The checklist below is about Routine Assessment of Dental Implants.
Assess Implant Health
Soft and hard tissue
Successful Implant Debridement
Intrumentation options for the various implant suface materials
Establish Home Care Protocol
Options and considerations
Home care aids
Integrity of Prosthesis
Check 2 x per year maintenance appoinments
Check for lateral contact with articulating paper.
Include evaluation of prosthesis.
Check for fractures and cracks.
If visible, check for integrity of screws
Replace loose screws.
Place instrument under embrasures.
Apply gentle pressure.
Presence of mobility check with side to side movement.
Prosthetic mobility and component mobility.
Hard Tissue Assessment
Diagnostic, accurate radiograph
Able to see thread count
Crestal view is very important.
Titanium dental implants have been used very successfully for the last four decades. Implants have evolved in shape, size, design and materials. However with the popularity and widespread use of titanium and titanium alloys as dental implant materials, there has been a steady increase in patients having an immediate and in most cases developing delayed sensitivity to their dental implants.
For the last twenty years a variety of alternative materials have been utilized but with limited success in dentistry. Continue reading
Dentin graft is the advanced clinical concept based on materials science. We achieved the first autograft of demineralized dentin matrix (DDM) for the sinus graft in 2002. The bone inducing property of rabbit dentin was discovered in 1967 by Urist’s Group. However most dental doctors still don’t know the important evidences of dentin matrix. Biorecycle of patient own teeth is an attractive unique technique.
Dentin and bone are almost similar in chemical components. They consist of collagen (18%), non-collagenous proteins (2%), HAp (70%) and body fluid (10%) in weight volume. The matrix is a repository of BMPs, TGF-B, IGF and bFGF.
It’s often difficult to make a choice when confronted with a heavily compromised tooth. We are bombarded with information about the wonders of new composite resin, ceramic materials and techniques which suggest we can restore just about any type of defects. Conversely, we are also led to believe that implants can solve any problem, hence no need for restoration.
Here are some of the most vexing questions:
- Does the tooth need a root canal therapy and if RCT was done before?
- What should we look out for?
- Is there science behind claims of a dental material being more protective than another?
- Is crowning a tooth always benefecial?
- When is composite restoration an ideal treatment modality?
- How do I ensure success and longevity for the crowns I place for patients?
- How does occlusion play a role in the success of the treatment that I provide?
- How do I know if this tooth is even worth saving.
Today, the replacement of missing teeth with restorations anchored on endosseous dental implants is a standard treatment option in most dental practices and / or clinics. The number of dental implants placed worldwide is increasing every year. However, the increasing number of implants is accompanied by an increasing incidence of peri-implantitis, leading to the disintegration of a formerly successful osseointegrated dental implant.
The field of implant dentistry has expanded very rapidly in recent years, with the introduction of new materials, techniques and technology. Information is often contradictory and it is difficult to determine which treatment approach is the best for the patient.
The implant practitioner has a responsibility to ensure that the patient receives optimum functional and esthetic outcome from the treatment. In order to provide the highest standard of care, knowledge on identification of the degree of complexity and risks involved and application of evidence based appropriate treatment strategies is necessary.
Nowadays, with the growing acceptance of dental implant placement and restorations in daily practices, it is but natural to see more dentist caring for the longevity of these dental implants in their own dental clinics.
Truly dentistry now has been exciting and challenging with the increasing availability and accessibility of dental implants to many patients all around the world. Continue reading
The most important characteristic of dental implant is that the direct bone anchorage can support a free standing fixed denture. Dental implants in themselves, can support a denture and do not rely on atural abutment dentition for additional stabilization.
Dental implant treatment was originally designed for the edentulous patient to support a full arch denture using four to six fixtures. This type of full arch denture was called Toronto denture but better termed a fully bone anchored denture. Toronto denture are cantilevered through the second premolar areas.
With dental implant, the abutment to implant fixture junction corresponds to the cemento-enamel junction present in natural teeth. The peri-implant membrane is similar to that present in natural teeth, consisting of peri-implant freee gingiva which correspond to natural teeth free gingiva. In the peri-implant gingiva, the sulcular epithelium forms the peri-implant gingival crevice and junctional epitheliumn attaches to the abutment forming a cuff.
Periradicular surgery is commonly performed to remove a portion of the root with undebrided canal space or to retroseal the canal when a complete seal cannot be obtained with an orthograde (through the crown) approach. The main indications for periradicular surgery are (1) nonsurgical root canal therapy is unfeasible (2) retreatment of failed root canal therapy is impossible or would not produce a better result (3) biopsy is indicated.
Specifically, periapiacal surgery may be neccesary in the folowing situations: (a) anatomic problems (b) procedural accidents requiring surgery (c) irretrievable materials in the canal (d) persistent symptoms (e) horizontal root fractures with apical necroses (f) irretrievable material preventing canal treatment (g) procedural error during treatment (h) large unresolved lessions following root canal treatment.