221. Gustavo Avila-Ortiz DDS, MS, PhD - Marginal Implant Bone Loss
May 6, 2024
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Gustavo Avila-Ortiz, DDS, MS, PhD talks about tissue grafting choices for implants, errors in implant placement, strategies to minimize bone loss, retrieving fractured implant screws, and optimizing ridge preservation in dentistry.
Different materials serve different purposes in tissue grafting, acting as osteogenic scaffolds and barriers against soft tissue ingrowth.
Understanding bone remodeling around dental implants and the impact of implant depth, abutment strategies, and implant dimensions is crucial for successful outcomes and complication prevention.
Deep dives
Types of Dental Tissue Grafting Materials
There are two main families of materials used for tissue grafting in dentistry. One family includes autogenous materials like tajama's bone or blood-derived products such as PMP and PRF. The other family consists of non-autogenous products. Distinctions are made between what is placed in the socket for grafting, what is inserted into the socket, and how the socket is sealed. Different materials serve different purposes, with each serving as an osteogenic scaffold and barrier against soft tissue in growth.
Implant Depth and Placement Considerations
When placing dental implants, the depth plays a crucial role in bone remodeling around the implant. Optimal implant depth depends on factors like tissue thickness, bone characteristics, and implant design. The concept of 'one abutment, one time' has emerged as a strategy to minimize bone loss around implants. Understanding the influence of bone and soft tissue thickness is vital in maximizing implant outcomes and preventing complications.
Implant Length and Width Selection
The choice of implant length and width impacts primary stability and long-term outcomes. Short implants, also known as minis, can be effective, but considerations must be made regarding surface design and biomechanical behavior. Maintaining an appropriate implant-to-crown ratio, ideally not exceeding two to one, can reduce the risk of complications like screw loosening and fractures. Careful selection of implant dimensions, including length, width, and design, is essential to avoid biomechanical issues in the future.
Dr. Gustavo Avila-Ortiz obtained a DDS degree and completed a PhD training program at the University of Granada (Spain), before moving to Ann Arbor, Michigan (USA) where he graduated with an MS degree and a Certificate in Periodontics from the University of Michigan. He is also a Diplomate of the American Board of Periodontology. Dr. Avila-Ortiz has over 10 years of experience as an educator and has worked to advance the profession in numerous institutional committees and scientific organizations. He is a former faculty member at the University of Michigan School of Dentistry and at the University of Iowa College of Dentistry, where he was the Phillip A. Lainson Professor and Chair of the Department of Periodontics until 2022. He currently serves as Editor-in-Chief of The International Journal of Periodontics & Restorative Dentistry. He has authored more than 100 articles published in peer-reviewed journals and numerous book chapters. He is the co-author of the book TISSUES: Critical Issue in Periodontics and Implant-Related Plastic and Reconstructive Surgery (Quintessence Publishing 2022), which has been critically acclaimed within the profession. Dr. Avila-Ortiz is currently a Visiting Professor in the Division of Periodontics at Harvard School of Dental Medicine and a member of Atelier Dental Madrid (Spain), a center for dental excellence where he maintains a private practice limited to Periodontics and Implant Dentistry and is regularly engaged in scholarly and continuing-education activities.
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