Implant Failures: how to prevent and manage them



A recap and highlights from our lecture:

39% of implants will have a complication within the first 5 years of placement.  After 10 years, that number is 50%.  Whether it is peri mucositis, peri implantitis, implant failures, malposition, or the unaesthetic implant the number of complications are growing worldwide, as the number of implants being placed are growing.

 

Dr. Alex Shvartsman spoke of how to prevent these complications using his 5 Golden Rules.

  1. Screw retained implant whenever possible
  2. Morse taper
  3. Platform switching
  4. Adequate attached gingiva
  5. Implant position relative to the future crown, bone, and blood supply (guided surgery whenever possible)

We spoke of the dangers of cement and the detrimental effects it can have on an implant if the excess is not properly removed.  Dr. Shvartsman shared his technique of creating an extraoral abutment with PFTE tape to create the appropriate 50 micron spacer before cementation in the mouth.  He spoke of his bias towards screw retained implants and platform switching to move the microgap.  He spoke of the importance of checking the occlusion and wear patterns with his preference of cuspid guidance.

 

I then shared :

  • my experience with Straumann SLA active implants that can be restored with a final restoration of 2-3 weeks.  I spoke of how to diagnose and prevent perimucositis (similar to gingivitis) and peri-implantitis (similar to periodontitis).
  • an algorithm to treat deep probing depths around implants.implant failures.025
  • my success treating peri-implantitis with the titanium brush  and the protocol we developed.
  • some cases where by using my Piezo surgery unit, I did a “mini sinus lift” with immediate implant placement, a simultaneous ridge split, sinus lift, immediate loading multiple implant case.  I also showed distraction cases  of the alveolus and a malpositioned implant.
  • other cases where I was able to reposition osseointegrated implants into the proper position after they were placed incorrectly by other surgeons.
  • some cases of proper treatment planning and preparation to create the correct gingival form, alveolar emergence and implant placement.
  • my technique of treating the black triangle for those with a shortened interdental papilla.  These can be done after Invisalign or after an implant case with improper aesthetics.

We look forward to more of these types of lectures in the future, and appreciate the wonderful turnout.

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