Shorter Implants and Abutments

Dear Dr. Borgner, Tony and associates:
I have restored quite a few of implants lately. I have found that 5 mm uniposts are still too long for occlusion's purpose. It is not enjoyable to trim hard titanium abutments. I wonder whether you can make 3 mm long uniposts.
Second, I have done a few cases of sinus lift using 5-7 mm diameter implants. What I found is that even 11 mm length implants are still quite long. I either have to stick implant a little too much into the sinus (I hate using bone graft, which may be source of infection) and leave too much supragingival. When I restore them, I have to trim a lot of uniposts. I wonder whether you can consider fabricating 8 mm long implants (probably range: 4.5-8 mm in diameter, 6 mm in bone, better with microthreads coronally, just as one-piece implants have). Thank you for consideration so that we can stay with your company for long time to come.
Xin Wei, DDS, PhD, MS Thursday, April 18, 2013 10:02 AM

Dr Wei, The poor crown/root ratio is the reason to not use too short implants. There is no problem with infections in the graft unless you introduce it with your treatment. That is why we teach you how not to introduce infections into your treatments. Our purpose is to teach how to get long term succes in your reconstructions. Learning the proper technique to lift the floor of the sinus and the floor of the nose will allow you to place the 11mm implants or longer without compromising the forces the bone must respond to without breaking down under function. The reason most reconstructions breakdown under function is overloading of bone, if these loads are managed properly the bone will actually become stronger under function. Dr Borgner Saturday, April 20, 2013 11:39 AM

Dear Dr. Borgner:
It is my fortunate to be your student as well as Dr. Tatum and Dunson's, although I have not commanded your techniques and thinking. Can you give me a few days to let me organize a few cases of short implant application? I appreciate the thought of sinus lift and sinus graft. However, neither of the procedures can improve crown/root ratio tremendously. Only coronal bone graft can improve it the most efficient.
In fact I placed Bicon implants before Tatum's. I am using both of them. What Bicon implant cannot do is to achieve primary stability. I love the primary stability associated with Tatum's. Eight mm Tatum's tapered implant with large diameter (4.5-8 mm) should be able to achieve sufficient primary stability. Anyway, I hope that I do not offend my dear mentors by expressing my immature idea. Thanks for the message.
Xin Wei, DDS, PhD, MS Saturday, April 20, 2013 7:50 PM

Dr Wei, I have placed many Bicon implants in the past. I know the individual that developed the syetem. The crown/root ratio is another way of representing surface area. The Bicon does this by very deep threads in the wide implants. I believe you are incorrect when you say the grafting does not improve crown/root ratio. A 20 mm implant, which is possible with augmentation, dramatically improves the ratio. When this is the terminal abutement for a reconstruction you have improved the long term survival of the entire reconstruction as the terminal abutement is a stress risor within the bone. Dr Borgner Monday, April 29, 2013 10:25 AM


Xin Wei, DDS, PhD, MS 1st edition 04/28/2013, last revision 04/29/2013