More Complications Articles

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

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.

This month’s clinical tip from the editor: After a tooth extraction, are you guilty of chucking the tissue? by Scott Froum, DDS

This month's clinical tip from the editor: After a tooth extraction, are you guilty of chucking the tissue?

There are many etiologies behind the development of a radiolucent lesion at the apex of a tooth root. What clinicians are most familiar with are lesions of endodontic origin. But what happens when that lesion is of nonendodontic origin? What happens when the clinician proceeds with business as usual and performs an apicoectomy or extraction with subsequent implant placement because of a perceived root canal failure down the line? Perio-Implant Advisory Editorial Director Scott Froum, DDS, and Dr. Naomi Ramer, chief of oral pathology at Mt. Sinai Hospital, offer advice on how to handle these situations.

This month’s clinical tip from the editor: ‘The implant you put in my mouth is now bleeding; what should I do?’ by Scott Froum, DDS

This month's clinical tip from the editor: 'The implant you put in my mouth is now bleeding; what should I do?'

A dreaded phone call that every dental office involved in dental implant therapy may encounter is when a patient calls and says, “Hey Doc, the implant you put in my mouth a few days (or months or years) ago started to bleed.” Most often patients will claim that the problem started “out of the blue” and they tried rinsing their mouths with various medicaments all to no avail. Perio-Implant Advisory Editorial Director Scott Froum, DDS, shares his advice and gives the top five reasons why implant restorations can bleed in his clinical tip of the month.

healing abutment Scott Froum, DDS

This month's clinical tip from the editor: 'Help! My implant fell out!'

When a patient calls your dental office saying, “The implant you put in my mouth fell out. What should I do?” Dr. Scott Froum, editorial director of Perio-Implant Advisory, suggests you tell the patient to send you a picture via text of the “implant that has fallen out.” Nine times out of 10 it will be a healing abutment usually caused by noncompliance with postop instructions to have a soft food diet rather than the implant.

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.

Tina Beck, DDS

A periodontist's protocols to avoid dental implant complications: Part 1

Dental implants are becoming increasingly common with greater long-term success rates. However, there are some basic principles and guidelines clinicians should follow to achieve high predictability and long-term stability. Dr. Tina Beck shares her office’s protocol, which has improved patient case acceptance, understanding of treatment timelines, compliance with postoperative instructions and multiple appointments, predictable restorative outcomes, healthy peri-implant tissues, and stable long-term results.

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.

Guillaume Gardon-Mollard, DDS

Dental implant therapy in the future

Contrary to a common belief of patients and even of some dentists, dental implant therapies are not everlasting. Guillaume Gardon-Mollard, DDS, goes through a case of a 61-year-old woman, with no particular health problem who comes to his practice, seeking help to escape from an implant rehabilitation dead end.

peri-implantitis dental

Literature review: Peri-implant disease

Surgical-Restorative Resource™ Co-Editor Chris Salierno, DDS, cites key literature references as he focuses on the subject of peri-implant disease, which can be divided into peri-implant mucositis and peri-implantitis.

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