Workshop Guidelines on Immediate Loading in Implant Dentistry

Dental Publication / Article Details

Workshop Guidelines on Immediate Loading in Implant Dentistry

Author(s):

Tiziano Testori, MD, DDS, FICD; Mohamed Sharawy, B.D.S., Ph.D.; Leonard Linkow, DDS, DMSc; Jack A. Hahn, DDS; Edward Joseph Mills, DDS; Henry Salama, DMD; Carl E. Misch, DDS, MDS, Kenneth W. Judy, DDS, Jack E. Lemons, PhD, Jamie L. Lozada, DDS, Craig M. Misch, DDS, MDS, Hom-Lay Wang, DDS, MDS

Date Added:

1/1/2005

Summary:

Predictable formation of a direct bone-to implant interface is a treatment goal in implant dentistry. The 2-stage surgical protocol established by Branemark et al to accomplish osseointegration consisted of several prerequisites, including (1) countersinking the implant below the crestal bone, (2) obtaining and maintaining a soft-tissue covering over the implant for 3 to 6 months, and (3) maintaining a minimally loaded implant environment for 3 to 6 months. The primary reasons cited for the submerged, countersunk, surgical approach to implant placement were (1) to reduce and minimize the risk of bacterial infection, (2) to prevent apical migration of the oral epithelium along the body of the implant, and (3) to minimize the risk of early implant loading during bone remodeling. After this procedure, a second-stage surgery was necessary to uncover these implants and place a prosthetic abutment. Predictable, long-term, clinical rigid fixation has been reported after this protocol in patients who were either completely or partially edentulous. During the past 15 years, several authors have reported that root-form implants may osseointegrate, even though the implants extend above the bone and through the soft tissues during early bone remodeling. This surgical approach has been called a 1-stage or nonsubmerged implant procedure because it eliminates the second-stage implant uncovery surgery. As a result, the discomfort, inconvenience, and appointments of the surgery and suture removal are eliminated. In addition, the soft tissue is more mature before fabricating a final prosthesis.

Osseointegrated Titanium Implants for Maxillofacial Protraction in Monkeys
Titanium implants were placed surgically into the maxillary, zygomatic, frontal, and occipital bones of four pigtail monkeys. After a 4-month healing period, the implants were exposed and abutments were placed. Extraoral traction appliances were then attached to the abutments. The cranial implants were used to support the framework of the traction appliance; those in the facial bones were used to attach springs that delivered a protraction force. The application of force varied among animals. In animal…

Author(s):

Vincent G. Kokich, Sr., DDS, MSD; Ward M. Smalley, DDS, MSD, Peter A. Shapiro, DDS, MSD, Thomas H. Hohl, DDS, Per-Ingvar Branemark, MD

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Nifedipine-induced Gingival Enlargemenr Around Dental Implants
Calcium channel-blocking agents are used extensively for the management of cardiovascular conditions, including angina pectoris, coronary artery spasm, cardiac arrhythmias, and hypertension. Gingival overgrowth around natural teeth has been previously reported in the literature with patients taking calcium channel-blocking agents. This clinical report describes hyperplasia of tissues around titanium dental implants in a patient taking Nifedipine along with the multiphasic approach to treating this…

Author(s):

Lee H. Silverstein, DDS, MS, FACD, FICD; J. Paul Koch, DMD, Michael D. Lefkove, DDS, Jerry J. Garnick, DDS, MS, Baldev Singh, BDS, PhD, David E. Steflik, MS, EdD

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The Use of Free Gingival Soft Tissue to Improve Implant/Soft Tissue Interface
Various techniques for the placement of different types of dental implants have evolved to the point where predictable bone-to-implant integration occurs if proper surgical technique is followed. The soft-tissue adaptation to the implant abutment is the first line of defense to prevent the development of peri-implantitis and subsequent bone loss. Given that there is a tenuous protective seal around dental implants, the rationale for soft-tissue augmentation around dental implants to provide an improved,…

Author(s):

Lee H. Silverstein, DDS, MS, FACD, FICD; Michael D. Lefkove, DDS, Jerry J. Garnick, DDS

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