Views: 271 Author: Kaylee Publish Time: 2023-09-01 Origin: Site
It is crucial to choose patients carefully and organize your strategy thoroughly. Always determine the patient's suitability for implant treatment prior to any procedure based on their general medical history, periodontal health, and oral hygiene.
Additionally, I strongly advise using 3D imaging and planning software for the diagnosis and planning of the treatment. CBCT analysis of bone volume enables preoperative implant selection, taking into account anatomical risk factors in terms of length and diameter. You can optimize the anticipated implant placement depending on the desired ultimate treatment outcome because the planning also takes tissue management and the final prosthesis into account.
It should be the goal of implant site preparation to minimize bone stress and promote primary stability. As a result, understanding the bone quality is necessary for site preparation.
The amount of guesswork that this requires presents a significant barrier at this point. If you are not an implant specialist or have less experience with implant treatment, you should regularly attend hands-on training to improve this ability. I especially recommend attending cadaver training courses. placement based on the desired final treatment outcome. While the experienced implantologist might "feel" the bone quality with the first drill.
This information is crucial because the drilling strategy must be adjusted based on the quality of the bone in order to avoid over- or under-sizing the implant site. Traditional site preparation calls for the use of many drills of varying diameters, which, when combined with irrigation, cause damage to the alveolar bone nearby—a so-called "zone of death." Osseointegration may be hampered if the trauma is sufficiently severe, which can happen particularly in a lower jaw with mostly cortical bone (bone quality I). Vertical resorption may take place if the platform is the primary site of the trauma. The primary stability of the implant is further compromised by excessive preparation of primarily cancellous bone (bone quality IV), which may result in early implant loss.
The choice of the implant itself comes next, and this is where the condition of the bone and how well the implant site has been prepared come into play once more. Selection of the implant (geometry, diameter, and platform) and implant site preparation (inadequate osteotomy preparation) affect primary stability and are crucial for osseointegration. 7 The torque value is an often-debated number. For immediate loading, high torque values are frequently considered advantageous. Overtightening, however, has the potential to fracture or harm the implant, necrose the bone site, and result in early implant failure.
Although a common torque value of 35 Ncm is frequently advised, I personally do not think that the torque values of the various implant systems are comparable because each implant's unique geometry has a different effect on the bone. You should abide by the maximum torque values recommended by the implant manufacturer.
Success depends on a seamless and tension-free connection between the implant and the superstructure, as well as regular follow-up visits shortly after the procedure and stable dental hygiene.With both immediate loading and delayed restorations, you should strive for a prosthetic reconstruction that is gap- and tension-free. In the absence of this, vertical bone loss, screw loosening, and subsequent peri-implant problems take place. Taking an impression of several implants includes the hazards of errors and tension, which should be taken into consideration when planning a screw-retained restoration, especially with connections with a deep cone. If a screw becomes loose, the restoration must be taken out, the problem must be identified, and a fresh original implant system screw must be put in.
