Contemporary Implant Dentistry Edwin Medical Assignment Help

CHAPTER OUTLINE

BIOLOGIC CONSIDERATIONS FOR OSSEOINTEGRATION
Soft Tissue-to-Implant Interface
Biomechanical Factors Affecting long-Term Implant
Success
CLINICAL IMPLANT COMPONENTS
Implant
Cover Screw
Healing Cap
Abutment
Impression Post
Laboratory Analog
Waxing Sleeve •
Prosthesis-Retaining Screw
IMPLANT PROSTHETIC OPTIONS
Completely Edentulous Patients
Implant- and Tissue-Supported Overdenture
All Implant-Supported Overdenture
Fixed Detachable Rest~ration
Partially Edentulous Patients
Free-End Distal Extension
Single-Tooth Implant Restorations
PREOPERATIVE MEDICAL EVALUATION OF IMPLANT
PATIENT
SURGICAL PHASE: TREATMENT PLANNING
Evaluation of Implant Site
Bone Height, Width, and Anatomic limitations
Informed Consent
Surgical Guide Template
BASIC SURGICAL TECHNIQUES
Patient Preparation
Soft Tissue Incision
Preparation of Implant Site
Implant Placement
Postoperative Care
Uncovering
COMPLICATIONS
Failing Implant
ADVANCED SURGICAL TECHNIQUES
Guided Bone Regeneration
Block Bone Grafting
Alveolar Distraction
Transantral Grafting (Sinus Lift)
SPECIAL SITUATIONS
Postextraction Placement of Implants
Anterior Maxilla Esthetic Zone
Atrophic Anterior Mandib.le
.II< Atrophic Posterior’ Mandible
Atrophic Max.illa
Implants in Growing Patients
“Implants in Irradiated Bone
Early Loading
Extraoral Implants
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The  dentalconsiderable clinical skill Whelp patients cope wit11 the
. . effects of partial or co mplete cdentulism. Dental problems that were historically the most difficult can be solved today with the assistance of dental Implants . . Completely edentulous patients now enjoy the security
and function of fixed restorations (Fig. 14-1). Patients missing a posterior abutment, who would ordinarily require a distal extension. removable partial denture, may now enjoy the benefits of a fixed restoration with
dental implants (Fig. 1-1-2). Trauma victims who -are missing teeth and bone can be successfully rehabilitated with fixed restorations (Fig. 14-3). Even the patient missingonly a single tooth can receive a restoration more
analogous to the missing natural tooth (Fig. 14-4). Likewise, a patient with the available bone can receive a complete fixed implant rchabilitatlon (Fig. 14-5). These examples illustrate advantageous and predictable alternatives
to ,edentulism tl1at arc becoming the standar-d of care within the dental community. The dental profession has not always’ had a positive opinion of dental implants. Implants had their beginnings.around the middle ‘of the twentieth century. Early types of dental implants came into relatively common1I~l’ during till’ 19()()s because of patient demand,

tlG. 14-1 Complete-arch implant restoration supported by five implants-in completely edentulous patient

tlG. 14-1 Complete-arch implant restoration supported by five
implants-in completely edentulous patient

FIG. 14-2 Radiograph of two-unit implant restoration used to restore dentition. Conventionally, replacement with removable -partial denture would be required.

FIG. 14-2 Radiograph of two-unit implant restoration used to
restore dentition. Conventionally, replacement with removable -partial
denture would be required.

although little or no scientifically sound research had been done to characterize implant success rates. In a 19~2 conference held in Toronto, the North American dental profession was .introduced to a body oi scientific literature on Swedish research into the bone- oimplant interface-a concept called osseointegration. This new conce pt is based on atraumatic implant placement and delayed implant loading. These factors contribute to a remarkably higher degree of implant predictably than was previously possible. The Swedish research team led by p. l. Branemark reported high success in the mandible for over 15 years. The knowledge gained from the experience of the Swedish team was used in the development of other systems currently available. on’ the market, Today
the American Dental Association (ADA) has also accepted many other systems. “In 1988 a National Institutes of Health (NIH) consensus conference was held in Washington, D.C. This conference
evaluated term long-term effectiveness ‘of dental implants ami established indications and contraindications for the various types of dental implants. Stnngcnt criteria for success were proposed and have gained general
acceptance (Box 14-1), By these criteria a success rate of 85% at the end of a 5-year observattothe end of a l Ovyear-period are minimal levels for sucess.

fiG. 14-3 A, Twenty-six-year-old patient with large dental defect rilused by shotgun wound, Three Irnplants placed in defect. B, Trau-' matic defect restored with implant-supported hybrid restoration retained by screws

fiG. 14-3 A, Twenty-six-year-old patient with large dental defect
rilused by shotgun wound, Three Irnplants placed in defect. B, Trau-‘
matic defect restored with implant-supported hybrid restoration
retained by screws

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FIG. 14-4 A, Thirty-year-old patient with missing mandibular premolar. Sinqle dental implant has been placed in extraction site. Abutment projects througb soft tissue. 8, Single-tooth implant restored without comprornlsinq adjacent tooth structure.

FIG. 14-4 A, Thirty-year-old patient with missing mandibular premolar. Sinqle
dental implant has been placed in extraction site. Abutment projects througb soft
tissue. 8, Single-tooth implant restored without comprornlsinq adjacent tooth
structure.

FIG. 14-5 Radiqgraph of complete-mouth fixed implant restoration .

FIG. 14-5 Radiqgraph of complete-mouth fixed implant restoration .

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