Dental Implant Complications

Stuart J. Froum, DDS, is a Diplomate of American Board of Periodontology, Clinical Professor Department of Periodontology and Implant Dentistry, New York University Krieser Dental Center, Director of Clinical Research at the Department of Periodontology and Implant Dentistry, NYU Dental Center, and maintains a Private Practice limited to Periodontics & Implant Dentistry in New York City. Dr. Froum is Past President of the American Academy of Periodontology. He lectures nationally and internationally, has authored over 100 published research articles, and has authored and contributed to several books related to periodontics and implant dentistry.

• List of contributors xiiiForeword xviiMyron NevinsIntroduction xixStuart J. Froum1 Implant complications: scope of the problem 1Stuart J. FroumIntroduction 1Etiology 1Prevention and treatment 6Acknowledgments 7References 82 Implant complications associated with systemic disorders and medications 10Louis F. Rose and Brian L. MealeyIntroduction 10Etiology 10Prevention 24Treatment 36Take-home hints 41References 413 Complications of drug prescribing in implant therapy 49Mea A. WeinbergIntroduction 49Etiology of drug prescribing complications 49Types of drug and drug prescribing complications 49Prevention of drug prescribing complications 51Antibiotic prescribing in dental implant therapy 52Analgesic prescribing 60Steroid prescribing 63Conclusions 63Take-home hints 64References 644 Complications associated with implant planning: etiology, prevention, and treatment 68Hans-Peter Weber and Panos PapaspyridakosIntroduction 68Etiology 68Prevention through careful diagnosis and risk assessment 71Prevention of complications through careful treatment planning 81Take-home hints 98Acknowledgments 98References 995 Implant complications associated with two- and three-dimensional diagnostic imaging technologies 102Scott D. GanzCase 1: Complications due to scanographic templates 103Case 2: Long-term complications due to nerve perforation 104Case 3: Sinus augmentation complications diagnosed by three-dimensional imaging 109Case 4: Complications related to improper surgical technique, diagnosis, and free-hand implant placement 118Case 5: Complications in the mandibular symphysis – related to diagnostic imagery 122Conclusions 129Take-home hints 129References 1296 Implant fractures: etiology, prevention, and treatment 132Steven E. Eckert, Thomas J. Salinas, and Kivanç AkçaIntroduction 132Incidence 132Etiology 133Treatment of the fractured implant 142Conclusion 142Take-home hints 143References 1437 Implant naturalization: restoring osseointegrated dental implants with damaged platforms and connections 145Dennis E. Waguespack and Brian C. ButlerIntroduction 145Etiology and prevention 145Etiology 147Treatment 149Take-home hints 152Acknowledgments 152References 1528 Implant failure: prevalence, risk factors, management, and prevention 153J. Kobi Stern, Emily E. Hahn, Cyril I. Evian, Jonathan Waasdorp, and Edwin S. RosenbergIntroduction 153Definition and classification of implant failure 153Incidence of implant failures 155Etiology and risk factors 156Prevention of implant failures 162Treatment for implant failure 162Take-home hints 167References 1679 Peri-implantitis: etiology, pathogenesis, prevention, and therapy 170Niklaus P. Lang and Maurizio S. TonettiEtiology 170Microbiological aspects 170Pathogenesis of peri-implant diseases 172Diagnostic aspects 175Prevention: prophylactic procedures 178Treatment: therapeutic strategies 179Conclusions and clinical implications 183Take-home hints 184Acknowledgments 184References 18410 Complications related to cemented implant restoration 187Chandur P.K. WadhwaniIntroduction 187Advantages of the cement-retained implant restoration 187Problems associated with cemented implant restorations 187Cementing restorations onto teeth versus implants – why the difference? 188Etiology 193Prevention 197Treatment 201The future of cement-retained implant restorations 203Take-home hints 206Note 207References 20711 Esthetic complications due to implant malpositions: etiology, prevention, and treatment 209Stephen T. Chen and Daniel BuserIntroduction 209Etiology 210Prevention of implant malposition 217Treatment of esthetic complications due to implant malposition 223Conclusions 230Take-home hints 230References 23112 Prosthetic-related dental implant complications: etiology, prevention, and treatment 233Charles J. Goodacre and Mathew T. KattadiyilIntroduction 233Etiology and timing of complications and failure 233Mechanical complications 234Phonetic complications 245Esthetic complications 245Biologic complications attributable to the prosthesis 253Conclusions 256Take-home hints 257References 25713 The loose implant restoration syndrome 259Harel SimonIntroduction 259Scenario 1: Loose implant restoration emergency 259Etiology of the loose implant restoration syndrome 263Treatment protocol 263Scenario 2: Loose screw-retained crown 263Scenario 3: Loose cement-retained posterior crown 269Scenario 4: Loose cement-retained anterior crown 272Scenario 5: Loose anterior implant crown: screw-retained or cement-retained? 275Scenario 6: Loose screw-retained fixed partial denture 280Treatment considerations 284Contributing factors and prevention of screw loosening 288Take-home hints 295References 29514 Management of complications associated with single-implant esthetics 298Oswaldo Scopin de Andrade, Dario Adolfi, Maristela Lobo, and Maurício Contar AdolfiIntroduction 298Possible failures, prevalence, and etiology 299Targeted strategies for implant success in the esthetic zone 300Tooth extraction: an important factor in avoiding complications 301Key elements in implant placement and resolving esthetic complications 302Case report: step-by-step clinical procedures to resolve an implant complication in the esthetic area 305Conclusions 312Take-home hints 313Acknowledgments 313References 31315 Esthetic complications with adjacent implant restorations 316Dennis P. Tarnow, Sang-Choon Cho, Stephen J. Chu, and Stuart J. FroumComplications 316Etiology 317Prevention 318Treatment 320Case report 322Conclusions 326Take-home hints 330References 33016 Complications of autogenous bone grafting 332Craig M. MischIntroduction 332Donor sites 332Recipient site complications: early healing complications 344Recipient site complications: late healing complications 350Take-home hints 357References 35817 Complications in guided bone regeneration 362Filippo Fontana, Isabella Rocchietta, and Massimo SimionIntroduction 362Literature review 363Prevention of complications: surgical technique 364Clinical management of GBR complications 370Conclusions 379Take-home hints 380References 38018 Avoiding complications of alveolar segmental osteoperiosteal flaps 383Ole T. JensenAlveolar distraction osteogenesis 383Sandwich osteotomy 386Alveolar width distraction 388Island osteoperiosteal flap 390Book bone flap 392Major orthognathic distraction procedures 393Summary 395Take-home hints 395References 39519 Complications in lateral window sinus elevation surgery 396Stephen S. Wallace and Tiziano TestoriIntroduction 396Intraoperative complications 396Take-home hints 399Take-home hints 413Postoperative complications 413Take-home hints 421Conclusion 423References 42420 Complications with transcrestal sinus floor elevation: etiology, prevention, and treatment 427Michael Toffler and Paul S. RosenIncidence 427Etiology 430Prevention 437Management 445Take-home hints 450References 45121 Implant complications related to immediate implant placement into extraction sites 457Barry D. Wagenberg and Stuart J. FroumIntroduction 457Etiology and prevention 457Immediate tooth replacement (non-occlusally loaded) at the time of extraction of the natural tooth 463Procedures to prevent failure using the immediate implant placement protocol with a non-loading provisional 467Treatment of maxillary molars with the IIP protocol 468Treatment of mandibular molars 470Prevention 474Treatment of complications 478Take-home hints 479References 47922 Complications associated with flapless surgery 481Thomas G. Wilson, Jr.Introduction 481Definition of flapless surgery 481Goals of therapy 481Etiology 481Prevention 482Treatment 490Summary 493Take-home hints 493Potential conflicts of interest 493References 49323 Complications related to immediately loaded dental implants 495Jeffrey Ganeles and David GrossbergFailure to achieve osseointegration 495Surgical complications related to immediate loading 499Esthetic complications 502Implant malposition 511Restorative complications 513Guided surgery and prefabricated restorations 518Summary 532Take-home hints 532References 53324 Prosthodontic complications related to non-optimal dental implant placement 539Lyndon F. CooperIntroduction 539Etiology 540Implant location 541Prevention 547Treatment 553Take-home hints 557References 55725 Prosthodontic management of malpositioned implants and implant occlusion complications 559Avinash S. BidraIntroduction 559Etiology of malpositioned implants 559Prevention 562Treatment 563Etiologies of implant occlusion complications 565Prevention of implant occlusion complications 566Treatment 568Conclusion 569Take-home hints 570References 57026 Craniofacial growth in adults and its implications for implant reconstruction 572Fereidoun Daftary, Ramin Mahallati, Oded Bahat, and Richard M. SullivanIntroduction 572Etiology 573Prevention and treatment 575Take-home hints 583References 58327 Implant complications encountered during maintenance therapy 585Paul S. Rosen, Stuart J. Froum, Scott H. Froum, and Chris SaliernoIntroduction 585Diagnosis 585Prevention 587Treatment 594Take-home hints 597References 59728 Medicolegal issues related to implant complications 600Edwin J. ZinmanEtiology of malpractice litigation 600Etiology of implant-related legal claims 603Take-home hints 616References 617Appendix 28.1: Example of an informed consent form 620Appendix 28.2: Release of liability form 62529 Management of implant complications by the experts (part 1) 626Introduction 626Case 1: Treatment of midbuccal recession in the esthetic zone 627Pamela K. McClainCase 2: Treatment of buccal soft tissue recession on a restored central incisor implant 629Jeffrey R. LemlerCase 3: Repair of failed esthetic implant case 632Bobby ButlerCase 4: Treatment of an osseous defect associated with an immediately placed implant 635Donald S. ClemCase 5: Treatment of bone loss from an acute abscess around a dental implant 639Bradley S. McAllisterCase 6: Replacement of a failed implant in the esthetic zone 643Abd Elsalam ElaskaryCase 7: Treatment and replacement of a malpositioned implant in the esthetic zone 646Scott H. FroumCase 8: Corrective treatment for a malpositioned implant in the esthetic zone 653J. Daulton KeithCase 9: Treatment of implant malposition in the esthetic zone 658Burton Langer and Laureen LangerCase 10: Treatment of a malpositioned implant in the esthetic zone 661Stuart J. Froum and Jeffrey R. Lemler30 Management of implant complications by the experts (part 2) 666Case 1: Long-term retention of a “hopeless” implant 666Kirk PasquinelliCase 2: Treatment of implant malposition in the esthetic zone 671Burton Langer and Laureen LangerCase 3: Examples of esthetic implant complications – soft tissue repairs 676Bobby ButlerCase 4: Treatment of peri-implantitis due to residual cement around an implant 681Pamela K. McClainCase 5: The importance of occlusion in success of implant-supported restorations 685Farhad VahidiCase 6: Nonsyndromic oligodontia interdisciplinary approach: challenges and possible complications 688Farhad VahidiCase 7: Successful replacement of a failed dental implant: 5-year follow-up 692William BeckerCase 8: Management of a failed implant in the esthetic zone 695Donald S. ClemIndex 701

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