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More Complications Articles

dental implant, dental implant complications

Top 5 sources of dental implant pain when 'there is nothing wrong with the implant'

While clinical signs and radiographic evidence sometimes point to dental implant complications, ascertaining the etiology of a patient’s perceived pain post implant placement when all parameters are within normal limits can be daunting. Dr. Scott Froum, editorial director of Perio-Implant Advisory, focuses on five factors that can elicit pain post implant placement that are often elusive and obscure diagnosis unless a good knowledge base is present.

dental implant, implant dentistry, Anthony Sclar, DMD

AO Orlando preview: Morning with the Masters highlights from Dr. Anthony Sclar

Anthony G. Sclar, DMD, will present an interdisciplinary session titled “Avoiding and Managing Esthetic Implant Complications” during the Morning with the Masters Program at the upcoming Academy of Osseointegration Annual Meeting. Participants will learn scientific and clinical concepts required for diagnostically driven treatment planning and become familiar with risk stratification of simple-to-complex esthetic dental implant cases. Read more about the objectives of this program and the five key takeaways.

dental implant, implant abutment

Top factors leading to dental implant abutment/implant fixture misfit: The dreaded macrogap

Dr. Scott Froum, Perio-Implant Advisory’s editorial director, says recognizing the leading causes of dental implant abutment misfit can prevent implant failures from occurring. Because vertical misfit can have serious repercussions on the life span of the implant complex, careful attention must be paid to details at the time of insertion. In this article, Dr. Froum elaborates on six things that can cause implant abutment misfit and explains how you can avoid each.

paresthesia, tooth extraction, socket debridement, dental implants

Socket debridement paresthesia: A popular method of unintentionally making a patient numb after tooth extraction

Although the complication rate of tooth extraction is low, and complications are often minor, the incidence of overall paresthesia after tooth extraction is on the rise due to an increase in the number of extractions over the years. Injuries to the inferior alveolar nerve and lingual nerve can cause problems with speech and mastication, leading to complaints and possible litigation as these injuries begin to affect the patients’ quality of life. Perio-Implant Advisory Editorial Director Scott Froum, DDS, reviews one iatrogenic cause of mandibular nerve injury post tooth extraction and explains steps the dentist can take to prevent such injuries in the future.

EpiPen, epinephrine, anaphylaxis

An alternative to the EpiPen for the dental office and home that can save you hundreds of dollars

EpiPen, an epinephrine auto-injector manufactured by the drug company Mylan, has recently seen a substantial price increase that caused a national outcry. Once sold for $57 in 2007, the price for an EpiPen has skyrocketed to more than $500 today, with an average store selling it for $615. George Felt, DDS, a periodontist practicing in Meredith, New Hampshire, provides us with this month’s clinical tip on how to protect yourself, your family, and your patients from allergic reactions and anaphylaxis without having to pay such an expensive price.

root canal

Learning from root canal complications

When a root canal begins uneventfully and ends up with an obstacle, what do you do? You learn from it! Peter Mann, DDS, FICOI, FAGD, and Tina Tong, DMD, say: “Dentistry is a very humbling profession. But that’s what makes it exciting and interesting as well. After thousands of root canals, you still find one that surprises, teaches, and amazes.” Follow along with their case study.

dental implants, craniofacial growth, fixed partial denture

The ideal esthetic dental implant restoration: Will it still look like that in 10 years?

Craniofacial growth continues for humans even into adulthood. Because the tissues and teeth continue to move around a fixed, osseointegrated implant, restorations placed as many as five to 20 years ago can look vastly different from when they were first inserted. Thus ideal placement for dental implants and restorations may not continue to be ideal as the years progress. Perio-Implant Advisory Editorial Director Scott Froum, DDS, explains the implications craniofacial growth has on the position of dental implants and the types of patients who are at the highest risk for craniofacial growth that will impact dental implant positioning in future years.

osteonecrosis of the jaw, MRONJ, oral surgery, osteoporosis

Medication-related osteonecrosis of the jaw: Lowering the risk of MRONJ using new drug alternatives

By now, we have all faced the clinical decision about whether to proceed with elective oral surgery for the postmenopausal female patient who has begun bisphosphonate (BP) therapy. The potential for medication-related osteonecrosis of the jaw (MRONJ) that may occur after oral surgery persists for years after BPs have been administered, due to the fact that they have been found in bone 10 years after even a single administration. Michael DiPace, DDS, offers a general review of three alternative drugs used to treat osteoporosis that have little or no known association with MRONJ.

dental implants, dental restorations, peri-implantitis, dental crowns

Prosthetic screw loosening: An innovative technique to manage a common complication with dental implants

When abutment screw loosening occurs with a cement-retained crown, the clinician is faced with a difficult challenge, often requiring the dentist to send the crown to the lab to be “uncemented” from the abutment. The patient is left without a crown for several days until it comes back from the lab separated from the abutment. Daniel D. Gober, DDS, and Markus L. Weitz, DDS, illustrate a technique to reseat a cement-retained crown-abutment unit that loosened from the implant by converting a cement-retained crown into a screw-retained crown at the very same appointment.

Have infection, will travel: Paving the path to dental implant failure by Scott Froum, DDS - dental implants - pathology - dental infection

Have infection, will travel: Paving the path to dental implant failure

Why did this dental implant fail? You did everything right during your implant treatment. You properly diagnosed and treatment planned the patient’s implant therapy. The implant was surgically placed in a prosthetically driven orientation. You (or the restorative dentist) placed the abutment and crown on the implant with the correct contours, perfect fit, and (if not screw retained) without excess cement. The patient adhered to the follow-up appointments and had good oral hygiene. Follow-up visits showed good bone levels around the implant . . . and then one day there was implant infection and loss of integration. In his clinical tip, Perio-Implant Advisory’s Editorial Director Scott Froum, DDS, talks about one huge oversight that—if detected early and treated properly—is highly preventable and can change the entire outcome of your case.

peri-implant bone loss

Understanding and managing peri-implant bone loss

Although a high survival rate of implants has been documented in numerous long-term studies, peri-implant bone loss presents a problem that can compromise—or even result in the loss of—a successful dental implant restoration. Dr. Stuart J. Froum offers an in-depth look at how the dental professional can diagnose and prevent bone loss, and maintain a successful implant restoration.

Don't use permanent cement for implants by Chris Salierno, DDS

For the love of everything holy, don't use permanent cement for implants

Whether you prefer screw-retention or cement retention, I think we can all agree that the ability to retrieve the restoration is very important. If there is a fracture of restorative material, such as porcelain or acrylic, then it’s nice to be able to remove the thing and have the lab fix it. I would also urge you to consider how certain contours of the prosthesis can hinder hygienic access, so periodically removing some restorations can significantly aid peri-implant maintenance procedures. But when it comes down to the bitter end, let’s all make a pact together: no more permanent cement for implant restorations.

pumpkin on a toothpick by Stacey Simmons, DDS

Pumpkin on a toothpick

Should mini implants be used for crown and bridge restorations on implants? Dr. Stacey Simmons shares a case study and discusses why these clinical situations should probably be left to regular diameter implants.

Chris Salierno, DDS

3 patients who may not be candidates for complex dental care

Dr. Chris Salierno, co-editor of Surgical-Restorative Resource, says complex care cases take a great multidisciplinary team — the restorative dentist, specialists, laboratory technicians, and hygienist — who work together to effectively plan, execute, and maintain advanced dental therapy. But one critical member of the team that we often forget is the patient. All of the academic and technical skill in the world won’t help a patient who isn’t ready to be helped.

Jonathan Ford, DMD

Dentist-induced peri-implantitis

The restoring dentist directly controls one of the risk factors of peri-implant mucositis and peri-implantitis: residual cement. Dr. Jonathan Ford discusses a recent clinical case he encountered and stresses the need to be extremely diligent when cementing any type of restoration on implants.

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