Penam Periodontics - Evidence based Personalized Periodontics

Implant check list

A number of factors need to be assessed before implants may be considered over other restorative methods such as crowns and bridgework.

Aim: To place implants that fulfil their required aesthetic and functional roles and last as long as possible.

Initial Assessment should include:

  1. Plaque score (high plaque scores increase the risk of biological complications by >10 fold);
  2. Periodontal chart (the greater the periodontal issues the greater the risk of implant loss and biological complications >10 fold for the most aggressive disease cases);
  3. Smoking history/number per day (increased risk of loss and complications >5 fold);
  4. Other systemic condition issues (depends upon the condition as to the increase in risk of complications);
  5. Restorative issues with adjacent teeth. (A bridge may be a better option if these are highly restored).
  6. Bone status. Is there sufficient bone? Is there an issue with the maxillary sinus? Is the bone dense or of poor quality? Can one obtain a good angulation for a prosthetic outcome?
  7. Assessment of alternatives: bridgework, dentures. (Select the one with the best outcome and lowest risks for the patient). Calculate the patients risk.

Case type criteria and when the GP dentist may consider referral.

  1. Simple – refer if you do not want to do them yourself.
  2. Moderate – depends upon your competence. If unsure always refer – don’t take the risk.
  3. Complex – refer in most cases unless you are competent and have the experience to deal with the issues.
    1. Surgery: Oral surgeon or Periodontist for the surgical components.
    2. Prosthodontists for the Prosthetic components, who may work with the surgeons.
    3. Doctor of Clinical Dentistry (Implants) or graduate diploma of Implants for combined treatment.

For options 3. If you know of specialists who work as a team these may provide better outcomes as they understand each other and work together to gain the best outcome.

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