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implants – international magazine of oral implantology

I research _Implants are becoming increasingly popular with low-cost offers promoting this develop- ment. The number of customers preferring im- plants to customary restorations is expanding. The variety of client demands, individual settings, treatment options and risks related to inflamma- tionandbonedamagefollowingimplanttreatment advocate evident, comprehensible and durable so- lutions. Safeguarding implant treatment commences with careful tooth removal, pre-implant treatment and implant planning respecting four key issues: 1. Early decision making to ensure implant bone support with limited number of implant place- ments. 2. Sound tooth removal to protect bone loss by in- traalveolar root dissection. 3. Accuracy of implant diagnosis and implant placement by 3-D visualization (DVT) of implant surgical access. 4. Minimalsurgicalinvolvementwithshortandlow diameter implants while restricting augmenta- tion to prosthetic relevant settings. _Planning EarlyDecisionMaking Early implant decision making comprises anatomical,functionalandeconomicissues: a)Anatomy: Treated severe periodontitis usually displays clinical stability with further drawbacks around implant supported bone at buccal plates or interapproximal sites by inflammation (Figs. 1 &2).1 b) Function: Following untreated periodontal dis- eases or tooth removal, shifting of single tooth initiatesduetomyofunctionalimbalance.Byloss of front-canine equilibration, a group side shift emerges with further bite reduction as result of age and misusage.2 c) Dues: Periodontal therapy of severely compro- misedteethwithboneloss>50%oftenresultsin a later date implant treatment that doubles den- tal efforts and bills. Economic issues should downregulate this strategy. d) Oralcomfort:Stability,oralhygieneandesthetics become fostered by timely implant placement and optimized implant prosthetics. Implant planning affects periimplant diseases A time shift link Author_Rainer Buchmann, Daniel Torres-Lagares & Guillermo Machuca-Portillo, Germany & Spain 06 I implants3_2015 Fig. 1_Severe periodontitis, residual inflammation and bacteremia. Poor hygienic capability, comfort and esthetics with furcation caries. Fig. 2_Drawn-out expectation period in advanced periodontal disease at # 15, 16 with horizontal alveloar bone resorption at assigned implant site (see Fig. 14). Fig. 1 Fig. 2

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