Hello. I’m Doctor Richard Gangwisch. Today, we’re going to be restoring dental implants. Implants are a fantastic way to replace missing teeth. The bridge that we’re going to place will be cemented permanently to the implant so it will be almost like having your natural teeth. No plastic in the roof of the mouth; no unsightly clasps. In this video, the patient had implants placed six months ago. Now that the area has healed, let’s get started! What we’re doing now is we are taking the healing caps off the implants. Now what the healing cap is for is to get the gums into good shape and allow it to heal around there, so it gives a nice contour to the gums. It also protects the implant too. Now we have a little thing called an impression coping. What that’ll be used for is we’ll be making a mold of these areas along with the remaining teeth and that’s what we are going to send to the lab. They’re going to be making a beautiful set of teeth for her. It’s important that everything is precisely in place because if you can’t give the lab a good model to start with, they are not going to make a good finished product. Now this is an impression tray. Notice it’s got some thin plastic, there again I’ve poked a couple of holes up in there. That’s going to allow me to get those impression copings out. We’ll have to go through that plastic and unscrew those. So we’ll go ahead and make a mold of all this. That will just take a few minutes to set. And that’s the finished mold there. It will be sent to the lab. And back with the healing collars to make sure that everything’s well in place there. That will keep those gums in good healthy state; keep food from packing in the implants. And that’s called a flipper partial that the patient’s wearing in the interim. You better believe she will be quite happy when she gets the permanent placed. All right, the big day has come and now we’ve taken off the healing caps again. That’s what the implants look like inside the gums; healed up quite well. These are custom abutments. What those are is little posts that we are putting in that will end up holding the bridge in place. This is what’s going to be attached. We are screwing those right in to the implant It is very important that we get these precisely in place. There is no margin for error on this type of work here. Check for the fit and make sure that’s fully down and we’ll go ahead and hand tighten that into place. Notice we have the floss on that wrench there. We would prefer that if we would have to retrieve it that it’s better than to have it go down someone’s throat. Those get a little slippery sometimes. All right now we are going to go ahead and try the bridge in. That fits good, looks like it slipped in pretty easily there. A lot of work has been done ahead of time to make sure that things go well. Check with some floss to make sure that the contacts between the teeth are in good shape. Don’t want to give the patient an excuse not to floss. And the bite is extremely important. We have to make sure that she is not hitting too heavy on that. Looks pretty good here. So now we have to decide is this looking good which is far as I’m concerned that looks fantastic. Now it’s up to the patient to make that final decision. Now this is called a torque wrench. What we do is we have to put an exact amount of torque on those screws so that they won’t loosen during function. It’s very important that we get this exactly precise. I’ve been doing these for many decades at this point so I’ve gotten it down to a pretty good science so we usually don’t have too much problems with maintenance on these. Doesn’t bother the patient because the patient isn’t even flinching at all because that’s being torqued into the implant itself, which doesn’t even have any nerves in it. Now we’re going to go ahead and add some material inside those screw holes because even though we rarely have to go in them, if we do, we want to make sure that there’s not going to be a bunch of cement in there to clog it up and make it impossible to get to. So we’ll put some material in there to plug up those holes. Now it’s time to permanently cement that in place. Things are coming along real good at this point. Here’s the cement. Here’s what it looks like. We’ll go ahead and mix that up and we’ll go ahead and place that in the bridge. And we’ll seat that bridge fully into place. Always checking; got to make sure that everything is fitting perfectly before we wait for that cement to set. It’s looking pretty good so we’ll go ahead and clean that up and we’ve got a happy camper there. She loved them! Not only does our patient have a beautiful smile but she can also function with them just like her original teeth. We expect her to have many years of smiles from these implants. Thank you for watching. I’m Dr. Richard Gangwisch
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