The mainstream use of dental implants has allowed millions of patients to benefit from the predictability of dental implant therapy and, in many instances, dental implants have become the standard of care. Even though success rates in implant dentistry are well above 90 percent, complications do occur. Most complications are preventable with proper planning and execution. Others are inherent to the risks of surgery and may require intervention. The purpose of this paper is to classify the possible complications that may occur and to discuss their prevention and management.
The purpose of this article is to provide clinical recommendations for creating an esthetic restoration when utilizing an endosseous implant in the more demanding maxillary or mandibular anterior region of the mouth. The process attempts to correct alterations in form and function due to the undesirable effects of caries, periodontal infection or injury to the teeth and/ or their supporting tissues. Oftentimes, this requires an interdisciplinary approach that may be very delicate, involving the management of bone, soft tissue, and the design of the implant abutment and implant crown forms with carefully constructed physiologic contours. This article focuses on single implant-supported restorations that will have on influence on cosmesis of the esthetic region of the mouth.
Although the peri-implant hard tissue advantages of platform switching abutments have been well documented by many authors, the peri-implant soft tissue advantages of platform switching abutments has had limited mention. This article illustrates how the amount of peri-implant soft tissue volume is influenced by the dimensional extent of platform switching and the degree that an abutment's sulcular emergence profile has been modified. This article also introduces the term "abutment sulcular emergence profile enhancement" (ASEPE) to describe the combined effect of platform switching and abutment emergence profile modification. Three unrecognized clinical advantages of ASEPE are described by different clinical cases. First, elimination of excessive abutment impingement on gingival tissue adjacent to implants is achieved. Second, allowance for sufficient interproximal space between implant and adjacent tooth/implant for the entry of interproximal toothbrush is made possible. Third, excessive soft tissue blanching during abutment seating at prosthesis delivery is eliminated. Together, the combined application of platform switching and abutment emergence profile modification represents the opening of a new realm for managing soft tissue around implants to resolve dimensional problems.
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