Clinical complications with implants ..

If there is bone loss around the implant, but it is still stable, bone regenerative techniques may be used in addition to the preceding protocol to attempt to improve bone levels and reduce pocket depth. The prosthesis should be removed, and a cover screw placed to facilitate access and allow for coverage with a membrane. In addition, the defect should be treated with citric acid or tetracycline solution, and followed by sterile saline rinses before bone grafting material and a membrane are added. If despite attempts to salvage the implant, bone loss continues and mobility develops, the implant fixture should be removed, the site thoroughly debrided, and bone regeneration techniques employed. Early intervention when these issues are initially identified increases the prognosis of treating an ailing implant, whereas watching and waiting tends to lead to implant loss as the bone loss progresses to the point where salvaging the implant is not possible.

Clinical complications with implants and implant prostheses

01/01/2009 · Common complications with implants and implant ..

Clinical Complications with Dental Implants…


• Learn the laboratory and the clinical indications and protocol for the fabrication, the delivery and postoperative follow-up for the high-water implant prosthesis.

clinical evolution in patients with penile prosthesis implant

AB - The aim of this study was to evaluate the clinical outcomes from a predoctoral implant clinic over 3 years. All patients who received implant-retained mandibular overdentures (IODs) or a single-tooth implant (STI) restoration in the Predoctoral Implant Program at the University of Illinois-Chicago College of Dentistry between 2006 and 2009 were included in this study. A two-stage surgical placement and healing protocol was followed by oral surgery, periodontic, and prosthodontic specialty clinics. The following potential prognostic information was collected: patient age and sex; implant diameter, length, and sites; and complications related to the treatment. Life-table and Kaplan-Meier survival analyses were performed for both IOD and STI patient groups. A total of 371 implants were placed in 243 patients. There were 164 implants placed in 82 patients in the IOD group and 207 implants placed in 161 patients in the STI group. Two implants failed in the IOD group and 2 implants failed in the STI group. The cumulative survival rates for the implants in both the IOD and STI groups were 99%. Kaplan-Meier survival analysis showed no significant differences between the two groups. The most common complication observed in the IOD group was damage to the attachment inserts, and for the STI group, it was repair or remaking of the definitive prosthesis. As demonstrated by the 3-year clinical outcomes, a predoctoral implant program can provide predictable patient-centered therapy with few complications. Patient therapy, guided by thoughtful diagnosis and driven by restorative outcome, can lead to favorable results.

30/12/2017 · Biomechanical Implant Treatment Complications: A Systematic Review of Clinical Studies of Implants with at ..
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Breast Implant Removal - Medical Clinical Policy …

Implant position complications
The primary causes of implant failure can be attributed to poor planning and placement. A natural tooth, which is attached to the alveolar bone through a vascularized periodontal ligament space, may be only partially supported within bone. In contrast, it is imperative that there be an adequate volume of healthy bone surrounding a dental implant. Most of the data suggest that there should be at least a thickness of 1.8 mm–2.0 mm of healthy bone on the buccal (facial) and lingual (palatal) aspects of each implant fixture, as well as 1.5 mm or more between an implant and a natural tooth,3 and 3.0 mm between adjacent implants.4 One should keep in mind that these values are minimums. Violation of this minimal bone thickness leads to compromised vascular supply to the surrounding bone at the crest, lower loading handling during function, and ultimately bony resorption, resulting in implant failure, as well as potential loss of neighboring teeth. This is a situation that should be a thing of the past. When I trained in oral and maxillofacial surgery, we used only a panoramic radiograph, study models, and clinical examination to treatment plan implant surgery cases. It was impossible to accurately appreciate the three-dimensional anatomy of the patient’s jaws to determine ridge form and volume. Surgical guides, if they were even used, were only reference appliances for the initial and subsequent osteotomies. Even if the first drill was placed through a sleeve in the guide, there was no depth control, and subsequent drills were all used freehand, so the implant trajectory could deviate during site preparation. As the radiographs being used only provided a 2D image, a clinician could not easily assess the shape of the ridge in the buccal-lingual dimension unless a full flap was placed. This could lead to implant placement outside the confines of the ridge which may not be apparent until failure initiated (Figures 1 and 2). In addition, most implant sites were accessed through surgical flaps. It was not unusual for the implant position, size, and/or angulation to require modification once the ridge was directly visualized.

Knee Replacement Implant Types, Revision Surgery & …

Clinical Complications of osseointegrated implants

N2 - Introduction: Infection of a penile prosthesis requires that all device hardware and associated foreign materials are removed, irrespective of whether a salvage procedure will be performed. Failure to remove all foreign bodies from the operative field may result in persistent infection, necessitating surgical intervention. Aim: To review our experience with complications arising from retained foreign bodies following removal of an infected penile prosthesis. We highlight the clinical features that should raise suspicion of retained device-associated materials, and also the role of imaging in evaluating these patients. Finally, a rational approach to prevent these occurrences is proposed with the implementation of an implant-specific checklist. Methods: Medical records and imaging studies of patients presenting to our center with retained foreign bodies following removal of an infected penile prosthesis were reviewed. Main Outcome Measures: Clinical and radiologic details of each of these cases were abstracted, including patient demographics, presenting symptoms, characteristics of retained materials, bacterial cultures, treatment, and follow-up. Results: Presenting symptoms included: (i) persistent and relapsing drainage from cutaneous fistulae; (ii) cellulitis overlying an infected reservoir; (iii) persistent penile pain; and (iv) an asymptomatic individual requesting elective placement of a second implant. Infected foreign materials retrieved included: two rear-tip extenders, a tubing connector, two infected reservoirs, and nonabsorbable mesh. Preoperative computerized tomography scan confirmed the presence and the location of all of these materials. Using this data, we propose using an implant-specific checklist to insure removal of all device-related foreign bodies when explanting an infected penile prosthesis. Conclusions: A number of adverse sequelae may result from inadvertently leaving behind device-related materials when an infected implant is removed. Ultimately it is the responsibility of the surgeon removing an infected implant to insure that all device components and associated materials are removed. We believe that implementing a two-step implant-specific checklist is a rational prevention strategy.

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This complication is a good one to avoid, as it is a common cause of litigation against dentists. With the technology available to the implant surgeon today, it should be extremely rare. Three-dimensional imaging with CBCT allows for very accurate analysis of the position of the inferior alveolar canal at the sites of implant placement. Computerized treatment planning can be used to select the ideal fixture size, width, and position to avoid the mandibular nerve and maximize implant success (Figure 8). Combined with a surgical guide derived from this plan, CBCT-guided surgical techniques control the position, angulation and depth of each osteotomy and fixture placed (Figures 9-10). Following this protocol, inferior alveolar nerve injury can be completely avoided. The only other etiology for injury to either the mandibular, long buccal, or lingual nerve remains that from injection of local anesthetic. For many simple implant cases, a block injection can be avoided by simple infiltration of local anesthetic directly over the surgical site. Since the only innervation to an edentulous region is via the periosteum, good local anesthesia can be obtained for implant placement by infiltration alone.9