Prospective review of integral implants.

There are several factors that strongly correlate to HA-coated implant success and the prevention of implant morbidity. Surgical placement must be performed without compromise in technique. Implants placed into thin ridges or those that had dehiscence of their surface did not uniformly gain bone attachment levels during the healing period. Countersinking implants in extraction sites was critical; labial bone implant defects should be grafted with particulate HA. HA grafts to labial bone defects at the time of implant placement surgery are still short-term. Primary closure of all implant surgical sites prevented epithelial invagination into the surgical site and is associated with improved bone height around implants. Premature exposure of the implant during the healing period is associated with crestal bone loss. Loading forces should be physiologic, with maintenance of a physiologic equilibrium by a balanced restoration. Bone bulk should be created or preserved. Bone around implants may adversely respond to excessive loading forces. In the posterior maxilla, crestal bone loss has been observed that seems to result from excessive cantilever-type forces placed on the implants or from when implants are placed in the posterior mandible developed progressive bone loss that was associated with several factors. These factors included articulation against a natural occlusion, a horizontal ridge contour level with the external oblique ridge, a nonhygienic restoration, and the lack of keratinized gingiva against the abutment. Whether titanium implants develop progressive bone loss in the face of these factors is unknown. The presence of keratinized gingiva strongly correlated to bone maintenance in the posterior mandible. Because of this statistically significant finding, implant exposure should preserve all keratinized gingiva by transposing it labially to the implants. Most patients who receive implants for dental restoration have lost teeth because of caries and periodontal disease. The patient's behavioural patterns need to be redirected to maintain excellent oral hygiene in order to prevent peri-implant gingivitis. A hygienic restoration may be one of the most important factors associated with excellent implant health. Immediately upon receiving their restoration, patients did well maintaining their peri-implant hygiene. However, many patients do not continue their peri-implant hygiene. However, many patients do not continue their new hygiene methods and need to be strongly reminded to maintain their oral hygiene. Some patients do better than others. For some, a porcelain restoration with the restoration subgingival is well tended, but for others 4 to 5 mm of space needs to be established in order to prevent gingival problems.(ABSTRACT TRUNCATED AT 400 WORDS)