52. Types of implantation.

Question 1

Significance of performing restorative therapy on an implant placed in a fully healed and non-compromised alveolar ridge

Answer 1

• High clinical success rate
• Stable and healthy tissue environment=>
• Supports optimal osseointegration and long-term implant stability

Question 2

Type 1 implantation, and the preparation steps

Answer 2

• Placing implant immediately following tooth extraction=>
• Sulcus incision
• Full-thickness mucosal flap and tooth removal
• Preparing site for implant installation=> pilot and twist drills
• Pre-tapping apical portion of socket
• Installing non-cutting solid screw implant w/ rough surface
• Positioning implant so that marginal level of its rough surface portion apical to marginal level of buccal and/or lingual bone plates
• Replacing soft tissue flaps and “semi-submerging” implants during healing
• Performing surgical re-entry procedure after 4 months of healing

Question 3

Advantages of Type 1 implantation

Answer 3

• Reduced number of surgical procedures
• Reduced overall treatment time
• Prevention of bone atrophy

Question 4

Disadvantages of Type 1 implantation

Answer 4

• Site morphology may complicate optimal placement and anchorage
• Thin tissue biotype may compromise outcome
• Potential lack of keratinized mucosa for flap adaptation
• Adjunctive surgical procedures may be required
• Technique-sensitive procedures

Question 5

Type 2 implantation

Answer 5

• Placing implant after complete soft tissue coverage of socket=>
• 4-8 weeks post-extraction

Question 6

Type 2 implantation advantages

Answer 6

• Increased soft tissue area and volume=>
• Facilitates flap management
• Allows time for assessing and resolving local pathology

Question 7

Type 2 implantation disadvantages

Answer 7

• Site morphology may complicate optimal placement and anchorage
• Increased treatment time
• Varying amounts of resorption of the socket walls
• Adjunctive surgical procedures may be required

Question 8

Happens to extraction socket within 4-8 weeks post-extraction

Answer 8

• Socket fills w/ coagulum=>
• Replaced by granulation tissue within a few weeks
• By 4-8 weeks=>soft tissue fills the socket, and surface covered w/ epithelium
• Small amounts of new bone form in socket during this period=>
• Risk to achieving primary implant stability

Question 9

Type 3 implantation

Answer 9

• Substantial clinical and/or radiographic bone fill of socket (12-16 weeks post-extraction)
• Newly formed woven bone occupies socket area=>
• Entrance to socket closed w/ cap of woven bone undergoing remodeling

Question 10

Type 3 implantation advantages

Answer 10

• Substantial bone fill facilitates implant placement
• Mature soft tissues ease flap management
• Socket entrance covered w/ mucosa=>
• Proper volume for flap elevation and replacement procedures

Question 11

Type 3 implantation disadvantages

Answer 11

• Increased treatment time
• Adjunctive surgical procedures may be required
• Varying amounts of resorption of socket walls

Question 12

Type 4 implantation

Answer 12

• Placing implant in fully healed site=>
• 6-12 months post-extraction

Question 13

Advantages of Type 4 implantation

Answer 13

• Ridge clinically healed and lined by mature, well-keratinized mucosa on dense cortical bone
• Mature soft tissues facilitate flap management

Question 14

Disdvantages of Type 4 implantation

Answer 14

• Increased treatment time
• Adjunctive surgical procedures may be required
• Large variation in available bone volume

Question 15

Why adjunctive surgical procedures required for different types of implantation

Answer 15

• Address issues=>
• Inadequate bone volume or quality
• Insufficient keratinized mucosa
• Enhance stability and integration of implant
• Ensure optimal conditions for implant success and long-term functionality

Question 16

Factors influencing choice of implant type following tooth extraction

Answer 16

• Condition of alveolar ridge
• Timing of procedure relative to tooth extraction
• Amount of soft and hard tissue present
• Overall health and healing capacity of patient

The clinician’s experience and the specific clinical situation also play a crucial role in decision-making.