These are functional and esthetic problems that can be solved by prosthetic gingival reconstruction in Dental Implants:
1. Narrow and longer prosthetic teeth.
2. Inverted smile line.
3. Misalignment of the tooth axes.
4. Unsupported lip profile.
Individual papilla loss and situations of horizontal and vertical tissue dificiencies of the anterior region are some of surgical limitations of augmentation that can be solved by prosthetic gingiva.
Wax-up of Implant Supported Prosthesis with Artificial Gingiva
Indications for Dental Implant Treatment
1. Edentulous patient.
2. Partially edentulous patient with history of difficulty in wearing removable partial dentures.
3. Patient with missing dentition requiring long span fixed partial denture (bridge) treatment.
4. Patient who refuses using removable type dental prosthesis.
Hobo S, Ichida E, Garcia L T: Osseointegration and Occlusal Rehabilitation, Quintessence Publishing Co., Ltd. 1989
Radiation therapy is defined as the therapeutic use of ionizing radiation. The 2 principal types of ionizing radiation are electromagnetic irradiation and particle irradiation. In irradiation of implants in bone, it is recommended the removal of all abutments and superstructures and closure of skin and mucosa over the implants prior to radiation.  Radiation therapy can begin when healing is complete.
Irradiation of dental implants in bone results in backscatter. The tissues on the radiation source side of the implants receive a higher dose than the other tissues in the field. The dose in increased by about 15% at 1 mm from the dental implant. 
1. Granstrom G, Tjellstrom A, ALbrektsson T: Postimplantation irradiation for head and neck cancer treatment. Int J Oral Maxillofacial Implants 1993;8(4):495-500.
2. Wall JA, Burkee EA: Gamma dose distribution at and near the the interface of different materials. IEEE Trans Nucl Sci 1970; 17:305.
Application of chlorhexidine gel for filling implant cavities prior to connecting implant components:
1. After removal of the existing implant component such as the insertion post, healing cap or abutment, rinse the implant cavity with 0.2% chlorhexidine solution for cleaning and disinfection, using a syringe with a plastic cannula.
2. Remove the remaining chlorhexidine solution with suction.
3. Fill the implant cavity completely with 1% chlorhexidine gel, again using a syringe with a plastic cannula.
4. Connect the previous or a new implant component to the implant using a torque device and the torque recommended by the implant manufacturer.
5. Remove any excess chlorhexidine gel that is extruded from the implant cavity during insertion of the implant components of suction.
6. Rinse chlorhexidine gel remnants with water spray.
7. Complete subsequent procedures.
Kern M: Antimicrobial Filling of Implant Cavities, The Journal of Prosthetic Dentistry May 2010
Angulated Abutment is an innovative component designed to adjust access hole position, prosthetic screw angulation and improve cosmetics. Before the development of Angled Abutments, if screws and access holes were positioned jutting through the labial aspect of an anterior tooth, there were basically three options:
1. The double casting technique.
2. Unsightly patch marks which closed the access holes after final insertion.
3. The combination of implant supported posts securing a crown and bridge type prosthesis.
Implant Angulated Abutments
Factors to Consider in Dental Implant Treatment
1. How does the patient feel about surgery?
2. Is the patient prepared to pay the costs involved in implant theraphy?
3. Does the patient have sufficient bone to place dental implants? Bone grafting may be required and this could be a barrier to treatment.
4. If bone grafting is required, is the patient prepared to accept this?
5. Is the patient prepared to accept the burden of maintenance associated with implant retained prosthesis?
Implant Analog for Impression
Tools for titanium machining are used for drilling of titanium abutment. The fixture must be well fixed and correct RPM must also be checked before drilling. There must be adequate cooling so that overheating of abutments is prevented.
Titanium Implant Abutment Component
The success rate of bone grafts in the jaw for dental implants is high. But, there is always a chance that the bone graft will fail. They are not rejected like organ transplants. Failure of bone graft is usually because of infection. There’s also higher risk of bone graft failure in patients who smoke and those with certain medical conditions.
Torque wrench was used to to achieve the desired dental implant bone contact and avoid too much compression on the bone that may lead to necrosis of the implant bed.
Implant was placed mesial to tooth number 22 (FDI Two-Digit Notation).
Following dental implant surgical sequences and protocols, drilling should follow the desired RPM with copious irrigation preferably with an NSS refrigerated the night before surgery.