Pub Date : 2022-01-31DOI: 10.5772/intechopen.101359
G. Gupta
Implant stability is a prerequisite for successful dental implants and osseointegration. To determine the status of implant stability, continuous monitoring in an objective and qualitative manner is important. To measure implant stability two different stages are there: Primary and secondary. Primary implant stability at placement is a mechanical phenomenon that is related to the local bone quality and quantity, the type of implant and placement technique used. Primary stability is checked from mechanical engagement with cortical bone. Secondary stability is developed from regeneration and remodeling of the bone and tissue around the implant after insertion and affected by the primary stability, bone formation and remodeling. Implant stability is essential for the time of functional loading. Classical benchmark methods to measure implant stability were radiographs or microscopic analysis, removal torque, push-through and pull-through but due to lack of feasibility, time consumption and ethical reasons other methods have been propounded over period of time like measurement of implant torque, model analysis and most important ISQ which has the ability to monitor osseointegration and the life expectancy of an implant. ISQ is a valuable diagnostic and clinical tool that has far-reaching consequences on implant dentistry and this article throws light on advanced and reliable methods of assessing ISQ.
{"title":"Implant Stability Quotient (ISQ): A Reliable Guide for Implant Treatment","authors":"G. Gupta","doi":"10.5772/intechopen.101359","DOIUrl":"https://doi.org/10.5772/intechopen.101359","url":null,"abstract":"Implant stability is a prerequisite for successful dental implants and osseointegration. To determine the status of implant stability, continuous monitoring in an objective and qualitative manner is important. To measure implant stability two different stages are there: Primary and secondary. Primary implant stability at placement is a mechanical phenomenon that is related to the local bone quality and quantity, the type of implant and placement technique used. Primary stability is checked from mechanical engagement with cortical bone. Secondary stability is developed from regeneration and remodeling of the bone and tissue around the implant after insertion and affected by the primary stability, bone formation and remodeling. Implant stability is essential for the time of functional loading. Classical benchmark methods to measure implant stability were radiographs or microscopic analysis, removal torque, push-through and pull-through but due to lack of feasibility, time consumption and ethical reasons other methods have been propounded over period of time like measurement of implant torque, model analysis and most important ISQ which has the ability to monitor osseointegration and the life expectancy of an implant. ISQ is a valuable diagnostic and clinical tool that has far-reaching consequences on implant dentistry and this article throws light on advanced and reliable methods of assessing ISQ.","PeriodicalId":90816,"journal":{"name":"Dentistry (Sunnyvale, Calif.)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48447690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-27DOI: 10.5772/intechopen.101336
M. Blašković, D. Blašković
The peri-implant soft tissue (PIS) augmentation procedure has become an integral part of implant-prosthetic rehabilitation. Minimal width of keratinized mucosa (KM) of 2 mm is deemed necessary to facilitate oral hygiene maintenance around the implant and provide hard and soft peri-implant tissue stability. PIS thickness of at least 2 mm is recommended to achieve the esthetic appearance and prevent recessions around implant prosthetic rehabilitation. The autogenous soft tissue grafts can be divided into two groups based on their histological composition—free gingival graft (FGG) and connective tissue graft (CTG). FGG graft is used mainly to increase the width of keratinized mucosa while CTG augment the thickness of PIS. Both grafts are harvested from the same anatomical region—the palate. Alternatively, they can be harvested from the maxillary tuberosity. Soft tissue grafts can be also harvested as pedicle grafts, in case when the soft tissue graft remains attached to the donor site by one side preserving the blood supply from the donor region. Clinically this will result in less shrinkage of the graft postoperatively, improving the outcome of the augmentation procedure. To bypass the drawback connected with FGG or CTG harvesting, substitutional soft tissue grafts have been developed.
{"title":"Peri-Implant Soft Tissue Augmentation","authors":"M. Blašković, D. Blašković","doi":"10.5772/intechopen.101336","DOIUrl":"https://doi.org/10.5772/intechopen.101336","url":null,"abstract":"The peri-implant soft tissue (PIS) augmentation procedure has become an integral part of implant-prosthetic rehabilitation. Minimal width of keratinized mucosa (KM) of 2 mm is deemed necessary to facilitate oral hygiene maintenance around the implant and provide hard and soft peri-implant tissue stability. PIS thickness of at least 2 mm is recommended to achieve the esthetic appearance and prevent recessions around implant prosthetic rehabilitation. The autogenous soft tissue grafts can be divided into two groups based on their histological composition—free gingival graft (FGG) and connective tissue graft (CTG). FGG graft is used mainly to increase the width of keratinized mucosa while CTG augment the thickness of PIS. Both grafts are harvested from the same anatomical region—the palate. Alternatively, they can be harvested from the maxillary tuberosity. Soft tissue grafts can be also harvested as pedicle grafts, in case when the soft tissue graft remains attached to the donor site by one side preserving the blood supply from the donor region. Clinically this will result in less shrinkage of the graft postoperatively, improving the outcome of the augmentation procedure. To bypass the drawback connected with FGG or CTG harvesting, substitutional soft tissue grafts have been developed.","PeriodicalId":90816,"journal":{"name":"Dentistry (Sunnyvale, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49532850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-09DOI: 10.5772/intechopen.101082
D. Gupta
Normal healing procedure of bone involves various sequential events to develop bone and bridge the bone -to- bone gap. When this healing occurs with a metal (titanium) fixture on one side, it is called as osseointegration. After extensive studies on this topic, it is found that this procedure occurs in presence of various biologic constituents that are spontaneously released at the site. Thus, to accelerate normal healing after implant placement and make results more predictable, it has been proposed to use these autologous factors in the osteotomy site. Since it is the beginning of a new revolution in dental implantology, right now it is essential to analyze all possible combinations of host conditions, bone quality and quantity and bio factors being used. This can definitely be a boon for the patients with compromised systemic or local conditions.
{"title":"Growth Factors and Dental Implantology","authors":"D. Gupta","doi":"10.5772/intechopen.101082","DOIUrl":"https://doi.org/10.5772/intechopen.101082","url":null,"abstract":"Normal healing procedure of bone involves various sequential events to develop bone and bridge the bone -to- bone gap. When this healing occurs with a metal (titanium) fixture on one side, it is called as osseointegration. After extensive studies on this topic, it is found that this procedure occurs in presence of various biologic constituents that are spontaneously released at the site. Thus, to accelerate normal healing after implant placement and make results more predictable, it has been proposed to use these autologous factors in the osteotomy site. Since it is the beginning of a new revolution in dental implantology, right now it is essential to analyze all possible combinations of host conditions, bone quality and quantity and bio factors being used. This can definitely be a boon for the patients with compromised systemic or local conditions.","PeriodicalId":90816,"journal":{"name":"Dentistry (Sunnyvale, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45167302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-06DOI: 10.5772/intechopen.100038
A. Rampurawala, Amol S Patil
Orthodontic miniscrews have had a considerable impact on modern orthodontic treatment, not only by providing a new source of anchors for anchorage-demanding cases, but also for force management and control. Whilst miniscrews need to be mechanically stable during treatment to provide sufficient anchorage and predictable force control, as temporary anchorage devices they need also be easy to remove after orthodontic treatment. These requirements differentiate orthodontic miniscrews from dental implants - which once placed, are not to be removed - and dictate the approach as to how their clinical performance can be optimized. Over the past decade, various titanium surface modifications and improvements in implant surface topography have shown to enhance osseointegration of endosseous dental implants. Some of these techniques have helped provide a similar enhancement of the biomechanical potential of orthodontic miniscrews as well. In this perspective, we present a brief discussion on all such reported techniques followed by a detailed account of the most recently proposed ultraviolet photofunctionalization technique - a novel chair-side surface modification method.
{"title":"Surface Modification of Titanium Orthodontic Implants","authors":"A. Rampurawala, Amol S Patil","doi":"10.5772/intechopen.100038","DOIUrl":"https://doi.org/10.5772/intechopen.100038","url":null,"abstract":"Orthodontic miniscrews have had a considerable impact on modern orthodontic treatment, not only by providing a new source of anchors for anchorage-demanding cases, but also for force management and control. Whilst miniscrews need to be mechanically stable during treatment to provide sufficient anchorage and predictable force control, as temporary anchorage devices they need also be easy to remove after orthodontic treatment. These requirements differentiate orthodontic miniscrews from dental implants - which once placed, are not to be removed - and dictate the approach as to how their clinical performance can be optimized. Over the past decade, various titanium surface modifications and improvements in implant surface topography have shown to enhance osseointegration of endosseous dental implants. Some of these techniques have helped provide a similar enhancement of the biomechanical potential of orthodontic miniscrews as well. In this perspective, we present a brief discussion on all such reported techniques followed by a detailed account of the most recently proposed ultraviolet photofunctionalization technique - a novel chair-side surface modification method.","PeriodicalId":90816,"journal":{"name":"Dentistry (Sunnyvale, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44427202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-13DOI: 10.5772/intechopen.99704
L. Díez-Suárez
Various causes can be responsible for tooth loss. In general, caries, periodontal disease, facial trauma, pathology of the jaws, among other causes, could lead to the loss of a tooth or a group of teeth. As a consequence, the stimuli that participate in bone maintenance are compromised and bone reduction occurs gradually, making it difficult to use conventional prostheses. Fortunately, technological advances applied to dental implantology have allowed us to perform full-arch prosthetic treatments, managing to rehabilitate the form, function, esthetics and lost self-esteem in patients with severe atrophy of the jaws. The objective of this chapter is to describe the key and current aspects in full-arch rehabilitation with dental implants.
{"title":"A Review of Current Concepts in Full Arch Rehabilitation with Dental Implants","authors":"L. Díez-Suárez","doi":"10.5772/intechopen.99704","DOIUrl":"https://doi.org/10.5772/intechopen.99704","url":null,"abstract":"Various causes can be responsible for tooth loss. In general, caries, periodontal disease, facial trauma, pathology of the jaws, among other causes, could lead to the loss of a tooth or a group of teeth. As a consequence, the stimuli that participate in bone maintenance are compromised and bone reduction occurs gradually, making it difficult to use conventional prostheses. Fortunately, technological advances applied to dental implantology have allowed us to perform full-arch prosthetic treatments, managing to rehabilitate the form, function, esthetics and lost self-esteem in patients with severe atrophy of the jaws. The objective of this chapter is to describe the key and current aspects in full-arch rehabilitation with dental implants.","PeriodicalId":90816,"journal":{"name":"Dentistry (Sunnyvale, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42226105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-05DOI: 10.5772/intechopen.99937
Sergio Alexandre Gehrke
The research and development of new implant models modifying the micro and macro design has increased significantly in the last decades. With the advancement of knowledge about the biological behavior of these materials when implanted in living tissue, a great search for morphological changes at macrogeometric, microgeometric and even nanogeometric levels was started, to accelerate the process of osseointegration of implants, reducing the time for the rehabilitation treatment. This chapter will seek to demonstrate, through scientific evidence, the potential effect of the morphological characteristics of implants on osseointegration. Modifications in the surface treatment of implants will be discussed to improve the osseointegration process in terms of quality and time reduction, changes in the surgical technique used for the osteotomy of the implant installation site, and macrogeometric changes in the shape of the implant body.
{"title":"Characteristics of Implant Systems That Can Accelerate and Improve the Osseointegration Process","authors":"Sergio Alexandre Gehrke","doi":"10.5772/intechopen.99937","DOIUrl":"https://doi.org/10.5772/intechopen.99937","url":null,"abstract":"The research and development of new implant models modifying the micro and macro design has increased significantly in the last decades. With the advancement of knowledge about the biological behavior of these materials when implanted in living tissue, a great search for morphological changes at macrogeometric, microgeometric and even nanogeometric levels was started, to accelerate the process of osseointegration of implants, reducing the time for the rehabilitation treatment. This chapter will seek to demonstrate, through scientific evidence, the potential effect of the morphological characteristics of implants on osseointegration. Modifications in the surface treatment of implants will be discussed to improve the osseointegration process in terms of quality and time reduction, changes in the surgical technique used for the osteotomy of the implant installation site, and macrogeometric changes in the shape of the implant body.","PeriodicalId":90816,"journal":{"name":"Dentistry (Sunnyvale, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44165608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-26DOI: 10.5772/intechopen.100191
Ahmad Al Jaghsi
Inserting strategic implants under existing removable partial dentures requires a comprehensive understanding of removable prosthodontic basics and possible designs, as well as a thorough understanding of implant therapy. Prior to the widespread adoption of implants as standard prosthetic therapy, remaining roots were preserved and used to minimize bone resorption under the removable denture. Root-supported overdentures become less common after the overwhelming clinical studies that emphasize dental implants’ reliability and high success and survival rate. Fixed prostheses cannot be used to treat a severely decreased dentition unless a significant number of implants can be inserted, sufficient bone quantity and quality are available, and the patients can afford the treatment. On the other hand, using strategic implants under existing RPD upgrades the design to a more favorable support type. It improves patient satisfaction with the RPD in speaking, chewing, retention, stability, and RPD support. This improvement could be reached earlier if the patient received immediate loading. Strategic implants can also improve chewing ability, stabilize the occlusion, increase bite force and improve patient oral health-related quality of life. Moreover, better distribution of occlusal forces that may reduce bone resorption may be gained. Furthermore, strategic implants can improve comfort, confidence, and esthetics by reducing the RPD size and removing the retainers from the esthetic zone.
{"title":"Strategic Implants under Existing Partial Removable Dentures, Why, How Many, and Which Type?","authors":"Ahmad Al Jaghsi","doi":"10.5772/intechopen.100191","DOIUrl":"https://doi.org/10.5772/intechopen.100191","url":null,"abstract":"Inserting strategic implants under existing removable partial dentures requires a comprehensive understanding of removable prosthodontic basics and possible designs, as well as a thorough understanding of implant therapy. Prior to the widespread adoption of implants as standard prosthetic therapy, remaining roots were preserved and used to minimize bone resorption under the removable denture. Root-supported overdentures become less common after the overwhelming clinical studies that emphasize dental implants’ reliability and high success and survival rate. Fixed prostheses cannot be used to treat a severely decreased dentition unless a significant number of implants can be inserted, sufficient bone quantity and quality are available, and the patients can afford the treatment. On the other hand, using strategic implants under existing RPD upgrades the design to a more favorable support type. It improves patient satisfaction with the RPD in speaking, chewing, retention, stability, and RPD support. This improvement could be reached earlier if the patient received immediate loading. Strategic implants can also improve chewing ability, stabilize the occlusion, increase bite force and improve patient oral health-related quality of life. Moreover, better distribution of occlusal forces that may reduce bone resorption may be gained. Furthermore, strategic implants can improve comfort, confidence, and esthetics by reducing the RPD size and removing the retainers from the esthetic zone.","PeriodicalId":90816,"journal":{"name":"Dentistry (Sunnyvale, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46153412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-13DOI: 10.5772/intechopen.100567
P. Vizureanu, M. Baltatu, A. Sandu, D. Achiței, D. D. B. Nergis, M. Perju
Bioactive glasses are very attractive materials, used for tissue engineering materials, usually to fill and restore bone defects. This category of biomaterials, show considerable potential for orthopaedic surgery because they can promote bone tissue regeneration. Many trace elements have been incorporated in the glass network, an example is metallic glasses to obtain the desired properties. Because of tolerable mechanical properties, and because they are able to bond to living bone and stimulate its regeneration, this bioactive glasses have a particular interest and are in a continuous research and improvement. The chapter presents the history of bioactive glasses, classification, include a summary of common fabrication methods, applications, surface coatings, applications and future trends in relation to human bone. This review highlight new trends and areas of future research for bioactive glasses.
{"title":"New Trends in Bioactive Glasses for Bone Tissue: A Review","authors":"P. Vizureanu, M. Baltatu, A. Sandu, D. Achiței, D. D. B. Nergis, M. Perju","doi":"10.5772/intechopen.100567","DOIUrl":"https://doi.org/10.5772/intechopen.100567","url":null,"abstract":"Bioactive glasses are very attractive materials, used for tissue engineering materials, usually to fill and restore bone defects. This category of biomaterials, show considerable potential for orthopaedic surgery because they can promote bone tissue regeneration. Many trace elements have been incorporated in the glass network, an example is metallic glasses to obtain the desired properties. Because of tolerable mechanical properties, and because they are able to bond to living bone and stimulate its regeneration, this bioactive glasses have a particular interest and are in a continuous research and improvement. The chapter presents the history of bioactive glasses, classification, include a summary of common fabrication methods, applications, surface coatings, applications and future trends in relation to human bone. This review highlight new trends and areas of future research for bioactive glasses.","PeriodicalId":90816,"journal":{"name":"Dentistry (Sunnyvale, Calif.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49022316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-02DOI: 10.5772/intechopen.100293
A. Shatta, S. Anil
Dental implants have become a well-accepted treatment option for patients with partial or complete edentulism. The long-term success of the endosseous dental implant depends not only on osseointegration, but on the healthy soft tissue interface that surrounds the implant. Peri-implantitis is defined as an inflammatory process affecting the supporting hard and soft tissue around an implant in function, leading to loss of supporting bone. Peri-implant mucositis has been defined as a reversible inflammatory reaction in the peri-implant mucosa surrounding an osseointegrated dental implant. Peri-implant mucositis is assumed to precede peri-implantitis. Data indicate that patients diagnosed with peri-implant mucositis may develop peri-implantitis, especially in the absence of regular maintenance care. However, the features or conditions characterizing the progression from peri-implant mucositis to peri-implantitis in susceptible patients have not been identified. The most common etiological factors associated with the development of peri-implantitis are the presence of bacterial plaque and host response. The risk factors associated with peri-implant bone loss include smoking combined with IL-1 genotype polymorphism, a history of periodontitis, poor compliance with treatment and oral hygiene practices, the presence of systemic diseases affecting healing, cement left behind following cementation of the crowns, lack of keratinized gingiva, and previous history of implant failure There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of severe periodontitis, poor plaque control, and no regular maintenance care after implant therapy. Management of peri-implantitis generally works on the assumption that there is a primary microbial etiology. Furthermore, it is assumed that micro-organisms and/or their by-products lead to infection of the surrounding tissues and subsequent destruction of the alveolar bone surrounding an implant. A combination of surgical, open debridement, and antimicrobial treatment has been advocated for the treatment of peri-implantitis. Surgical intervention is required once a patient has bleeding on probing, greater than 5 mm of probing depth, and severe bone loss beyond that expected with remodeling. Access flaps require full-thickness elevation of the mucoperiosteum, facilitating debridement and decontamination of the implant surface via hand instruments, ultrasonic tips, or lasers. When necessary, surgical procedures may be used in conjunction with detoxification of the implant surface by mechanical devices, such as high-pressure air powder abrasion or laser.
{"title":"Peri-Implantitis Revisited","authors":"A. Shatta, S. Anil","doi":"10.5772/intechopen.100293","DOIUrl":"https://doi.org/10.5772/intechopen.100293","url":null,"abstract":"Dental implants have become a well-accepted treatment option for patients with partial or complete edentulism. The long-term success of the endosseous dental implant depends not only on osseointegration, but on the healthy soft tissue interface that surrounds the implant. Peri-implantitis is defined as an inflammatory process affecting the supporting hard and soft tissue around an implant in function, leading to loss of supporting bone. Peri-implant mucositis has been defined as a reversible inflammatory reaction in the peri-implant mucosa surrounding an osseointegrated dental implant. Peri-implant mucositis is assumed to precede peri-implantitis. Data indicate that patients diagnosed with peri-implant mucositis may develop peri-implantitis, especially in the absence of regular maintenance care. However, the features or conditions characterizing the progression from peri-implant mucositis to peri-implantitis in susceptible patients have not been identified. The most common etiological factors associated with the development of peri-implantitis are the presence of bacterial plaque and host response. The risk factors associated with peri-implant bone loss include smoking combined with IL-1 genotype polymorphism, a history of periodontitis, poor compliance with treatment and oral hygiene practices, the presence of systemic diseases affecting healing, cement left behind following cementation of the crowns, lack of keratinized gingiva, and previous history of implant failure There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of severe periodontitis, poor plaque control, and no regular maintenance care after implant therapy. Management of peri-implantitis generally works on the assumption that there is a primary microbial etiology. Furthermore, it is assumed that micro-organisms and/or their by-products lead to infection of the surrounding tissues and subsequent destruction of the alveolar bone surrounding an implant. A combination of surgical, open debridement, and antimicrobial treatment has been advocated for the treatment of peri-implantitis. Surgical intervention is required once a patient has bleeding on probing, greater than 5 mm of probing depth, and severe bone loss beyond that expected with remodeling. Access flaps require full-thickness elevation of the mucoperiosteum, facilitating debridement and decontamination of the implant surface via hand instruments, ultrasonic tips, or lasers. When necessary, surgical procedures may be used in conjunction with detoxification of the implant surface by mechanical devices, such as high-pressure air powder abrasion or laser.","PeriodicalId":90816,"journal":{"name":"Dentistry (Sunnyvale, Calif.)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41896532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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