BOOK
Dental Implants - E-Book
Charles A. Babbush | Jack A. Hahn | Jack T. Krauser | Joel L. Rosenlicht
(2010)
Additional Information
Book Details
Abstract
For coverage of cutting-edge techniques and procedures, Dental Implants: The Art and Science is your "go to" reference! This edition includes 20 new chapters and coverage of the latest advances and research from leading dental implant experts. Topics range from the business of dental implants and risk management to new treatment techniques such as Teeth In A Day® and Teeth In An Hour™, the All-on-4 concept, Piezoelectric bone surgery, the new NobelActiveTM implant, the use of dental implants in children, and more. Over 1,100 full-color clinical photographs and illustrations bring concepts to life and provide step-by-step visuals for surgical and prosthetic techniques. If you’re looking for a comprehensive, up-to-date resource you can trust, Dental Implants is the book you need!
- Over 1,100 full-color clinical photographs and line drawings help to clarify important concepts and provide step-by-step guidance for specific techniques.
- All aspects of both business and patient care are covered, including risk management, patient selection and master planning, radiographic evaluation, surgical techniques, postoperative care, maintenance, and dental hygiene.
- Highly-regarded lead author Charles A. Babbush, DDS, MScD, is one of the leading dental implant surgeons in the world and a highly regarded educator, speaker, and author.
- Expert contributors from all over the world describe the latest advances in implantology and represent the forefront of research.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Half title page | i | ||
| Dental Implants | iii | ||
| Copyright page | iv | ||
| ABOUT THE COVER | v | ||
| Dedication | vi | ||
| CONTRIBUTORS | vii | ||
| FOREWORD | x | ||
| PREFACE | xiii | ||
| ACKNOWLEDGMENTS | xiv | ||
| Table of Contents | xv | ||
| 1 THE FUTURE NEED AND DEMAND FOR DENTAL IMPLANTS | 1 | ||
| Background | 1 | ||
| Tooth Loss | 1 | ||
| Options for Replacement of Lost Teeth | 2 | ||
| Tissue-Supported Prostheses: Partial and Complete Dentures | 2 | ||
| Tooth-Supported Prostheses: Fixed Bridges | 4 | ||
| Bone-Supported Prostheses: Dental Implants | 5 | ||
| Need and Demand for Tooth Replacement | 6 | ||
| The Concept and Measurement of Need | 6 | ||
| The Concept and Measurement of Demand | 6 | ||
| Factors that Affect Need and Demand for Tooth Replacement | 7 | ||
| Macro Factors | 7 | ||
| Population Growth and Composition | 7 | ||
| Growth in Per Capita Income | 8 | ||
| Improvement in Educational Attainment | 9 | ||
| Trends in Dental Caries and Tooth Loss | 9 | ||
| Improvements in Dental Implant Technology | 13 | ||
| Summary of Macro Factors | 13 | ||
| Individual Factors | 14 | ||
| Time Horizon | 14 | ||
| REFERENCES | 15 | ||
| 2 THE BUSINESS OF IMPLANT DENTISTRY | 17 | ||
| History | 17 | ||
| Growth | 18 | ||
| New Investment | 18 | ||
| Patient Demand | 18 | ||
| Dental Implant Practice Growth | 18 | ||
| Costs and Overhead | 19 | ||
| Dental Laboratories | 20 | ||
| General Practitioners and Referral Patterns | 20 | ||
| Study Clubs | 20 | ||
| Insurance Coverage for Dental Implants | 20 | ||
| Third Party Financing | 21 | ||
| Factors Affecting Individual Practices | 21 | ||
| Sales Representatives | 21 | ||
| Internet | 22 | ||
| Training | 22 | ||
| Grafting and Site Development | 22 | ||
| Computer-Aided Implant Dentistry | 22 | ||
| Innovation | 23 | ||
| Challenges That Need Innovative Solutions | 23 | ||
| Projections and Predictions | 23 | ||
| REFERENCES | 23 | ||
| 3 ESSENTIAL SYSTEMS FOR TEAM TRAINING IN THE DENTAL IMPLANT PRACTICE | 25 | ||
| Four Presurgical Phases | 25 | ||
| Diagnostic Work-up | 25 | ||
| Laboratory Procedures | 28 | ||
| Treatment Planning Conference | 29 | ||
| Case Presentation | 29 | ||
| Clinical Assistant Responsibilities | 31 | ||
| The Morning Huddle | 35 | ||
| Hygiene Department | 35 | ||
| The Implant Coordinator | 38 | ||
| Key Concepts for the Implant Team Member | 38 | ||
| Conclusion | 38 | ||
| REFERENCES | 39 | ||
| 4 DENTAL RISK MANAGEMENT | 40 | ||
| Background | 40 | ||
| Risk Management for Dentists | 40 | ||
| Societal Forces Beyond the Control of the Individual Dentist | 40 | ||
| Decline of the Family Dentist | 40 | ||
| Availability of Legal Services | 41 | ||
| Competitive Forces | 41 | ||
| Circumstances Within the Control of the Individual Dentist | 41 | ||
| Meeting Patient Expectations | 41 | ||
| Dealing With Bad Results | 41 | ||
| Avoiding Unnecessarily Aggressive Collection Practices | 41 | ||
| Dental Malpractice Law | 42 | ||
| State Administrative Licensure Actions | 43 | ||
| Risk Management Practices | 43 | ||
| Documentation | 43 | ||
| What Should Be in the Records? | 43 | ||
| Noncompliance | 44 | ||
| Scope of Records | 44 | ||
| Communications With Patients | 44 | ||
| Record Retention | 45 | ||
| Alteration of Records | 45 | ||
| Risk Management Practice Pointers | 45 | ||
| Informed Consent | 46 | ||
| Iatrogenic Complications | 46 | ||
| Responding to the Adverse Inquiry | 46 | ||
| Statute of Limitations | 47 | ||
| Financial Considerations of the Patient | 47 | ||
| Frequent Allegations | 48 | ||
| Incidence of Payments Made to Settle Claims for Dental Malpractice | 49 | ||
| Complications Associated With Crown and Bridgework | 49 | ||
| Complications Associated With Root Canal Therapy | 49 | ||
| Complications Associated With Extractions | 50 | ||
| Failure to Diagnose Periodontal Disease | 50 | ||
| Temporomandibular Joint Injuries | 50 | ||
| Orthodontic Injuries | 50 | ||
| Inadequate Radiographs | 50 | ||
| Failure to Refer | 51 | ||
| Abandonment | 51 | ||
| Professional Liability Insurance Considerations | 51 | ||
| Frequent Complications Associated With Implant Dentistry | 52 | ||
| Implant Failure | 52 | ||
| Altered Sensation and Nerve Injuries | 52 | ||
| Infection and Bone Loss | 54 | ||
| Maxillary Sinus Complications and Failures | 55 | ||
| Subperiosteal Implants | 56 | ||
| Transmandibular Implants | 57 | ||
| Aesthetic Considerations and Prosthesis | 57 | ||
| Implant Fractures | 57 | ||
| Conclusion | 58 | ||
| REFERENCES | 58 | ||
| 5 MASTER PLANNING OF THE IMPLANT CASE | 60 | ||
| Initial Consultation | 60 | ||
| Chief Complaint | 60 | ||
| History of Present Illness | 61 | ||
| Medical History | 61 | ||
| Dental Status | 63 | ||
| Patient Education | 64 | ||
| Joint Treatment Planning | 68 | ||
| Final Treatment Considerations | 71 | ||
| REFERENCES | 85 | ||
| 6 DENTAL IMPLANT THERAPY FOR MEDICALLY COMPLEX PATIENTS | 86 | ||
| Dental Implant Therapy for the Diabetic Patient | 87 | ||
| Sedation for the Diabetic Patient | 88 | ||
| Emergency Treatment in the Diabetic Patient | 88 | ||
| Dental Implant Therapy for the Hypertensive Patient | 88 | ||
| Sedation for the Hypertensive Patient | 89 | ||
| Emergency Treatment in a Hypertensive Crisis | 89 | ||
| The Use of Epinephrine on Local Anesthesia for Medically Complex Patients | 89 | ||
| Oral Surgery Treatment for Patients With Acquired Bleeding Tendency | 90 | ||
| Oral Anticoagulant Agents | 91 | ||
| Antiplatelet Agents | 91 | ||
| Hemostatis | 92 | ||
| The Need for Definitive Oral Surgery Protocols for Bisphosphonate-Treated Patients | 93 | ||
| Osseointegrated Implants for the Irradiated Patient | 94 | ||
| Osseointegrated Implants for the Chemotherapy-Treated Patient | 95 | ||
| REFERENCES | 95 | ||
| 7 SURGICAL ANATOMICAL CONSIDERATIONS FOR DENTAL IMPLANT RECONSTRUCTION | 98 | ||
| Maxilla | 98 | ||
| Nasal Endoscopy Anatomy | 102 | ||
| Pterygoid Area | 102 | ||
| Mandible | 103 | ||
| Retromolar Area | 107 | ||
| Acknowledgments | 109 | ||
| REFERENCES | 109 | ||
| 8 CONTEMPORARY RADIOGRAPHIC EVALUATION OF THE IMPLANT CANDIDATE | 110 | ||
| Two-Dimensional Views | 110 | ||
| Periapical and Panoramic Images: Digital Versus Conventional | 110 | ||
| Computed Tomography and Digital Images | 113 | ||
| Cone Beam 3-D Imaging | 115 | ||
| Software Modules | 116 | ||
| Fabrication Software | 117 | ||
| Surgical Planning Software | 117 | ||
| The Advantages and Disadvantages of Digital Files | 118 | ||
| Note on Radiation | 119 | ||
| Additional Diagnostic Benefits Beyond Implant Placement | 121 | ||
| Important Note of Caution | 122 | ||
| REFERENCES | 122 | ||
| 9 BONE: | 124 | ||
| Bone | 124 | ||
| Embryology | 124 | ||
| Cellularity | 125 | ||
| Architecture | 125 | ||
| Bone Formation | 125 | ||
| Bone Healing | 127 | ||
| Initial Healing | 127 | ||
| Other Bioimplants | 128 | ||
| Bone Regeneration Products | 128 | ||
| Goals | 129 | ||
| Autogeneic Bone | 129 | ||
| Cancellous Grafts | 130 | ||
| Allogeneic Bone | 130 | ||
| Demineralized Bone Matrix (DBM) | 130 | ||
| Xenogeneic Bone | 131 | ||
| Alloplastic Bone | 132 | ||
| Hydroxyapatite | 132 | ||
| Ceramics | 132 | ||
| Bioglasses | 132 | ||
| Polymers | 132 | ||
| Osteoactive Agents | 132 | ||
| Osteoinducers | 133 | ||
| Osteopromoters | 136 | ||
| TGF-β | 136 | ||
| Platelet-Derived Growth Factor and Insulin-like Growth Factor | 137 | ||
| Platelet-Rich Plasma | 137 | ||
| Polypeptides | 138 | ||
| Stem Cells and Tissue Engineering | 138 | ||
| Conclusion | 138 | ||
| REFERENCES | 141 | ||
| 10 THE USE OF CT/CBCT AND INTERACTIVE VIRTUAL TREATMENT PLANNING AND THE TRIANGLE OF BONE: | 146 | ||
| Congenitally Missing Laterals | 147 | ||
| In the “Zone” with the Triangle of Bone | 148 | ||
| The Restorative Dilemma | 150 | ||
| Confirmation With Interactive 3-D Imaging | 150 | ||
| The Restorative Link: Virtual Teeth | 151 | ||
| Surgical Phase | 153 | ||
| Restorative Phase | 154 | ||
| Bone Grafting Assessment and Planning | 154 | ||
| Evaluation of the Fully Edentate Maxilla: The Importance of a Scanning Appliance | 161 | ||
| Conclusion | 165 | ||
| REFERENCES | 166 | ||
| 11 PERI-IMPLANT SOFT TISSUES | 167 | ||
| Soft Tissue Barrier at Implants | 167 | ||
| Healing Process | 167 | ||
| Junctional Epithelium | 167 | ||
| Connective Tissue Interface | 168 | ||
| Clinical Consequences | 168 | ||
| Probing Depth | 168 | ||
| Soft Tissue Stability/Instability | 168 | ||
| Influence of Transmucosal Components on Soft Tissue Barrier Formation | 168 | ||
| Chemical Composition | 168 | ||
| Surface Contamination | 168 | ||
| Influence of Implant Design on Soft Tissue Barrier | 169 | ||
| Influence of Transmucosal Component Design on the Soft Tissue Barrier | 169 | ||
| Surgical and Prosthetic Parameters Influencing Precocious Soft Tissue Barrier Formation | 170 | ||
| Surgical and Prosthetic Parameters Influencing the Stability of an Established Soft Tissue Barrier | 170 | ||
| Summary | 170 | ||
| Material Chemistry | 170 | ||
| Surface Topography | 171 | ||
| Implant Components and Connections | 173 | ||
| Clinical Cases | 173 | ||
| 12 MEMBRANE BARRIERS FOR GUIDED TISSUE REGENERATION | 181 | ||
| Materials Used for Membrane Barrier Techniques | 181 | ||
| Cellulose Filters | 182 | ||
| Expanded Polytetrafluoroethylene Membranes | 182 | ||
| Bioresorbable Guided Tissue Regeneration Membranes | 185 | ||
| Collagen Membranes | 185 | ||
| Polylactic Acid | 186 | ||
| Polyglycolic Acid and Polylactic Acid | 188 | ||
| Synthetic Liquid Polymer (Atrisorb) | 188 | ||
| Polyglactin | 190 | ||
| Calcium Sulfate | 190 | ||
| Acellular Dermal Allografts | 191 | ||
| Oxidized Cellulose Mesh | 191 | ||
| Microbiology Associated With Barrier Membranes | 192 | ||
| Membrane Selection | 193 | ||
| Guided Tissue Regeneration Membranes in the Prevention of Postextraction Bone Loss | 194 | ||
| A Rationale and Technique for Ridge Preservation Using dPTFE Membrane | 197 | ||
| Open Socket Regeneration Technique | 198 | ||
| Advantages | 202 | ||
| Case Reports | 202 | ||
| Case Report 1: Minimally Invasive Socket Reconstruction | 202 | ||
| Case Report 2: Dual-Layered Guided Tissue Regeneration Technique | 205 | ||
| Case Report 3: Guided Bone Regeneration Using High-Density Titanium-Reinforced PTFE Membrane | 205 | ||
| Case Report 4: Implant Site Development Using Bovine Collagen Membrane and Allogeneic Bone | 205 | ||
| Case Report 5: The Use of Tenting Screws With Titanium-Reinforced High-Density PTFE Membrane | 209 | ||
| REFERENCES | 214 | ||
| 13 Contemporary Subantral Sinus Surgery and Grafting Techniques | 216 | ||
| Historical Perspective | 216 | ||
| Biologic and Anatomic Considerations | 216 | ||
| Morphology | 216 | ||
| Vascular Supply, Lymphatic Drainage, and Innervation | 217 | ||
| Arterial Supply | 217 | ||
| Venous Return and Lymphatic Drainage | 217 | ||
| Innervation | 217 | ||
| Preoperative Preparation | 217 | ||
| Anesthesia | 217 | ||
| Incision | 217 | ||
| Quadrilateral Buccal Osteotomy | 217 | ||
| Elevation of the Schneiderian Membrane | 218 | ||
| Grafting the Osseous Cavity | 218 | ||
| Postoperative Instructions | 219 | ||
| Complications | 219 | ||
| Dehiscence of the Incision | 219 | ||
| Delayed Healing: Smoking | 219 | ||
| Swelling and Ecchymosis | 219 | ||
| Small Membrane Tears | 219 | ||
| Larger Membrane Tears | 221 | ||
| Antral Septum | 221 | ||
| Infections | 221 | ||
| Trephine Core Membrane Elevation | 221 | ||
| Balloon Elevation | 224 | ||
| Graft Materials | 225 | ||
| Bone Marrow Aspirate | 226 | ||
| Clinical Case Reports | 226 | ||
| Case Report 1 | 226 | ||
| Case Report 2 | 227 | ||
| Case Report 3 | 228 | ||
| Case Report 4 | 228 | ||
| Conclusion | 230 | ||
| REFERENCES | 230 | ||
| 14 INFERIOR ALVEOLAR NERVE LATERALIZATION AND MENTAL NEUROVASCULAR DISTALIZATION | 232 | ||
| Indications | 232 | ||
| Limitations | 232 | ||
| Nerve Anatomy | 237 | ||
| Preoperative Computed Tomographic Scans and Analysis | 237 | ||
| Alveolar Nerve Lateralization | 238 | ||
| Distalization of the Mental Neurovascular Bundle | 244 | ||
| Conclusion | 247 | ||
| REFERENCES | 249 | ||
| 15 GRAFTLESS SOLUTIONS FOR ATROPHIC MAXILLA | 251 | ||
| Pretreatment Planning | 252 | ||
| Phonetics | 252 | ||
| Lip Support | 252 | ||
| Oral Hygiene | 253 | ||
| Systematic Evaluation of the Edentulous Maxilla | 253 | ||
| Metal-Ceramic Restorations | 253 | ||
| Implant-Supported Fixed Prosthesis: Profile versus the Hybrid Prosthesis | 253 | ||
| Fixed-Removable Restoration | 254 | ||
| Factors for Successful Treatment | 254 | ||
| Presence or Absence of a Composite Defect | 254 | ||
| Visibility of the Residual Ridge Crest | 255 | ||
| Radiographic Zones of the Maxilla | 256 | ||
| Presence of Zone 1, 2, and 3 Bone | 256 | ||
| Presence of Zone 1 and 2 Bone | 257 | ||
| Presence of Zone 1 Bone Only | 257 | ||
| Bone Missing from Zones 1, 2, and 3 | 257 | ||
| Conclusion | 258 | ||
| REFERENCES | 258 | ||
| 16 COMPLEX IMPLANT RESTORATIVE THERAPY | 260 | ||
| Patient Assessment | 260 | ||
| Dental Evaluation | 261 | ||
| Case Planning | 262 | ||
| Restorative Options | 263 | ||
| Treatment Presentation | 264 | ||
| Provisionalization | 264 | ||
| Soft Tissue Aesthetics | 266 | ||
| Treatment Scenarios | 266 | ||
| Case 1 | 267 | ||
| The Challenge | 267 | ||
| 17 INTRAORAL BONE GRAFTS FOR DENTAL IMPLANTS | 276 | ||
| Bone Biology | 276 | ||
| Preoperative Evaluation | 277 | ||
| Patient Preparation | 278 | ||
| Bone Graft Donor Sites | 278 | ||
| Maxillary Tuberosity | 278 | ||
| Mandibular Symphysis | 279 | ||
| Mandibular Ramus | 281 | ||
| Graft Recipient Site | 284 | ||
| Implant Placement in Onlay Grafts | 288 | ||
| Conclusion | 290 | ||
| REFERENCES | 290 | ||
| ADDITIONAL READINGS | 291 | ||
| 18 THE USE OF COMPUTERIZED TREATMENT PLANNING AND A CUSTOMIZED SURGICAL TEMPLATE TO ACHIEVE OPTIMAL IMPLANT PLACEMENT: | 292 | ||
| Guided Surgery Approach | 293 | ||
| Case Report: Using the Guided Surgery Approach | 293 | ||
| Discussion | 298 | ||
| Conclusion | 299 | ||
| REFERENCES | 299 | ||
| 19 TEETH IN A DAY AND TEETH IN AN HOUR: | 300 | ||
| A Brief Examination of Osseointegration | 300 | ||
| Immediate Loading: What the Evidence Says | 301 | ||
| Teeth In A Day | 302 | ||
| Guiding Principles | 302 | ||
| Initial Evaluation | 303 | ||
| Initial Preparation of Screw-Retained All-Acrylic Conversion Prosthesis | 303 | ||
| Surgical Protocol | 304 | ||
| Completing the Conversion Prosthesis | 305 | ||
| Interim Prosthesis: Its Critical Role in Teeth In A Day | 305 | ||
| Teeth In An Hour | 306 | ||
| A Close Examination of the Protocol | 307 | ||
| No Bone Solution: Treating the Atrophied Posterior Maxilla Without Grafting | 309 | ||
| Combining Teeth In A Day and Teeth In An Hour Protocols to Treat the Atrophied Maxilla: A Case Report | 310 | ||
| REFERENCES | 312 | ||
| 20 EXTRACTION IMMEDIATE IMPLANT RECONSTRUCTION: | 313 | ||
| Methodology and Clinical Guidelines | 313 | ||
| Tapered Implants | 315 | ||
| NobelActive Expands Treatment Options | 315 | ||
| Clinical Benefits | 315 | ||
| Indications | 316 | ||
| Examination and Treatment Planning | 316 | ||
| Bone Quality | 316 | ||
| Vertical Bone Quantity | 316 | ||
| Horizontal Bone Quantity | 316 | ||
| Changing Direction (Active Placement) | 316 | ||
| Immediate Implantation: Aesthetic Zone | 316 | ||
| Case Reports | 317 | ||
| Case 1 | 317 | ||
| Case 2 | 320 | ||
| Case 3 | 320 | ||
| Case 4 | 325 | ||
| Case 5 | 325 | ||
| Case 6 | 325 | ||
| Case 7 | 329 | ||
| Case 8 | 329 | ||
| Case 9 | 331 | ||
| Conclusion | 331 | ||
| REFERENCES | 339 | ||
| 21 IMMEDIATE LOADING OF DENTAL IMPLANTS | 340 | ||
| What Is Immediate Loading? | 340 | ||
| Patient Selection | 341 | ||
| Immediate Loading for Single-Tooth Restoration | 343 | ||
| Immediate Loading of the Fixed Prostheses | 343 | ||
| Immediate Loading of Over-Denture Prostheses | 347 | ||
| Immediate Placement and Loading of Implants in Extraction Sites | 347 | ||
| CAD/CAM Technology in Immediate Loading | 349 | ||
| Conclusion | 350 | ||
| REFERENCES | 353 | ||
| 22 MANAGEMENT OF PATIENTS WITH FACIAL DISFIGUREMENT | 355 | ||
| Patient Rehabilitation | 355 | ||
| Osseointegrated Implants | 358 | ||
| Indications | 358 | ||
| Treatment Planning | 359 | ||
| Number of Implants | 359 | ||
| Location of Implants | 359 | ||
| Inclination of Implants | 360 | ||
| Case Reports | 360 | ||
| Case 1 | 360 | ||
| Case 2 | 360 | ||
| Case 3 | 365 | ||
| Case 4 | 365 | ||
| Conclusion | 365 | ||
| REFERENCES | 369 | ||
| 23 THE EVOLUTION OF THE ANGLED IMPLANT | 370 | ||
| The Pterygoid/Tuberosity Implant | 370 | ||
| Indications | 370 | ||
| The Zygoma Implant | 371 | ||
| Indications | 372 | ||
| Cancer | 372 | ||
| Trauma | 372 | ||
| Severe Atrophy | 372 | ||
| Moderate Atrophy | 375 | ||
| Immediate Loading | 375 | ||
| Modifications | 375 | ||
| Partial Edentulism | 376 | ||
| Angled Conventional Implants | 376 | ||
| Mandibular Arch | 377 | ||
| Maxillary Arch | 377 | ||
| The Evolving Future | 380 | ||
| Positional Considerations | 380 | ||
| Partial Edentulism | 383 | ||
| Age | 384 | ||
| Virtual Implant Dentistry | 384 | ||
| Conclusion | 386 | ||
| REFERENCES | 387 | ||
| 24 IMPLANTS FOR CHILDREN | 389 | ||
| Maxillary Growth | 389 | ||
| Mandibular Growth | 390 | ||
| Case Reports | 390 | ||
| Case 1 | 390 | ||
| Case 2 | 394 | ||
| Case 3 | 394 | ||
| Case 4 | 397 | ||
| Case 5 | 397 | ||
| CONCLUSION | 399 | ||
| ADDITIONAL READINGS | 402 | ||
| REFERENCES | 401 | ||
| 25 PIEZOSURGERY RELATED TO IMPLANT RECONSTRUCTION | 403 | ||
| Piezoelectric Bone Surgery: Clinical Idea and Development | 403 | ||
| Clinical Characteristics of Ultrasonic Cutting | 403 | ||
| Microprecision | 403 | ||
| Selective Cutting | 403 | ||
| Maximum Visibility During Operation | 404 | ||
| Excellent Healing of Bone Tissue | 404 | ||
| Inserts | 404 | ||
| Surgical Techniques | 404 | ||
| Dental Extraction | 404 | ||
| Bone Removal and Graft | 405 | ||
| Monocortical Block | 405 | ||
| Bone Chips | 406 | ||
| Ridge Expansion | 406 | ||
| Maxillary Sinus Lift | 406 | ||
| Orthodontic Microsurgery | 406 | ||
| Ultrasonic Implant Site Preparation | 406 | ||
| Experiences in Other Anatomical Districts and Bone Surgical Disciplines | 411 | ||
| REFERENCES | 412 | ||
| 26 A NEW CONCEPT OF TAPERED DENTAL IMPLANTS: | 414 | ||
| Biological Background | 415 | ||
| Critical Bone Volume Theory | 415 | ||
| Bone Physiology | 415 | ||
| Transmission of Forces to Natural Teeth and Bone | 416 | ||
| Clinical Observations Supporting the CBV Theory | 417 | ||
| Buccal Wall Resorption After Extraction | 417 | ||
| Interdental Bone and Papilla | 417 | ||
| Bone Walls Around Standard Implants | 417 | ||
| Immediate Implantation | 417 | ||
| Distraction Osteogenesis | 418 | ||
| Bone Volume and Resorption | 418 | ||
| Augmentation Prevents Bone Resorption | 418 | ||
| Implant Exposure | 418 | ||
| Implant Requirements | 418 | ||
| Technical Description of the NobelActive Dental Implant Design | 418 | ||
| The Core | 419 | ||
| The Threads | 419 | ||
| Apical Region | 421 | ||
| Reverse Tapping | 422 | ||
| Coronal Region | 422 | ||
| The Prosthetic Connection | 423 | ||
| Rationale for and Advantages of the Unique Design | 424 | ||
| Large Implant Anchorage Surface | 425 | ||
| Minimal Bone Trauma on Implant Bed Preparation | 425 | ||
| Smallest Possible Implant Volume | 425 | ||
| Use of Bone Elasticity | 425 | ||
| Versatility for Different Surgical Procedures | 425 | ||
| Promotion of Biological Incorporation | 425 | ||
| Primary Stability | 425 | ||
| Procedure Speed and Ease | 426 | ||
| Load Distribution | 426 | ||
| Crestal Bone Preservation | 426 | ||
| Ability to Change Direction During Insertion | 426 | ||
| Versatility for Different Prosthetic Solutions | 426 | ||
| Strength to Withstand Fatigue and Static Loads | 426 | ||
| Clinical Scenarios | 426 | ||
| Case 1 | 426 | ||
| Case 2 | 429 | ||
| Case 3 | 430 | ||
| Conclusion | 432 | ||
| REFERENCES | 433 | ||
| 27 THE ALL-ON-4 CONCEPT | 435 | ||
| Concept of Immediate Function | 435 | ||
| Clinical Rationale | 435 | ||
| Inclusion and Exclusion Criteria | 435 | ||
| Advantages | 436 | ||
| All-on-4 Standard | 437 | ||
| Flap Approach | 438 | ||
| Implant Placement in the Mandible | 440 | ||
| Implant Placement in the Maxilla | 440 | ||
| Immediate Prosthetic Protocol | 440 | ||
| Flapless Approach: NobelGuide Concept | 442 | ||
| Final Prosthetic Protocol | 442 | ||
| All-on-4 Hybrid and All-on-4 Extra-Maxilla | 442 | ||
| Clinical Data | 443 | ||
| Complications and Remedies | 446 | ||
| Conclusion | 446 | ||
| REFERENCES | 446 | ||
| 28 LABORATORY PROCEDURES AS THEY PERTAIN TO IMPLANT RECONSTRUCTION | 448 | ||
| Partially Edentulous Reconstruction | 448 | ||
| Appointment 1 (Impression) | 448 | ||
| Option 1: Closed Tray | 448 | ||
| Option 2: Open Tray | 449 | ||
| At the Laboratory | 450 | ||
| Option 1: Cement-Retained Restorations | 450 | ||
| DESIGN 1: STOCK ABUTMENTS | 450 | ||
| DESIGN 2: CUSTOM ABUTMENTS | 451 | ||
| Atlantis. | 451 | ||
| Nobel Biocare. | 451 | ||
| Option 2: Screw-Retained Restorations | 452 | ||
| Appointment 2 (Try-in) | 452 | ||
| At the Laboratory | 452 | ||
| Appointment 3 (Insert) | 453 | ||
| Option 1: Cement-Retained Restorations | 453 | ||
| Option 2: Screw-Retained Restorations | 453 | ||
| Fully Edentulous Restorations | 453 | ||
| Appointment 1: Impression | 455 | ||
| At the Laboratory | 456 | ||
| Appointment 2: Check Bar and Centric Jaw Relationship | 456 | ||
| 29 COMPLICATIONS AND FAILURES: | 467 | ||
| Categorization of Etiological Factors in Complications and Failures of Implants | 467 | ||
| Implant System | 467 | ||
| Patient | 468 | ||
| Doctor | 468 | ||
| Preoperative | 468 | ||
| Interoperative | 468 | ||
| Postsurgical | 468 | ||
| Restorative | 469 | ||
| Treatment Protocol | 469 | ||
| Implant Alignment and Position | 470 | ||
| Prosthesis Accuracy and Fit | 470 | ||
| Infection | 470 | ||
| Medical-Physical Patient Problems | 470 | ||
| Implant and Component Fracture and Breakage | 470 | ||
| Inferior Alveolar Nerve | 478 | ||
| Conclusion | 478 | ||
| REFERENCES | 489 | ||
| 30 HYGIENE AND SOFT TISSUE MANAGEMENT: | 492 | ||
| The Doctor’s Perspective | 492 | ||
| Evaluation and Assessment | 492 | ||
| Soft Tissue | 492 | ||
| Peri-implant Disease | 493 | ||
| Probing the Dental Implant | 493 | ||
| Bone Loss | 494 | ||
| Radiographic Assessment | 494 | ||
| Occlusion | 494 | ||
| Mobility | 494 | ||
| Measuring Success | 495 | ||
| The Hygienist’s Perspective | 495 | ||
| Natural Dentition Compared With Dental Implants | 496 | ||
| The Periodontal Ligament and Osseointegration | 497 | ||
| Postsurgery Professional Care | 497 | ||
| Probing the Dental Implant | 498 | ||
| Radiographic Assessment | 498 | ||
| Implant Instrumentation and Debridement | 498 | ||
| Designing Prosthetics to Maximize Aesthetics, Function, and Hygiene Access | 499 | ||
| Continuing Care | 500 | ||
| Home Care and Patient Education | 500 | ||
| Hygiene Aids | 501 | ||
| Continuing Education for Patients | 502 | ||
| Conclusion | 502 | ||
| REFERENCES | 502 | ||
| Index | 503 | ||
| A | 503 | ||
| B | 504 | ||
| C | 506 | ||
| D | 508 | ||
| E | 509 | ||
| F | 510 | ||
| G | 511 | ||
| H | 512 | ||
| I | 512 | ||
| J | 514 | ||
| K | 514 | ||
| L | 514 | ||
| M | 515 | ||
| N | 516 | ||
| O | 516 | ||
| P | 517 | ||
| Q | 519 | ||
| R | 519 | ||
| S | 520 | ||
| T | 521 | ||
| U | 523 | ||
| V | 523 | ||
| W | 523 | ||
| X | 523 | ||
| Z | 523 |