Soft tissue complications present biologic problems that can lead to bone and implant loss and this presentation will discuss the factors that cause such problems occur and how they could have been minimized or avoided.

Learning Objectives:

Identify the types of soft tissue complications that occur with dental implants and their incidence
Know how to avoid or minimize these complications
Understand contemporary cementation guidelines regarding technique and materials
Discuss the space required for appropriate implant placement
Describe the bioesthetic guidelines for anterior teeth
Predict interproximal soft tissue esthetics prior to implant placement
Predict midfacial soft tissue esthetics prior to implant placement
Know the factors that cause mucosal recessions and methods of minimizing recession
Describe the crown contours that promote favorable soft tissue positioning
Understand facial growth changes that occur during adolescence and continue throughout life

Abstract:

Soft tissue complications present biologic problems that can lead to bone and implant loss. In the anterior esthetic zone of patients with high smile lines, unesthetic soft tissue changes can occur that require special knowledge to avoid the changes. This presentation will identify how biologic and esthetic mucosal problems occur and how they could have been minimized or avoided.

Outline:

Incidence of implant fenestration/dehiscence
Incidences and causes of gingival inflammation/proliferation
Incidence and causes of fistulas
Effect of residual cement on fistula development
Cementation guidelines
Space requirements for implant placement
1. Space required between adjacent teeth
2. Space required between implant and adjacent natural teeth
3. Space needed between adjacent implants
Bioesthetic guidelines for anterior single implants
1. Mediolateral implant positioning guidelines
2. Apical implant positioning guidelines
3. Faciolingual implant positioning guidelines
4. What bone grafting does and does not do
Challenges associated with the peri-implant mucosa and interdental papilla
Predicting interproximal soft tissue esthetics
1. Effect of periodontal biotype
2. Effect of distance from interproximal bone crest to proximal contact
3. Effect of adjacent natural tooth or implant
4. Effect of long epithelial attachments
Predicting the midfacial soft tissue location after extraction and implant placement
1. Incisocervical location of midfacial bone crest
2. Incisocervical implant location
3. Facial implant position/angulation
4. Proximity of implant to facial bone
5. Faciolingual thickness of facial bone
Factors causing mucosal recession around implants
Methods of minimizing recession around implants
Affect of crown contours on soft tissue health, position, and contours
The S-shaped crown form
Compromised mucosal outcomes and their management
Facial growth changes during adolescence and during aging

Course created: 2016
Course reviewed: 2022