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Contemporary Implant Dentistry - E-Book

Contemporary Implant Dentistry - E-Book

Carl E. Misch

(2007)

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Book Details

Abstract

Turn to this new third edition for consistent outcomes on even your most complex implant cases! World-renowned dental implantologist Carl E. Misch gives you expert advice and guidance on the various surgical approaches to placing implants in the revision of his best-selling classic. Over 1,000 full-color illustrations depict details of implants, related materials, and surgical procedures, while well-known contributors (Mohamed Sharawy, Martha Warren Bidez, Adriano Piatelli, and others) share a wealth of knowledge in their respective fields. This third edition provides an excellent opportunity for you to develop and refine your skills and experience more consistent, predictable clinical outcomes.

  • Thorough explanations of the rationale for implants and their specific characteristics discuss why different options work better for different patients; the rationale behind implant materials and sizes; and the overall science of osteointegrated implants – providing a full understanding of how implants behave under certain circumstances and how to make the best choices for implant patients.
  • Chapter on Diagnostic Imaging and Techniques focuses on the latest technology available to determine patient conditions, familiarizing you with recent advances and how they apply to treatment planning principles.
  • Section on Treatment Planning discusses the rationales for implant placement, variables in implants and patient conditions, and the four degrees of jaw bone density, Dr. Misch’s best-known criterion for successful implant placement.
  • Prepares you for actual treatment by reviewing scientific fundamentals such as applied anatomy, biomechanical principles, current biomaterials, prevention and management of dental infections, and pharmacologic considerations.
  • Surgical procedure chapters are of benefit to the implant surgeon and are critical to the restoring dentist who wants to better understand and appreciate surgical concepts.
  • Over 1,000 full-color illustrations depict details of implants, related materials, and surgical procedures.
  • Brand-new coverage includes: Key Implant Positions and Number, Ideal Implant Surgery, Extraction Socket and Barrie Membrane Bone Grafts, Sinus Pathology and Complications of Sinus Grafts, Immediate Loading for a Single Tooth, Partially Edentulous and Completely Edentulous Patient.
  • Important updates include indications and contraindications for rationale of biomechanical treatment plans, layered approach to bone grafting, autograft block bone grafting, soft tissue surgery, and implant esthetics and maintenance.
  • A new chapter on Tissue Engineering uses current information on platelet-rich plasma membranes and other elements of tissue engineering so you can take advantage of appropriate materials.
  • Emphasis on evidence-based implant outcomes provides valuable information on which procedures have the greatest likelihood of success and lowest risk of complications.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Contemporary Implant Dentistry iii
Copyright Page iv
Table of Contents xv
Contributors v
Foreword vii
Dedication viii
About the Author ix
Preface xi
Acknowledgments xiii
Part I: Rationale for Implants 1
Chapter 1. Rationale for Dental Implants 3
EFFECTS OF AN AGING POPULATION 3
AGE-RELATED TOOTH LOSS 5
ANATOMICAL CONSEQUENCES OF EDENTULISM 9
DECREASED PERFORMANCE OF COMPLETE DENTURES 15
NEGATIVE CONSEQUENCES OF REMOVABLE PARTIAL DENTURES 16
PSYCHOLOGICAL ASPECTS OF TOOTH LOSS 17
ADVANTAGES OF IMPLANT-SUPPORTED PROSTHESES 17
SUMMARY 21
References 22
Chapter 2. Generic Root Form Component Terminology 26
GENERIC PROSTHETIC COMPONENT TERMINOLOGY 27
GENERIC IMPLANT BODY TERMINOLOGY 28
IMPLANT BODY REGIONS 29
IMPLANT SURGERY 30
SUMMARY 34
References 35
Chapter 3. Diagnostic Imaging and Techniques 38
IMAGING OBJECTIVES 38
IMAGING MODALITIES 38
PRESURGICAL IMAGING (PHASE 1) 39
PERIAPICAL RADIOGRAPHY 40
DIGITAL RADIOGRAPHY 41
OCCLUSAL RADIOGRAPHY 42
CEPHALOMETRIC RADIOGRAPHY 43
PANORAMIC RADIOGRAPHY 44
TOMOGRAPHY 46
COMPUTED TOMOGRAPHY 47
INTERACTIVE COMPUTED TOMOGRAPHY 52
MAGNETIC RESONANCE IMAGING 54
RADIOGRAPHIC IMAGING OF VITAL STRUCTURES IN ORAL IMPLANTOLOGY 56
RECOMMENDED PRESURGICAL TREATMENT PLANNING 58
INTRAOPERATIVE IMAGING 58
FABRICATION OF DIAGNOSTIC TEMPLATES 62
IMPLANT IMAGING IN PERSPECTIVE 64
References 65
Chapter 4. Stress Treatment Theorem for Implant Dentistry 68
SURGICAL FAILURE 69
EARLY LOADING FAILURE 70
IMPACT OF OCCLUSAL OVERLOAD ON MECHANICAL COMPONENTS 70
MARGINAL BONE LOSS 72
EFFECT ON TREATMENT PLANNING 84
SUMMARY 87
References 88
Chapter 5. Prosthetic Options in Implant Dentistry 92
COMPLETELY EDENTULOUS PROSTHESIS DESIGN 92
PARTIALLY EDENTULOUS PROSTHESIS DESIGN 94
PROSTHETIC OPTIONS 94
SUMMARY 102
References 104
Chapter 6. Treatment Planning: Force Factors Related to Patient Conditions 105
NORMAL BITE FORCE 105
PARAFUNCTION 106
CROWN HEIGHT SPACE 117
MASTICATORY DYNAMICS 124
ARCH POSITION 125
OPPOSING ARCH 126
SUMMARY 127
References 127
Chapter 7. Bone Density: A Key Determinant for Treatment Planning 130
INFLUENCE OF BONE DENSITY ON IMPLANT SUCCESS RATES 130
ETIOLOGY OF VARIABLE BONE DENSITY 131
BONE CLASSIFICATION SCHEMES RELATED TO IMPLANT DENTISTRY 134
MISCH BONE DENSITY CLASSIFICATION 134
BONE DENSITY LOCATION 135
RADIOGRAPHIC BONE DENSITY 137
BONE DENSITY—TACTILE SENSE 138
SCIENTIFIC RATIONALE OF A BONE DENSITY–BASED TREATMENT PLAN 138
TREATMENT PLANNING 142
SUMMARY 144
References 144
Chapter 8. Treatment Plans Related to Key Implant Positions and Implant Number 147
ABUTMENT OPTIONS 147
IMPLANT NUMBER 154
SPLINTED IMPLANTS 157
SUMMARY 158
References 159
Chapter 9. Implant Body Size: A Biomechanical and Esthetic Rationale 160
CHARACTER OF FORCES APPLIED TO DENTAL IMPLANTS 160
SURFACE AREA 163
IDEAL IMPLANT SIZE 166
IMPLANT DIAMETER 168
NATURAL TEETH 173
IMPLANT SIZE BASED ON ESTHETICS 174
SUMMARY 175
References 176
Chapter 10. Available Bone and Dental Implant Treatment Plans 178
LITERATURE REVIEW 178
AVAILABLE BONE 180
DIVISIONS OF AVAILABLE BONE 184
SUMMARY 197
References 198
Chapter 11. Scientific Rationale for Dental Implant Design 200
IMPLANT DESIGN RELATED TO OCCLUSAL FORCES 202
IMPLANT BODY: FUNCTIONAL VERSUS THEORETICAL SURFACE AREA 206
IMPLANT BODY GEOMETRY VERSUS OCCLUSAL LOAD 207
SCIENTIFIC RATIONALE FOR IMPLANT DESIGN 208
IMPLANT BODY BIOMATERIAL RELATED TO FRACTURE 221
FORCE DURATION AND IMPLANT BODY DESIGN 223
IMPLANT BODY SIZE AND DESIGN RELATED TO FRACTURE 223
SUMMARY 226
References 226
Part II: Treatment Planning 231
Chapter 12. Preimplant Prosthodontics: Overall Evaluation, Specific Criteria, and Pretreatment Prostheses 233
MAXILLARY ANTERIOR TOOTH POSITION 233
EXISTING OCCLUSAL VERTICAL DIMENSION 234
MANDIBULAR INCISOR EDGE POSITION 238
EXISTING OCCLUSAL PLANES (POSTERIOR MAXILLARY AND MANDIBULAR PLANES OF OCCLUSION) 238
LIP LINES 241
MAXILLOMANDIBULAR ARCH RELATIONSHIP 243
EXISTING OCCLUSION 244
CROWN HEIGHT SPACE 245
TEMPOROMANDIBULAR JOINT 250
EXTRACTION OF TEETH WITH HOPELESS OR GUARDED PROGNOSIS 250
EXISTING PROSTHESES 253
ARCH FORM 253
NATURAL TEETH ADJACENT TO IMPLANT SITE 255
SOFT TISSUE SUPPORT 267
FIXED RESTORATIONS 268
REMOVABLE PROSTHESES 269
OCCLUSAL VERTICAL DIMENSION 269
ESTHETIC ASSESSMENT 270
PSYCHOLOGIC ATTITUDE 270
FINANCIAL BARRIERS 270
PROGRESSIVE LOAD 270
SUMMARY 270
References 272
Chapter 13. Diagnostic Casts and Surgical Templates 276
DIAGNOSTIC CASTS 276
RESTORATIVE DIAGNOSIS VERSUS SURGICAL DIAGNOSIS 279
SURGICAL GUIDES 280
ADVANCED SURGICAL GUIDANCE 284
SUMMARY 290
References 290
Chapter 14. The Edentulous Mandible: An Organized Approach to Implant-Supported Overdentures 293
REVIEW OF THE LITERATURE 294
ADVANTAGES OF IMPLANT OVERDENTURES 295
DISADVANTAGES OF IMPLANT OVERDENTURES 297
OVERDENTURE MOVEMENT 298
MANDIBULAR IMPLANT SITE SELECTION 299
OVERDENTURE TREATMENT OPTIONS 300
DIVISION C–H ANTERIOR MANDIBLES 309
DISCUSSION 310
SUMMARY 310
References 310
Chapter 15. The Completely Edentulous Mandible: Treatment Plans for Fixed Restorations 314
COMPARING FIXED VERSUS REMOVABLE IMPLANT PROSTHESES 314
FORCE FACTORS 315
MANDIBULAR DYNAMICS 316
IMPLANT TREATMENT OPTIONS FOR FIXED RESTORATIONS 318
LONG-TERM TREATMENT PLANNING 324
SUMMARY 325
References 325
Chapter 16. Single-Tooth Replacement: Treatment Options 327
POSTERIOR MISSING TOOTH 327
POSTERIOR SINGLE-TOOTH REPLACEMENT OPTIONS 327
CONTRAINDICATIONS AND LIMITATIONS OF POSTERIOR SINGLE-TOOTH IMPLANTS 333
IMPLANT BODY SELECTION 335
PREMOLAR IMPLANT REPLACEMENT 335
FIRST-MOLAR IMPLANT REPLACEMENT 337
ESTHETIC MAXILLARY ANTERIOR TOOTH REPLACEMENT 340
ALTERNATE TREATMENT OPTIONS FOR ANTERIOR SINGLE-TOOTH REPLACEMENT 341
SPECIFIC SINGLE-TOOTH IMPLANT INDICATIONS 351
IMPLANT CREST MODULE DESIGN 360
SUMMARY 362
References 362
Chapter 17. Maxillary Arch Implant Considerations: Fixed and Overdenture Prostheses 367
EDENTULOUS ANTERIOR MAXILLA 367
TREATMENT OPTIONS 369
PREMAXILLA PARTIALLY EDENTULOUS TREATMENT PLANS 378
COMPLETELY EDENTULOUS MAXILLAE TREATMENT PLANS 379
SUMMARY 387
References 387
Chapter 18. Treatment Planning for the Edentulous Posterior Maxilla 389
ANATOMICAL CONSIDERATIONS FOR THE POSTERIOR MAXILLA 389
ANATOMY 390
TREATMENT HISTORY 394
SUMMARY 401
References 403
Chapter 19. Treatment Plans for Partially and Completely Edentulous Arches in Implant Dentistry 406
PARTIALLY EDENTULOUS ARCHES 406
HISTORY 406
CLASSIFICATION OF PARTIALLY EDENTULOUS ARCHES 406
CLASSIFICATION OF COMPLETELY EDENTULOUS ARCHES 413
SUMMARY 417
References 418
Part III: Fundamental Science 419
Chapter 20 Medical Evaluation of the Dental Implant Patient 421
MEDICAL EVALUATION 421
MEDICAL HISTORY 423
LABORATORY EVALUATION 427
SYSTEMIC DISEASE AND ORAL IMPLANTS 434
SYSTEMIC AUTOIMMUNE DISEASES 454
MEDICATIONS OF INTEREST TO IMPLANT DENTISTRY 455
LIFESTYLE-RELATED FACTORS 458
IRRADIATION 460
References 461
Chapter 21. Pharmacology in Implant Dentistry 467
ANTIMICROBIALS 467
THERAPEUTIC USE OF ANTIBIOTICS: POSTOPERATIVE INFECTIONS 472
MANAGEMENT OF POSTOPERATIVE INFLAMMATION 474
POSTSURGICAL PAIN MANAGEMENT 476
MANAGEMENT OF POSTOPERATIVE PAIN 477
COMBINATION ANALGESIC THERAPY FOR POSTOPERATIVE PAIN 480
SEDATIVE AGENTS 483
COMPREHENSIVE PHARMACOLOGIC PROTOCOL 486
References 486
Chapter 22. Applied Anatomy for Dental Implants 490
SURGICAL ANATOMY OF THE MAXILLA AS AN ORGAN 490
SURGICAL ANATOMY OF THE MANDIBLE 495
BLOOD SUPPLY TO THE MAXILLA AND MANDIBLE 498
References 501
Chapter 23. Spread of Dental Infection in the Head and Neck 502
SIGNIFICANT COMPLICATIONS AND IMPLANT DENTISTRY 502
PATHOLOGIC ENTITIES 503
MAXILLARY INFECTIONS 503
MANDIBULAR INFECTIONS 505
SIGNIFICANT COMPLICATIONS OF INFECTIONS IN THE FACE AND NECK 508
LYMPHATIC SPREAD OF INFECTION 508
SUMMARY 509
BIBLIOGRAPHY 510
Chapter 24. Biomaterials for Dental Implants 511
COMPATIBILITY OF SURGICAL BIOMATERIALS AND THE ROLE OF SYNTHETIC MATERIALS 511
BULK PROPERTIES 511
PHYSICAL, MECHANICAL, AND CHEMICAL REQUIREMENTS FOR IMPLANT MATERIALS 512
METALS AND ALLOYS 515
CERAMICS AND CARBON 518
POLYMERS AND COMPOSITES 524
FUTURE AREAS OF APPLICATION 525
SURFACE CHARACTERISTICS 526
SURFACE CHARACTERIZATION AND TISSUE INTERACTION 526
SUMMARY 535
ACKNOWLEDGMENT 535
References 536
Chapter 25. Clinical Biomechanics in Implant Dentistry 543
LOADS APPLIED TO DENTAL IMPLANTS 543
MASS, FORCE, AND WEIGHT 543
FORCES 544
FORCE DELIVERY AND FAILURE MECHANISMS 549
MOMENT OF INERTIA 555
SUMMARY 555
References 555
Chapter 26. Bone Physiology, Metabolism, and Biomechanics 557
OSTEOLOGY 558
BONE PHYSIOLOGY 562
SKELETAL ADAPTATION: MODELING AND REMODELING 570
CORTICAL BONE GROWTH AND MATURATION 571
BONE METABOLISM 576
CALCIUM CONSERVATION 577
SKELETAL COMPROMISE 581
METABOLIC BONE DISEASE 582
BIOMECHANICS 582
SUTURES 585
IMPLANT-ANCHORED ORTHODONTICS 588
SUMMARY 595
ACKNOWLEDGMENTS 595
References 596
Chapter 27. Dental Implant Surfaces: A Review 599
TITANIUM 601
TURNED SURFACES 602
SANDBLASTED SURFACES 602
PLASMA-SPRAYED SURFACES 605
SURFACE COATING 605
HYDROXYAPATITE 612
ZIRCONIA 615
SUMMARY 615
References 616
Chapter 28. Bone Response to Mechanical Loads 621
BIOLOGICAL RESPONSE 621
MECHANOTRANSDUCTION 621
CHANGES IN GENE EXPRESSION 627
BIOMECHANICAL RESPONSE 629
References 634
Part IV: Implant Surgery 643
Chapter 29. Density of Bone: Effect on Surgical Approach and Healing 645
LITERATURE REVIEW 645
BONE DENSITY CLASSIFICATIONS 646
SUMMARY 665
References 665
Chapter 30. Posterior Single-Tooth Replacement: Surgical Guidelines 668
POSTERIOR MISSING TOOTH 668
SINGLE-TOOTH IMPLANTS 668
IMPLANT BODY SELECTION 668
PREMOLAR IMPLANT REPLACEMENT 669
MOLAR IMPLANT REPLACEMENT 669
POSTERIOR SINGLE-TOOTH IMPLANT SURGERY 672
SURGICAL PROCEDURE 673
STEP-BY-STEP SURGERY 678
References 682
Chapter 31. Root Form Surgery in the Edentulous Anterior and Posterior Mandible: Implant Insertion 684
SURGICAL APPROACH TO THE ANTERIOR MANDIBLE 684
SOFT TISSUE REFLECTION—LANDMARK IDENTIFICATION 687
SURGERY IN THE POSTERIOR MANDIBLE—DIVISION A 698
SOFT TISSUE REFLECTION 699
MANDIBULAR NERVE LOCATION: CLINICAL ZONE OF SAFETY 700
ZONE OF SAFETY 703
IMMEDIATE POSTOPERATIVE PROCEDURES AND INSTRUCTIONS 708
COMPLICATIONS 709
SUMMARY 716
References 716
Chapter 32. Stage II Surgery: Uncovery and Treatment of Healing Complications 720
NOMENCLATURE FOR IMPLANT FAILURES 720
SPONTANEOUS EARLY EXPOSURE 721
UNCOVERY PROCEDURE 723
RIGID FIXATION DETERMINATION 728
REVERSE TORQUE TESTING 728
IMPLANT POSITION 730
TISSUE THICKNESS 731
KERATINIZED TISSUE 733
TRANSITIONAL PROSTHESIS 736
SUMMARY 737
References 737
Chapter 33. Anterior Single-Tooth Replacement: Surgical Considerations 739
ALTERNATE TREATMENT OPTIONS FOR ANTERIOR SINGLE-TOOTH REPLACEMENT 739
CHALLENGING ESTHETICS 740
IMPLANT BODY POSITION 744
IDEAL IMPLANT ANGULATION 747
SOFT TISSUE INCISION 750
SOFT TISSUE CLOSURE 754
IMMEDIATE IMPLANT INSERTION AFTER EXTRACTION 755
STAGE II SURGERY AND SOFT TISSUE EMERGENCE CONTOURS 758
COMPLICATIONS 765
SUMMARY 766
References 766
Chapter 34. Premaxilla Surgery: Implant Insertion, Bone Spreading, Nasal Floor Elevation, and Incisive Foramen Implants 769
INTRODUCTION 769
PREMAXILLA EDENTULOUS TREATMENT PLANS 769
PREMAXILLA ARCH FORM AND IMPLANT NUMBER 770
MULTIPLE ANTERIOR IMPLANT DIAMETER 773
MAXILLARY OVERDENTURE TREATMENT PLANS 774
PREMAXILLA SURGERY 775
BONE SPREADING 778
SUBNASAL ELEVATION 789
SURGICAL TECHNIQUE 791
SUMMARY 795
References 797
Chapter 35. Immediate Load and Restoration in Implant Dentistry: Rationale and Treatment 799
TERMINOLOGY 799
COMPLETELY EDENTULOUS PATIENTS 800
PARTIALLY EDENTULOUS PATIENTS 819
SINGLE-TOOTH NONFUCTIONAL IMMEDIATE-RESTORATION PROCEDURES 823
RISKS OF IMMEDIATE OCCLUSAL LOADING 833
SUMMARY 833
References 834
Part V: Soft and Hard Tissue Rehabilitation 837
Chapter 36. Keys to Bone Grafting and Bone Grafting Materials 839
ALVEOLAR RESORPTION 839
SURGICAL KEYS TO BONE GRAFTING 839
BONE GRAFT MATERIALS 855
SUMMARY 863
References 863
Chapter 37. Tooth Extraction, Socket Grafting, and Barrier Membrane Bone Regeneration 870
ATRAUMATIC TOOTH EXTRACTION 870
HEALING OF EXTRACTION SOCKETS 874
SOCKET GRAFTING 875
SOFT TISSUE HEALING 888
LAYER GRAFT POSITIONS 894
Barrier Membrane and Guided Bone Regeneration: The Layered Approach 890
SUMMARY 901
References 901
Chapter 38. Maxillary Sinus Anatomy, Pathology, and Graft Surgery 905
ANATOMICAL CONSIDERATIONS OF THE POSTERIOR MAXILLA 905
DENTAL CONTRAINDICATIONS FOR IMPLANT TREATMENT OF THE POSTERIOR MAXILLA 905
MAXILLARY SINUS 907
MAXILLARY SINUS PATHOLOGY 919
INFLAMMATION 919
CYSTIC LESIONS 922
NEOPLASMS 923
ANTROLITHS AND FOREIGN BODIES 924
CONSIDERATIONS SPECIFIC TO SINUS GRAFTS 924
SURGICAL ENVIRONMENT 926
PREMEDICATIONS 926
SURGICAL TECHNIQUE 929
SINUS SURGERY: HISTORY 929
TREATMENT CLASSIFICATIONS FOR THE POSTERIOR MAXILLA 929
SURGICAL TECHNIQUE 930
VASCULAR HEALING OF THE GRAFT 951
POSTOPERATIVE INSTRUCTIONS 952
IMPLANT INSERTION 955
INTRAOPERATIVE COMPLICATIONS RELATED TO SURGERY 956
SHORT-TERM POSTOPERATIVE COMPLICATIONS 962
LONG-TERM RESULTS 968
SUMMARY 969
References 969
Chapter 39. Mandibular Donor Block Bone Grafts: Symphysis and Ramus 975
INTRODUCTION 975
PREOPERATIVE EVALUATION OF HOST SITE 977
MANDIBULAR SYMPHYSIS DONOR SITE 982
SUMMARY 1007
References 1008
Chapter 40. Extraoral Autogenous Donor Bone Grafts for Endosteal Implants: Ilium and Tibia 1013
HISTORY 1013
ILIAC CREST CORTICAL AND TRABECULAR BLOCK GRAFTS 1015
SURGICAL APPROACH: HARVEST OF THE ILIAC CREST TRICORTICAL BLOCK 1020
SUMMARY 1047
References 1047
Part VI: Soft and Hard Tissue 1053
Chapter 41. An Implant Is Not a Tooth: A Comparison of Periodontal Indices 1055
LITERATURE REVIEW 1055
LONGEVITY 1056
PAIN 1056
MOBILITY 1057
PERCUSSION 1059
CRESTAL BONE LOSS 1059
RADIOGRAPHIC EVALUATION 1060
KERATINIZED TISSUE CONCERNS 1061
PROBING DEPTHS 1063
BLEEDING INDEX 1067
PERI-IMPLANT DISEASE 1068
SUMMARY 1069
References 1069
Chapter 42. Maintenance of Dental Implants: Implant Quality of Health Scale 1073
PLAQUE BIOFILM AND DENTAL IMPLANTS 1074
SOFT TISSUE INTERFACE 1075
INSTRUMENT SELECTION 1076
IMPLANT MAINTENANCE PROCEDURES 1076
CHEMOTHERAPEUTIC AGENTS 1077
IMPLANT QUALITY OF HEALTH SCALE: A CLINICAL ASSESSMENT OF THE HEALTHDISEASE CONTINUUM 1077
REPAIR OF THE AILING, FAILING DENTAL IMPLANT 1081
IMPLANT FAILURE 1082
IMPLANT CROWN ESTHETIC INDEX 1082
SUMMARY 1083
References 1083
Appendix A: Extraoral and Intraoral Evaluation 1086
Index 1089