November 23, 2023


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The following case is a good example of why you shouldn't postpone your implant surgery for too long. And this time, the scope of work was above and beyond the surgery itself. Since there was no immediate conversion possibility due to the very soft bone, it caused the delay before attaching the restoration. Notably, the patient presented with a collapsed vertical dimension, prompting the strategic adjustment of her occlusal relationship. Subsequently, we initiated interventions, including botox therapy, to optimize the patient's muscular function. Concurrently, modifications were made to the patient's oral hygiene and dietary habits to create favorable conditions for successful implantation.

The restoration process extended beyond implantology, requiring a phased approach to address various aspects incrementally. Throughout the treatment, the patient's inquiries about the status of her teeth were accommodated, emphasizing effective communication. To mitigate muscular tension in the Masseter and Temporalis muscles, influential in the closure of the oral cavity, a concerted effort was made to induce relaxation, facilitating the controlled restoration of the vertical dimension. Upon completion of the procedures for the upper dental arch, a postoperative measure involved issuing a night guard. This protective appliance serves to discourage inadvertent muscle overactivity during sleep, safeguarding the integrity of the implants and preventing potential damage resulting from excessive closure.

Materials used:

DSI Premium Spiral Implants
DSI Premium Multi-Unit Kits
DSI Conical Surgical Kit
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Dr Carmy Michael


A graduate of University of Western Ontario Schulich School of Medicine & Dentistry with a degree of Doctor of Dental Surgery 2004 with a 6 months residency. Also a graduate of Cairo University, School of Dentistry 1993 with a 1 year residency. Extensive training in the field of Dental Implantology and Digital Work Flow in Dentistry, A journey that started over 10 years ago and is still ongoing. Certified in Oral Sedation through DOCS and IV Conscious Sedation. Active member of the Academy of Osseointegration (AO)A Fellow of the Global Dental Implant Academy-CA (GDIA)A member of the International Congress of Implantologists (ICOI)Extensive training in Full Arch Restoration (Nobel and GDIA)A Certified Provider for Institute for Advanced Laser Dentistry (LANAP & LAPIP)Specialized training on 3 Shape & ExocadFellowship from Dental Implant Association (DIA)Member with good standing in the CDA, MDA, ADA & OCDSDigital Work flow for Implant Restoration.‍

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