Ridge preparation for implant placement - part 1

Ridge preparation for implant placement ElHawary
Ridge Preparation
For
Implant Placement

DEFINITION
Ridge Preparation For Implant Placement

Surgical improvement
of the alveolar ridge
and the surrounding tissues
for implant placement

CRITERIA OF IDEAL EDENTULOUS RIDGE

1. Adequate bone support
2. Adequate soft tissue covering the bone
3. Adequate buccal and lingual sulci
4. No undercuts or protuberences
5. No sharp ridges
6. No scar bands
7. No muscle or frenal attachments
8. No soft tissue folds or hypertrophic tissues
9. Free from neoplastic or other pathological
conditions
10. Offering protection to the neurovasuclar
bundles
11. Satisfactory maxillo-mandibular relations

TIMING

Implant
placement
Immediate Delayed

Implant
placement
Immediate Delayed
Implant
loading
Immediate Delayed

Implant
placement
Immediate Delayed
Implant
loading
Immediate Delayed
Immediate implant placement -Immediate loading

Implant
placement
Immediate Delayed
Implant
loading
Immediate Delayed
Immediate implant placement –Delayed loading

Implant
placement
Immediate Delayed
Implant
loading
Immediate Delayed
Delayed implant placement –Immediate loading

Implant
placement
Immediate Delayed
Implant
loading
Immediate Delayed
Delayed implant placement –Delayed loading

Implant Planning

Implant
Planning

No Absolute
Contraindication
For Implants

Relative contraindications
• except
– Can the patient’s body do bone ???
• VITAMIN D
• CHOLESTIROL (LIPID)
– Who have conditions affect bone healing or fitness to surgery
• Smoking
• Diabetes
• Chronic steroid therapy
• Collagen diseases
• CV diseases
• Anticoagulant therapy
– Bleeding
– Vit K dependent proteins
• Irradiation
• Organ transplant

Bone Height

Bone Length

Clinical types of bone (Bone Quality)
• Type I “D1”
Almost the entire jaw is composed of
homogenous compact bone
• Type II “D2”
A thick layer of compact bone surrounds
a core of dense trabecular bone
• Type III “D3”
A thin layer of cortical bone surrounds a
core of dense trabecular one of favorable
strength
• Type IV “D4”
A thin layer of cortical bone surrounds a
core of low density trabecular bone

TREATMENT PLANNING

Problem
Soft tissue Bone
Combined

Excess Deficiency Excess Deficiency
Problem
Soft tissue Bone
Combined

Excess ST
Excess B
Problem
Soft tissue Bone
Combined

Excess ST
Excess B
Excess ST
Deficient B
Problem
Soft tissue Bone
Combined

Excess ST
Excess B
Excess ST
Deficient B
Deficient ST
Excess B
Problem
Soft tissue Bone
Combined

Excess ST
Excess B
Excess ST
Deficient B
Deficient ST
Excess B
Deficient ST
Deficient B
Problem
Soft tissue Bone
Combined

Factors affecting Treatment Planning
1. Patient needs
2. Medical condition
3. Condition of hard and soft tissues
4. Patient acceptance to the procedures and to
spare the use of his dentures for long period

Classification of surgical procedures
1. Preventive procedures
– Routine measures during and after
extraction
– Socket Preservation
2. Corrective procedures
– Hard tissue surgery
– Soft tissue surgery
– Alveolar atrophy and flat ridge

• Corrective hard tissue procedures
– Reduction of bony enlarged tuberiosity
– Reduction of bony prominences and undercuts
• Corrective soft tissue procedures
– Correction of labial frenum
– Correction of lingual frenum
– Correction of flabby ridge
– Correction of fibrous enlarged tuberiosity
• Corrective alveolar atrophy and flat ridge procedures
– Relative heightening procedures
• Vestibuloplasty
– Submucosal vestibuloplasty
– Secondary epithelialization vestibuloplasty
– Mucosal grafting vestibuloplasty
– Skin grafting vestibuloplasty
– Absolute heightening procedures
• Osteotomy
• Ridge augmentation Procedures (GBR)
• Distraction osteogenesis

Preventive methods
1. Routine measures during and after
extraction
2. Socket Preservation

Preventive methods
Routine measures during and after
extraction

• The aim of those procedures are
1. Promote healing
2. Preserve the shape of the alveolar ridge

Cawood Classification

• The aim of those procedures are
1. Promote healing
2. Preserve the shape of the alveolar ridge
• Technique
1. Atraumatic extraction (closed – open)
2. Avoid injury to adjacent soft tissue
3. Compression of the extraction socket
4. Removal of fracture loose bone pieces
5. Removal of projecting interseptal bone
6. Trimming of sharp bone edges

Preventive methods
Routine measures during and after
extraction
Socket Preservation

Definition
• Socket preservation or alveolar ridge
preservation (ARP) is a procedure to reduce
bone loss after tooth extraction to preserve
the dental alveolus (tooth socket) in the alveolar
bone
Without socket preservation, the bone quickly resorbs resulting
in 30-60% loss in bone volume in the six months after dental
extraction. The jaw bone will never revert to its original shape
once bone is lost and tissue contour has changed

Technique
1. Extraction
2. Debridement
3. Copious irrigation
4. Bone grafting
5. Membrane covering
6. Approximation of the egdes
7. closure

Ridge preparation for implant placement - part 1

Recomendados

Recomendados

Mais conteúdo relacionado

Mais procurados

Mais procurados (20)

Semelhante a Ridge preparation for implant placement - part 1

Semelhante a Ridge preparation for implant placement - part 1 (20)

Mais de Hesham El-Hawary

Mais de Hesham El-Hawary (20)

Último

Último (20)

Ridge preparation for implant placement - part 1

Notas do Editor