A cement type prosthesis is recommended in most dental implant cases. The said type of prosthesis has a simple procedure with lesser number of components and most prosthetic complications which could develop later can be resolved by recementation. Impression taking and correct passive fit can be obtained much easier. There is also a study that cement buffer biting force.
Dental Implant body is installed with the recommended insertion torque. Appropriate insertion torque is needed to avoid too much compression of the bone. Excessive compression on the bone blocks blood supply and may lead to necrosis of the implant bed.
These are the Guidelines in Treatment of Aesthetic Implant Cases, according to Dr. Sherwin Villareal, Resident Oral Implantology, Ashman Department of Periodontology and Implant Dentistry, New York University, College of Dentistry.
1. Pre-surgical planning
2. Site development
3. 3-D Implant positioning
4. Soft tissue management
6. Prosthetic management
Bone quality for the 3rd implant is assessed under the raised full thickness flap. Drilling should follow the same desired RPM ang copious irrigation preferably with an NSS refrigerated the night before the surgery.
According to Dr. Sherwin Villareal – NYU, “The establishment of optimum and predictable esthetics is one of the most important and challenging aspects of rehabilitaion with dental implants.” Esthetic rehabilitation has to be predictable implying reproducibility and stability of the outcome in both short and long term. Achieving these characteristics depends on the interactions between multiple valuables namely biological, surgical, prosthetic and implant design.
Dental Implants which are favorable to immediate placement after extraction are as follows:
For immediate replacement after extraction, initial fixation is very important because the contact area between fixture and bone is inevitably small. Therefore, a tapered implant with has excellent initial fixation is more favorable than the straight type.
Implant Favorable to Bone Grafts
In case of placement after extraction, Guided Tissue/Bone Regeneration or GBR is frequently performed because of the dehiscence or space between the fixture and alveolar bone. Therefore, an implant design with a proper surface treatment for its alveolar ridge should be selected.
Dental Implants after RTR placement and before suturing. Thorough understanding of the rationale of specific suturing techniques and materials used is important to get proper implant closure.
GTR or Guided Tissue Regeneration material is placed in bony defect area. It is used to to assist in regeneration of bone tissue to maximize the potential for success of dental implant procedure.
Implant closure – the mucosa was sutured in a water-tight manner.