Dentaltown October 2019 - 70
Diet
Poor diet is a significant factor in tooth
loss. Has there been adequate research to
say whether diet contributes to implant
failure? Everyone placing implants has seen
the enormous differences in bone quality
and quantity from patient to patient. Bone
health, including the presence of osteoporosis,
has to be a significant factor related to diet.
Fig. 3: The extent of bone degeneration on
the implant shown in Figs. 1 and 2.
Systemic disease
Numerous systemic diseases or conditions are recognized as contraindications
for implant placement. Most practitioners
placing implants know them well. These
negative factors are probably related to
implant failure due to whatever caused
the systemic condition. Some of them are:
* Active treatment of a malignancy.
* Bleeding issues.
* Drug abuse.
* Immunosuppression.
* Intravenous bisphosphonate use.
* Psychiatric illness.
* Recent cerebrovascular accident.
Smoking
This is one factor that is negative in
almost every study done on the subject.
The actual reasons for the negative reports
are many, and more research is still needed.
Most dentists placing implants consider
smoking to be a significant contraindication
to placing implants.
Fig. 4: The implant and crown were
rescued with conventional implant
salvage procedures. (Images courtesy
of Dr. George Bailey, periodontist)
70
OCTOBER 2019 // dentaltown.com
Improper implant placement
There are innumerable potential negative
factors related to improper implant placement, including inadequate lavage when
making the osteotomy, lack of blood present
when placing the implant, burning the bone
when making the osteotomy, fracturing the
bone when placing the implant, inadequate
vascular supply. ... This list goes on and on.
Angulation of implants
Many implants are now being placed with
significant angulation from perpendicular to
the occlusal plane. Again, there is controversy
on the subject.
Inadequate bone
Many implants are placed in questionable
bone that is potentially inadequate in density
or in patients who have osteoporosis. In such
cases, conventional procedures would often
serve the patients better and with less risk.
Poorly planned prostheses
Some prostheses are made with anatomical characteristics that do not allow adequate
oral hygiene or that have abnormal occlusion.
Both of these factors could contribute to
failure.
Loading too early
It is well known that if adequate bone
is present, implant placement is acceptable
on the day the tooth is removed. However, it
is clear that some of these implants still fail
when loaded too early. Waiting a few months
to load in those cases is a better choice.
Microbes
Are there specific organisms that are
related to peri-implantitis and peri-implant
mucositis? It is quite likely. Although research
is ongoing on this subject, little is known
for sure.
http://www.dentaltown.com
Dentaltown October 2019
Table of Contents for the Digital Edition of Dentaltown October 2019
Dentaltown October 2019 - Intro
Dentaltown October 2019 - Cover1
Dentaltown October 2019 - Cover2
Dentaltown October 2019 - 1
Dentaltown October 2019 - 2
Dentaltown October 2019 - 3
Dentaltown October 2019 - 4
Dentaltown October 2019 - 5
Dentaltown October 2019 - 6
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Dentaltown October 2019 - Cover3
Dentaltown October 2019 - Cover4
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