Key Concepts:
1 – Plan the front teeth as a unit: 3 non-restorable lower front teeth were removed and implants were placed at sites #23 and #26 for a 4-unit bridge, which matches better than a single implant crown in the front.
2 – Trace critical anatomy first: a CBCT shows bone height and width in the front, and in the back the inferior alveolar nerve and the mental foramen have to be mapped before an implant goes in.
3 – Make up for narrow bone with length: thin implants in the lower front can be longer, and I like to place the implant 1–2 mm below the crest of bone.
4 – Position the #30 implant for the crown: parallel to the tooth it's matched to, centered under the palatal cusps of the opposing maxillary first molar, and 6–8 mm distal to #29 for a 12–14 mm crown.
5 – Respect torque: I like over 35 Ncm before an abutment goes on, and I stay between 45 and 65 Ncm, because too much torque causes pressure necrosis and heat transfer (a rise of more than 10°C within 1 minute degrades collagen in the bone)
Key Instruments/Materials:
• CBCT: measured bone height and width before choosing thin, longer implants.
• Panoramic radiograph: showed the inferior alveolar nerve, the mental foramen and the implants; a 2D image doesn’t show bucco-lingual angulation.
• Abutment: placed on the #30 implant the same day with stability over 45 Ncm.
• 3-0 chromic gut suture: closed the #30 implant site.
• 4-0 Vicryl suture: closed the grafted front site to hold the bone graft in longer; removed at about 2 weeks.
* Instrument Partner Of This Project – (Looking for a partner with instruments, I'll be talking about and showing the instruments I used in each case)
* Dental Implant Partner - (I place 3 different brands of implants and I'm waiting for my favorite one to partner with me on this project so I can finally reveal it...)
* Bone Grafting Partner - (This could be you! You know who you are lol let me know)
Top 15 Viewers on this Episode on TikTok LIVE 126 Q&A:
1st – @emmac623
2nd – User248, @jacob12456789
3rd – @hofblinders
4th – @laquizexad8
5th – J-mar..i, @jpamplin23
6th – kangaroojack30, @kjacke3090
7th – user3094365976936, @greenlucky70
8th – moustafa 🎩, @risingkpopstar
9th – alskfjrn, @kdkrjtheh
10th – Gaby Sousou, @gaby.sousou
11th – Anoopy, @anoopy_
12th – ., @akona2_
13th – User, @chemist_k
14th – Craig, @craig4137
15th – Ryan, @ryanhhhhhhhhhh
Top Questions:
“How did you decide on dentistry?”
“How much planning goes into a case before you start a procedure?”
“Can you do referrals for double jaw surgery?”
“How do you get good bitewings? I can't get rid of the overlaps on the interproximals.”
Now available on:
- Dr. Gallagher’s Podcast & YouTube Channel
My watch in this episode = Citizen Ecozilla Diver (overnight on-call watch in residency)
10.2026
#podcast #dentalpodcast #doctor #dentist #dentistry #oralsurgery #dental #dentalschool #dentalstudent #oralsurgeon #doctorgallagher #doctorgallagherspodcast
