So you have a complication. …

Dr. Justin Moody discusses ways to avoid possible implant glitches

OTH_Moody_Complications_Fig1No one ever wants patients to experience a complication during implant treatment, especially after the final restorations have been placed. However, clinicians who place enough dental implants will inevitably have some cases that “take a turn south.” Seems everyone wants to take a course or learn how to fix the issues, but what gets lost in the panic is what caused the condition, and how we are going to keep it from recurring. Many of the calls and emails I get regarding complications result from bone loss around integrated implants in function.

Finding the root cause of the problem is not often that easy but is essential to finding the solution and, ultimately, the subsequent treatment. In my opinion, many of them are peri-implantitis cases that can be contributed to residual excess cement — those are the easy ones. But what about bone loss around screw-retained crowns? Locators? Sometimes we just don’t know. These cases, I think warrant a look back at the overall health of the patient; here is where I am finding many clues to potential issues.

Figure 2: Saucer or cupping loss around the implant
Figure 2: Saucer or cupping loss around the implant

OTH_Moody_Complications_Fig3-4Risk assessment at the beginning of treatment pays off tenfold in the long-term prognosis of implant dentistry. Identifying uncontrolled diabetes, alcoholism, multiple medications, and parafunctional habits are just a few in the long list of items to look for and to ask questions about.

Proper treatment planning and execution are the factors that we as surgeons have control over and need to master. The use of surgical guides has helped in the proper placement of implants in the bone for ideal restorative outcomes coupled with cone beam CT and the available software. The future is bright; we just need to stay focused and concentrate on avoiding implant complications!

OTH_Moody_Complications_Fig5
Figure 5: Failed implants can lead to large amounts of bone loss and lost sleep

Justin MoodyJustin Moody, DDS, DICOI, DABOI, is a Diplomate of the American Board of Oral Implantology and of the International Congress of Oral Implantologists, Fellow and Associate Fellow of the American Academy of Implant Dentistry, and Adjunct Professor at the University of Nebraska Medical College. He is an international speaker and is in private practice at The Dental Implant Center in Rapid City, South Dakota. He can be reached at justin@justinmoodydds.com or at www.justinmoodydds.com.

Disclosure: Dr. Moody is a paid speaker for BioHorizons.

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