- Thorough and precise treatment planning that should be based on firm documentation
- Implant treatment must be aesthetically and functionally navigated
- Lip support, smile- and transition line must be assessed in the very early stages of implant therapy as to conclude upon removable prostheses or fixed ones
- Potential regenerative techniques are to be evaluated pre-operatively
- Composition (titanium grade IV, or zirconia) of implant-to-be-used must be verified with SerialNumbers and Certificates
- Smoking and/or alcohol intake must be controlled because it jeopardizes implant's osseointegration/success
- High-end implants to be used as they promote minimal invasiveness
In the recent years special implant designs (i.e. angulated , short , zygomatic) facilitate deviating of grafts in almost 95% of the cases with compromised bone volume.
Periodontal lesions must be treated prior to implant therapy. This is of paramount importance mainly due to pathogenic bacteria accumulated on periodontally infected teeth. These bacteria can either migrate to the implant surface and implicate the osseointegration process or elicit bone loss around teeth. After periodontal treatment is applied, success of implant therapy is fully guaranteed.
- Sensitive and demanding technique
- More expensive
However, large-scale clinical studies demonstrate similar success rates for immediate implant loading as with conventional loading of implants in non-dentate patients. This occurs on specific indications, such as single implant therapy or full upper/lower reconstruction.
Aesthetics is implants' big asset. However, the morphology of the gums (i.e. ''pink'' aesthetics) around implant site may be unstable in the long span. Special tissue management is typically conducted thus preserving the gum volume in the long term.
Although 5-year success rates are high (93-98%), the 10- or 20-year evaluation appear with compromised results mainly due to
- Insufficient adaptation between implant and its super-structure (crowns/bridges)
- Unsuccessful evaluation of the sequence of therapeutical stages, that result in gum recession
- Heavy occlusal contacts that need to be adjusted on centric relation
- Problematic compliance to the re-calls and the hygiene
Precise synergy of diagnostic methodology and evidence-based treatment planning prevents the afore-mentioned issues and provides a long-term success for implant rehabilitations.