Dental Asia May/June 2022

CLINICAL FEATURE
may indicate the beam angle to the
implant is not right.
Cement should complete settling first,
then screw-in abutment with a crown
to ensure no excess cement outside
the margin, which would increase
roughness and food trap that would
cause peri-implantitis in the long
term.
Papaspyridakos reported that 70%
of complications occurred in the
full-arch prosthesis in five years
and 91.5% in 10 years. The common
technical complications were veneer
chipping, abutment screw loosening,
and abutment screw fracture due
to heavy parafunctional habits that
caused overloading. They suggested
overcoming these complications by
proper planning and knowledge of
material including screw mechanism
and design.
Fig. 9 Fig. 10
High-risk patients should be informed
of the high incidence of complications
including fees concerned to repair
and replace, especially for high-risk
group patients like smokers, bruxism
and diabetics. Patients wearing
complete dentures exert less pressure
than natural teeth or implanted teeth
as opposing dentitions 4 .
Fig. 11 Fig. 12
C. Implantitis
Poor oral hygiene and plaque
accumulation cause marginal tissue
reactions in osseointegrated implants.
The inflammatory changes lead to
two stages of syndromes:
a) peri-implant mucositis confined to
superficial soft tissue
b) peri-implantitis that involves the
deeper soft tissue and bone around
implants (Figs. 9-10)
Fig. 13 Fig. 14
Patients with thick gingival biotype
and intact buccal bone, flapless
approach and provisional crown may
produce little risk. Patients with a
history of periodontitis are reported
with a lower success rate and require
Fig. 15 Fig. 16
32 DENTAL ASIA MAY / JUNE 2022