5. The ISI Complete ™ , TSI, and The ERI Immediate Load capable Dual-Stabilization Dental Implant System In 2002 OCO Biomedical introduced the next generation of endosseous implants: July 20, 2010 Patent Pending

6. OCO Biomedical’s Dual Stabilization Line designed to “grow bone” by compressing it with tension For a Predictable Immediate Load or 2 stage conventional Dental Implant Placement:

7. Product Overview Dual Stabilization and how it works July 20, 2010

13. 2 Bio Horizon implants placed in upper and 2 OCO Biomedical TSI implants in lower 6 yrs ago s

20. Mount study models, mounted. A must for treatment planning and Case Presentation

21. Study models, mounted. A must for treatment planning and Case Presentation

22. Edentulous Mandible An immediate denture placed 17 yrs ago July 20, 2010

23. Pantographic X=Ray, a must for any implant case. Is there abundance of bone?

24. Model of lower, sectioned at the center and mapped

25. Zoll bone width measuring device

26. Bone Densities July 20, 2010

29. Basics for fixed: 4 Main buttresses for fixed or implant supported teeth Ideal minimum Implant diameter Minimum implant length 10 to 12 mm

31. So, if not following the buttress parameters and ignoring the physical properties:

32. Edentulous upper left quadrant: Ideal implant placement 4.0mm bicuspid areas 5.0 mm 1 st molar area 4 or 5mm 2 nd molar

33. Bi-Lateral lower edentulous: R- normal ridge, L- narrow ridge Treatment R- Ideal, 5.0mm at Molar, 4mm for bicuspids L- Narrow ridge- compromise, 2 3.25 At molar. 3.25 in bicuspid Areas. Prosthesis, splinted crowns No wider than bicuspids, Lighter occlusion and no Lateral interferences.

35. To maximise To maximize A-P place markers in the denture, take a pano and establish the location of the mental foramina O I I O

36. Implants placed and at least 3mm anterior to the mental foramina

37. Edentulous upper and lower Treatment: Stabilize lower denture Or, if the residual ridge Permits: moderate height, Wide ridge 4 to 6 standard sized 3.25 or 4mm Implants placed between the mental foramina, 2 - 4.0 mm 2 – 3.25 mm Never! 2 Implants in Cuspid Areas Crates a fulcrum The denture will rock

38. Edentulous upper and lower Treatment: Stabilize lower denture Or, if the residual ridge Permits: Tall, med width OR: 5 or 6 3.25 mm implants between the mental foramina

39. Five implants placed comfortably in the safety zone by placing markers in denture first

40. Post- Op Pano

41. In less than 2 weeks the healing looks great and he’s ready for a reline and the final female attachments

42. Flanges are trimmed and the size of the denture is minimized

43. The Chronic Perio Patient Presents for Implants

54. Simple Central Incisor Replacement – 5 Years after Ortho

67. 3 Months after Home Treatment, Deep Scaling & Extractions

98. 8-6-09 6years post-op

100. Establishing the path of implant insertion after removing the tooth or tooth roots

101. With a high speed drill, always break through the cortical bone lining the socket wall in the direction of implant alignment Use a # 8 surgical or XXL straight fissure burr/ water cooling only, no air

102. Use the pilot drill in the surgical HP aligned and go to the final depth

103. Select the implant diameter by placing the final drill into the socket. It must not drop more that half the selected length

104. Drill with osteotomy former to the final depth established by the pilot Drill

105. Implant placed with grafting material, if dual stabilization is present, ISI can be used. If not, a TSI must be used

106. An emergency visit for a loose UL Cuspid

107. UL Cuspid has a RCT With a post and core. Fractured root

117. Impression taken the day the fractured root was removed and implant placed

123. Temp placed the same appointment, Patient left the office with a tooth

127. Zirconium core tried-in a month later

130. Final crown seated, note the emergence profile

132. Case finalized

133. Patient: 87 yr old Female Friend Full lower, all remaining teeth to be removed

134. First surgery, all fractured teeth removed, implants immediately placed and voids grafted

135. All lower teeth removed, voids grafted and implants placed immediately using single stage flapless procedure in edentulous areas

136. Lower temp in place

137. Final PFM final splint. Stress breakers on distal of cupids and dove tail on LL 2 nd Bi

138. Full upper and fixed lower

139. My 88 yr old friend no longer fears the horrors of a lower denture

140. Crown needed on # 31, large filling breaking down. Why not fill space with a simple pontic?

141. 3 Unit bridge? Then followed by constant pain, solution: RCT # 20

142. Pain persists, referred to endodontist

143. Bridge removed, molar sectioned and removed. Grafting and immediate placement of 5.0 X 10 TSI Implant

144. 4.0 X 12mm ISI placed at 30. Sutures removed , abutment and temp placed after 3 weeks

145. 6 Months post op, healing complete and 3 removed and grafted.

146. Healing after extracting # 3 with socket lift and bone grafting with pericardium barrier membrane

147. Teeth to be removed, 3 and 5. On which can an immediate implant be placed?

148. 1 st bicuspid removed buy teasing out with straight elevator and focepts

149. Root is not bifurcated and divergent, narrow and ideal for immediate placement

150. Place final drill to be used into socket, if half or less should bottom out to determine implant diameter to be used

151. Break through the cortical bone at the tip of the socket

152. Use the pilot drill to the final depth, in this case, 2mm beyond

153. Place colletape and bone into socket in case sinus was perforated and to fill gaps in final osteotomy

154. Use osteotomes to condense grated bone and open center for the implant

155. Driving the implant into the socket

156. Implant placed

157. Temp in place

158. Root tip and implant, sinus at the tip

159. Socket of 3 was elevated with a large osteotome, grafted, opening covered with pericardium and sutured

160. Implant placed in 5 and socket elevation and grafting on 3 to place a 5 X10mm Implant later

161. 5.0 X 10mm TSI placed 3 Mo Later

162. Thank You Questions? Q&A OCO Biomedical is a debt-free Company serving the dental Implant Community since 1976