Can Dental Implant Develop A Tactile Sensibility Of Its Own?

By evaluating patients to bite on copper foils it is concluded that dental implants develop ability to detect tactile sensations. This is known as osseoperception. Though much of this tactile sensing ability is attributed to the opposing natural tooth in early stages.
Ref: Clinical Implant Dentistry and Related Research, 
DOI 10.1111/j.1708-8208.2009.00252.x

Recent Advances In Implants Every Dentist Ought To Know

How To Manage Papillary Deficiencies Between Implants ?

A number of cases show deficiency of papilla in the interdental area, which may be between implants, or an implant and teeth. This can impose critical esthetic problem for the patient as well as the dentist. The most recent advancement in this field is the injection of hylauronic acid commercially availabel as Restylane (TM). The effect lasts for 6-24 months after which a new dose is required. (1)

Maxillary Sinus Floor Augmentation

Recently Calcium sulfate has been used for maxillary sinus floor augmentation. Calcium sulfate placement showed significant maxillary sinus bone formation. Placement of implants after this procedure led to successful implant placement and loading. (2)

Can Bone Regeneration Occur In Uncontrolled Diabetic Patients ?

Diabetic Patients reporting for implant placement with angular bone loss require bone regenerative techniques before proceeding with implants. Experiments on rats with artificially created bone defects and uncontrolled, drug induced diabetes were carried out. The results were encouraging as it showed significant de novo bone formation via GBR even in uncontrolled diabetics. (3)

Is Osseointegration Possible In Diabetics ?
A review study of MEDLINE/PubMed articles published from 1982 up to and including July 2009 were carried out by researchers. 33 articles were selected. It was concluded that proper glycemic control and HbAA1c in normal range will lead to successful implant osseointegration in diabetics similar to normal individuals. (4)

How Do Implants Fare In Periapically Infected Bone?
Placement of implants in fresh extraction sockets has been taking place for long. How ever a question was intriguing, that whether an immediate implant can survive if placed in an extraction socket of a periapically infected tooth. A 24 months follow up of patients showed 100% success rate in implants placed in the sockets of teeth previously infected at the periapical region. (5)

References:

1. Clinical Implant Dentistry and Related Research  Digital Object Identifier (DOI)
10.1111/j.1708-8208.2009.00247.x
2. Clinical Implant Dentistry and Related Research Digital Object Identifier (DOI) 10.1111/j.1708-8208.2009.00249.x
3. Clinical Oral Implants Research Digital Object Identifier (DOI) 10.1111/j.1600-0501.2009.01805.x
4. Journal of Periodontology 2009, Vol. 80, No. 11, Pages 1719-1730 , DOI 10.1902/jop.2009.090283
5. Journal of Periodontology Posted online on November 4, 2009. http://www.joponline.org/doi/abs/10.1902/jop.2009.090505

By: Dr. Hamid Raihan
Jaipur Dental College
Jaipur.

PERIIMPLANTITS: Challenge in Implant Success

Periimplantitis is an inflammatory process affecting the hard and soft tissues around the functional implant with progressive marginal bone loss eventually resulting in loss of osseointegration

Etiology: Poor oral hygiene, implant design, occlusal disharmony, surgical trauma, periimplant microgap.

Pathophysiology:

Periimplantitis can occur in two different ways depending on the type of etiology:

1. Traditional pathway

Accumulation of plaque debris around the implant leads to the inflammation of periimplant tissues subsequently damaging the supporting osseous tissues.

2. Retrograde pathway

o Occlusal trauma or defective restorations causes micro fractures of the bone-implant interface leading to bone loss and loosening of implant.
o Implant contamination

Diagnostics:

(a)Clinical diagnosis: Based on the following parameters

* Bleeding on probing
* Probing depth
* Mobility
* Suppuration
* Erythema
* Flaccidity of tissues

(b)Microbiological diagnosis:

* Bacterial cultures
* Antibiotic sensitivity tests

(c)Radiological diagnosis:

* Level and amount of bone loss
* Depth of pocket

Differential diagnosis: Peri-implant mucositis

Management: 3 approaches

1. Therapeutic:

* Antimicrobials(Metronidazole, Vancomycin, Amoxicillin) +surgical debridement

* Decontamination(0.10 ml,0.12 % chlorhexidine and saline-Submucosal + 0.2 w/w Minocycline HCl –Subtopical)
* Ozone therapy
* Radiation therapy(Er:YAG laser,CO2 laser, Vector R System)

2. Surgical methods:

* Resective surgical techniques

* Guided tissue regeneration
* Bone grafts/barrier membranes

All these procedures when formulated and performed as a single management plan it is termed as Cummulative Interceptive Supportive Therapy (CISP)

About The Author:

Dr. Dipika Bumb; www.omrcafe.blogspot.com;

Contact email: drdipikabumb@gmail.com

PG,MDS Oral Medicine and Radiology

Dental Implants Nobel Guide

Flapless Implants and Immediate Loading : Dr Cesar Luchetti

By Dr. Cesar Luchetti from Argentina

DDS - National University of La Plata, Buenos Aires, Argentina.
MS in Oral Implantology - National University of La Plata, Buenos Aires, Argentina.
Associate Professor. Department of Implant Dentistry. National University of La Plata, Buenos Aires, Argentina.

Implant dentistry is pushing their limits towards less invasive procedures and with results in a day.

Although this is a valid approach, an adequate diagnosis is necessary to perform these cases in a secure way.

Flapless surgery is usually faster and gives more postoperative comfort to the patient. However, the adequate tridimensional position of the implants must not be sacrificed just to avoid a flap, especially in cases when bone reconstruction is needed.

Long term prognosis is influenced by a good tridimensional positioning of the implants which is determined by the biomechanical requirements of the teeth being replaced.

Immediate loading is useful because the patient retrieves the function instantaneously, but it must be done just in cases with a good initial fixation.

The following video shows a case with a flapless approach.

Implant site development was made with threaded expanders in order to increase bone density allowing a better initial fixation.

The implant used, B&W CIH (Argentina), has an implant carrier who can be adapted as an abutment. A provisory crown was made over it a few moments after surgery.

Dental Implants Video Series

Introduction to Implants

• What are implants
• Where to use implants
• Time duration for completion of implants treatment
• Outcome of implant dentistry

Imtec Mini Dental Implant Dr. Benjamin D. Oppenheimer

Dr. Benjamin D. Oppenheimer is a graduate of the University at Buffalo School of Dental Medicine. There he received a Dean’s letter for Academic Excellence as well as the International Congress of Oral Implantoligists award. He is now one of the leading experts in the world on Mini-Dental Implants. He has taught hundreds of dentists to use minis and currently is a consultant to the IMTEC Corporation, the manufacturer of the MDI product. He is also the author of a number of scientific journal articles on the subject. As well as offering dental implants, Dr. Ben provides all aspects of patient care for adults and children in Amherst, NY. Dr. Oppenheimer also is the president of Foundation Milling Centre, LLC, a dental contract manufactuing firm, and heads research and development for high tech dental products including their yittria-zirconia line of products and sintered diamond abrasives. Dr. Oppenheimer also is a business consultant and Board member for Jenius Industries Inc. and VBS Holdings LLC both technology firms focusing on healthcare and Web 2.0 internet applications.