causing soft tissue necrosis due to impaired blood supply;
When a temperature of over 47°C is reached for 1 minute intraosseous blood vessels coagulate and extended necrotic areas are formed which become radiographically visible after 2-4 weeks.
If a thorough cleaning of the recess in the implant body does not solve the problem, then, where the joint is screwed, it may be necessary to clean the thread using manufacturer-specific instrumentation.
This is a delicate task and subsequently care must be taken to remove all the debris, which frequently includes metal swarf, by thorough irrigation with normal saline.
Uncovering of the implants will be postponed by 2-4 months; – a small horizontal defect, apical repositioning of the soft tissues will be performed with cleaning of the exposed threads to avoid plaque buildup; – a larger horizontal defect, a graft of autologous bone will be performed and a membrane positioned after accurate curettage of the area to help restore blood supply and promote new bone formation. Uncovering of the implants will be postponed by 3-4 months; – a vertical or horizontal defect deeper than half the length of the implant, the implant will have to be removed because of inadequate stability and cosmetics. Bone defects may be prevented by identifying and avoiding all the conditions that may engender the risk of such an event. Hence, treatment planning will take into account the quantity and quality of bone present. Proper surgical techniques will be performed and careful postoperative management ensured to protect the surgical wound from excessive stress.
This is a more serious situation and is called peri-implantitis.
Treatment of peri-implantitis is based on removal of the cause, prevention of its recurrence and symptomatic treatment of the inflamed tissues.
This typically involves scaling the abutment using plastic sealers, irrigation of the sulcus and advice on home care.
Probing depth more than 4mm + bleeding + suppuration + radiographic bone loss
Non-axial loading of a screwed joint reduces its fatigue strength, and occurs due to cantilevering effects. These can range between the lateral off-axis locations of load-bearing cusps to extensive distal cantilevers. In both situations joint failure is more likely. The loading pattern will, however, be partly determined by the configuration of the superstructure.
Fatigue failure- This arises as a result of cyclical loading
racture of an acrylic resin tooth in a fi xed full-arch implant- supported maxillary prosthesis.
the lack of replicates for the interdental papillae, producing a