Periodontally Considerations of Dental Implantology
Lee H. Silverstein, DDS, MS, FACD, FICD;Jerry J. Garnick , David Kurtzman, DDS, Peter C. Shatz
The endosseous dental implant has steadily progressed to become an important modality of restoring incomplete dentitions in either fully or partially edentulous patients. Osseointegrated dental implants have demonstrated relatively high success rates in both the maxillary and the mandibular jaws. The American Academy of Implant Dentistry (AAID), the American Dental Association (ADA), and numerous other professional organizations have endorsed the placement of osseointegrated dental implants as a viable and predictable treatment modality.
Inclusion of the placement, restoration, and maintenance of dental implants is an important part of the newly defined responsibilities of general dental practitioners, prosthodontists, periodontists, and oral surgeons. Recently, postdoctoral periodontics training requirements have been modified to include mandatory teaching of the diagnosis, treatment planning, placement, and maintenance of osseointegrated dental implants in all graduate periodontics residency programs.
The critical prerequisite for successful endosseous- type dental implants, in addition to their being osseointegrated, is the achievement of perimucosal seals of the various soft tissue layers adjacent to the implant surface. The presence of an adequate zone of attached keratinized peri-implant gingiva may be essential for (1) maintenance of peri-implant health, (2) prevention of gingival recession, and (3) establishment of stable levels of the connective tissue and alveolar bony attachments. Failure to obtain or maintain this perimucosal seal may result in loss of connective tissue adhesion. This results in apical migration of the epithelium into the alveolar bone-implant surface, which ultimately results in a soft -tissue encapsulation of the endosseous portion of the dental implant. This connective tissue encapSUlation will eventually cause the failure of the dental implant.
Subsequent to exhaustive evaluations of most implant systems, the consensus has been that there is currently no single "ideal" implant design. Implants of different designs, shapes, widths, and heights are necessary to overcome the limitations imposed by inadequate residual bone morphology and density.
Maximizing Aesthetics in the Deficient Alveolar Ridge
This article will present a predictable method for replacing the lost bone prior to implant placement through the ramus block graft technique.
A Novel Drilling Procedure and Subsequent Bone Autograft Preparation
A Technical Note
Influence of a Nanometer-Scale Surface Enhancement on De Novo Bone Formation on Titanium Implants
In this prospective randomized controlled clinical study, small titanium implants were placed in posterior maxillae for the purpose of assessing the rate and extent of new bone development. Nine pairs of site evaluation implants were placed in posterior areas of maxillae and retrieved with trephine drills after 4 or 8 weeks of unloaded healing. The amount of bone in linear contact (%) with the implant surface was used to determine the osteoconductive potential of the implant surface. Implant surfaces…
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Dr. Bassam Rabie details the critical biomechanical and occlusal considerations that clinicians must incorporate in planning posterior implant restorations.
Biologic and Surgical Strategies for Achieving Implant Esthetics – Part 3
Dr. André Saadoun outlines in detail how to implement the ten most important surgical and restorative factors that lead to predictable implant esthetics.
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This webinar with Dr. George Duello and Dr. Maurice Salma will discuss the various treatment options available today for this patient segment and emphasize when and where the All-On-Four protocol can be successfully utilized to eliminate the need for costly augmentation procedures and months of healing time.
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