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Endosseous Implants
Presented by
Haifa
CONTENTS
Introduction
Definition
Classification of failures
Warning signs of implant failure
Treatment
Summary and Conclusion
Reference
Introduction
Endosseous dental implants have been a successful
treatment alternative for restoring missing teeth.
Since
the
introduction
of
the
concept
of
dramatically
understanding
of
bone
because
response
of
and
better
the
However,
treatment
is
not
always
the
reasons
for
implant
others
have
attributed
dental
traumatic
retention
resulting
prosthetic
occlusion,
from
restoration,
debris
improper
and
bone
of
otherwise
successful
Definition of implant
failure
Implant failure: The total failure of the
implant
to
fulfill
its
purpose
different
understanding
equilibrium,
implants
and
elements
of
the
where
the
in
the
biomechanical
osseo-integrated
surrounding
bone
integration
result
in
does
a
not
satisfied
of
failure
caused
by
Connecting screw
loosening
Connecting screw
fracture
Fracture prosthetic
component
Classification
According to condition of failure
By Meffert
Ailing Implant
Failing Implant
Failed Implant
According to etiology
Host factor
Surgical factor
Implant selection factor
Restorative factor
stage II
After stage II
After restoration
of osseointegration
Unacceptable aesthetics
Functional problems
Psychological problems
tissue loss
Bone loss
Combination
Host factor
Medical status
Habits
Oral status
Medical status
Osteoporosis and other bone diseases.
Postmenopausal osteoporosis is a skeletal disorder
in which there is a decrease in bone density and
bone mass. It is considered_to be a relative
contraindication
caused
by
for
osseointegrated
decreased
bone
density,
implants,
which
'implant-
Habits
Smoking: Studies have shown that
'One of the primary factors that leads
to implant failure is smoking
Para
functional
habits
Habits such as bruxing and Clenching
create
mechanical
and
complications
related
components,
materials
anchored
hardware
or
to
biologic
prosthetic
and
the
Bonestate
of
osseointegration.
This is the m.ost common cause of
implant bone loss or lack of rigid fixation
during first year after implant insertion
English
,occlusal
contacts
in
implants
to
provide
Misch
recommends
intervals
increased
between
time
prosthetic
for
progressive
bone
Oral status :
Management
It is recommended that the patient be
recalled frequently, preferably at a
minimum of 3-month intervals.
are
similar
to
the
microbiota
of
Irradiation therapy :
the
Surgical factors
failure. No design is
Contamination of
before insertion .
the
implant
body
Contaminated
IMPLANT SELECTION
Restorative Problems :
Excessive cantilever :
For partially
Pier abutments :
Because of the difference in mean axial
displacement between natural teeth and
implants the breakdown of supporting
tissues is extremely rapid because the
dental implant will take most of the
load as a result of difference in mean of
axial displacement
No passive fit :
Achieving a passive fit during prosthesis
insertion is considered to be one of
the
keys
to
success
of
dental
components,
and
bone
fixture
microbial
population
and
strain
on
the
implant
presurgical
prosthetic
Existing occlusion
Existing prostheses
Number and location of missing teeth
Lip line
Mandibular flexure
Bending moments:
Bending
implant
supported
prosthesis
Premature loading:
Too rapid loading of the implant support
systeem is considered to be one of the
most common causes of prosthetic
related failure.
Branemark stated that strict protocol
requires a stressfree healing period of 3
to 6 months for osseoingration to occur.
Excessive torquing:
Preloading of the implant components
was first accomplished by hand. Then,
a torque wrench was introduced to
apply a fixed amount of torque .
Acid-etched
surfaces
resisted
After restoration
Before stage II
It
Implant
misplacement,
that
is
previously
augmented
or
Infection
Lack
of biocompatibility
Excessive
Lack
surgical trauma
implant
connection
prosthetic placement
and
before
Could be due to
Excessive torquing during abutment
connection.
of an insufficient bone contact
surface area with the implant .
Poor surface treatment of the fixture.
the
recommended
time,
or
The
implant
can
asymptomatically
stay
because
in
place
of
its
before
prosthetic
After restoration
This particular timing of failure is
most
common.
It
starts
after
an
It
has
its
own
clinical
Peri-implantitis
Bacterial invasion of the peri-implant
tissues
results
in
soft
tissue
inflammatory changes and rapid bone
loss.
The clinical signs of inflammation,
bleeding, and purulence, in addition to
increased
mobility,
peri
implant
radiolucency,
and
probing
depths
greater than 6 mm, are associated with
failing implants.
PERIMPLANTITIS
Prevention
Selection of implant candidate
Complete periodontal therapy before
implant placement
Maintenance of good oral hygiene
Regular recall appointments
Early intervention , treatment at the
stage of mucositis
Retrograde periimplantitis
Retrograde
implant
loading
or
The
microflora
is
The
biomechanical
demand
has
They
not
accommodate
increased
Another
fact
is
that
with
overload,
natural
teeth
because
the
Prevention
Careful
Increased
Precise
no of implants
implants
Proper
follow up
of osseointegration
Unacceptable
Functional
aesthetics
problems
Psychological
problems
Lack of osseointegration
Osseointegration
is
defined
as
remodeled
surface
bone
and
without
an
the
Adell
et
al
proposed
that
lack
of
Surgical trauma
can
result
from
surgical
potential
or
bone-to-
formation occurs,
of
bone-to-
fibrocartilage
whereas
loss
of
osseointegration
Thin
radiographically
Thin
fixture removal
Unacceptable esthetics
The esthetic outcome of an isp
affected by 4 factors :
Improper placement
Soft tissue management
Bone grafting considerations
Prosthetic considerations
Positional failure
Malposition
Biomechanical failures
These types of failures range from
loosening of screws to breakage of
implant components and implants.
Failures can be avoided with proper
treatment
planning,
a
good
understanding
of
screw
joint
mechanics and knowledge of the
implant system used.
Functional problems
The
masticatory
efficiency
of
an
implant
Functional problems
The
masticatory
efficiency
of
an
implant
Anchorage
related factors
Osseo integration
Marginal bone height
Prosthesis
related factor
Prosthesis design
Occlusal scheme
Psychological problems
Failure to fulfill the patient expectations and
failure to gain the patient acceptance and
satisfaction with such treatment will
definitely be considered part of the failure.
Educational tools (eg, slides, radiographs,
models, pictures, real cases, and computer
imaging) should be used before surgery to
give the patient an image of what he or she
will look like after treatment.
tissue problems
Bone
loss
Both
Soft
tissue
proliferation
may
occur
under
bevel
resection
as
used
in
or
discomfort
may
the
less
than
satisfactory
Bone loss
which
withstands
applied
Improper
stress
distribution
defective
prosthetic
design
caused
and
by
occlusal
trauma
Failing
These
Failed
impants
are
those
with
Radiographically,
failed
ones
own
long-term
With
proper
treatment
implants
patient
selection
planning,
to
support
using
and
dental
restorations