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Product Information:
Author: Zinner, Ira D.; Panno, Francis V.; Small, Stanley A.; Landa, Lloyd S. - Not Available
Title: Implant Dentistry: From Failure to Success
Clinicians face multiple challenges in treating patients who present with failed implants: they must identify the cause of failure, find a way to salvage the restoration, and satisfy an unhappy patient. This book, a collaborative effort by a group of seasoned clinicians, offers a guiding philosophy as well as practical strategies for treating common types of failure. Emphasizing the need for diligent planning, precise techniques, and complete cooperation among all members of the implant team, the authors advocate a sequential treatment approach and the use of long-term, screw-retained, fixed provisional prostheses to enhance patient comfort and function and to improve treatment predictability. They also share strategies they have learned through experience for reducing prosthetic, surgical, and technical complications. Detailed clinical cases demonstrate the most common types of failure and the steps taken to restore function. All members of the implant team—restorative dentists, surgeons, and laboratory technicians—will benefit from the interdisciplinary approach presented in this text.
ISBN: 0-86715-438-1
978-0-86715-438-2 , 9780867154382
208 pp; 365 illus (272 color)
Contents
Foreword
Preface
Contributors
1 Sequential Approach to Rehabilitation of Failing Cases/Ira D. Zinner, Francis V. Panno
2 Diagnosis and Treatment Planning for Implant-Supported Fixed Prosthodontics/Ira D. Zinner, Yale E. Schnader
3 Presurgical Prosthodontics/Ira D. Zinner, Stanley Markovits
4 Troubleshooting and Managing Surgical Problems/Stanley A. Small
5 Second-Stage Screw-Retained Provisional Prostheses/Ira D. Zinner, Lloyd S. Landa
6 Occlusal Considerations to Prevent Prosthesis and Component Complications/Trudy M. Burke, Yale E. Schnader
7 Maxillary Sinus Grafts and Prosthetic Management/Ira D. Zinner, Stanley A. Small
8 Sinus Augmentation and the Prevention and Management of Maxillary Sinus Complications/Scott D. Gold
9 Technical Considerations to Optimize Prosthetic Success/Paul Federico, Patrick E. Reid, Ira D. Zinner
10 Repair and Replacement of Damaged or Fractured Implant Components/Curtis E. Jansen
11 Salvaging a Failed Implant-Supported Fixed Prosthesis in the Completely Edentulous Patient/Israel M. Finger, Stanley Markovits, Ariel J. Raigrodski
12 Esthetic Considerations in Implant Dentistry/Lloyd S. Landa, George P. Argerakis
13 Legal Aspects of Implant Practice/Milton Palat
Index
Preface
Since implant prosthodontics were introduced in the 1980s, my implant team has been involved in the treatment of implant failures. Most unsuccessful cases are the result of a lack of communication among the team members, insufficient knowledge of each member’s responsibilities, false assumptions, and attempts by practitioners to treat situations for which they were not trained. This book was written to teach practitioners sequential treatment planning for and management of failed cases.
Understanding failures and their causes is more difficult with implant-supported prostheses than with conventional prosthodontics, perhaps because of the greater risk or invasiveness of the procedure and/or the greater expense to the patient. Nonetheless, the principles of conventional prosthodontics must remain central in the treatment of patients with implant-supported prostheses. Complications frequently occur as a result of poor diagnosis and treatment planning, a lack of proper case sequencing, or inadequate use of provisional prostheses. Inadequate technical skill in the fabrication of the prostheses also can cause failure. In addition, management of patients with failed prostheses requires the restorative practitioner not only to solve and prevent further failure but also to defuse legal problems between patients and their previous clinicians.
Implant dentistry is prosthetically driven, not surgically based. Therefore, the restorative clinician is the director of the team and bears the responsibility for the end result of treatment. Because patients often blame the restorative clinician for any complications, it is important for clinicians to understand not only the need for retrievability of the prosthesis and its components, but also the surgical requirements and the technical nuances of prosthesis fabrication.
When implant prosthodontics was first taught at the University of Toronto and the Mayo Clinic in the 1980s, the surgeon and the prosthodontist were educated as a team: the prosthodontist learned about surgery and the surgeon learned about prosthodontics. This allowed both members of the team to understand the challenges faced by the other team member. Unfortunately, today, surgical and prosthetic training are usually taught independently, placing both team members at a significant disadvantage.
Successful treatment must begin with an optimal, sequential prosthetic diagnosis and treatment plan. After the treatment plan has been formulated, the surgical consultation is completed and the treatment plan is modified as needed. The laboratory technician must be involved in all stages of planning because the technical requirements of the prosthesis will influence treatment. Throughout the process, it is also important that the patient be kept informed of the protocol for treatment and maintenance of implant-supported prostheses as well as their advantages, disadvantages, and limitations.
Clinicians should keep in mind the following principles to minimize failures of implant prostheses. To achieve optimum patient management and treatment, all practitioners involved need to work as a team, and the team must agree on the diagnosis and treatment-planning sequence. The sequential approach to treatment necessitates a team that functions well together. Clinicians should be able to achieve the treatment goals without the use of a removable prosthesis following implant placement. Fixed provisional prostheses improve the patient’s comfort, esthetics, and function and should be used whenever possible. After the implants have been uncovered, long-term use of metal-reinforced provisional prostheses allows time for the tissues to heal and for the practitioner to create an esthetic restoration. This type of second-stage provisional prosthesis also serves as a protective mechanism for the clinician: if an implant fails or if a component is changed, any modifications can be made before the definitive prosthesis is completed. Finally, use of screw retention facilitates inspection of components, repairs, and the addition or removal of implants and is recommended for provisional prostheses. Screw-retained prostheses demand absolute precision and skill during fabrication, but their predictability and retrievability are indispensable.
Edited by
Ira D. Zinner, DDS, MSD
Clinical Professor
Director of Full-Mouth Rehabilitation Program
Louis Blatterfein Department of Prosthodontics
Division of Reconstructive and Comprehensive Care
New York University College of Dentistry
New York, New York
Francis V. Panno, DDS
Associate Dean for Clinical Affairs
Ira E. Klein Chair and Professor
Louis Blatterfein Department of Prosthodontics
Division of Reconstructive and Comprehensive Care
New York University College of Dentistry
New York, New York
Stanley A. Small, DDS
Associate Clinical Professor
Anthony S. Mecca Department of Oral and Maxillofacial Surgery
Division of Biological Science, Medicine, and Surgery
New York University College of Dentistry
New York, New York
Lloyd S. Landa, DDS, MSD
Clinical Professor
Louis Blatterfein Department of Prosthodontics
Division of Reconstructive and Comprehensive Care
New York University College of Dentistry
New York, New York
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