Presurgical considerations regarding implant placement in the esthetic zone
Zafeirios-Rafail KALAMPOKIS, Agamemnon CHLIAOUTAKIS, Fotios TZERBOS
Department of Oral and Maxillofacial Surgery, Dental School, National and Kapodistrian University of Athens (Head: Prof. N. Papadogeorgakis)
Hellenic Archives of Oral & Maxillofacial Surgery (2017) 1, 9-19
SUMMARY: The esthetic zone remains a challenge in modern implant therapy. There are many factors that need to be considered before the surgery in order to achieve a successful implant-supported restoration in the esthetic zone, such as the quality and volume of the alveolar bone and soft tissues, the gingival biotype and the smile line.
The patient’s medical history is the first source of possible aggravating factors or contra-indications for an implant- supported restoration. The clinical parameters defining the esthetic zone in each patient are evaluated and recorded carefully. The quality and the extent of soft tissues are key parameters that must be studied and be considered in the treatment plan. Also, the Conical Beam Computed Tomography (CBCT) is essential for the pre- operative examination of the available bone volume. As regards the time of implant placement, it seems that the delayed approach is the one with the best results. Finally, any reconstructive techniques required should be highly evaluated, regarding the way and the time that they are going to be done.
KEY WORDS: presurgical considerations, implant therapy, esthetic zone
REFERENCES
Al-Sabbagh M: Implants in the Esthetic Zone. Dent Clin N Am 50:391– 407, 2006
Bedrossian E, Sullivan RM, Malo P: Fixed-Prosthetic Implant Restoration of the Edentulous Maxilla: A Systematic Pretreatment Evaluation Method. J Oral Maxillofac Surg 66:112-122, 2008
Bouri A Jr, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I: Width of Keratinized Gingiva and the Health Status of the Supporting Tis- sues Around Dental Implants. Int J Oral Maxillofac Implants 23:323–326, 2008
Buser D, Martin W, Belser UC: Optimizing Esthetics for Implant Restoration in the Anterior Maxilla: Anatomic And Surgical Considerations. Int J Oral Maxillofac Implants 19(Suppl):43-61, 2004 Chen ST, Beagle J, Jensen SS, Chiapasco M, Darby I: Consensus state- ments and recommended clinical procedures regarding surgical techniques. Int J Oral Maxillofac Implants 24(Suppl):272-278, 2009 Chen ST, Buser D: Esthetic Outcomes Following Immediate and Early Implant Placement in the Anterior Maxilla—A Systematic Review. Int J Oral Maxillofac Implants 29(Suppl):186–215, 2014
Δημητρίου Π, Ζήσης Α, Καρκαζής Η, Πολυζώης Γ, Σταυράκης Γ: Κι- νητή Προσθετική: Ολικές Οδοντοστοιχίες. Εκδόσεις Μπονισέλ 2001, σελ. 213
Fuentealba R, Jofré J: Esthetic Failure in Implant Dentistry. Dent Clin N Am 59:227–246, 2015
Greenstein G, Cavallaro J: The Clinical Significance of Keratinized Gin- giva Around Dental Implants. Compend Cont Educ Dent 32:24– 31, 2011
Hammerle CH, Araujo MG, Simion M: Evidence-based knowledge on the biology and treatment of extraction sockets. Clin Oral Im- plants Res 23(Suppl 5):80–82, 2012
Juodzbalys G, Kubilius M: Clinical and Radiological Classification of the Jawbone Anatomy in Endosseous Dental Implant Treatment. J Oral Maxillofac Res 4:e2, 2013
Kassim B, Ivanovski S, Mattheos N: Current Perspectives on the Role of Ridge (Socket) Preservation Procedures in Dental Implant Treatment in the Aesthetic Zone. Aust Dent J 59:48-56, 2014
Kourtis S, Kokkinos K, Roussou V: Predicting the Final Result in Implant-Supported Fixed Restorations for Completely Edentulous Patients. J Esthet Restor Dent 26:40-47, 2014
Levine RA, Huynh-Ba G, Cochran DL: Soft Tissue Augmentation Procedures for Mucogingival Defects in Esthetic Sites. Int J Oral Max- illofac Implants 29(Suppl):155-85, 2014
Lindhe J, Berglundh T: The Interface Between the Mucosa and the Im- plant. Periodontol 2000 17:47–54, 1998
Milinkovic I, Cordaro L: Are there Specific Indications for the Different Alveolar Bone Augmentation Procedures for Implant Placement? A Systematic Review. Int J Oral Maxillofac Surg 43:606–625, 2014
Ortega-Martínez J, Pérez-Pascual T, Mareque-Bueno S, Hernández-Al- faro F, Ferrés-Padró E: Immediate implants following tooth ex- traction. A systematic review. Med Oral Patol Oral Cir Bucal 17(2):251-261, 2012
Rodriguez AM, Rosenstiel SF: Esthetic considerations related to bone and soft tissue maintenance and development around dental implants. J Prosthet Dent 108:259-267, 2012
Sanz I, Garcia-Gargallo M, Herrera D, Martin C, Figuero E, Sanz M: Surgical protocols for early implant placement in post-extraction sockets. A systematic review. Clin Oral Implants Res 23:67–79, 2012
Wood MR, Vermilyea SG: A review of selected dental literature on evidence-based treatment planning for dental implants. J Prosthet Dent 92:447-462, 2004
Department of Oral and Maxillofacial Surgery, Dental School, National and Kapodistrian University of Athens (Head: Prof. N. Papadogeorgakis)
Hellenic Archives of Oral & Maxillofacial Surgery (2017) 1, 9-19
SUMMARY: The esthetic zone remains a challenge in modern implant therapy. There are many factors that need to be considered before the surgery in order to achieve a successful implant-supported restoration in the esthetic zone, such as the quality and volume of the alveolar bone and soft tissues, the gingival biotype and the smile line.
The patient’s medical history is the first source of possible aggravating factors or contra-indications for an implant- supported restoration. The clinical parameters defining the esthetic zone in each patient are evaluated and recorded carefully. The quality and the extent of soft tissues are key parameters that must be studied and be considered in the treatment plan. Also, the Conical Beam Computed Tomography (CBCT) is essential for the pre- operative examination of the available bone volume. As regards the time of implant placement, it seems that the delayed approach is the one with the best results. Finally, any reconstructive techniques required should be highly evaluated, regarding the way and the time that they are going to be done.
KEY WORDS: presurgical considerations, implant therapy, esthetic zone
REFERENCES
Al-Sabbagh M: Implants in the Esthetic Zone. Dent Clin N Am 50:391– 407, 2006
Bedrossian E, Sullivan RM, Malo P: Fixed-Prosthetic Implant Restoration of the Edentulous Maxilla: A Systematic Pretreatment Evaluation Method. J Oral Maxillofac Surg 66:112-122, 2008
Bouri A Jr, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I: Width of Keratinized Gingiva and the Health Status of the Supporting Tis- sues Around Dental Implants. Int J Oral Maxillofac Implants 23:323–326, 2008
Buser D, Martin W, Belser UC: Optimizing Esthetics for Implant Restoration in the Anterior Maxilla: Anatomic And Surgical Considerations. Int J Oral Maxillofac Implants 19(Suppl):43-61, 2004 Chen ST, Beagle J, Jensen SS, Chiapasco M, Darby I: Consensus state- ments and recommended clinical procedures regarding surgical techniques. Int J Oral Maxillofac Implants 24(Suppl):272-278, 2009 Chen ST, Buser D: Esthetic Outcomes Following Immediate and Early Implant Placement in the Anterior Maxilla—A Systematic Review. Int J Oral Maxillofac Implants 29(Suppl):186–215, 2014
Δημητρίου Π, Ζήσης Α, Καρκαζής Η, Πολυζώης Γ, Σταυράκης Γ: Κι- νητή Προσθετική: Ολικές Οδοντοστοιχίες. Εκδόσεις Μπονισέλ 2001, σελ. 213
Fuentealba R, Jofré J: Esthetic Failure in Implant Dentistry. Dent Clin N Am 59:227–246, 2015
Greenstein G, Cavallaro J: The Clinical Significance of Keratinized Gin- giva Around Dental Implants. Compend Cont Educ Dent 32:24– 31, 2011
Hammerle CH, Araujo MG, Simion M: Evidence-based knowledge on the biology and treatment of extraction sockets. Clin Oral Im- plants Res 23(Suppl 5):80–82, 2012
Juodzbalys G, Kubilius M: Clinical and Radiological Classification of the Jawbone Anatomy in Endosseous Dental Implant Treatment. J Oral Maxillofac Res 4:e2, 2013
Kassim B, Ivanovski S, Mattheos N: Current Perspectives on the Role of Ridge (Socket) Preservation Procedures in Dental Implant Treatment in the Aesthetic Zone. Aust Dent J 59:48-56, 2014
Kourtis S, Kokkinos K, Roussou V: Predicting the Final Result in Implant-Supported Fixed Restorations for Completely Edentulous Patients. J Esthet Restor Dent 26:40-47, 2014
Levine RA, Huynh-Ba G, Cochran DL: Soft Tissue Augmentation Procedures for Mucogingival Defects in Esthetic Sites. Int J Oral Max- illofac Implants 29(Suppl):155-85, 2014
Lindhe J, Berglundh T: The Interface Between the Mucosa and the Im- plant. Periodontol 2000 17:47–54, 1998
Milinkovic I, Cordaro L: Are there Specific Indications for the Different Alveolar Bone Augmentation Procedures for Implant Placement? A Systematic Review. Int J Oral Maxillofac Surg 43:606–625, 2014
Ortega-Martínez J, Pérez-Pascual T, Mareque-Bueno S, Hernández-Al- faro F, Ferrés-Padró E: Immediate implants following tooth ex- traction. A systematic review. Med Oral Patol Oral Cir Bucal 17(2):251-261, 2012
Rodriguez AM, Rosenstiel SF: Esthetic considerations related to bone and soft tissue maintenance and development around dental implants. J Prosthet Dent 108:259-267, 2012
Sanz I, Garcia-Gargallo M, Herrera D, Martin C, Figuero E, Sanz M: Surgical protocols for early implant placement in post-extraction sockets. A systematic review. Clin Oral Implants Res 23:67–79, 2012
Wood MR, Vermilyea SG: A review of selected dental literature on evidence-based treatment planning for dental implants. J Prosthet Dent 92:447-462, 2004
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