36th Int’l Dental ConfEx CAD/CAM Digital & Oral Facial Aesthetics

Abstract

Oral implantology has proven to be a reliable and predictable technique for the rehabilitation of edentulous spaces. Attainment of this goal, however, is predicated on the ability of the implant to achieve osseointegration with its bony environment. This process passes through a primary stage characterized by mechanical stabilization of the implant, and a secondary stage of biological anchorage, the actual osseointegration process.  Different parameters play a major role in achieving optimal implant primary stability and smooth less secondary stability. Understanding these parameters will allow clinicians to predictably plan future loading protocol (immediate, early or delayed).

When bone conditions permit it, implant placement should be performed and immediate or early prosthetic loading should be the treatment of choice. This choice of loading protocol is predicated by numerous factors related to both bone environment and choice of implant, since bone density, implant geometry and surgical technique can directly affect implant primary stability. The quest for an implant macro geometry conferring good stability in soft bone while reducing bone compression in hard bone is today of utmost importance to predictably perform accelerated loading protocols. This geometry was recently introduced by adapting implant core diameter to drilling shape and thread diameter to bone density thus allowing the clinician to achieve optimal implant stability in any bone type. Implant shape, thread design and implant surface characteristics will not only confer enhanced primary stability but also maintained stability values during the first critical weeks leading to predictable accelerated loading protocols.

During this presentation, scientific and clinical rationale will be presented to give the clinician an evidence-based approach for implant loading protocol.  A special emphasis will be made on the importance of implant macro and micro geometry to fulfill local mechanical and biological conditions for accelerated loading.

Leraning Objectives

• Understand how bone density, implant geometry and surgical technique affect implant mechanical primary stability.
• Comprehend biological changes following placement of dental implants and their clinical implications.
• Understand the rationale for immediate implant placement into extraction sockets.
• Understand the clinical and scientific rationale behind immediate and early loading protocol.
• Recognize and avoid risk factors leading to failure of accelerated loading protocols when planning implant reconstructions.