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Einband grossSurgical Complications in Oral Implantology
ISBN/GTIN

Surgical Complications in Oral Implantology

E-BookEPUBDRM AdobeE-Book
248 Seiten
Englisch
Quintessence Publishing Co, Incerschienen am30.09.2019
This exceptional new book is designed as a self-instruction guide to the diagnosis, management, and prevention of surgery-related complications in implant dentistry. It functions in two ways: First, it is a valuable resource for the implant surgeon seeking practical and succinct information about how to manage a complication in an emergency setting; and second, it can be read from cover to cover as a primer on implant surgery, from the initial consultation and treatment planning through the restorative phase of treatment. Besides addressing pre-, intra-, and postoperative implant surgery complications, the book also includes a comprehensive treatment-planning protocol that allows for the early detection of potential surgical complications and how to avoid them. Early detection of complications that are amenable to rescue therapies may reverse the fate of a failing implant or a bone-grafting procedure. Invaluable for the novice and experienced implant surgeon alike.

Louie Al-Faraje, DDS, MD, is a board-certified private practitioner of oral implantology as well as the founder and CEO of the California Implant Institute, which conducts a one-year fellowship program in implant dentistry. Since 2001, more than 600 dentists from 20 countries have received training at the Institute. Dr Al-Faraje studied dentistry at the Kiev Medical Institute and at Loma Linda University in California. He is a fellow of the American Academy of Implant Dentistry and a diplomate of the International Congress of Oral Implantologists and the American Board of Oral Implantology. He also claims membership to the American Society of Osseointegration, the American Association of Clinical Anatomists, and the editorial board of the Journal of Oral Implantology (JOI). Dr Al-Faraje has placed over 4,000 implants throughout his career and shares his experience through national and international lectures.mehr
Verfügbare Formate
E-BookEPUBDRM AdobeE-Book
EUR4,99
E-BookPDFDRM AdobeE-Book
EUR4,99

Produkt

KlappentextThis exceptional new book is designed as a self-instruction guide to the diagnosis, management, and prevention of surgery-related complications in implant dentistry. It functions in two ways: First, it is a valuable resource for the implant surgeon seeking practical and succinct information about how to manage a complication in an emergency setting; and second, it can be read from cover to cover as a primer on implant surgery, from the initial consultation and treatment planning through the restorative phase of treatment. Besides addressing pre-, intra-, and postoperative implant surgery complications, the book also includes a comprehensive treatment-planning protocol that allows for the early detection of potential surgical complications and how to avoid them. Early detection of complications that are amenable to rescue therapies may reverse the fate of a failing implant or a bone-grafting procedure. Invaluable for the novice and experienced implant surgeon alike.

Louie Al-Faraje, DDS, MD, is a board-certified private practitioner of oral implantology as well as the founder and CEO of the California Implant Institute, which conducts a one-year fellowship program in implant dentistry. Since 2001, more than 600 dentists from 20 countries have received training at the Institute. Dr Al-Faraje studied dentistry at the Kiev Medical Institute and at Loma Linda University in California. He is a fellow of the American Academy of Implant Dentistry and a diplomate of the International Congress of Oral Implantologists and the American Board of Oral Implantology. He also claims membership to the American Society of Osseointegration, the American Association of Clinical Anatomists, and the editorial board of the Journal of Oral Implantology (JOI). Dr Al-Faraje has placed over 4,000 implants throughout his career and shares his experience through national and international lectures.
Details
Weitere ISBN/GTIN9780867158823
ProduktartE-Book
EinbandartE-Book
FormatEPUB
Format HinweisDRM Adobe
FormatE101
Erscheinungsjahr2019
Erscheinungsdatum30.09.2019
Seiten248 Seiten
SpracheEnglisch
Dateigrösse22755 Kbytes
Artikel-Nr.4896417
Rubriken
Genre9201
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Inhalt/Kritik

Inhaltsverzeichnis
Identifying Preoperative Conditions That Could Lead to Complications - Intraoperative Complications in Implant Placement - Postoperative Complications - Complications Associated with Lateral Window Sinus Elevation - Prevention and Management of Intra- and Postoperative Pain and Infectionmehr
Leseprobe

COMPLICATION 2
Inadequate Horizontal Restorative Space

A minimum amount of horizontal space must be maintained between implants or between implants and natural teeth to prevent unnecessary bone loss or compromised esthetics that can result from invading that space.

The horizontal restorative space refers to the mesiodistal distance between implants, between an implant and a natural tooth, and between natural teeth.

Implant-to-implant space requirement

The distance between two implants, or interimplant distance, should be a minimum of 3 mm. When this distance is maintained, vertical bone loss resulting from crestal bone remodeling during establishment of the biologic width at the implant-abutment interface will have a minimal lateral or horizontal component. In a study by Tarnow et al,11 horizontal bone loss around implants at the crest was only 0.45 mm when the interimplant distance was greater than 3 mm and 1.04 mm when it was less than 3 mm.

The clinical significance of this phenomenon is that crestal bone loss increases the distance between the interproximal contact of the adjacent implant restorations and the crestal bone. This distance may determine whether the interdental papilla is present or absent, which has implications for both hygiene and esthetics.

It is important to note that for fixed-detachable, spark-erosion, and overdenture types of implant prostheses, the distance between implants can be less or much more than 3 mm; the 3-mm guideline applies primarily to the fixed partial denture-type of implant prosthesis.

Calculating ideal implant-to-implant space

There are three ways of calculating an ideal mesiodistal space between implants.

1. Width of implant crowns

The first formula, which is based on the width of the planned implant crowns, requires a diagnostic wax-up and is ideal for determining the space between implant centers (Fig 1-5):



Fig 1-5 The distance between the centers of two adjacent implants (A) is calculated by adding B (width of crown 1 divided by 2) and C (width of crown 2 divided by 2).




2. Papillary fill of interproximal space

The second method is less accurate; however, in most cases the result is close to the ideal distance between implants, which will vary in proportion to the diameter of the implants used (Fig 1-6):


R1 + R2 + 3 mm (where R = implant radius)


This method is based on the fact that, as discussed above, the horizontal distance between implants influences the appearance of the papillae,12 and a 3-mm interimplant distance most closely correlates with adequate papillary fill of the interproximal space.13



Fig 1-6 The distance between the centers of two adjacent implants (A) is calculated by adding 3 mm to the sum of implant 1 radius (R1) and implant 2 radius (R2).




3. Standard distance

The third method is to allow a standard distance of 7 to 8 mm between narrow platform and regular platform implants and 8 to 9 mm between two regular platform implants or one regular and one wide platform implant. These distances are acceptable for restoration with a fixed prosthesis (Fig 1-7).



Fig 1-7 Standard distance (center-to-center) between implants of different diameters and optimal distance (edge-to-edge) between implants and natural teeth. NP, narrow platform; RP, regular platform; WP, wide platform.






Implant-to-natural tooth space requirement

Calculating ideal implant-to-natural tooth space

There are two ways of calculating an ideal mesiodistal space between an implant and a natural tooth.

1. Width of implant crown

The first approach is similar to the first method described for calculating the mesiodistal space between implants, ie, it is based on the width of the planned implant crown (Fig 1-8):


2. Standard distance

The second method is to place the edge of the implant 1.5 to 2.0 mm away from the adjacent root surface.14 Therefore, the following formula can be used:


1 to 2 mm + R (where R = implant radius)


This distance will prevent vertical bone resorption at the adjacent tooth; moreover, if bone loss occurs around the implant, it will not affect the adjacent tooth and vice versa (see Fig 1-7).



Fig 1-8 An optimal way of calculating the distance between an implant and a natural tooth. Distance A is half of the width of the future implant crown.





Case examples

Figure 1-9 illustrates a case of incorrect implant positioning. An implant to replace the missing mandibular right first molar was placed 3 to 4 mm distal to the mandibular right second premolar so as to avoid damaging the premolar´s distally inclined root. As a result, the prosthesis has a large and biomechanically undesirable mesial cantilever. The proper course of action in this case would have been to adjust the root position of the second premolar by orthodontic intervention before implant placement. Figure 1-10 shows a case with ideal implant-tooth and interimplant distances.



Fig 1-9 (a to d) The distance between the second premolar and the mesial implant is greater than ideal to avoid the inclined root. The result was an undesirable mesial cantilever of the implant prosthesis, which could have been avoided if the inclined root had been straightened using orthodontic treatment before implant placement.





Fig 1-10 (a to d) Clinical case with optimal distance of 3 mm between implants (edge-to-edge) and 2 mm between implants and natural teeth (edge-to-edge).





Tooth-to-tooth space requirement

Anterior teeth

The minimum mesiodistal space required for treating loss of a single tooth in the anterior area with a dental implant is the implant diameter + 1.5 mm to the adjacent root on either side (ie, 3 mm). For example, a minimum distance of 6.5 mm is required for a 3.5-mm narrow platform implant, 7.5 mm if the implant diameter is 4.5 mm, and 8.5 mm if the implant diameter is 5.5 mm (Fig 1-11).

It is important to note that the distance of implant diameter + 3 mm is adequate for osseointegration but not necessarily ideal esthetically. Because the abutment diameter is usually wider than the diameter of the implant, 1 mm or more additional space is preferable for a more esthetic emergence profile of the implant crown. Alternatively, a smaller-diameter implant can be used.



Fig 1-11 The minimum recommended distance for implant placement between two teeth is the diameter of the planned implant + 3 mm.




Posterior teeth

As in the anterior area, the mesiodistal distance of implant diameter + 3 mm between two natural posterior teeth is acceptable for placement of an implant. However, in the posterior region, there is often a problem of too much rather than not enough space. Although the natural molar is multirooted, it should be replaced by only a single implant. The placement of two implants to replace one missing molar is not recommended because it is surgically challenging, difficult to restore, and esthetically unacceptable to most patients. Moreover, the prosthesis must be configured such that an opening can be maintained between the implants for hygiene purposes, creating a so-called tunneled molar. Figure 1-12 demonstrates such a case.

If the alveolar ridge is wide (> 7 mm), a 5- or 6-mm-diameter implant should be used to replace one molar. Otherwise, one of the methods described below can be used for space management.



Fig 1-12 (a to d) Restoration of a missing mandibular molar using two implants. Note that space is maintained between the two implants for hygiene access under the prosthesis.





Management of horizontal restorative space problems

Orthodontic treatment

If the edentulous area is not ideal for implant placement because of space concerns, orthodontic treatment can be initiated to increase or decrease the edentulous area. This may be especially helpful when space is excessive. Without such treatment, the restoration may be substantially wider than the diameter of the implant. The resulting torque, or moment of force, on the implant will increase as a factor of the magnitude and off-axis distance of occlusal forces applied (torque = force × distance; Fig 1-13), which has negative implications for the long-term outcome of the...



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Autor

Louie Al-Faraje, DDS, MD, is a board-certified private practitioner of oral implantology as well as the founder and CEO of the California Implant Institute, which conducts a one-year fellowship program in implant dentistry. Since 2001, more than 600 dentists from 20 countries have received training at the Institute. Dr Al-Faraje studied dentistry at the Kiev Medical Institute and at Loma Linda University in California. He is a fellow of the American Academy of Implant Dentistry and a diplomate of the International Congress of Oral Implantologists and the American Board of Oral Implantology. He also claims membership to the American Society of Osseointegration, the American Association of Clinical Anatomists, and the editorial board of the Journal of Oral Implantology (JOI). Dr Al-Faraje has placed over 4,000 implants throughout his career and shares his experience through national and international lectures.