Implants

Minimum Interocclusal Space Requirements for Dental Restorations Successful dental restorations depend not only on implant placement and bone quality, but also on adequate restorative space. One of the most common reasons for prosthetic complications is insufficient interocclusal space. When restorative clearance is inadequate, clinicians may face compromised esthetics, weakened prosthetic materials, screw access issues, or […]

Vertical bone height may be a consideration in the treatment planning phase of simultaneous sinus lifting and implant placement. In general 4 mm of vertical bone height will provide a situation that may allow for simultaneous placement however, the true determinate is primary implant stability.

Peri-implantitis is defined as radiographically detectable peri-implant bone loss occurring after initial successful osseointegration combined with soft tissue inflammation lesion that demonstrates suppuration and probing depths of 6mms or more. The process begins at the coronal aspect of the implant, whereas the more apical portion remains clinically stable (osseointegrated).

The cortical screws for the transmandibular implant systems are available in lengths of 5,8,11,14 mm. Protocol is for the cortical screws to extending beyond the bone for a length of 2mm. This allows for tenting of the periosteum and thought to lead to subsequent bone growth.

A thick biotype provides greater stability for the peri-implant soft tissues with more predictable healing response following surgery and around restorations. Thin bioptypes predispose to unpredibtable healing and allow titanium show through.   Dennis Tarnow demonstrated that a distance of 6mm or more from the alveolar crest to contact point reduces the probability of intact papillae. 

Contraindications Developing patients (particularly in the maxilla where vertical growth continues after permaenet teeth are fully erupted) Uncontrolled periodontal disease  Aesthetic areas with thin, highly scalloped gingiva Adjacent periapical pathology Non-motivated patients Relative contraindications Adjacent root flaring (correction needed with orthodontics) Smokers (increased risk of failure in type IV bone) Connective tissue disease Diabetes Autoimmune