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Implant Exposure

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by

Yasmin Ali

on 28 January 2014

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Transcript of Implant Exposure

Implant Exposure
Implant Exposure Techniques
Dental Implant Surgery can be performed either as :
Techiques chosen for uncovering the implant depends on :
Premature Exposure of the cover screw
Excisional Techniques
Incisional Techniques
One - Stage procedure
Two - Stage
procedure
Characteristics of tissues that overlies the implant .
The amount of attached gingiva .
The thickness of overlying mucosa .
The Presence or absence of interdental papilla .
The early exposure of the cover screw results in breakdown of the mucosal seal inflammation & mucosal damage accelerate early peri-implant crestal bone loss.
HOW TO TREAT
Implant exposure techniques for second-stage surgery can be divided into:
Excisional or “destructive”
because excisional techniques reduce the width of the fixed mucosa .

Incisional “reconstructive”



Incisional techniques preserve the soft tissues at the implant site, and they can be classified into two categories:
1-without tissue transference
2-with tissue transference

For fixed mucosa greater than 4 mm
excisional techniques

For fixed mucosa between 1mm and 4mm
incisional techniques

For patients with too little mucosa.
a free-gingival graft preceding incisional technique

To Determine which technique to employ
the amount of preoperative fixed gingiva can help clinicians :

Tissue Punch
Scalpel Blade
Laser
At times, the excisional method can be preferred
even if the attached gingiva is insufficient, as is the
case with mandibular implants, with which there is no other choice but to perform a connective tissue graft taken from the palate at a later time .

N.B
Without tissue transference
Cross - type Incision "+"

if implant site cannot be accurately located a midcrestal incision is performed .
Diagonal Incision "X"
U-Shaped Incision
With tissue transferance
The first action is to completely expose the implant the cover screw is then removed the implant body irrigated with chlorhexidine 0.12% a permucosal extension is then inserted into the implant .
Osama Hussien
Rana Hazem
Raghda Alaa
Haneen ahmed
Nouran Osama
Nada Waleed

Rotated Palatal Flap

The T-shaped incision
After reflecting the flap , A T- shaped incision is made on the buccal aspect of the flap to allow both sides of the flap to slide laterally to fill the spaces between the healing abutments & adjacent teeth .
Pouch Roll technique
A surgical approach to increase the keratinized tissue width in maxillary implant uncovering .
A surgical technique to restore a papilla-like tissue
between implants
(unilateral Semilunar Incision )
The attached masticatory mucosa is displaced buccally , thereby increasing the tissue volume at the buccal side of the implant(s).
The repositioned buccal tissue is stabilized by the connected abutments , the excess buccal tissue allow for dissection & rotation of pedicles with the purpose of filling the inter-implant space with papilla like tissue .
The main objectives of the proposed technique are to enhance the marginal gingival thickness for a more stable gingival margin around the dental implant & to augment a mild to moderate soft tissue deficiency on the buccal aspect of a dental implant site .
FINALLY
Criteria for Evaluation of Successful Implants at II stage surgery :

1- Rigid Fixation
2- Absence of crestal bone loss
3- Absence of Pain
4- Adequate Zone of Keratenized Gingiva
5- Sulcus Depth 4 mm
6- Absence of Inflammation
7- Proper Hard and soft tissue Contour


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