DISCUSSION
Many authors consider placement of an implant in a socket with periapical lesion as a contraindication, but several studies which were conducted do not show any significant difference compared to those with healthy sockets.
The disadvantage of the placement of implants into the sockets of teeth with periapical lesions is the potential for implant contamination during the initial healing period because of remnants of the infection.(8,13,162)Bacteroides species can inhabit tooth periapical lesions while being encapsulated in a polysaccharide that promotes its virulence, survival, and importance in mixed infections. Bacteroides forsythus has been shown to persist in asymptomatic periradicular endodontic lesions and may survive in
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These positive results could be explained by various biological events occurring during bone healing process, dependent on aspects such as primary stability of the implant, the surgical technique, the prosthetic load and the associated inflammatory response.(84)
Fugazzotto conducted the only study comparing implants immediately placed into sites with periapical pathology with those immediately placed into sites without periapical pathology in the same patient, it was observed that both treatments yielded comparable results with no statistically significant difference in survival rates.(165)
Regarding the treatment protocol, appropriate clinical procedures to perform the decontamination of the implant’s site, such as antibiotic administration, meticulous cleaning, and alveolar debridement, combined with GBR with or without bone grafting, is suggested to create adequate conditions for bone regeneration and osseointegration despite the previous contamination.(6,85,166)
The natural healing process after tooth extraction normally manages residual infection, but as an infection increases inflammatory activity, infection may result in increased bone resorption and a higher risk of implant stability loss and failure. The presence of granulation tissue in the socket of an infected tooth must be considered as an inflammatory response to bacteria. This reactive
Treating the completely edentulous upper jaw with fixed implant-supported teeth has always been difficult, especially if it is suffering from moderate to severe bone loss. One procedure that has long been available is the use of bone transplant or bone grafting, usually from the patient’s skull, hip, jaw or skin, to supply the missing bone in the upper jaw. Because this requires a second
At your first visit, you will be evaluated for gum disease, and a treatment plan will be implemented. Once your gum infection has been treated, you can continue with your plan to get implants
By having a bone graft procedure, we will restore the bone that you’ve lost in your jaw, which will make it possible to place implants. Having a bone graft will not only make it possible to place your dental implants, but it will also improve your appearance through giving you a full jawline.
Subsequent a symposium held at McGill University in 2002, a panel of experts prepared the following statement: (the evidence currently available suggests that the restoration of the edentulous mandible with a conventional denture is no longer the most appropriate first choice prosthodontic treatment. There is now overwhelming evidence that a two-implant overdenture should become the first choice of treatment for the edentulous mandible) .Moreover, empirical studies have reported
Implant overdentures have contraindications, mainly in relative to the risks related to the surgical procedures, even if in specific cases it can be regarded as a minimally invasive one. Additionally, using this specific treatment concept is limited to cases with reduced prosthetic vertical space that makes it impossible to apply the attachment systems and also provide adequate prosthesis resistance (e.g., using Locators requires a minimum of 8.5mm vertical space and 9mm horizontal space; bar attachments require 10 to12 mm vertical space) .Implant overdentures are not recommended when there is a decreased D4 bone density, in bruxism and in severe oral hygiene deficiency.
The implant-retained overdenture is a treatment option for edentulous patients in the following situations: poorly retained and unstable mandibular dentures, poor bone quality or insufficient available bone to accommodate 4 or more implants, as the original Branemark protocol suggests, and to aid patients with financial constraints. When compared to the fixed implant-supported restoration, the removable implant-retained overdenture offers several advantages including enhanced access for oral hygiene, easy modification of prosthesis base, and the provision of a labial flange to improve esthetics in situations of unfavorable jaw relationship.
In the last few decades, Science has discovered many fascinating discoveries which has increased life expectancy and have made human lives less painful. One of the brilliant discoveries has been being able to renovate human body parts. However, all of these great techniques and methods to “repair” human body parts also have the side effects. The greatest example would be dental implantation which brings back the ‘taste’ in many lives. While reading the article, “Prevalence and Predictive Factors for Peri-Implant Disease and Implant Failure: A Cross-Sectional Analysis”, I learned that dental implantation is also causing the disease called “Peri-implant” which cause discomfort, negative impact on health and may lead to loss of the implant.
One problem that develops when you have missing teeth is that the bone in your jaw recedes. Your bone needs stimulation from teeth roots to stay strong and healthy. If you don't have enough bone, your dentist is unable to stabilize an implant. However, the dentist may be able to work around the problem by spacing the implants in such a way they are inserted in areas of healthy bone and avoid areas of recessed bone. Also, a bone graft may be considered. A graft increases the size of your bone, but since it is an additional procedure that requires time to heal, it prolongs the process of getting your implants.
You may need to have a tooth removed due to infection of the dental pulp, gum disease,
One of the best things about implants is that they cannot decay like natural teeth. However, the metal surfaces of the implant connector pieces are very susceptible to plaque build up, which can happen fast if not cleaned regularly and thoroughly. This plaque provides a “safe house” of sorts for bacteria, which can work their way
Many years back one may have not of thought that a joint could be replaced with an implant, the implant also being man made. Between the years 1960 and 1970 there were a number of materials that were tried as joint implants. Some materials that were tired were; stainless steel, cobalt-chromium, and Teflon. While between 1980-1990 cobalt-chromium and polyethylene was the choice material for implants. Many materials are tired because of the problem with ear and friction. As small particles from the implant are shed into the surrounding joint cavity, it causes and aggressive inflammatory response and possible osteolysis. The many types of materials are tested and studied for solution. The best research comes from clinical results of patients who have had a joint replaced by an implant.
Dental implants are an excellent long term option for patients in good health who have lost teeth. A prospective study published in the International Journal of Oral and Maxillofacial Implants reviewed two hundred and twenty three Branemark dental implants placed in seventy eight patients by the same surgeon. The study showed that patients who followed the smoking cessation protocol had a significantly higher success rate of osseointegration than that of patient who smoked during the early stages of dental implant placement. Smoking has been shown to compromise a patient’s healing potential after the initial implant placement (Williams, 1994).
Generally, when adjacent teeth have been moved in order to accomplish adequate space for placing an implant, the roots of these teeth may have tipped into closer proximity. In this condition there may be inadequate space to place the implant between the apices and Thereby the use of resin-bonded restoration will be recommend.
In our prospective study, PTX3 levels in PMICF were observed before and after orthodontic force application. In the present study, PMICF sample was collected after 1 hour of MSI placement. Following tissue damage, the inflammatory response is elicited with the aim to limit the damage or to replace the lost or damaged tissue by regeneration or reparation.21 Since MSI placement is an invasive procedure, it obviously stimulates the host immune system to secrete inflammatory mediators that corresponds well with initial rise in PTX3 in the PMICF.
The approach of the authors towards this topic is more of a theoretical approach rather than an experimental one. They emphasize that many of the controversies of using biomaterials loaded with antibiotics in surgeries will keep coming until some good randomized, double-blind clinical trials are properly and systematically conducted. They investigate each aspect of implanting a biomaterial in different ways and areas and then revolve around the possible outcomes, besides the desired ones, of the study. In one particular study, where they analyze the delivery systems of previous implants, they describe them to often fail to achieve ideal release kinetics. The authors propose that a desirable sustained release of drug should ensure that adequate tissue concentrations are maintained over a sufficient time to entirely cover the period after surgery where the wound is still prone to infection. They also propose four major components that must be taken