Criteria for success for osseointegrated endosseous implants

Question 1

Osseointegration is

Answer 1

• A measure of implant stability
• Crucial for implant survival and success.

Question 2

Measuring implant stability helps with:

Answer 2

• Decisions making, as the loading of an implant
• The choice of protocol on a patient to patient basis
• Better case documentation

Question 3

A successful implant

Answer 3

• Reflects good bone to implant contact
• Is determined by good stability both primary and secondary .
• Implant stability is achieved at two different stages

Question 4

Primary vs Secondary implant stability

Answer 4

• Primary (immediately after implant placement)
• Secondary (3-4 months after implant placement).

Implant stability has been confirmed to affect the process of osseointegration and therefore is essential to understand the methods of measuring implant stability and influencing factors.

Question 5

Criteria for success

Answer 5

1. Immobile implant when tested clinically
2. No evidence of peri-implant radiolucency on radiograph
3. Mean vertical bone loss is less than 0.2 mm annually after the first year of placement
4. No persistent pain, discomfort, or infection
5. Implant has to allow placement of a prosthesis

Question 6

Further categorization of the criteria

Answer 6

1. Mobility
2. Peri-implant radiolucency
3. Marginal bone loss
4. Patient comfort
5. Gingival status
6. Persistent infection
7. Damage to adjacent teeth
8. Violation of the maxillary sinus, mandibular canal, or floor of the nasal cavity
9. Appearance
10. Length of service

Question 7

Mobility Test

Answer 7

Question 8

Peri-implant radiolucency

Answer 8

1. In some ways mobility and peri-implant radiolucency measure the same aspects of implant response.
2. A complete peri-implant radiolucency indicates the presence of soft tissue and probable implant mobility and is a predictor of impending implant loss .

Question 9

Gingival Status

Answer 9

Question 10

Infection

Answer 10

1. Implants that are the source of persistent or recurrent infections should not be considered successful.
2. Some specific implant designs, allow them to be present in place despite this problem.
3. However, this situation should not be considered healthy, and implants that are so involved are considered failures.

Question 11

Damage to adjacent teeth

Answer 11

Although an implant that is impinging on adjacent roots could not be considered successful but on this example they survived, and the main problem is of iatrogenic origin.

Question 12

Violation of maxillary sinus, mandibular canal, floor of the nasal cavity

Answer 12

1. Implants penetrating the maxillary sinus or floor of the nasal cavity have a decreased percentage of success .
2. Penetration of the maxillary sinus or nasal cavity is often done intentionally by the surgeon when the quantity of bone is deficient.
3. Impingement on the mandibular canal has not been studied, but when it occurs it is a serious complication requiring immediate action by the clinician.

Question 13

Length of service

Answer 13

• Length of service is an important criterion for success because most implant modalities are highly successful for 1 or 2 years after placement.
• The success rate at the end of 5 years appears to be reasonable time to evaluate success.