Implant Dentistry - E-Book , livre ebook

IMPLANT DENTISTRY
A PRACTICAL APPROACH
Second Edition

ARUN K. GARG, DMD
Visiting Professor, College of Dentistry, University of Florida, Gainesville, Florida
Former, Professor of Surgery, Division of Oral/Maxillofacial Surgery, University of Miami School of Medicine, Miami, Florida
Mosby
Copyright

3251 Riverport Lane
Maryland Heights, Missouri 63043
IMPLANT DENTISTRY: A PRACTICAL APPROACH ISBN: 978-0-323-05566-6
Copyright © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
Copyright © 1995 by Arun K. Garg
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com . You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions .
Notice
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Authors assumes any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book.
The Publisher
Vice President and Publishing Director: Linda Duncan
Executive Editor: John Dolan
Developmental Editor: Brian S. Loehr
Publishing Services Manager: Julie Eddy
Project Manager: Rich Barber
Design Direction: Karen Pauls
Cover Designer: Tony Reiss
Text Designer: Kim Scott
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Preface
While teaching dental implant courses throughout the years, I became aware of how general dentists and dental specialists needed a practical book or manual that would guide them, step by step, through the processes that I taught them. The realization that clinicians had no such tool available motivated me to write the first edition of Implant Dentistry: A Practical Approach , a book that quickly became a must for dentists nationwide, especially to those who found in dental implantology a remarkable and professionally gratifying field.
To me, it has been exceedingly satisfying to know that thousands of dentists have benefited from my first edition of this practical, exceptionally detailed, and graphic approach.
Just as this second edition’s predecessor, Practical Implant Dentistry came about as a result of my seminars and teachings, this one has evolved in a similar manner. Throughout the years, the technique and science of implant dentistry have evolved. My courses have evolved. Dental implant science has become more comprehensive, concepts have changed, and some have even disappeared. In order to keep up with the science and the times, I suddenly found myself giving my dentists several updated guides, instead of one, so they could firmly grasp all the important concepts and lessons. Very soon, it became clear to me that we now needed a single guide that effectively compiled all the information and detailed images from my seminars.
This was the genesis of this edition. It is intended to be one single source of invaluable information, resources, techniques, and strategies aimed not only for those dentists who time and again take my courses, but to all those that have found in dental implantology the most gratifying, fulfilling, and lucrative area of dentistry today.
The book starts by looking at the historical development of dental implants, followed by a step-by-step guide to bone grafting, implantology, and restorative dentistry.
One of the highlights of the book includes immediate loading of dental implants, bone biology, and a detailed, one-of-a-kind list of guidelines for handling complications. This guide is a must-have for all dentists, regardless of their specialty.
I hope this book inspires dentists to place and restore more implants and gives them the information needed to effectively enhance the health and well-being of their patients. This is, after all, the most gratifying and rewarding part of our profession!

Arun K. Garg, DMD
Acknowledgments
The creation of this book was made possible thanks to the dedication and commitment to excellence by the people at Elsevier who constantly pushed me to be my best. I especially want to thank publisher, John Dolan, and editor, Brian Loehr.
I also what to thank the team at Implant Seminars and the team at the Center for Dental Implants for their fantastic support in helping me complete this second edition of Implant Dentistry . They constantly took the weight off my shoulders, giving me the time to complete this important project.
My deepest appreciation and love goes to my wife, Heather, whose loyalty and selflessness were vital in giving me the time to spend at the computer. Her energy and support have been instrumental to developing the teachings and clinical care enjoyed by doctors and patients.
And finally, thanks to my three adored children, who are my biggest inspirations.
New to this Edition

Outstanding photos and illustrations!


Keep up with the innovations, techniques, and procedures of oral implantology with these new chapters!
Chapter 15: Immediate Loading of Implants in the Edentulous Patient

Chapter 16: Bone Biology, Osseointegration, and Bone Grafting

Chapter 19: Guidelines for Handling Complications Associated with Implant Surgical Procedures


Practical information for you and your patients!
Delicious postoperative recipes to offer your patients!

A detailed glossary devoted to implantology terminology.

Consent forms for your practice.
Table of Contents
Copyright
Preface
Acknowledgments
New to this Edition
Chapter 1: The Historical Development of Dental Implants
Chapter 2: Basic Armamentarium for Implant Surgery
Chapter 3: Patient Medical History for Dental Implant Surgery
Chapter 4: Anatomic Considerations in Oral Implantology
Chapter 5: Sterilization, Disinfection, and Asepsis in Implantology
Chapter 6: Radiographic Modalities for Dental Implants
Chapter 7: Implant Surgical Templates in Implant Dentistry
Chapter 8: Generalized Surgical Technique for Endosseous Root-Form Implants
Chapter 9: Wound Healing and Suturing Techniques in Dental Implant Surgery
Chapter 10: Pharmacological Agents in Implant Dentistry
Chapter 11: Anterior Single-Tooth Implants in the Esthetic Zone
Chapter 12: Implant Exposure Techniques at Second-Stage Surgery
Chapter 13: Impression Materials, Concepts, and Techniques for Dental Implants
Chapter 14: Principles of Occlusion in Implant Dentistry
Chapter 15: Immediate Loading of Implants in the Edentulous Patient
Chapter 16: Bone Biology, Osseointegration, and Bone Grafting
Chapter 17: Considerations for Implants in the Geriatric Patient
Chapter 18: Peri-implantitis
Chapter 19: Guidelines for Handling Complications Associated With Implant Surgical Procedures
Glossary
Useful Dental Codes for Dental Implant Surgery and Related Procedures
Consent Form: Dental Implant(s)
Surgical Trays
Postoperative Instructions and Menus for Patients of Implant Surgery
Index
chapter 1 The Historical Development of Dental Implants
The historical development of dental implants can be understood properly only in the context of the history of dentistry. We may define a dental implant as a device surgically placed underneath the gingiva within the alveolar bone, to which is attached a permanent or removable single artificial tooth or teeth. Issues important to the historical development of dental implants are issues important to the history of dentistry. These issues include, fundamentally, only two: the function and esthetics of a patient’s teeth. Related issues include preventive dentistry, anesthesiology, pathobiology, and orthopedics, specifically, the anatomy of the mandible and maxilla, and subcategories such as bone grafting and radiology.
The historical development of implants before the modern era in dentistry began (since approximately 1700) can be discussed only tangentially, and we must be careful not to apply modern methods of thinking—especially regarding technological skill—to ancient practices, because only in the twentieth century have nonautologous materials existed that could be fashioned for medical use to avoid their rejection by the human body. 1 Only since the end of the first quarter of the twentieth century have modern dental implants been developed and widely used. These implants fall roughly into two major categories: subperiosteal implants (which rest on alveolar bone beneath the gingiva and usually are not