Surgical Trauma in Dental Implants

Heat produced during the time of drilling, elevation from the periosteal flap and excessive pressure in the crestal region throughout implant positioning may lead to implant bone loss throughout the recovery.

Heat generation and excessive pressure

Eriksson and Albrektsson reported the critical temperature for implant site preparation was 47 degrees Celcius for just one minute or 40 degrees Celcius for seven minutes. Matthews and Hirsch shown that temperature elevation was affected more through the pressure applied than drill speed. When both drill speed and applied pressure were elevated, no significant rise in temperature was observed because of efficient cutting.

Sharawy et al. in comparison the heat produced through the drills of 4 different implant systems run at speeds of just 1,225, 1,667 and 2,500 revoltions per minute. All the drill systems could prepare an 8 mm site with no temperature rising by a lot more than 4 Celcius (to 41 Celcius).
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CAD CAM in Dental Implants

In recent years, implant technique is widely used for replacing a lost dentition inside the oral cavity. Osseointregrated implant system has been introduced and used in many countries. A lot of company offers various implant system in the market worldwide. Different fabrication style of implant are now available but with the advancement of technologies, like the development of different system supported by computer, CAD-CAM is now used in almost all dental lab field.

Pointers in applying CAD CAM System to fabricate implat structures abutment
1. Design, diagnosis for implant restoration.
2. Immediate pressure for implant restoration.
3. Fabrication of custom abutment.
4. Implant abutment structure fabrication by using CAD CAM System.
5. Occlusion in implant restoration.

Demineralized Dentin Matrix on Alveolar Bone with Implant

One study in Korea, describes the use of autogenous demineralized dentin matrix as material for repair of various alveolar bone defect. According to the study, several cases of tooth and alveolar bone loss were treated with titanium implants with demineralized dentin matrix as bone grafts.

Wounds were classified:
1. Guided Bone Regeneration with demineralized dentin matrix powder.
2. One or two wall repair with root form.
3. Volume or anatomic defect repair with root on.
4. Socket preservation.
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Protocols in Implant Dentistry

With the increasing number of implant pratitioners, the dental laboratories need to be ready to support the demand for implant supported dentures. There are requirements needed in fabricating both fixed and removable dentures. Both dentists and dental technicians should have a common understanding of the techniques and procedures involved. Protocols for both dental clinics and dental laboratories should be established and observed as they work together on implant cases.
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Implant System in Anterior Esthetics

Dental Implant therapy has been a predictable treatment modality in long term studies. Nevertheless, the predictability of anterior dental implant esthetics has always been a challenge for the long term results.

Since the alveolar bone around implant platform area constantly shows bone resorption of approximately 1.5 mm in depth and 1.4 mm in depth after function, the recession of gingiva around the implant occurs.

It is possible that we can maintain the alvoelar bone. There are differences among implant systems, regarding bone resorption. Implant designs cause different degrees of bone resorption. Implant and abutment design create differences in anterior esthetics.

Implant System in Anterior Esthetics