Basic information on the SURGICAL PROCEDURE - Straumann
Basic information on the SURGICAL PROCEDURE - Straumann
Basic information on the SURGICAL PROCEDURE - Straumann
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
1<br />
4. Local risk factors<br />
p Erosive or bullous diseases of <strong>the</strong> oral mucosa such as cicatrical pemphigoid<br />
are local c<strong>on</strong>traindicati<strong>on</strong>s for implant placement due to <strong>the</strong>ir autoimmune<br />
background. <strong>the</strong>y usually require a topical or systemic immunosuppressive<br />
treatment (Weinberg et al. 1997).<br />
p Xerostomia (dry mouth) may be associated with l<strong>on</strong>g-term drug <strong>the</strong>rapy or<br />
autoimmune diseases and is frequently encountered in elderly patients (Wu & ship<br />
1993; navazesh et al. 1996). saliva c<strong>on</strong>tains antimicrobial agents and exerts a<br />
cleansing effect. <strong>the</strong>refore, a reduced saliva flow rate is c<strong>on</strong>sidered to be a local<br />
risk factor.<br />
p Bruxism has been shown to be correlated with an increased risk for implant<br />
failure, such as implant fractures or lass of osseointegrati<strong>on</strong> (Perel 1994; rangert et<br />
al. 1995).<br />
Informed c<strong>on</strong>sent<br />
<strong>the</strong> patient can <strong>on</strong>ly c<strong>on</strong>sent to <strong>the</strong> proposed implant treatment if <strong>the</strong> following issues<br />
have been discussed in detail (Worthingt<strong>on</strong> 1995):<br />
p Treatment alternatives: a number of different <strong>the</strong>rapeutic approaches might exist<br />
to solve <strong>the</strong> dental problem in questi<strong>on</strong>. <strong>the</strong> decisi<strong>on</strong> to use dental implants for oral<br />
rehabilitati<strong>on</strong> must be based <strong>on</strong> careful evaluati<strong>on</strong> of all possible treatment<br />
alternatives.<br />
p Risk of implant surgery: any surgical procedure implies certain risks pertaining to<br />
local complicati<strong>on</strong>s or adverse systemic effects. Local complicati<strong>on</strong>s include<br />
damage of adjacent anatomical structures (nerves, vessels, teeth, sinuses). <strong>the</strong><br />
possibility of immediate or late postoperative complicati<strong>on</strong>s (soft tissue dehiscence<br />
or hyperplasia; peri-implantitis; fracture of implant, suprastructure or a part <strong>the</strong>reof)<br />
should also be menti<strong>on</strong>ed to <strong>the</strong> patient (ellies 1992; Weyant 1994; mordenfeld<br />
et al. 1997).<br />
p L<strong>on</strong>g-term prognosis: L<strong>on</strong>g-term clinical studies enable <strong>the</strong> implant surge<strong>on</strong> to<br />
assess <strong>the</strong> l<strong>on</strong>g-term prognosis of a specific implant system and to disclose this<br />
<str<strong>on</strong>g>informati<strong>on</strong></str<strong>on</strong>g> to <strong>the</strong> patient (Buser et al. 1997; fritz 1997).<br />
p<br />
Cost: <strong>the</strong> patient should be informed about <strong>the</strong> approximate cost of <strong>the</strong> proposed<br />
implant <strong>the</strong>rapy.