Dr. Gustavo Avila-Ortiz, a DDS, MS, PhD holder and Diplomate of the American Board of Periodontology, discusses topics such as preserving hard tissue post tooth extraction, factors influencing bone atrophy, implant challenges with periodontitis, facial plate thickness impact on implant placement, and pre-implant diseases like cositis and implantitis in this informative podcast.
Minimally traumatic extraction is vital for bone preservation during tooth extraction.
Thicker soft tissue and mucosal seal influence implant success and aesthetics.
Regular monitoring and gentle cleaning are crucial for long-term implant maintenance.
Proper reconstruction and tissue preservation are essential for successful implant replacement post-peri-implantitis failure.
Deep dives
Importance of Minimally Traumatic Extraction for Preservation of Extraction Site
Performing a minimally traumatic extraction is crucial for effective preservation of the extraction site, ensuring integrity of the bone. Understanding the tooth type and potential anatomical variations is essential during extraction. After tooth extraction, assessing the site for bone integrity guides further actions. Immediate implant placement is suitable for well-preserved sites, but regenerative materials can aid in preserving architecture in damaged areas.
Impact of Tooth Extraction on Alveolar Bone and Peri-Implant Tissues
Tooth extraction leads to progressive atrophy of the alveolar bone due to blood supply changes and biomechanical factors. Alveolar bone remodeling can result in significant bone resorption, especially in thin bone phenotypes. Interproximal dehiscence, indicative of periodontal disease progression, can lead to microbial colonization and tissue inflammation.
Significance of Soft Tissue and Mucosal Seal in Implant Dentistry
Thicker soft tissue and a well-maintained mucosal seal play vital roles in implant success. Understanding the mucosal phenotype informs treatment decisions for implant placement. Factors affecting soft tissue, such as mucosal thickness and tissue phenotype, impact aesthetic and functional outcomes. Attention to soft tissue around implants is essential for long-term implant health and stability.
Probing and Maintenance Around Implants
Using a plastic probe for probing around implants avoids tissue damage and bleeding. Monitoring probing depth and taking regular radiographs are necessary for implant maintenance. Air polishers are preferred over scalars for implant cleaning, with careful consideration of tissue response to avoid peri-implant diseases. Recognizing early signs like peri-implant cositis helps in timely intervention and treatment.
Challenges and Considerations in Peri-Implantitis Treatment
Treating peri-implantitis poses challenges due to implant materials, designs, and extent of bone loss. Success rates decrease when replacing implants due to peri-implantitis. Reconstruction and proper site development post-implant failure are crucial. Re-establishing a healthy bone foundation is key for successful implant placement after peri-implantitis.
Effects of Replacing Implants Post-Peri-Implantitis
Replacing implants after peri-implantitis failure can result in decreased success rates. Careful reconstruction of the site and elimination of disease tissue are essential for subsequent implant success. Informing patients of the risks and ensuring proper site development pre-implant placement are critical steps.
Clinical Considerations for Implant Replacement After Failure
Implant replacement post-peri-implantitis failure requires meticulous reconstruction and tissue preservation. Ensuring proper site development and eliminating disease tissue are crucial for long-term success. Informing patients about potential risks and balancing anatomical conditions with skilled treatment help optimize implant outcomes.
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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