As per Carranza 11th edition

4. According to this, implant success rate:
• 61% after 5 years for implant supported FPD
• 50% after 10 years after combined tooth/ implant FPDs
(Lee et al)

5. INDEX Proposed by CRITERIA SCORES INTEPRETATION
Restorative
Index
Jensen et al Subjective and Objective
Evaluates size & shape of
implant to contralateral tooth,
blending to arch, presence of
papilla, gingival form, color etc
1-10 1: Extremely poor
10: Superlative esthetic
Pink Esthetic
Score (PES)
Furhauser et al 7 soft tissue parameters
Color, contour and texture of
papilla & facial mucosa
Each
parameter:
score of 0-2
Best score:14- highest
level of esthetics
For single-tooth
implant
restorations:
Modified PES
Index with a
white esthetic
score (WES)
Belser et al 5 parameters
Tooth form, hue, value, surface
texture, and translucency
(focused on visible part of
implant restoration)
Max score: 10
Aimed at quantifying
esthetic result to judge
“Implant Esthetic
Success”

6. AUTHORS Study
Eckert et al Implant fractures occur mostly in partially edentulous
restorations (1.5%) than in complete edentulous(0.2%)
Rangert et al Highest number of fracture in posterior edentulous segment than
anterior
Pjetursson et al Peri-implantitis and Soft tissue lesions occur in 8.6% implant
supported FPD after 5 years
Esposito et al Predictability of Branemark implant was especially good for
partially edentulous patients compared with totally edentulous
patients, with failures in the latter population being twice as high
Implant failure – 3 times more in edentulous maxilla than
mandible; also failure rate of ed. max= that of partially ed. mand

7. 1. Haemorrhage and hematoma
2. Neurosensory disturbances
3. Damage to adjacent teeth
4. Implant malpositioning
5. Related to Sinus Lift Procedures
6. Related to Bone grafting

8.  Common accident as a consequence of
local-anatomical or systemic causes.
Primary Primary
Secondary

9. Bleeding site during
Implant Osteotomy
Arteries Treatment
Posterior mandible Mylohyoid Finger pressure at site
Middle lingual of
mandible
Submental Surgical ligation of facial
and lingual arteries
Anterior lingual of
mandible
Terminal branch of Sublingual
or
Submental
Compression,
vasoconstriction,
cauterization, or ligation
Invading the
mandibular canal
Inferior Alveolar Artery Bone graft

10. • Causes:
 Wide flaps,
 Bone regenerating techniques
 Submucosal bleeding into connective tissue
 Intra-Operative time
• Management:
 Careful management of tissues
 NSAIDS
 Cold pack
 Corticosteroids

13. PARAMETERS CRITERIA VIOLATION
Apicocoronal 2-3mm apical to gingival
margin of anticipated
restoration
• At or above GM level- Metal collar/ implant exposure
occurs yielding unesthetic result
• Too apical- long transmucosal abutment necessary to
restore implant leading to deep pocket n difficult
hygiene access for patient and clinician.
Mesiodistal 2- 3 mm inter-implant distance
1.5 - 2 mm away from natural
tooth
violation of biological width --- bone loss
Buccolingual atleast 2mm bone
circumferentially around the
implant
B/L: Abscess/ Suppuration
Too palatal/ lingual: Prosthetic compensation(buccal ridge
lap)– difficult to clean----inflammation
Angulation Anterior: Implant long axis
towards cingulum
Posterior: Towards central
fossa/stamp cusp of opposing
tooth
Minor misangulation(15-20°): Prefabricated stock-angle
abutments
Moderate(20-35°): Customized UCL-type abutments
Extreme(>35°):Unrestorable (has to be left submerged
(sleeper) or removed)

14. 1. Inflammation
2. Dehiscence and recession
3. Periimplantitis and bone loss
4. Implant loss or failure

16. • Occurs due to absence/lack of
supporting tissues.
• Recession- Common in anterior area
when soft tissues are thin and not well
supported.
• FENESTRATION and its surgical
management by bone grafting. (Spray
et al)
• Patient with high smile line/high
esthetic demand would consider this as
a failure.

22. LATERAL WINDOW SINUS LIFT:
1.Schneiderian Membrane Perforation-
-------20-30% (Wallace et al)
1.Bleeding from nose
2.Infection of graft material – 2-5.6% (Misch
CE et al)
3.Sinusitis
4.Graft coming out from nose
CRESTAL (OSTEOTOME) SINUS LIFT:
1.Benign paroxysmal positional vertigo
(Garcia et al) ; Prevalence -1.25%
•To prevent BPPV complication:
• Use manual force instead of hammer
percussion
• Surgical fraise+ Osteotome-- ↓ craniofacial
trauma specially in older patients
• Usage of Selective drill systems &
piezoelectric surgical instruments--- Cuts
bone leaving the membrane intact.

23. Immediate implant
placement:
1.Poor implant position
2.Marginal bone loss
3.Peri-implant soft tissue
recession
4.Compromised aesthetics
5.Failure to attain primary
stability
6.Implant failure
Immediate implant loading:
•Failure to achieve primary
stability
To avoid complications:
1.Use Long and wide
implants
2.Active Thread design
3.Full edentulous arch 4-6
implants min.
4.Cross arch stabilization
5.Minimize cantilever
Related to flapless approach:
• Lack of proper visualization
•Improper positioning
Technique sensitive and
requires:
1. Surgical experience,
2.Proper case selection,
Accurate surgical guide &
3.Knowledge of anatomy in
vicinity of implants.