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More Complications Articles

gingival enlargement, laser, systemic disease

Top causes of gingival enlargement and treatment options

Scott Froum, DDS, editorial director of Perio-Implant Advisory, describes the various causes and dental treatment options for gingival enlargement, a condition mistakenly used synonymously with gingival hypertrophy and gingival hyperplasia. He also presents a new form of surgical treatment that can assist in correcting certain types of gingival enlargement.

bone grafting, dental implant, peri-implantitis, bone loss

Treatment of exposed dental implant surfaces with the minimally invasive bone grafting technique: SMART

As dental implant placement has become ubiquitous in dental practice, interest has increased in treatment options to manage peri-implantitis and other complications. In cases of exposed implant surfaces, a subperiosteal minimally invasive bone grafting technique (SMART) has delivered consistent outcomes without flaps, membranes, or tenting screws, and fewer complications—a promising alternative for the management of peri-implant bone loss.

infection, periodontic, teeth, endodontic

5 questions to ask when determining if teeth with perio-endo infections can be saved

When faced with an infection from an endodontic, periodontic, or combination lesion, is it worth trying to save the tooth involved versus replacing it with a dental implant or bridge? Dr. Scott Froum, Perio-Implant Advisory's editorial director, and Dr. Marcus Johnson explain how to diagnose the infection and suggest questions to ask as you decide upon treatment.

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.

how much do you guarantee a dental implant for?

'If I choose the dental implant option, how long do you guarantee it?'

This question can be a tough balancing act for the dentist being that you do not want to give patients false expectations, but at the same time, you do not want to have your patients forgo treatment they need or go to another dental office. Perio-Implant Advisory’s Editorial Director Dr. Scott Froum posed this question to 100 different dentists of varying years in practice, in various locations throughout the United States, of those who place dental implants. Here is a sample of responses from some of the leaders in the dental implant industry.

anxious girl - Dreamstime.com

It's 10 p.m.; do you know where your patient's hemostasis is?

If you are a dentist who performs surgical treatment, such as extractions and/or implant therapy, a dreaded phone call can be from your emergency service regarding a patient you treated earlier in the day who now has uncontrollable bleeding. This is of greater concern if the patient has a medical history that warrants anticoagulation medication and the physician did not let your patient go off medication prior to surgery. Dr. Scott Froum, editorial director of Perio-Implant Advisory, introduces the feature article on hemostasis that will help you answer pertinent questions prior to surgery.

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