Immediate implant placement and provisionalization of maxillary anterior single implants

An inevitable loss of soft and hard tissue after tooth extraction often results in a compromised site for anterior implant esthetics in both vertical and horizontal dimensions. Immediate implant placement and provisionalization has been a viable option for replacing failing maxillary anterior teeth as it preserves the vertical existing osseous and gingival architecture. With the simultaneous addition of soft‐ and hard‐tissue grafts, the peri‐implant horizontal tissue topography can also be maintained. The esthetic success of immediate implant placement and provisionalization procedures is influenced by a number of factors that can be identified as patient‐dependent or clinician‐dependent. This article describes in detail the process of patient selection, indications, contraindications, diagnosis, treatment planning and treatment execution required to achieve functional and esthetic success with immediate implant placement and provisionalization.     

Site development for anterior single implant esthetics: the dentulous site

An inevitable loss of soft and hard tissue after tooth extraction often results in a compromised site for anterior implant esthetics. Various augmentation techniques have been advocated as corrective procedures, but these techniques are time-consuming and not always predictable. Therefore, the fundamental concept of site development for anterior single implant esthetics in the event of a failing tooth is to preserve the existing gingival and osseous tissue. This article identifies factors that affect tissue changes and describes an integration of surgical and prosthodontic approaches that can optimize the tissue maintenance in the anterior esthetic zone.     

The Use of a Dental Surgical Microscope to Aid Retrieval of a Fractured Implant Abutment Screw: A Clinical Report

This clinical report outlines a method to retrieve a fractured implant abutment screw through the use of high‐power magnification and ultrasonic instrumentation. Furthermore, the use of manufacturer's specific components is highlighted to minimize occurrences of such clinical complications from arising.     

Computer-guided immediate provisionalization of anterior multiple adjacent implants: surgical and prosthodontic rationale.

Immediate implant restoration has gained popularity in recent years due in part to technological advancements that use computed tomographic images to simulate the actual clinical situation. This computer-assisted simulation enables clinicians to develop a comprehensive treatment plan that can be precisely executed in a timely manner. In the aesthetic zone, however, a successful outcome requires more than merely accurate implant placement. This article discusses the significance of site development for aesthetic implant restoration and describes a computer-guided immediate pro visionalization procedure and its surgical and prosthodontic rationale     

Interimplant papilla preservation in the esthetic zone: a report of six consecutive cases

Simultaneous removal of multiple adjacent teeth in the anterior maxilla often leads to collapse of the labial bony plate as well as flattening of the interproximal bony scallop, resulting in long implant restorations with missing interimplant papillae. An interimplant papilla preservation technique involving alternate immediate implant placement and provisionalization, one following the osseointegration healing period of the other, was introduced. All 14 implants placed in six consecutive patients maintained osseointegration after a mean functioning time of 22.6 months (range 12 to 34 months). A highly satisfactory esthetic outcome and a papilla index score of 3 was observed in all patients.     

Implants as absolute anchorage

Anchorage control is essential for successful orthodontic treatment. Each tooth has its own anchorage potential as well as propensity to move when force is applied. When teeth are used as anchorage, the untoward movements of the anchoring units may result in the prolonged treatment time, and unpredictable or less-than-ideal outcome. To maximize tooth-related anchorage, techniques such as differential torque, placing roots into the cortex of the bone, the use of various intraoral devices and/or extraoral appliances have been implemented. Implants, as they are in direct contact with bone, do not possess a periodontal ligament. As a result, they do not move when orthodontic/orthopedic force is applied, and therefore can be used as "absolute anchorage." This article describes different types of implants that have been used as orthodontic anchorage. Their clinical applications and limitations are also discussed.     

Clinical complications with implants and implant prostheses

The purpose of this article is to identify the types of complications that have been reported in conjunction with endosseous root form implants and associated implant prostheses. A Medline and an extensive hand search were performed on English-language publications beginning in 1981. The searches focused on publications that contained clinical data regarding success/failure/complications. The complications were divided into the following 6 categories: surgical, implant loss, bone loss, peri-implant soft tissue, mechanical, and esthetic/phonetic. The raw data were combined from multiple studies and means calculated to identify trends noted in the incidences of complications. The most common implant complications (those with a greater than a 15% incidence) were loosening of the overdenture retentive mechanism (33%), implant loss in irradiated maxillae (25%), hemorrhage-related complications (24%), resin veneer fracture with fixed partial dentures (22%), implant loss with maxillary overdentures (21%), overdentures needing to be relined (19%), implant loss in type IV bone (16%), and overdenture clip/attachment fracture (16%). It was not possible to calculate an overall complications incidence for implant prostheses because there were not multiple clinical studies that simultaneously evaluated all or most of the categories of complications. Although the implant data had to be obtained from different studies, they do indicate a trend toward a greater incidence of complications with implant prostheses than single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores.