appears as though the maxillary molars have three implants â€“ one for each root and the mandibular implants each has two implants â€” one for each root. I was wondering about the justification for adopting this kind of approach to the treatment planning for implant installation and restoration. Does anybody know of a reference in the peer reviewed literature recommending this approach? I count 22 implants in the maxilla and 18 in the mandible. What do you think of this treatment plan?

41 Comments on 22 Implants in the Maxilla and 18 in the Mandible: Any Ideas?

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John Kong, DDS

09/25/2011

Wow, talk about over engineering the case. It must be tough trying to keep all 40 implants maintained. Though I question their treatment plan, I give the surgeon and the restorative doc a lot of credit b/c this could not have been an easy case for them to execute. I don't know how it looks esthetically, but from the look of the PAN, it seems to be 'working.'

pisitroj

09/26/2011

enough or too many

sergio

09/26/2011

I see even 2nd molars have been replaced with implants but still 10 or 12 implants would've been enough in each arch. I don't know what the circumstances were at the initial consult appt. so I can't say whether this was done out of unethical motive or not. A slong as the patient consented to it knowing this many implants are going in and they work, I don't see the problem with it. I agree this probably took some skill to finish the case.

Dr. B

09/26/2011

Now that's what I call: overkill

direnc

09/27/2011

Ä± thÄ±nk thÄ±s case Ä±s from turkey and thÄ±s Ä±s socÄ±al economÄ±c Ä±ndÄ±catÄ±on:)

John Manuel DDS

09/27/2011

With some short, small implants in a highly resorbed mandibular ridge, two implants for a first molar have performed well for me on several patients. Usually not enough clearance nor need for two on the lower second molars to my experience. John

Robert Wolanski

09/27/2011

I do not know of any peer reviewed literature that advocates this many fixtures> I have seen this type of case in the past. Knowing when and where it was done would be of interest. Certainly a testament to many older ideas, remember there was a time where we questioned "should there be one implant for every missing tooth." I would love to see a ct of this case :-)

Junaid Ahmed

09/27/2011

I've seen this case at an implant meeting in Cyprus 6/7 years ago. The implants are Pitt Easy by Oraltronics (now owned by another company). The joke is that this case was referred to another colleague with a view to replace the missing third molars!! Would anyone like to take on this case?

Michael W. Johnson DDS, M

09/27/2011

i'm thinking someone had kids in college!

Dr. Gerald Rudick

09/27/2011

WOW...WHAT WILL THE ADVOCATES OF "ALL ON FOUR" SAY?

Dr. V

09/27/2011

This is an old xray that is going aroun, and a lot of ys is using it as a relaxing part of a lecture. It is an implant per root, and i've heard that the treatment was done somewhere in easten Europe. My question is, how di they take the impresions? If this patient showed up in your office, can you prowide us with recent xray (this one is from 2002)?

ben manz

09/27/2011

Interestingly they all survival rate is 100% astonishing. Its not easy to place that many at molar site especially in maxilla so i am assuming a lot of immediate placements. I hope its not done at one of those hands on course where patient volunteer:)

Dr. V

09/27/2011

sorry for misspeling, I'm writing from my phone :)

09/27/2011

Wow, I would also love to see a CT scan, especially in the area of the fixtures in the lower molar region, to see how they were able to avoid the IAN...

doria

09/27/2011

Photoshop or similar performs miracles! This is nonsense.

Robert Wolanski

09/27/2011

I assume Dr. D is real and this is a pan he has taken. I expect Dr. D to respond.

Baker vinci

09/27/2011

I would have loved to have been the" fly on the wall "of this torture chamber, when the surgeon was selling this case to the patient. He must hate money! Does this guy spend have of his day cleaning his implants? Bv

Baker vinci

09/27/2011

Half of

PITUCH

09/28/2011

This foto you can reach from internet for last 8 years. Please share current x-ray.

Bill Schaeffer

09/28/2011

Dear Dr. D, If this is a new patient of yours as you claim in the first line of your post, why does the date stamp on the photo of the x-ray say 17th of July 2002?? I suspect someone is telling fibs! Please prove me wrong by posting something of this patient from this year - some new x-rays or some clinical photos perhaps.

alistair

09/28/2011

I have seen this radiograph going around for years !

naser

09/28/2011

hi every body i believe this xray had been taken for askull after hands on practical course in IMPLANTOLOGY or for ((showoff)}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}

Baker vinci

09/28/2011

If these accusations are true , then I'm going to encourage the "gentleman", to get a life and some counseling . In my office, that would be a 100,000 dollars at least for implants and more for grafting. I don't discount unless the patient is poor and deserving. What is your point, for pulling this prank? Bv

dr payal

09/28/2011

I really appreciate the doc who has done this case...he has tried to replace the ditto of wots lost...inbtwn i dont think cleaning of implants will be a problem as there doent seem to be interdental spacing or recession since its one on one...also the xray shows no bone loss...only if we culd see the recent one....still if the patient doent mind paying..we shudnt blame the doc

E. Richard Hughes, DDS, F

09/28/2011

Engineered well. The lab bill must of been a fortune. I would like to see the case live, to evaluate the hygiene.

Baker vinci

09/28/2011

I'm calling a big BS on this case . Please let us see a current cbct. I'll pay for it. Bvinci

Baker vinci

09/28/2011

I'm amazed that folks are applauding three implants for a single tooth. THIS GUY LOST ALL OF HIS TEETH. so you all are ok with him paying for immediate furcations. In my little opinion this aborts the premise of dentistry and implants. I will pay for the cbct, if the implants are in just relative fair repair. Give me your email and we can set it up, ok? Bv

Baker vinci

09/28/2011

111,955 us dollars for bilateral nerve laterlization , bilateral sinus lift , with bone grafting , cbct , general anesthesia fee. Ucr. Bv

dr.adrian

09/29/2011

if everything is OK??? so far he should send this case to Guinness World record

Baker vinci

09/29/2011

As I thought , when you call out a fraud , they typically crawl back under the wood work! Offer still applies, dr. D( deceitful ). Please prove me wrong , it would be a rather spectacular case, regardless of the poor tx planning at the posterior . Bv

Dr sebastian

09/30/2011

Maybe that picture it-s just a fake photoshop ( it is my opinion, i saw that pic 4years ago ) also i think Dr d upload this photo for fun :)

Baker vinci

09/30/2011

Dr. Sebastion, I am all about fun. I am the most sarcastic guy on the site. This crosses the line. Bv

Baker vinci

10/01/2011

Since the D . Bag put this case up here, we may as well pick it apart. Aside from the intential furcation placements, if you are going to do nerve lateraliztions , the least the surgeon could have done was approach the inferior cortex. Every one ive done, I almost go thru the inferior border. Secondly, the only way that this could be done in my opinion would have been in stages and with computer generated guides. They most likely didn't exist at that time. Thirdly , and lastly, this patient would never go to another restorative guy, unless the original dentist was dead, or trying to collect his/her fees. Go tigers!!!!!! Bv

Baker vinci

10/04/2011

Dr. D or should I say mr. D, there are 35 responses from "guys" trying to learn on this site. Fortunately I write when I'm exercising , so no skin off my back. But ,pretty inconsiderate I might say. I'm voulenteering some implants for war vets, and if I can find the right candidate , I will do one of these. I'll get the help of a boarded prosthodontist and show you how I think this should be done. All Money will not come out of my pocket, by the way . I have an implant company helping out. Your"dead" to me. That would be a figure of speech, for any foreign correspondents . Bv

Robert Wolanski

10/04/2011

On Sept 27 I said I expected Dr. D to respond. I suspected this is a hoax as well. I also did ask the site who the moderator is if any. Yehuda informed me that Dr. Gary Kaplowitz is the editor, so I would ask him to investigate Dr. D.I would expect them to clean this up as it reflect on the quality of what they are trying to do.

Baker vinci

10/07/2011

Fully agree dr. Wolanski. Bv

Fabio B.

10/14/2011

Fantastic...this is an " ALL ON FOURTY ". !!!!!! I think and hope it's a joke, a "photoshop miracle" :-) if it would be true i think the implantologist Who has made this performance, has to be immediately locked in a jail or in a psichiatric clinic....

Dr Talamantes

11/09/2011

NO HAY NADA MAS PELIGROSO QUE UN PENDEJO CON INICIATIVA ,,,,

Dr F

11/10/2011

Search for "implantes dentales topete" he did it in Guadalajara, Mexico. I'm sure the patient loose'em all.

Dr.R

11/17/2011

I think doc did mistake..premolars are 2 -rooted..He\she forget to place 2 implant- palatal implants in both upper premolars!!

Dr.R

11/17/2011

Dr.Talamantes +1000