We’re finishing up our week discussing implants in periodontal treatments by taking a broad view of some issues in the field, including placement, failures, and maintenence.
Immediate Implant Placement
If an implant is to be inserted into an extraction site, the timing of the extraction is important due to the potential for post-extraction bone resorption and ridge deformation. Insertion of implants at the time of extraction (immediate placement) is viable if mechanical fixation can be achieved.
At present there are short-term data to support immediate placement of implants. Alternately, implants can be inserted after complete healing of the extraction socket.
However, research is still needed on the quality of bone regenerated by such procedures and on the long-term survival analysis of the inserted implants.
Implant Complications And Maintenance
A failed implant has been described as one that is clinically mobile.
Implants showing progressive loss of supporting bone, but is immobile, is also a failing implant.
Early implant failures denote a lack of initial integration while late failures and failing implants occur after initial integration, physiological remodelling, and loading.
Problems limited to the soft tissues surrounding implants and not involving the supporting bone have been defined as “ailing implants” and, more recently, as biological complications.
Endosseous dental implants rarely fail beyond the first year after restoration. It has been suggested, however, that conventional periodontal therapy should be instituted if inflammation develops around an implant.
The microbiological findings related to healthy and failing implants are the same as those for healthy and periodontally compromised teeth.
Failing dental implants have been attributed to bacterial infection, improper surgical procedures, and occlusal overload.
In one report, the terms infectious and traumatic failure were used to describe different clinical and microbiological features. Little information is available on the effect of occlusion on implant survival.
Currently, there is no direct evidence that non-axial loading is detrimental to the bone-implant interface, but abnormal occlusal loading will adversely affect the prosthesis.
Furthermore, there are limited data on the effects of splinting implants to natural teeth, and other data indicate that a lack of keratinized tissue attached to an abutment or machined surface implant will have no adverse effect on implant survival.
Patients should be on a regular monitoring recall schedule and, due to a lack of data detailing precise recall intervals, maintenance programs should be designed on an individual basis.
Additionally, literature review determined that roughened implant abutment surfaces caused by different maintenance techniques have not been shown to increase implant complications.
Endosseous dental implants have revolutionized the fields of implants and periodontics and a great deal of information has been generated concerning their effectiveness and predictability.
Implant placement is a viable option in the treatment of partial and full edentulism and has become an integral facet of periodontal therapy. The available implants are remarkably successful.
However, there is no one ideal implant system.
Biterite offers a wide variety of solutions for implants, from CAD/CAM design, to ISUS, to custom Astra Atlantis zirconia. If you want to know more, feel free to get in touch over phone or email, or find me social media:
Image courtesyof: ISUS