This article discusses the "implant team" concept as it is actually carried out in an implantology practice. The restorative dentist is designated to function as the head of the team, directing each stage of the treatment. He is the first one the patient consults, he refers the patient to the surgeon, and he consults other specialists, if necessary. Excellent communication between the members of the team is stressed throughout.
The safety and efficacy of HA-coated screw-type titanium dental implants was studied in an 8-year retrospective study. The results show that HA-coating clearly decreases failure rates in the posterior mandible and the anterior and posterior maxilla.
Retrievability is the major advantage of screw-retained implant restorations compared to cement retention; however, implant screw loosening continues to be a frequently cited disadvantage of this technique. This paper describes the factors involved in maintaining a stable screw joint assembly by maximizing preload on the retaining screw while minimizing joint-separating forces. Practical clinical solutions to minimize this clinical problem are suggested. Readers are cautioned to address both the occlusal and biomechanical etiologies of screw loosening.
A protocol for implant dentistry is presented including preoperative and postoperative planning stages. The focus is on post-second-stage-surgery restoration, understanding the currently available dental components, and the communication between the surgeon, restorative dentist, and laboratory technician. Some of the common pitfalls that occur are discussed, and six key points are described.
The inevitable loss of alveolar bone following tooth loss deserves a prophylactic approach from the dental profession. By preserving bone through regenerative procedures, the patient option and likelihood of successful future dental implant treatment are enhanced. The use of fascia lata similarly extends surgical and restorative options to patients who otherwise might not be candidates for dental implants. A variety of materials is available for these procedures, but whichever are selected, it is imperative that the dental implant professional operate as a member of a team of interrelated disciplines if the results of dental implant treatment are to be optimized.
Modern digital radiographic techniques can aid the clinician in planning dental implant selection and placement before and during surgery, a well as in the long term assessment of periimplant bone support. Implant treatment planning can be facilitated using computed tomography on film-based motion tomography. During surgery, direct digital radiography allows the clinician to visualize the relationship of the osteotomy sit to important anatomic structures such as the mandibular nerve. Following placement, digital subtraction radiography permits detection of osseous changes too small to be seen by eye with an accuracy approaching 95%. Such sensitivity and specificity encourages early evaluation and, if necessary, intervention on behalf of the ailing implant.
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