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.
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.
Dental Implant is being inserted mesial to 14 - FDI Two-Digit Notation, upper right first premolar.
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
Dental Implant placed mesial to 14 - FDI Two-Digit Notation, upper right first premolar.