Dr. Amr Saad discusses risk assessment for dental implants. A thorough risk assessment involves taking medical and dental histories, examining the patient, and taking radiographs to evaluate bone quality. Key risk factors include poor oral hygiene, smoking, diabetes, radiation therapy, and non-compliance with maintenance protocols. Proper risk assessment allows clinicians to avoid high-risk cases and minimize complications and implant failure.
AAP 2017 CLASSIFICATION OF PERIODONTAL DISEASE PART 1Babu Mitzvah
This document outlines the proceedings of a world workshop on classifying periodontal and peri-implant diseases and conditions. It discusses the need to update the 1999 classification system to current understanding. The outline covers periodontal health, gingival diseases, periodontitis, peri-implant diseases and key changes. Specifically, it defines periodontal health as having less than 10% bleeding sites and no probing depths over 3mm. It also discusses categories for periodontal health with an intact versus reduced periodontium, such as for successfully treated periodontitis patients.
1. The document outlines the classification of periodontal and peri-implant diseases and conditions. It discusses periodontal health, gingivitis, periodontitis, necrotizing periodontal diseases, and other conditions affecting the periodontium.
2. It also covers peri-implant diseases and conditions including peri-implant health, mucositis, peri-implantitis, and tissue deficiencies. Systemic diseases affecting the periodontium are discussed.
3. The classification of gingival biotype and gingival recession is presented along with factors influencing recession. Occlusal trauma and excessive occlusal forces are defined.
Critical apprisal of 2018 classification of periodontal disease yasmin parvin ss
The document provides a critical appraisal of the 2018 classification of periodontal diseases. It summarizes the key changes from the previous 1999 classification. The 2017 workshop with 130 experts from around the world developed the new classification framework based on new evidence from various studies. The new classification addresses some of the drawbacks of the previous system by introducing concepts such as periodontal health, risk factors, staging and grading of periodontitis, and inclusion of peri-implant diseases. While it provides several improvements, some experts note that the new classification is complex and may be difficult to implement in daily clinical practice. Future efforts are needed to disseminate and explain the new classification system.
Periodontitis as a manifestation of systemic diseasesDr.Nazia
Periodontal diseases and certain systemic disorders share similar genetic and/or environmental etiological factors, and affected patients may show manifestations of both diseases. Characterizing these diseases and the nature of the association between them could have important diagnostic value and therapeutic implications for patients
2017 classification of periodontal and periimpalnt diseasesPerio Files
In World Workshop 2017, American Academy of Periodontology (AAP) and European Federation of Periodontology (EFP) with expert participants updated the 1999 classification of Periodontal Diseases.
Since 1999, new evidences have emerged regarding environmental and systemic risk factors, prompting the experts to develop new classification.
1. The document discusses a new classification system for periodontal diseases and conditions.
2. It describes periodontal health, gingival diseases, forms of periodontitis, and other conditions affecting the periodontal tissues.
3. The classification system separates conditions into categories including periodontal health and gingival health, gingivitis, gingival diseases, necrotizing periodontal diseases, periodontitis, and other conditions affecting the periodontium.
Periodontal diseases Classifications and treatmentsRiad Mahmud
Prof. Dr. Md. Zahid Hossain, Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, Najran University, Saudi Arabia.Former Professor of Periodontology, City Dental College, Dhaka
The document discusses factors involved in determining the prognosis and treatment plan for periodontal disease. It defines prognosis as a prediction of the course and outcome of a disease based on risk factors. Several types of prognoses are described from excellent to poor based on remaining bone support, tooth mobility, furcation involvement, maintenance difficulties, and presence of systemic/environmental factors. Both overall and individual tooth prognoses are considered based on patient age, disease severity, plaque control, compliance, smoking, systemic disease, genetic factors, subgingival restorations, and anatomic root factors. A favorable prognosis requires adequate bone support, control of etiologic factors, patient cooperation and absence of negative systemic influences.
AAP 2017 CLASSIFICATION OF PERIODONTAL DISEASE PART 1Babu Mitzvah
This document outlines the proceedings of a world workshop on classifying periodontal and peri-implant diseases and conditions. It discusses the need to update the 1999 classification system to current understanding. The outline covers periodontal health, gingival diseases, periodontitis, peri-implant diseases and key changes. Specifically, it defines periodontal health as having less than 10% bleeding sites and no probing depths over 3mm. It also discusses categories for periodontal health with an intact versus reduced periodontium, such as for successfully treated periodontitis patients.
1. The document outlines the classification of periodontal and peri-implant diseases and conditions. It discusses periodontal health, gingivitis, periodontitis, necrotizing periodontal diseases, and other conditions affecting the periodontium.
2. It also covers peri-implant diseases and conditions including peri-implant health, mucositis, peri-implantitis, and tissue deficiencies. Systemic diseases affecting the periodontium are discussed.
3. The classification of gingival biotype and gingival recession is presented along with factors influencing recession. Occlusal trauma and excessive occlusal forces are defined.
Critical apprisal of 2018 classification of periodontal disease yasmin parvin ss
The document provides a critical appraisal of the 2018 classification of periodontal diseases. It summarizes the key changes from the previous 1999 classification. The 2017 workshop with 130 experts from around the world developed the new classification framework based on new evidence from various studies. The new classification addresses some of the drawbacks of the previous system by introducing concepts such as periodontal health, risk factors, staging and grading of periodontitis, and inclusion of peri-implant diseases. While it provides several improvements, some experts note that the new classification is complex and may be difficult to implement in daily clinical practice. Future efforts are needed to disseminate and explain the new classification system.
Periodontitis as a manifestation of systemic diseasesDr.Nazia
Periodontal diseases and certain systemic disorders share similar genetic and/or environmental etiological factors, and affected patients may show manifestations of both diseases. Characterizing these diseases and the nature of the association between them could have important diagnostic value and therapeutic implications for patients
2017 classification of periodontal and periimpalnt diseasesPerio Files
In World Workshop 2017, American Academy of Periodontology (AAP) and European Federation of Periodontology (EFP) with expert participants updated the 1999 classification of Periodontal Diseases.
Since 1999, new evidences have emerged regarding environmental and systemic risk factors, prompting the experts to develop new classification.
1. The document discusses a new classification system for periodontal diseases and conditions.
2. It describes periodontal health, gingival diseases, forms of periodontitis, and other conditions affecting the periodontal tissues.
3. The classification system separates conditions into categories including periodontal health and gingival health, gingivitis, gingival diseases, necrotizing periodontal diseases, periodontitis, and other conditions affecting the periodontium.
Periodontal diseases Classifications and treatmentsRiad Mahmud
Prof. Dr. Md. Zahid Hossain, Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, Najran University, Saudi Arabia.Former Professor of Periodontology, City Dental College, Dhaka
The document discusses factors involved in determining the prognosis and treatment plan for periodontal disease. It defines prognosis as a prediction of the course and outcome of a disease based on risk factors. Several types of prognoses are described from excellent to poor based on remaining bone support, tooth mobility, furcation involvement, maintenance difficulties, and presence of systemic/environmental factors. Both overall and individual tooth prognoses are considered based on patient age, disease severity, plaque control, compliance, smoking, systemic disease, genetic factors, subgingival restorations, and anatomic root factors. A favorable prognosis requires adequate bone support, control of etiologic factors, patient cooperation and absence of negative systemic influences.
1. daignostic process and history 11-2-2014Soliman Ouda
This document outlines the course contents and assessment for an Oral Diagnosis course. It discusses the diagnostic sequence used in oral diagnosis, which involves 8 steps: 1) detecting abnormalities, 2) taking a patient history and doing an exam, 3) reexamining, 4) classifying abnormalities, 5) listing possible diagnoses, 6) developing a differential diagnosis, 7) determining a working diagnosis, and 8) making a final diagnosis. The goal is to systematically gather information to identify oral conditions and formulate an appropriate treatment plan.
2017 classification of periodontal and periimplant diseasesDr. Bibina George
The document summarizes the key changes in the 2017 classification of periodontal and peri-implant diseases compared to the 1999 classification. The 2017 classification introduces staging and grading systems for periodontitis to indicate disease severity and risk of progression. It also includes classifications for peri-implant health, mucositis, and implantitis, as well as mucogingival deformities. The document reviews these changes and provides references for the revised classification system.
This document outlines a proposed new classification scheme for periodontal and peri-implant diseases and conditions. It discusses the need to update the 1999 classification scheme and develop a similar scheme for peri-implant diseases to align with current understanding. Key areas covered include definitions of periodontal health, gingivitis, and periodontitis at both the patient and site levels. Factors that determine the development and severity of gingivitis are summarized. Diagnostic criteria for gingivitis and approaches to classifying mild, moderate, and severe cases are discussed. The document also addresses non-dental plaque induced gingival conditions and future research needs.
Classification of diseases and conditions affecting the periodontiumPeriowiki.com
The document discusses the historical development of classification systems for periodontal diseases from the 1870s to present. It describes the three dominant paradigms that influenced classification: the clinical characteristics paradigm from 1870-1920 which based classifications on observable symptoms; the classical pathology paradigm from 1920-1970 which considered the pathological changes; and the current infection/host response paradigm since 1970 which considers the roles of infection and the body's response. It provides details on influential classification systems under each paradigm.
Periodontal disease results from a complex interplay between subgingival biofilm and the host immune-inflammatory response. While several bacteria are found in periodontal pockets, no single organism causes the disease. The pathogenesis involves the host response to the bacterial challenge, which can remain at a low, asymptomatic level or progress to tissue destruction if left unchecked. Understanding these disease processes is important for developing improved treatment strategies.
The document discusses factors that determine the prognosis of periodontal disease and dental treatment. It identifies local factors like plaque, calculus and tooth anatomy as well as systemic factors like smoking and genetics. The prognosis can be excellent, good, fair, poor or questionable depending on the number of risk factors present and their severity. Overall prognosis influences the prognosis of individual teeth.
This presentation focusses on definition, history, goals and objectives of SPT, patient compliance, ways to improve patient's compliance, parts of SPT, SPT in daily practice, classification of post treatment patients, AAP Guidelines for periodontist and dentist and studies related to SPT.
classification of periodontal diseasesneeti shinde
The document provides an overview of the historical development of classification systems for periodontal diseases from the 1870s to present. It discusses early systems based on clinical characteristics and concepts of classical pathology and the current dominant paradigm of periodontal diseases having an infectious etiology. The American Academy of Periodontology classification from 1999 is summarized, categorizing diseases as gingival diseases, chronic periodontitis, aggressive periodontitis, periodontitis as a manifestation of systemic diseases, and necrotizing periodontal diseases.
This document discusses the historical development of classifications of periodontal diseases from the 18th century to present. It covers early classifications based on clinical features, the paradigm of inflammatory vs non-inflammatory forms in the 1920-1970s, and more recent classifications under the infection/host response paradigm from the 1970s onward. A key development was the 1999 international classification agreeing on separate categories for gingival diseases and replacing early terms with chronic periodontitis and aggressive periodontitis.
This document discusses prognosis in periodontics. It begins by defining prognosis and distinguishing it from related terms. It describes different types of prognoses, such as short-term versus long-term, and classifications like good, fair, poor, and hopeless. The document outlines factors that determine prognosis, including overall clinical factors, local anatomic factors, systemic/environmental factors, and restorative factors. Specific examples like age, disease severity, plaque control, smoking, and furcation involvement are provided. The relationship between diagnosis and prognosis is also addressed.
Scaling and root planing (SRP) is a non-surgical treatment for periodontitis that aims to remove dental plaque and calculus from tooth surfaces. It involves scaling to remove deposits and root planing to smooth root surfaces. The goals are to eliminate periodontitis by removing irritants and restoring a healthy environment for tissue healing. The long-term effectiveness depends on factors like patient compliance, disease severity, and anatomical challenges. Overhanging restorations can interfere with cleaning and disturb the ecological balance, allowing disease-causing bacteria to proliferate.
The document discusses the determination of prognosis and phases of periodontal treatment. It defines prognosis as a prediction of the probable course and outcome of a disease based on knowledge of pathogenesis and risk factors. Prognosis is determined by specific disease information and treatment options, and can be influenced by clinical experience. Prognosis is re-evaluated over time. Factors like attachment loss, furcation involvement, tooth mobility, and patient compliance impact the prognosis, which can be good, fair, poor, or questionable. Periodontal treatment involves preliminary, nonsurgical, surgical, restorative, and maintenance phases to eliminate etiological factors, control disease, and stabilize the periodontal condition. The response to initial therapy further informs the accuracy
classification of periodontal diseases-includes 2017Missri Ya
This document provides an overview of the historical development and changes to classification systems for periodontal diseases. It discusses the three main paradigms that have influenced classification: the clinical characteristics paradigm from 1870-1920, the classical pathology paradigm from 1920-1970, and the infection/host response paradigm from 1970 to present. The document reviews several influential classification systems and the paradigm each was based on. It also discusses the ongoing challenges in classifying periodontal diseases as understanding of the diseases continues to evolve.
Periodontitis is a chronic, slowly progressing disease which mainly results in the destruction of tooth supporting apparatus. Earlier it was classified as Chronic and Aggressive periodontitis with different clinical features and etiology. Current classification ( 2017) of periodontal disease involves periodontitis with is further divided into 4 stages and 3 grades depending on severity and rate of disease progression respectively. Diabetes meelitus and smoking are the validated risk factors for the progression of periodontitis.
This document provides classifications for various conditions affecting the periodontium, including:
- Gingival diseases such as dental plaque-induced and non-plaque induced gingivitis.
- Periodontitis, which is further classified into necrotizing periodontitis, periodontitis as a manifestation of systemic diseases, and other forms.
- Other conditions like periodontal abscesses, endo-peridontal lesions, mucogingival deformities, traumatic occlusal forces, and teeth/prosthesis factors.
It also defines terms like peri-implant mucositis and peri-implantitis, and discusses factors associated with soft and hard tissue deficiencies around dental
This document discusses prognosis in periodontal disease. It defines prognosis as the prediction of the course and outcome of a disease based on general knowledge of pathogenesis and risk factors. Prognosis is classified on a scale from excellent to hopeless based on factors like bone loss, patient cooperation, and systemic conditions. Key prognostic factors include disease severity, plaque control, smoking, diabetes, genetic factors, tooth mobility, furcation involvement, and anatomic abnormalities. A favorable prognosis indicates periodontal stability with treatment, while an unfavorable prognosis means further breakdown is likely despite therapy. Prognosis for gingivitis is generally good if plaque is controlled, while prognosis for periodontitis depends on the severity and controllability of local and
This meta-analysis examined the influence of smoking on dental implant failure. The authors analyzed 19 relevant studies comprising over 10,000 implants. They found that smokers had over twice the odds of implant failure compared to non-smokers. Specifically, implants in the maxillary arch of smokers had over twice the odds of failure, while implants in the mandibular arch did not show a significant increased risk from smoking. This study revealed a significant relationship between smoking and risk of dental implant failure, particularly for implants located in the maxillary arch.
Systemic And Local Factors Contributing to Peri-implantitis (Research Proposal)Dr. Mohammad Alhomsi
This research proposal examines systemic and local risk factors that may contribute to peri-implantitis. The study will retrospectively analyze data from 1000 patients with dental implants to identify correlations between peri-implantitis diagnosis and factors like age, general health, diabetes, smoking, bone quality, radiation therapy, and periodontal health. A retrospective cohort study design is proposed, possibly modified with a case control and cross-sectional qualitative approach. Statistical analysis will compare incidence and prevalence of peri-implantitis between groups to determine the strongest risk factors. The results aim to further understand peri-implantitis etiology and suggest preventive and treatment strategies.
1. daignostic process and history 11-2-2014Soliman Ouda
This document outlines the course contents and assessment for an Oral Diagnosis course. It discusses the diagnostic sequence used in oral diagnosis, which involves 8 steps: 1) detecting abnormalities, 2) taking a patient history and doing an exam, 3) reexamining, 4) classifying abnormalities, 5) listing possible diagnoses, 6) developing a differential diagnosis, 7) determining a working diagnosis, and 8) making a final diagnosis. The goal is to systematically gather information to identify oral conditions and formulate an appropriate treatment plan.
2017 classification of periodontal and periimplant diseasesDr. Bibina George
The document summarizes the key changes in the 2017 classification of periodontal and peri-implant diseases compared to the 1999 classification. The 2017 classification introduces staging and grading systems for periodontitis to indicate disease severity and risk of progression. It also includes classifications for peri-implant health, mucositis, and implantitis, as well as mucogingival deformities. The document reviews these changes and provides references for the revised classification system.
This document outlines a proposed new classification scheme for periodontal and peri-implant diseases and conditions. It discusses the need to update the 1999 classification scheme and develop a similar scheme for peri-implant diseases to align with current understanding. Key areas covered include definitions of periodontal health, gingivitis, and periodontitis at both the patient and site levels. Factors that determine the development and severity of gingivitis are summarized. Diagnostic criteria for gingivitis and approaches to classifying mild, moderate, and severe cases are discussed. The document also addresses non-dental plaque induced gingival conditions and future research needs.
Classification of diseases and conditions affecting the periodontiumPeriowiki.com
The document discusses the historical development of classification systems for periodontal diseases from the 1870s to present. It describes the three dominant paradigms that influenced classification: the clinical characteristics paradigm from 1870-1920 which based classifications on observable symptoms; the classical pathology paradigm from 1920-1970 which considered the pathological changes; and the current infection/host response paradigm since 1970 which considers the roles of infection and the body's response. It provides details on influential classification systems under each paradigm.
Periodontal disease results from a complex interplay between subgingival biofilm and the host immune-inflammatory response. While several bacteria are found in periodontal pockets, no single organism causes the disease. The pathogenesis involves the host response to the bacterial challenge, which can remain at a low, asymptomatic level or progress to tissue destruction if left unchecked. Understanding these disease processes is important for developing improved treatment strategies.
The document discusses factors that determine the prognosis of periodontal disease and dental treatment. It identifies local factors like plaque, calculus and tooth anatomy as well as systemic factors like smoking and genetics. The prognosis can be excellent, good, fair, poor or questionable depending on the number of risk factors present and their severity. Overall prognosis influences the prognosis of individual teeth.
This presentation focusses on definition, history, goals and objectives of SPT, patient compliance, ways to improve patient's compliance, parts of SPT, SPT in daily practice, classification of post treatment patients, AAP Guidelines for periodontist and dentist and studies related to SPT.
classification of periodontal diseasesneeti shinde
The document provides an overview of the historical development of classification systems for periodontal diseases from the 1870s to present. It discusses early systems based on clinical characteristics and concepts of classical pathology and the current dominant paradigm of periodontal diseases having an infectious etiology. The American Academy of Periodontology classification from 1999 is summarized, categorizing diseases as gingival diseases, chronic periodontitis, aggressive periodontitis, periodontitis as a manifestation of systemic diseases, and necrotizing periodontal diseases.
This document discusses the historical development of classifications of periodontal diseases from the 18th century to present. It covers early classifications based on clinical features, the paradigm of inflammatory vs non-inflammatory forms in the 1920-1970s, and more recent classifications under the infection/host response paradigm from the 1970s onward. A key development was the 1999 international classification agreeing on separate categories for gingival diseases and replacing early terms with chronic periodontitis and aggressive periodontitis.
This document discusses prognosis in periodontics. It begins by defining prognosis and distinguishing it from related terms. It describes different types of prognoses, such as short-term versus long-term, and classifications like good, fair, poor, and hopeless. The document outlines factors that determine prognosis, including overall clinical factors, local anatomic factors, systemic/environmental factors, and restorative factors. Specific examples like age, disease severity, plaque control, smoking, and furcation involvement are provided. The relationship between diagnosis and prognosis is also addressed.
Scaling and root planing (SRP) is a non-surgical treatment for periodontitis that aims to remove dental plaque and calculus from tooth surfaces. It involves scaling to remove deposits and root planing to smooth root surfaces. The goals are to eliminate periodontitis by removing irritants and restoring a healthy environment for tissue healing. The long-term effectiveness depends on factors like patient compliance, disease severity, and anatomical challenges. Overhanging restorations can interfere with cleaning and disturb the ecological balance, allowing disease-causing bacteria to proliferate.
The document discusses the determination of prognosis and phases of periodontal treatment. It defines prognosis as a prediction of the probable course and outcome of a disease based on knowledge of pathogenesis and risk factors. Prognosis is determined by specific disease information and treatment options, and can be influenced by clinical experience. Prognosis is re-evaluated over time. Factors like attachment loss, furcation involvement, tooth mobility, and patient compliance impact the prognosis, which can be good, fair, poor, or questionable. Periodontal treatment involves preliminary, nonsurgical, surgical, restorative, and maintenance phases to eliminate etiological factors, control disease, and stabilize the periodontal condition. The response to initial therapy further informs the accuracy
classification of periodontal diseases-includes 2017Missri Ya
This document provides an overview of the historical development and changes to classification systems for periodontal diseases. It discusses the three main paradigms that have influenced classification: the clinical characteristics paradigm from 1870-1920, the classical pathology paradigm from 1920-1970, and the infection/host response paradigm from 1970 to present. The document reviews several influential classification systems and the paradigm each was based on. It also discusses the ongoing challenges in classifying periodontal diseases as understanding of the diseases continues to evolve.
Periodontitis is a chronic, slowly progressing disease which mainly results in the destruction of tooth supporting apparatus. Earlier it was classified as Chronic and Aggressive periodontitis with different clinical features and etiology. Current classification ( 2017) of periodontal disease involves periodontitis with is further divided into 4 stages and 3 grades depending on severity and rate of disease progression respectively. Diabetes meelitus and smoking are the validated risk factors for the progression of periodontitis.
This document provides classifications for various conditions affecting the periodontium, including:
- Gingival diseases such as dental plaque-induced and non-plaque induced gingivitis.
- Periodontitis, which is further classified into necrotizing periodontitis, periodontitis as a manifestation of systemic diseases, and other forms.
- Other conditions like periodontal abscesses, endo-peridontal lesions, mucogingival deformities, traumatic occlusal forces, and teeth/prosthesis factors.
It also defines terms like peri-implant mucositis and peri-implantitis, and discusses factors associated with soft and hard tissue deficiencies around dental
This document discusses prognosis in periodontal disease. It defines prognosis as the prediction of the course and outcome of a disease based on general knowledge of pathogenesis and risk factors. Prognosis is classified on a scale from excellent to hopeless based on factors like bone loss, patient cooperation, and systemic conditions. Key prognostic factors include disease severity, plaque control, smoking, diabetes, genetic factors, tooth mobility, furcation involvement, and anatomic abnormalities. A favorable prognosis indicates periodontal stability with treatment, while an unfavorable prognosis means further breakdown is likely despite therapy. Prognosis for gingivitis is generally good if plaque is controlled, while prognosis for periodontitis depends on the severity and controllability of local and
This meta-analysis examined the influence of smoking on dental implant failure. The authors analyzed 19 relevant studies comprising over 10,000 implants. They found that smokers had over twice the odds of implant failure compared to non-smokers. Specifically, implants in the maxillary arch of smokers had over twice the odds of failure, while implants in the mandibular arch did not show a significant increased risk from smoking. This study revealed a significant relationship between smoking and risk of dental implant failure, particularly for implants located in the maxillary arch.
Systemic And Local Factors Contributing to Peri-implantitis (Research Proposal)Dr. Mohammad Alhomsi
This research proposal examines systemic and local risk factors that may contribute to peri-implantitis. The study will retrospectively analyze data from 1000 patients with dental implants to identify correlations between peri-implantitis diagnosis and factors like age, general health, diabetes, smoking, bone quality, radiation therapy, and periodontal health. A retrospective cohort study design is proposed, possibly modified with a case control and cross-sectional qualitative approach. Statistical analysis will compare incidence and prevalence of peri-implantitis between groups to determine the strongest risk factors. The results aim to further understand peri-implantitis etiology and suggest preventive and treatment strategies.
The effect of cigarette smoking and native bone heigthBerenice Gomes
This study examined the effect of cigarette smoking and residual native bone height on the survival of dental implants placed immediately in grafted sinuses. The study reviewed records of 75 patients who received 155 implants. Implant survival rates after 12 months were significantly lower for smokers (79%) compared to non-smokers (87%). Analysis also showed smoking had a more significant negative effect on implant survival when the preoperative bone height was less than 4 mm, with survival rates of 82.4% for non-smokers and 60% for smokers. The study concludes smoking should be considered a high risk factor for implants placed immediately in grafted sinuses, especially in areas of limited bone height.
1. Dental implant risk assessment involves evaluating local, systemic, and behavioral factors that may increase the risk of implant failure.
2. A comprehensive risk assessment includes taking a thorough medical and dental history, and performing a complete intraoral examination to identify any variables that could complicate implant treatment or survival.
3. The goal of risk assessment is to avoid high failure rates by determining suitable implant candidates, identifying issues that may impact osseointegration or long-term maintenance, and minimizing future problems.
Bone quality and quantity are important factors for successful implant treatment. Poor bone quality is more prevalent in the posterior maxilla. Smoking and diabetes can negatively impact bone density and healing around implants. Complications of implants include surgical risks, implant loss, bone loss, soft tissue issues, mechanical problems, and esthetic concerns. Failure rates are higher for shorter implants, in lower quality bone, and for smokers and diabetics. Implants should be removed if they cause pain, mobility, uncontrolled bone loss, or cannot be restored. Maintaining good glycemic control is important for diabetics undergoing implant treatment.
The document discusses various factors that can contribute to dental implant failures, including host factors like poor medical health, smoking, bruxism, and poor oral hygiene; surgical factors like trauma during surgery; and implant selection factors like bone quality. It provides definitions for different types of implant failures and lists criteria for determining implant success. The classifications, predictors, warning signs, and ways to enhance outcomes with implants are also examined.
The document discusses dental implants, including their classification, geometry, surfaces, and interfaces with bone and soft tissue. It covers implant design categories like endosseous, subperiosteal, and transmandibular implants. The stages of bone healing and osseointegration are described, from initial woven bone formation to remodeling of bone structure and quality over time to adapt to loads. A healthy peri-implant soft tissue interface features firm, keratinized mucosa and microscopic junctional epithelium similar to that around natural teeth.
Dental implants can be used to support crowns, bridges, or dentures for patients who are missing one or more teeth. There are several types of implants based on placement location and material. Implant surgery involves placing the implant fixture into the jawbone, with some procedures allowing the implant to heal below gum tissue or protruding above gum tissue. Regular dental visits are needed after implant placement to monitor bone and soft tissue health around the implants.
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professionals who wish to advance in their dental practice,Offers certified
courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,
Prosthetic Dentistry, Periodontics and General Dentistry.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
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The document discusses dental implant treatment planning and considerations. It notes that proper diagnosis, history taking, treatment planning, investigations, biomechanical factors and system requirements are important. Key factors in treatment planning include a patient's oral hygiene, medical conditions, dental condition, occlusion, age and finances. Clinical, radiographic and laboratory investigations are outlined. Guidelines are provided for optimal implant positioning and limitations on cantilevers and adjacent pontics. Risk factors for implant failure and the influence of implant diameter and length on stress distribution are examined through studies. All-on-4 treatment is discussed and a study shows three implant restorations may not adequately support occlusal loads while four implants with a 10mm cantilever can properly resist loading
Management of impacted teeth /certified fixed orthodontic courses by Indian d...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078
prevention of peri implant disease 8.pdfmlhdakafera
The document discusses prevention of peri-implant disease by identifying risk factors and proper maintenance. It identifies factors such as a history of periodontal disease, lack of maintenance therapy, smoking, diabetes, incorrect implant positioning, excess cement, and improper prosthetic design as increasing the risk of peri-implantitis. Regular cleaning using non-abrasive tools and polishes as well as a soft toothbrush are recommended for implant maintenance to prevent plaque buildup and bone loss.
Combined orthodontic and prosthetic therapy special considerations.(52)Abu-Hussein Muhamad
Agenesis, the absence of permanent teeth, is a common occurrence among dental patients. The total incidence of tooth agenesis is about 4.2% among patients that are seeking orthodontic treatment and with the exception of third molars, the maxillary lateral incisors are the most common congenitally missing teeth with about a 2% incidence. The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisor using dental implants. The paper discusses the aspects of pre-prosthetic orthodontic diagnosis and the treatment that needs to be considered with conservative and fixed prosthetic replacement.
failures of dental implants /certified fixed orthodontic courses by Indian de...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Orthodontic Procedures after Trauma, Injuries to Permanent DentitionKaruna Sawhney
This document summarizes orthodontic procedures that can be used after dental trauma. It discusses primary, secondary, and tertiary care after trauma and how orthodontics can be an adjunct to post-trauma treatment. Primary treatment involves urgent care like repositioning displaced teeth. Secondary treatment includes monitoring healing and using orthodontics to treat displaced teeth. Preventive orthodontics is not recommended to reduce trauma risk, but mouthguards are an effective prevention method, especially for those with increased overjet.
This case report describes the endo-surgical management of a large radicular cyst in the maxillary anterior region that had completely resorbed the maxillary nasal floor. After non-surgical root canal treatment of teeth 11 and 12, surgical enucleation of the cyst was performed, followed by apicoectomy and retrograde filling of the root canals with mineral trioxide aggregate. The cyst had extended supero-posteriorly into the maxilla and nasal cavity. Complete removal of the cyst was achieved while preserving surrounding structures. Post-operative healing was uneventful. This case demonstrates the effective treatment of a large cyst using a combined nonsurgical endodontic and surgical approach.
This document reviews potential complications that can arise from dental implant placement and treatment. It discusses common complications such as screw loosening, implant displacement, nerve injury, cortical plate perforation, and peri-implantitis. The review aims to highlight challenges related to treatment planning, patient anatomy, and surgical procedures. Proper training and planning are necessary to avoid complications, but clinicians should also be prepared to manage any complications that do occur. Overall knowledge of potential implant complications and their treatment is important in providing successful implant therapy.
This document reports on a case study of the surgical removal of 38 odontomes from the palatomaxillary area of a 9-year old patient. Odontomes are benign odontogenic tumors composed of dental hard tissues. The patient presented with delayed tooth eruption and radiographs revealed multiple radiopaque structures in the palatomaxillary area. Under local anesthesia, a triangular flap was elevated to expose the lesion and 38 odontomes were surgically removed. The area was irrigated and closed. The patient had no further issues at follow up. Odontomes are generally asymptomatic but can cause complications if left untreated due to their potential for growth and associated tooth impaction.
The document discusses risk assessment for dental implant treatment. It finds that poor oral hygiene, a history of periodontitis, and cigarette smoking are strong risk indicators for peri-implant disease based on evidence from experimental and clinical studies. Future prospective studies are still needed to confirm these factors as true risk factors. The review also identifies that probing depth, bleeding on probing, and suppuration should be regularly assessed to diagnose peri-implant diseases, and radiographs are required to evaluate bone levels around implants.
Management of Congenitally Missing Lateral Incisors with Orthodontics and Sin...Abu-Hussein Muhamad
This case report describes the management of a congenitally missing maxillary lateral incisor using an interdisciplinary approach involving orthodontics, bone grafting, dental implant placement, and prosthodontics. Specifically, orthodontic treatment was used to create sufficient space between the central incisor and canine for an implant. A bone graft was then used to augment the alveolar ridge prior to placing a dental implant. After osseointegration, a crown was placed on the implant to replace the missing lateral incisor. Follow up after one year showed successful treatment outcomes with good esthetics, function, and periodontal health.
This study evaluated the relationship between maxillary third molars and the maxillary sinus based on an analysis of 864 orthopantomograms. The proximity was categorized into three classes based on the amount of bone separating the root and sinus: Class I had 2+ mm bone, Class II had 0-2 mm bone, and Class III had roots within the sinus. The study found that Class II, with 0-2 mm of bone, was the most common relationship seen in both males and females. Roots present within the sinus (Class III) were most frequently observed in patients in their second and third decades of life. The findings provide information on maxillary third molar-sinus relationships that can aid treatment planning and the
This document discusses how technology can be used to improve endodontic treatment and restorations. It describes how a dental operating microscope, cone beam computed tomography (CBCT), and CAD/CAM technology allow dentists to perform endodontic treatment and place a restoration in a single visit. The microscope enhances visibility during root canal treatment, while CBCT provides additional diagnostic information. CAD/CAM technology enables same-day fabrication of ceramic restorations with digital impressions. The document provides examples of cases where these technologies were used together from initial endodontic treatment through final restoration.
In 1989, Shetty and Freymiller [7] reviewed indications for removal of teeth in the line of fracture. They recommended the following indications:
1. Significant periodontal disease with gross mobility and periapical pathology
2. Partially erupted third molars with pericoronitis or cystic areas
3. Teeth preventing the reduction of fractures
4. Teeth with fractured roots
5. Teeth with exposed root apices or teeth in which the entire root surface from the apex to the gingival margin is exposed
6. Excessive delay from the time of fracture to the time of definitive treatment
In addition to these indications, another indication that requires extraction of teeth in the line of fracture is an acute, recurring abscess at the site of the fracture despite antibiotic therapy(8)
This document summarizes the management of dentoalveolar fractures. It begins by classifying different types of dentoalveolar injuries including injuries to the tooth crown and root, periodontium, and bone. It then discusses the initial assessment and management of different injury types such as concussion, subluxation, extrusive luxation, and avulsion. Management may include repositioning displaced teeth, splinting, antibiotics, and endodontic treatment. Factors like dry time, stage of root development, and splinting time are considered. Alveolar fractures can require open or closed reduction and fixation depending on severity. Prompt diagnosis and treatment of dentoalveolar injuries is important to achieve
The document summarizes complications that can occur with dental implants made of titanium or zirconium. Titanium abutments show less screw loosening than zirconium abutments. Screw loosening is one of the most common mechanical complications and can lead to bacterial infection. Implant fracture is rare but can be caused by defects, overload from bruxism or large forces, or small implant diameter. Peri-implantitis is inflammatory disease around implants that develops over 5 years due to bacterial imbalance. Prevention focuses on proper planning, reducing parafunctional habits, and minimizing cantilevers and occlusal forces.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 31st publication IJAR 1st name
Diagnosis, treatment planning and radiographic evaluation/ cosmetic dentistry...Indian dental academy
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Dr. Amr Saad presents on impression techniques and laboratory procedures in implant dentistry. Implant dentistry replaces missing teeth with artificial tooth roots (implants) that are surgically placed in the jawbone. Successful rehabilitation requires taking accurate impressions of the implant positions and transferring this information to dental laboratories to create functional and aesthetic restorations. Dr. Saad discusses different impression techniques and components, including impression posts, analogues, and trays. He emphasizes the importance of collaboration between dentists and dental technicians for optimal implant treatment outcomes.
This document describes various dental implant components and prosthetics made by Oraltronics, including posts, gingiva formers, bars, balls, and attachments that allow for individualized solutions. It highlights features like different angulations, heights, materials, and designs to compensate for divergencies and provide optimal esthetics and function. Many of the components can be customized during the wax-up process prior to casting.
Wilhelm Roentgen discovered X-rays in 1895 while experimenting with cathode ray tubes. He found that photographic plates were sensitive to these new rays, which he called X-rays. In one experiment, he placed his wife's hand on a photographic plate and saw the bones and rings on her finger clearly after developing the image. Since then, specialized radiography techniques have been developed like panoramic radiography, CT, MRI, and CBCT to provide detailed cross-sectional views of anatomy for diagnostic purposes like dental implant planning. Diagnostic templates can also be used to incorporate proposed treatment plans into radiographic exams.
The document discusses different types of anchorage used in orthodontic treatment, including direct and indirect anchorage. Direct anchorage involves connecting mini-implants directly to the dental units to be moved using compression or tension springs. Indirect anchorage uses mini-implants to anchor other orthodontic appliances. The document also discusses using mini-implant anchorage for rapid palatal expansion and replacing missing teeth as anchorage units.
Maxillary sinus septa are common anatomical structures that can be detected through CT scans but not reliably through panoramic radiographs. When performing sinus elevation or grafting procedures, the Schneiderian membrane lining the maxillary sinus may occasionally perforate. In these cases, resorbable membranes can be used to cover any perforations.
This document discusses various implant components including implant fixtures, abutments, healing abutments, impression copings, and implant analogs. It notes implant fixtures can have tapered or parallel designs and be one or two pieces. Connection designs can be external or internal. The document also lists various super structure components like cover screws.
The document describes several anatomical landmarks of the maxilla and mandible that are visible on dental radiographs. Key maxillary landmarks include the median palatine suture, nasal fossa, nasal septum, anterior nasal spine, incisive foramen, maxillary sinus, malar bone, maxillary tuberosity, hamular process, and nasolacrimal duct. Mandibular landmarks include the lingual foramen, genial tubercles, mental ridge, mental foramen, mental fossa, external and internal oblique lines, mylohyoid line, mandibular foramen, inferior dental canal, and submandibular gland fossa. These landmarks appear as radiopaque or
This document discusses important anatomical structures to consider when placing dental implants, including the inferior alveolar canal, mental foramen, incisive foramen, maxillary sinus, and interdental spaces. It recommends using cross-sectional imaging to assess bone dimensions and distances from structures like the inferior alveolar canal. Shorter implants may be used when vertical bone is compromised. Safety zones of 1-2mm from structures like the mental foramen are advised. The size and location of the incisive papilla must also be determined for maxillary anterior implants.
3. . Bad oral hygiene
. Bad habits (clenching , nail biting …etc)
. Smoking
. Diabetes
. Osteoporosis
. Hormonal disorders
. Radiation therapy
. Chemo therapy
Dr. Amr Saad
4. It is the evaluation of all circumstances that
can affect the outcome of a therapeutic
intervention.
In the case of dental implants the
assessment is to identify variables that
increase the risk of complications leading to
implant loss.
Dr. Amr Saad
5. Risk assessment should be performed:
1) Before placement of implants (designed to
avoid high failure rates by identifying suitable
candidates for implant treatment).
2) During the phase of implant placement and
osseointegration (designed to identify and
avoid technical issues that can affect implant
survival).
Dr. Amr Saad
6. 3) During the phase of implant maintenance
(designed to minimize failure by heading
off problems).
4) After an implant has failed and been
removed ( to identify the causes of failure )
.
Dr. Amr Saad
7. It is an environmental, behavioral, or
biological factor.
If present directly increases the
probability of a disease occurring and, if
absent or removed, reduces that
probability.
Dr. Amr Saad
8. In the case of risk assessment for implant
failure, risk factors can be broadly
categorized as
1) Local risk factors.
2) Systemic risk factors.
3) Behavioral risk factors.
Dr. Amr Saad
9. 1. Taking thorough medical/dental histories.
2. Complete examination of the prospective
candidate for dental implants.
Dr. Amr Saad
10. A comprehensive evaluation of the patient
should contain a review of past dental
history including:
1) Earlier periodontal treatment.
2) Reasons for tooth loss.
3) How extraction sockets were treated at the
time of extraction.
4) History of increased susceptibility to
infection.
Dr. Amr Saad
11. 5) Awareness of parafunctional habits such
as clenching and grinding.
6) Evaluation of the patient’s socioeconomic
status.
7) Dissatisfaction with earlier dental
treatment may indicate an increased risk
for complications during implant therapy.
The comprehensive medical history should
include past and present medications and
any substance abuse.
Dr. Amr Saad
12. A complete intraoral examination should be
performed to determine the feasibility of placing
implants in desired locations.
This examination includes:
1. Oral hygiene status.
2. Periodontal status.
3. Jaw relationships.
4. Occlusion.
5. Signs of bruxism.
6. Temporomandibular joint conditions.
Dr. Amr Saad
13. 7. Endodontic lesions.
8. Status of existing restorations.
9. Presence of non-restored caries.
10. Crown-root ratio.
11. Interocclusal space.
12. Available space for implants.
13. Ridge morphology.
14. Soft and hard tissue conditions.
15. Prosthetic restorability.
Dr. Amr Saad
14. Radiographic evaluation of the
quality and quantity of available bone
is required in order to determine the
optimal site(s) for implant placement.
Dr. Amr Saad
15. 1. Periapical radiographs.
2. Panoramic projections.
3. Cross-sectional tomographic images give
accurate estimation of bone height and
width.
Dr. Amr Saad
16. A comprehensive radiographic evaluation
minimizes the risk of injuring vital
anatomic structures during the surgical
procedure and is also helpful in
determining which cases require bone
augmentation surgery before implants can
be placed.
Dr. Amr Saad
17. An evaluation of the quality and quantity
of peri-implant soft tissues at the
proposed implant site will help determine
how closely this tissue will mimic the
appearance of gingival tissue once the
implant has been inserted.
Dr. Amr Saad
18. The presence of keratinized mucosa around
a dental implant is an important part of an
esthetically successful dental implant.
It is important to evaluate the patient’s
perception of esthetics prior to implant
placement especially in situations with
compromised hard and soft tissues.
Dr. Amr Saad
19. Diagnostic casts and intraoral photographs
can be helpful in evaluating potential esthetic
outcomes as well as in the overall treatment-
planning process.
In general, to minimize the risk of implant
complications and failure, any diseases of
the soft or hard oral tissues should be
treated before implant therapy.
Dr. Amr Saad
20. Poor oral hygiene and microbial biofilms are
important etiologic factors leading to the
development of peri-implant infections and
implant loss.
Dr. Amr Saad
21. There are several reasons to believe that
untreated or incompletely treated
periodontitis increases the risk for implant
failure.
1) There are case reports that suggest an
association (Malmstrom et al. 1990,
Fardal et al. 1999)
Dr. Amr Saad
22. 2) A similar subgingival microbiota has
been found in pockets around teeth and
implants with similar probing depths.
3) Evidence exists that periodontal
pockets might serve as reservoirs of
pathogens that hypothetically can be
transmitted from teeth to implants.
Dr. Amr Saad
23. Subgingival sites are the natural or preferred
habitat of a diverse group of oral
microorganisms.
In an interesting study of 15 patients, Devides
and Franco (2006) sampled mucosa-associated
biofilms of edentulous sites with paper points
and analyzed the specimens using polymerase
chain reaction (PCR) methods to detect certain
periodontal pathogens.
Dr. Amr Saad
24. At the edentulous sites Aggregatibacter
actinomycetemcomitans was detected in 13.3% of
subjects, Prevotella intermedia was detected in
46.7% of subjects, and Prophyromonas gingivalis
was not detected.
Six months after placement of endosteal implants
at the same sites, subgingival plaque samples
taken from around the implants were positive for
A. actinomycetemcomitans in 73.3% of subjects,
Pr. Intermedia in 53.3% of subjects, and P.
gingivatis in 53.3% of subjects.
Dr. Amr Saad
25. None of the implants showed any clinical
signs of either failure or peri-implantitis.
These results indicate that healthy
subgingival sites around implants are
readily colonized by periodontal
pathogens without any development of
clinically detectable disease.
Dr. Amr Saad
26. It is important to remember that the
microbiota adjacent to failing implants will
differ depending on the cause of the failure.
For example, the microbiota associated with
implants failing because of traumatic loads
was different to that found around implants
failing because of infection.
Dr. Amr Saad
27. There are several reports that the survival
rate of implants is decreased when the
patient has a history of periodontitis.
Patients who have had periodontitis might
also be more susceptible to peri-implant
infections.
Dr. Amr Saad
29. It is clear that implants can be quite
successful when placed in patients who are
in their eighth and ninth decades of life.
Several reports indicate that there is not a
statistically significant relationship between
age of the patient and implant failure.
Dr. Amr Saad
30. A potential problem associated with the
placement of dental implants in still-growing
children and adolescents is the possibility of
interfering with growth patterns of the jaws.
Osseointegrated implants in growing jaws
behave like ankylosed teeth in that they do
not erupt and the surrounding alveolar
housing remains underdeveloped.
Dr. Amr Saad
31. It is highly recommended that implants
not be placed until craniofacial growth
has almost complete.
14-15 years in females
17 years in males
Dr. Amr Saad
32. Cigarette smoking is often identified as a
statistically significant risk factor for implant
failure.
The reasons that smokers are more
susceptible to both periodontitis and peri-
implantitis, but usually involve impairment of
innate and adaptive immune responses and
interference with wound healing.
Dr. Amr Saad
34. Smoking is such a strong risk factor for
implant failure that some clinicians
highly recommend smoking-cessation
protocols as part of the treatment plan
for implant patients.
Dr. Amr Saad
35. Bisphosphonates are drugs used for the
treatment of osteoporosis.
These drugs are potent inhibitors of osteoclast
activaty (apoptosis) , have a high affinity for
hydroxyapatite and have a very long half-life.
Dr. Amr Saad
36. An uncommon complication associated with
the use of bisphosphonates is the increased
risk of developing osteonecrosis of the jaws
(ONJ) after implant placement.
In general, it is not recommended that
implants be placed in patients who have
been on the drug for more than 3 years.
Dr. Amr Saad
37. Gingival enlargement has been reported
around dental implants in individuals taking
either phenytoin or a calcium-channel
antagonist.
Dr. Amr Saad
38. It has been reported that some cancer
patients who had received cytotoxic
antineoplastic drugs experienced
infections around existing transmucosal or
endosteal dental implants (Karr et al. 1992).
Dr. Amr Saad
39. Patients who are receiving cancer
chemotherapy should have thorough
periodontal and implant maintenance care to
minimize the development of adverse events.
Dr. Amr Saad
40. Patients who have blood-coagulation
disorders or are taking high doses of
anticoagulants are at an elevated risk of
post-operative bleeding problems after
implant surgery.
Dr. Amr Saad
41. Corticosteroids can interfere with wound
healing by blocking key inflammatory events
needed for satisfactory repair.
In addition, through their
immunosuppressive effects on lymphocytes,
they can increase the rate of post-operative
infections.
Dr. Amr Saad
42. In the early years of the AIDS epidemic
placement of dental implants was ill advised
since affected patients developed major life-
threatening oral infections.
With the advent of effective HAART (highly
active anti-retroviral therapy) regimens, most
HIV-positive patients who take their
medications live for many years without
developing Amr Saad
Dr. severe opportunistic infections.
43. Low T-helper (CD4) cell counts (i.e.<200/L)
do not appear to predict increased
susceptibility to intraoral wound infections or
elevated failure rates of dental implants
(Achong et al. 2006).
Although more studies are needed, it appears
that it is safe to place dental implants if the
patient’s HIV disease is under medical control.
Dr. Amr Saad
44. Patients who have received radiation to the
head and neck as part of the treatment for
malignancies are at an increased risk of
developing osteoradionecrosis (ORN).
Implant failure rates of up to 40% have been
reported in patients who have had a history of
radiation therapy.
Dr. Amr Saad
46. It has been recommended that oral surgical
procedures in patients at risk of ORN be
performed in conjunction with hyperbaric
oxygen (HBO) therapy.
From the perspective of risk- assessment
procedures for implant placement, patients
who have a history of irradiation to the jaws
should be considered at high risk or implant
failure and HBO interventions will probably
lower that risk.
Dr. Amr Saad
49. In the risk evaluation of diabetics it is
important to establish the level of
metabolic control over the last 90 days is a
blood test for glycosylated hemoglobin
(HbA1C).
Normal values for a non diabetic or a
diabetic under good metabolic control are
HbA1C 6-6.5%
Dr. Amr Saad
50. Diabetics with HbA1C values of ≥8% are
under poor control and have an elevated
risk of encountering wound healing
problems and infection if dental implants
are placed.
Dr. Amr Saad
51. Osteoporosis is a skeletal conditions
characterized by low bone mineral.
There are multiple case reports that
conclude that osteoporosis alone is not a
significant risk factor for implant failure (Dao
et al. 1993; Freiberg 1994; Fujimoto et
al.1996; Freiberg et al. 2001).
Dr. Amr Saad
52. Implants placed in individuals with
osteoporosis appear to successfully Osseo
integrate and can be retained for years.
However, in cases of secondary
osteoporosis there are often accompanying
illnesses or conditions that increase the risk
of implant failure (e.g. poorly controlled
diabetes mellitus, corticosteroid
medications).
Dr. Amr Saad
53. Long-term success of dental implants
requires that the patient is able to
comply with the recommended post-
insertion maintenance procedures
required for long-term survival and
success of implants.
Dr. Amr Saad
54. Since poor oral hygiene is a documented
risk factor associated with failure of
implants, it is critically important that
patients understand this and are taught
the skills necessary to perform plaque
removal on a daily basis.
Dr. Amr Saad
55. In addition, since patient-performed oral
hygiene does not adequately remove disrupt
dental plaque biofilms at subgingival
locations, periodic maintenance visits are
needed.
It is recommended that these visits be at 3-
month intervals.
The patient’s compliance with the
recommended maintenance schedule is a
major key to long-term success.
Dr. Amr Saad
56. Patients who have addictions to alcohol and
drugs are usually poor candidates for dental
implants.
Since the success of implant therapy
requires a considerable amount of patient
cooperation at all stages of care, individuals
with substance-abuse problems should
receive prosthetic care that does not
depend on implants.
Dr. Amr Saad
57. In general, Patients who have severe mental
health problems or exhibit psychotic
behavior are not good candidates for dental
implants.
The cooperation needed for successful
implant therapy is missing.
However, people with medically controlled
mental health problems, such as depression,
can be successfully treated with implants.
Dr. Amr Saad
58. It is important that the practitioner determine if
the information they tried to convey was
understood.
One of the best ways to do this is to convey the
information in easily understood (nontechnical)
language and in small increments.
Patients who understand what is being done are
usually quite cooperative and this cooperation
leads to the increased probability of successful
therapeutic outcomes.
Dr. Amr Saad
59. Daily self-care (oral hygiene) and
adherence to a maintenance-recall
schedule is absolutely required for long-
term success.
This is best discussed to the patient at the
consultation Saad
Dr. Amr visit.
60. An effective way to reduce the risk of
implant complications and failure is to
stress the importance of the patient’s
role as and active participant in the
overall therapeutic program.
Long-term success of both periodontal
and implant therapy depends on an
effective partnership between the patient
and practitioner.
Dr. Amr Saad
61. ASA Classification of Physical Status
P1: Normal, healthy patient
P2: Patient with mild systemic disease with no functional
limiltation,
ie, a patient with a significant disease that is under good day to
day control,
eg controlled hypertension, oral agents for DM, mild COPD
P3: Patient with severe systemic disease with definite functional
limitations, ie, patient who is concerned with their health
problems each day, eg. a
DM on Insulin, significant COPD
P4: patient with severe systemic disease that is constant threat to
life
P5: Moribund patient who is not expected to survive 24hrs
P6: Declared brain dead
Dr. Amr Saad
62. Post-operative infections increase the risk of
early implant failure.
It is important to perform implant surgeries
with a strict hygiene protocol to minimize
bacterial contamination of the surgcial site.
Dr. Amr Saad
63. The incidence of post-operative infection
associated with implant placement is only about
1% (Powell et al. 2005), some clinicians attempt
to reduce this risk by prescribing pre-operative
systemic antibiotics (Dent et al. 1997; Laskin et
al. 2000).
In addition, the results of several case-control
studies indicate that there is no advantage in
using antibiotics in conjunction with implant
placement (Gynther et al. 1998; Morris et al.
2004; Powell et al. 2005).
Dr. Amr Saad
64. Thermal damage to bone can be caused
during the drilling sequence if dull drills are
used or if osteotomy is performed without
using enough liquid coolant.
Dr. Amr Saad
66. In situations where there are less than
optimal bone conditions. (thin cortex, low
trabecular density), increased initial
stability have to be established
Dr. Amr Saad
67. Anatomic structures that are at risk of
damage during the placement of implants
include:
Nerves,
Blood vessels,
Floor of the mouth,
Nasal cavity, maxillary sinuses,
Adjacent teeth.
Dr. Amr Saad
68. 1. A Key part of implant therapy is the risk-
assessment process that includes thorough
medical and dental histories, a complete
clinical examination, and an appropriate
radiographic survey.
2. The presence of one risk factor alone is
usually insufficient to cause the adverse
outcome. It is the combination of multiple
risk factors that the has clinical importance.
Dr. Amr Saad
69. 3. To minimize the risk of implant complication
clinicians can use a number of technical
procedures, such as adhering to a strict
hygienic surgical protocol, performing the
osteotomies with sharp drills, achieving early
implant stability, and avoiding damage to vital
anatomic structures during surgery.
4. Any endodontic, periodontal, and other oral
infections be treated prior to implant
placement.
Dr. Amr Saad
70. 5. Existing evidence does not support the
routine use of pre-operative systemic
antibiotics in implant therapy.
6. Most of the systemic risk factors for implant
complications are those that increase the
patient’s susceptibility to infections or those
that interfere with wound healing.
Dr. Amr Saad