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Treatment guidelines

Single tooth

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Biologic complications

Extraction of teeth with persistent periapical lesions requires a specific drilling protocol to remove infected bone, to reach healthy trabecular bone and start up a bleeding. Residual dens sclerotic bone may harbor latent pathogenic microorganisms for a...

Complications & long-term success
Peri-implant therapy
Peri-implantitis
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Treatment guidelines

Edentulous

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Sinus lifting

Less than 4-6 mm of vertical residual bone height in the posterior segment of the maxilla is an indication for a sinus augmentation procedure [Esposito]. The external access to the maxillary sinus is carried out at a lateral buccal alveolar...

Posterior implants
Sinus augmentation
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Treatment guidelines

Edentulous

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Tapered implant placement

With appropriate pre-drilling based on their shape upon insertion into the bone, tapered implants will achieve a gradually increasing contact pressure with the surrounding bone and thus provide a high primary stability. This primary...

Immediate implant placement
Edentulous treatments
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Treatment guidelines

Edentulous

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Healed vs fresh extraction socket

The treatment of the edentulous jaw can be a mixture of placing implants in healed and fresh extraction sockets. Unequal hard and soft tissue levels around the implants (Fig. 1&2), especially in the interforaminal region, can be adjusted by leveling the bone...

Immediate implant placement
Success & failure
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Treatment guidelines

Edentulous

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Grafting, maxilla

In the edentulous upper jaw implant insertion can be limited due to the adjacent anatomical structures (nasal floor, maxillary sinus). Less than 5-6 mm in height and 6 mm in width requires augmentation before implant placement....

Bone grafting and regeneration
Sinus augmentation
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Treatment guidelines

Edentulous

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Biologic complications

This is the reversible inflammatory process in the soft tissues around functioning implants. Peri-implant mucositis occurs in almost 60% of subjects (± 30% of sites), restored with implants. Diagnosis is stated by clinical examination: redness, ...

Peri-implantitis
Peri-implant therapy
Local factors
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Treatment guidelines

Edentulous

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Inflammation and infection

Inflammation can be limited to the soft tissue around the implant (mucositis) or involve the underlying bone tissue as well (peri-implantitis). Infection can be caused by various risk factors, such as inadequate hygiene and patient compliance...

Peri-implantitis
Aftercare / follow up
Peri-implant therapy
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Treatment guidelines

Edentulous

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Infection - microbiological diagnostics

Presence/number of implants influences aerobe and anaerobe species in saliva and on tongue in edentulism. Subgingival microbiota in periimplantitis vary according to studies. Less periodontal pathogens than in partial edentulism. Prevotella nigrescens,...

Peri-implantitis
Aftercare / follow up
Peri-implant therapy
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Treatment guidelines

Edentulous

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Smoking

Smoking and nicotine consumption have a constrictive effect on blood vessels thereby reducing blood supply. It increases the susceptibility to periodontal inflammatory diseases, dry extraction sockets and wound healing...

Peri-implantitis
Systemic factors
Patient assessment