The primary function of a dental implant is to act as an abutment for a prosthetic device, similar to a natural tooth root and crown. Any success criteria, therefore, must include first and foremost support of a functional prosthesis. In addition, although clinical criteria for prosthetic success are beyond the scope of this article, patient satisfaction with the esthetic appearance of the implant restoration is necessary in clinical practice. The restoring dentist designs and fabricates a prosthesis similar to one supported by a tooth, and as such often evaluates and treats the dental implant similarly to a natural tooth. Yet, fundamental differences in the support system between these entities should be recognized. The purpose of this article is to use a few indices developed for natural teeth as an index that is specific for endosteal root-form implants. This article is also intended to update and upgrade what is purported to be implant success, implant survival, and implant failure. The Health Scale presented in this article was developed and accepted by the International Congress of Oral Implantologists Consensus Conference for Implant Success in Pisa, Italy, October 2007.
It can be concluded that platform switching does not prevent crestal bone loss if, at the time of implant placement, mucosal tissue is thin. In thick soft tissue, use of platform-switched implants maintained crestal bone level with minimal remodeling.
Useful in a variety of oral surgery procedures, piezosurgery has therapeutic features that include a micrometric cut (precise and secure action to limit tissue damage, especially to osteocytes), a selective cut (affecting mineralized tissues, but not surrounding soft tissues), and a clear surgical site (the result of the cavitation effect created by an irrigation/cooling solution and oscillating tip). Because the instrument's tip vibrates at different ultrasonic frequencies, since hard and soft tissues are cut at different frequencies, a "selective cut" enables the clinician to cut hard tissues while sparing fine anatomical structures (e.g., schneiderian membrane, nerve tissue). An oscillating tip drives the cooling-irrigation fluid, making it possible to obtain effective cooling as well as higher visibility (via cavitation effect) compared to conventional surgical instruments (rotating burs and oscillating saws), even in deep spaces. As a result, implantology surgical techniques such as bone harvesting (chips and blocks), crestal bone splitting, and sinus floor elevation can be performed with greater ease and safety.
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