CONTENTS

Cover

Title Page

Foreword

Decision Making in Dental Implantology

Preface

About the Authors

Chapter 1: Current Status of Clinical Practice with Dental Implants: An Evidence-Based Decision Making Overview

Osseointegration and its Application to the Treatment of Completely or Partially Edentulous Patients in Clinical Practice
Anatomical Implications to Implant Therapy and the Current Impact of Guided Bone Regeneration
Implant: Abutment Connections
Evolution of Imaging Diagnosis Methods
Root-Treated Teeth: Decision Making for Implant Placement
Evidence-Based Decision Making in Implant Dentistry: “What is the Importance of Founding a Treatment Plan on Evidence-Based Clinical Approaches?”
References

Chapter 2: Treatment Planning for Bone Defects in the Alveolar Ridge

The Dilemma of Treating Alveolar Ridge Bone Defects
Goals of Reconstructive Procedures
Implant Placement Simultaneously with or Prior to GBR
Condition of the Alveolar Ridge
Morphology and Dimensions of the Bone Defect
Biological Mechanisms of Bone Grafts
Types of Bone-Filling Materials
Membranes and Guided Bone Regeneration (GBR)
Assessment of Grafted Sites
Treatment of Osseous Dehiscence and Fenestrations Around Dental Implants
Alveolar Ridge Augmentation
Sinus Floor Augmentation
Strength and Direction of Recommendation Regarding the Need for Therapy and Procedures
References

Chapter 3: Treatment of Esthetic Areas

General Aspects Related to an Esthetic Smile
Photographic Facial Analysis
Soft-Tissue Esthetics and the Role of Peri-Implant Plastic Surgery
Gingival Esthetic Parameters and Peri-Implant Mucosa
Periodontal Conditions Adjacent to Implant Sites
Implant Placement Timing: Recipient Site Conditions
Alveolar Ridge Preservation
Strength and Direction of Recommendation Regarding the Need for Therapy and Procedures
References

Chapter 4: Treatment of Posterior Areas

General Aspects Related to the Rehabilitation of the Posterior Maxilla and Mandible
Immediate Implant Placement in Posterior Sites
Early Implant Placement in Posterior Sites
Late-Implant Placement in Posterior Sites
Ridge Preservation of Posterior Sites
Strength and Direction of Recommendation Regarding the Need for Therapy and Procedures
References

Chapter 5: Implant-Supported Rehabilitation of Completely and Partially Edentulous Patients

General Aspects Involving Implant-Supported Rehabilitations
Diagnostic Phase
Treatment Planning Phase
Prognosis Phase
Corrective Phase
Follow-Up: Maintenance and Control Phase
Strength and Direction of Recommendations Regarding the Need for Therapy and Procedures
References

Chapter 6: Multidisciplinary Decision Making: The Complexity of Some Potential “Real World” Clinical Scenarios

Concluding Remarks on the Decision Making Process in Dental Implantology: What is Coming Next?
References

Index

End User License Agreement

List of Illustrations

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Library of Congress Cataloging-in-Publication Data

Names: Tosta, Mauro, author. | Moura Filho, Gastao Soares de, author. | Chambrone, Leandro, author.

Title: Decision making in dental implantology : atlas of surgical and restorative approaches / Mauro Tosta, Gasto Soares de Moura Filho, Leandro Chambrone.

Description: Hoboken, NJ : Wiley, 2018. | Includes bibliographical references and index. |

Identifiers: LCCN 2017017766 (print) | LCCN 2017018825 (ebook) | ISBN 9781119225959 (pdf) | ISBN 9781119225966 (epub) | ISBN 9781119225942 (cloth)

Subjects: | MESH: Dental Implantation | Reconstructive Surgical Procedures | Atlases | Case Reports

Classification: LCC RK667.I45 (ebook) | LCC RK667.I45 (print) | NLM WU 17 | DDC 617.6/93–dc23

LC record available at https://lccn.loc.gov/2017017766

Cover image: Courtesy of Leandro Chambrone
Cover design by Wiley

Foreword

With today's rapidly changing and improving technologies available in implant dentistry, the clinician performing surgical and restorative treatments on implant patients must make an appropriate selection of treatment options to achieve successful outcomes for their patients. The demands and expectations of the implant patient today place more pressure on treating clinicians to provide both functional and highly esthetic results. Many teaching and educational courses today focus only on the mechanical aspects needed to provide the dental patient with an implant. Currently, there are too many training courses and textbooks on how to prepare an implant recipient site, how to perform hard and soft tissue augmentation procedures, and subjective management of complications. The biologic principles of osseointegration as introduced by P.-I. Brånemark in the early 1980s are lost or forgotten. The authors of this new textbook have clearly and sequentially moved through the stages of managing an implant patient. They have returned to the scientific and biologic basis of implant dentistry by providing evidence-based principles. Using the clinical practice guidelines established by the American Dental Association, the recommendations made in this textbook have included rankings for implant procedures based on the strength of the literature and level of scientific evidence.

The textbook takes the reader through every clinical scenario, from the fully edentulous to partially edentulous, including the patient missing a single tooth. The chapters clearly delineate the different thought processes the clinician must go through when treating the functional (posterior) zone versus the esthetic (anterior) zone. The chapters are very well illustrated with the authors' documented cases, highlighting the concepts and biologic principles that the surgical and restorative team must consider. There is equal focus on the restorative and surgical aspects of implant dentistry and procedures for both specialties are thoroughly covered with systematic reviews followed by a measurement of strength and level of certainty for the treatment recommendations.

The publication of this textbook is timely and surely will become the go-to reference for clinicians actively providing dental implant treatment for their patients and seeking evidence-based approaches to treating their implant patients.

Peter K. Moy, DMD
Nobel Biocare Endowed Chair, Surgical Implant Dentistry
Director, Straumann Surgical Implant Dental Center
Clinical Professor, Department of Oral & Maxillofacial Surgery
UCLA, School of Dentistry

Decision Making in Dental Implantology

Decision making’ is a key to the successful management of patients, particularly when dental implants are considered beneficial to the achievement of the treatment goals. Many factors come together to bring predictability to treatment outcomes and each is given appropriate, chronologically correct consideration in this Atlas. The holistic approach to presentation of information by the authors is refreshing and timely in an era where patient centered philosophies are coming to the fore.

The authors appropriately consider and interpret the scientific foundation for clinical decision making, and through recognition of publication quality increase the credibility of information provided in subsequent chapters. Interpretation of the evidence by clinicians with superior training and experience is seen, through the excellent clinical presentations, to result in patient rehabilitations that are sound functionally and pleasing from the esthetic perspective. Importantly, the reader can rely on the protocols presented through patient care as a result of the diagnostic and treatment acumen presented.

The patient documentation is meticulous and of the highest quality and their treatment recommendations are both understandable and usable by the reader. This is important because the information provided will ultimately result in benefit to a broader spectrum of patients. By presenting patient related information as comprehensive treatments, the authors encourage treatment teams to consider this treatment approach.

The authors are to be commended for their efforts. This Atlas provides a benchmark for quality treatment outcomes both now and in the future. Congratulations on bringing a valuable addition to the information base related to patient care utilizing dental implants.

Dean Morton, BDS, MS, FACP
Chairman, Department of Prosthodontics
Indiana University School of Dentistry
Director, American Board of Prosthodontics
Member, Board of Directors, ITI

Preface

We all know that the advances in the field of dentistry, the ever-changing area of the evidence base, and the sometimes dazzling array of proposals for new treatment procedures would make it seem that the basic concepts of treatment may no longer be a reality. Indeed, this is not true. This new book, Decision Making in Dental Implantology: An Atlas of Surgical and Restorative Approaches, came to join together important basic biologic and surgical procedures of periodontology and implantology with the most predictable and well-established treatment approaches available in the literature.

We have tackled the important task of writing an atlas, focusing attention on the management of predictable dental implant treatment approaches in order to achieve significantly positive clinical functional and esthetic results, based on well-established prosthodontic procedures. It is anticipated that the proposal of any treatment approach for the various clinical scenarios must be based on a concept of having the best source of evidence shared within a large audience. In this atlas, we tried to achieve that key idea (i.e. to establish the best practical way to treat patients with implant dentistry procedures).

More than a simple “beautiful presentation of cases,” we tried to work with professionalism and passion to present the most solid treatment options clinicians may face during daily practice. This atlas is the outcome of more than 20 years of experience in the field of implant dentistry, in private practice as well in clinical education.