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Practical Procedures in Implant Dentistry


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antibiotics and pain medicationsPlanned implant and components in stockAnticipated events, e.g. soft tissue or hard tissue grafting, provisionalisation, and immediate loading.

Schematic illustration of an example of a surgical checklist.

       Make sure you have explained all treatment options, even those you may not consider within your area of expertise. This should include all advantages and disadvantages as well as any risks of treatment.

       Be prepared to refer the patient if the treatment is beyond your area of expertise or experience.

       It is good practice to conduct a consultation with your patient and provide a written treatment plan. Time must be allowed for the patient to have opportunity to discuss and ask any questions pertaining to their intended treatment.

       The patient needs to be informed of all likely costs and time for treatment. This should also include any future costs of treatment including any maintenance required.

      1 1 Banerji, S., Mehta, S., and Ho, C. (2017). Practical Procedures in Aesthetic Dentistry, 3–5. Chichester: Wiley.

       Kyle D. Hogg

Schematic illustration of a tripartite effect of tooth loss.

      5.1.1 Local Site Effects of Tooth Loss

Photo depicts resorption patterns of the mandibular edentulous ridge. Schematic illustration of progressive healing of extraction socket. Photos depict hard and soft tissue healing of a single tooth extraction. (a) Clinical photograph of UR4 prior to atraumatic extraction and (b) four months following extraction. (c) Radiographic image of UR4 prior to extraction, and (d) four months following extraction.

      The alteration of soft tissue dimension following tooth extraction happens more rapidly than that of the hard tissue, with more than 50% of the changes observed in the first two weeks following extraction [11]. In the pre‐extraction condition, no significant correlation has been observed between soft tissue thickness and the buccal bony wall thickness under the tissue [12]. Soft tissue thickness generally tends to increase, sometimes quite substantially, following tooth extraction in subjects with the more common thin buccal bony wall phenotypes [11, 13]. This thickening of the soft tissues may mask an underlying deficient bony ridge. Conversely, subjects exhibiting thicker bony wall phenotypes do not exhibit changes in the facial soft tissue thickness from the pre‐extraction condition [11].

      Changes in hard and soft tissues following extraction of a tooth may be further exacerbated by systemic factors such as smoking [14]. Local site‐specific factors include the pre‐existing condition of the tooth and surrounding tissue, the