1) Absence of persistent signs/symptoms such as pain, infection, neuropathies, parathesias, and violation of vital structures
2) Implant immobility
3) No continuous peri-implant radiolucency
4) Negligible progressive bone loss (less than 0.2 mm annually) after physiologic remodelling during the first year of function
5) patient/dentist satisfaction with the implant supported restoration.
Analysis of clinical trials indicated that implants with rough surfaces may offer advantages over implants with relatively smooth machined surfaces.
Additionally, implants placed in the mandible appear to have significantly higher success rates than those in the maxilla.
It’s important patients desiring implants be evaluated for potential problems in their placement.
While I’ve seen no reports of absolute medical contraindications for placement of implants, relative contraindications do exist. These may include uncontrolled diabetes, alcoholism, heavy smoking, post-irradiated jaws, and poor oral hygiene.
Individuals with a strong susceptibility to periodontitis, however, can be treated successfully with implants. Age is not always an important factor in implant survival although it may be of considerable importance to treatment planning.
Prospective recipients should be emotionally stable, cooperative, and willing to keep the appointments required for completion of treatment and maintenance.
Every candidate for an implant should understand not all implants are successful and that if an implant fails, an alternative treatment without implants may be the only viable option.
Restorative requirements, interarch space and jaw relationships, location of edentulous areas, and the quantity and quality of available bone should all be evaluated before implants are selected as a treatment option.
Radiographs may be necessary to determine the height of available bone for selection of the dimensions of the implants as well as to determine the proximity of potentially complicating structures such as the maxillary sinuses, foramina, mandibular canal, and adjacent teeth or roots.
If bone quality and quantity are inadequate for the placement of implants, bone augmentation procedures may be indicated.
These could include the use of either bioabsorbable or non-resorbable barrier membranes, bone grafts or bone substitutes to enhance bone regeneration.
A review of the literature indicated that implants in grafted bone are successful. However, it was unclear which graft materials are most efficacious.
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