Parameter on Placement and Management of the Dental Implant (2)|palmerah.implantgigi.com

IMPLANT PLACEMENT

Prosthetic considerations for patients requiring implant placement should include evaluation of:

Number and location of missing teeth;
Interarch distance;
Number, type, and location of implants to be placed;
Existing and proposed occlusal scheme;
Design of planned restoration.

The surgical technique is based on the pretreatment evaluation and on the type of implant to be utilized. The following also should be considered:

Aseptic technique;
Appropriate surgical protocol;
Surgical template utilization;
Appropriate postoperative instructions.

A staged approach has been used to place endosseous implants. Implants can be placed at the time of tooth extraction as well. Post-placement procedures: The following considerations should be reviewed prior to the restorative phase:

Quantity, quality, and health of soft and hard tissues;
Implant stability;
Implant position and abutment selection;
Oral hygiene assessment.

Appropriate restorative procedures may be initiated upon satisfactory completion of the above con-

siderations. Mechanical failures of both the implant components and prosthetic superstructures have been associated with occlusal overload.

IMPLANT MANAGEMENT

Periodic evaluation of implants, surrounding tissues and oral hygiene are vital to the long-term success of the dental implant. Considerations in the evaluation of the implant are:

Presence of plaque/calculus;
Clinical appearance of peri-implant tissues;
Radiographic appearances of implant and peri-implant structures;
Occlusal status, stability of prostheses and implants;
Probing depths;
Presence of exudate or bleeding on probing;
Modiﬁcation of maintenance interval
Patient comfort and function.

MANAGEMENT OF IMPLANT-RELATED COMPLICATIONS

The etiology of implant complications can be multi-factorial, involving both structural components and tissue considerations. Routine evaluation may reveal the need for procedures to correct the following:

Prosthesis instability;
Fixture mobility;
Occlusal traumatism;
Fractured or loosened components;
Inﬂammation/infection;
Excessive/progressive loss of hard and soft tissues;
Pain;
Neuropathy/paresthesia.

An unfavorable response to corrective procedures may warrant adjustment of the prostheses and/or removal of the implants.

OUTCOMES ASSESSMENT

The desired outcome of successful implant therapy is maintenance of a stable, functional, esthetically acceptable tooth replacement for the patient. Variations from the desired outcome of implant placement include:

Implant mobility or loss;
Persistent pain and/or loss of function;
Progressive bone loss;
Persistent peri-implant radiolucency;
Persistent uncontrolled inﬂammation/infection;
Inability to restore the implant;
Increased probing depths;
Implant fracture.