Impact of Smoking on Implant Survival

Smoking might produce negative effects on implant survival both directly and via a possible effect on jaw bone density. _______ has also been mentioned as a possible risk factor for lack of success with osseointegration.

Concerning osteopenia, it was demonstrated that implants placed in lower quantities of ______ were at higher risk of failure. Indirect evidence also comes from the recognition that shorter implants in the past had higher failure rates than longer ones in a given time period.

Uncontrolled diabetes has been shown to be a risk factor for periodontal disease. A 1-year report of implant survival in non-insulin-dependent diabetics indicated a 7.3% failure rate. This seems to indicate that osseointegration can be obtained in the majority of diabetic patients.

A medical and medication history has been associated with an increased risk of implant loss. Few isolated reports have associated implant failure with the assumption of anti-osteoporosis drugs and Diphosphonate in particular.

_______ has been shown to be a psychological condition affecting treatment and has been linked to an increased risk of implant loss.

An important objective of the preoperative radiographic evaluation of the implant patient is to determine the height and the width of the bone available for implant insertion. Ideally, the bone width should allow complete coverage of all implant threads 1mm – 2mm on both the buccal and the lingual sides. The available bone height must be estimated from the part of the alveolar bone in which a sufficient bone width is found to a site specific anatomic border in the vertical direction, e.g. the lower border of the nasal cavity, the lower border of the maxillary sinus, or the upper border of the mandibular canal. Sufficiently accurate estimations of bone width and height cannot be obtained without cross sectional tomography. To achieve ideal conditions for a successful integration of the implant with the surrounding bone, it is important that good images of the implant recipient site can be obtained during the diagnostic phase. The most important factor is the presence of a sufficient amount of cancellous bone ratio to compact bone 3:1 in which the implant can be anchored: - The compact bone at the marginal bone crest can provide stability of the marginal part of the implant. The cancellous can provide the cells and nourishment for the implant. - Stability in the anterior part of the mandible is obtained by anchoring the implant in a layer of cortical bone at the base of the mandible.

Sufficiently accurate estimations of bone width and height cannot be obtained without ______ tomography.

To achieve ideal conditions for a successful integration of the implant with the surrounding bone, it is important that good images of the implant recipient site can be obtained during the ______ phase.

The most important factor is the presence of a sufficient amount of cancellous bone ratio to compact bone 3:1 in which the implant can be ______.

Stability in the anterior part of the mandible is obtained by anchoring the implant in a layer of ______ bone at the base of the mandible.

The critical selection of patients and the critical application of endosteal dental implants are the two most important prerequisites for the treatment success that we're all desire, LANNEY 1986. The three most basic principles that apply to all medical treatment are of particular importance for implant therapy: - Nihil nocere ('do not harm'), - evaluate risks and benefits, - avoid ______ treatment.

A brief review of the patient's general physical health: - is the patient's cardiovascular & renal system stable? - does the patient have any bleeding disorders? - is the patient immunocompromised? - does the patient have an uncontrolled endocrine disorder (e.g. ______)?

A screening oral examination: - does the patient have an adequate oral hygiene? - is there sufficient soft and hard tissues for placing & ______ implants?

Radiographs of the implant sites: - Periapical radiograph for individual implant sites - Panoramic radiograph for overview of anatomical structures - Tomographies in case of anatomic proximities, surgical templates etc. ______: - Pre-operative Intraoral and extra oral photographs of the selected patient.

Initial workup for patient selection: The critical selection of patients and the critical application of endosteal dental implants are the two most important prerequisites for the treatment success that we're all desire, LANNEY 1986. The three most basic principles that apply to all medical treatment are of particular importance for implant therapy: - Nihil nocere ('do not harm'), - evaluate risks and benefits, - avoid ______ treatment.

Concerning osteopenia, it was demonstrated that implants placed in lower quantities of ______ were at higher risk of failure.

Uncontrolled diabetes has been shown to be a risk factor for periodontal disease. A 1-year report of implant survival in non-insulin-dependent diabetics indicated a 7.3% failure rate. This seems to indicate that osseointegration can be obtained in the majority of ______ patients.

_______ has been shown to be a psychological condition affecting treatment and has been linked to an increased risk of implant loss.

A medical and medication history has been associated with an increased risk of implant loss. Few isolated reports have associated implant failure with the assumption of anti-osteoporosis ______ and Diphosphonate in particular.

Smoking might produce negative effects on implant survival both directly and via a possible effect on jaw bone density. _______ has also been mentioned as a possible risk factor for lack of success with osseointegration.

Differences in ______ surface have also been associated with increased risk of ______ loss: hydroxyapatite coated ______s have been found to be at higher risk for failure in a large independent medium term investigation (WEYANT 1994).This finding is no longer observed anymore (et al. 2008) with recent improved HA coated surfaces.Clinical Significance: Knowledge of subject risk should assist the clinician with determining the prognosis for the individual case and thus with patient selection.Improved understanding of subject based on risk for peri______itis and biomechanical overload combined with a careful preoperative assessment of ______ based risk could be useful in determining number, location and type of ______s as well as the design of the reconstruction.

_______ surface have also been associated with increased risk of implant loss: hydroxyapatite coated implants have been found to be at higher risk for failure in a large independent medium term investigation (WEYANT 1994).

This finding is no longer observed anymore (et al. 2008) with recent improved HA coated surfaces.Clinical Significance: Knowledge of subject risk should assist the clinician with determining the prognosis for the individual case and thus with patient selection.

Improved understanding of subject based on ______ for periimplantitis and biomechanical overload combined with a careful preoperative assessment of implant based ______ could be useful in determining number, location and type of implants as well as the design of the reconstruction.