Clinical Recommendations for Avoiding and Managing Surgical Complications Associated With Implant Dentistry: A Review

Abstract

Proposing to place endosseous implants is an integral facet of dental treatment plans. Their insertion is usually associated with a low incidence of untoward events. However, despite careful planning, surgical complications can arise: infection, intraoral hemorrhage, wound dehiscence, postoperative pain, lack of primary implant stability, inadvertent penetration into the maxillary sinus or nasal fossa, sinus lift sequelae, neurosensory disturbances, injuries to adjacent teeth, tissue emphysema, and aspiration, or ingestion of surgical instruments. This article addresses some surgical complications associated with dental implant placement and discusses how to avoid and manage them when they occur.

Clinical Complications of Dental Implants

“…A safety margin of 2 mm between the entire implant body and any nerve canal should be maintained (Greenstein et al, 2008, as cited in Greenstein & Tarnow, 2006;Worthington, 2004). Additionally, surgical placements of implants should be at least 3 mm in front of the mental foramen (Greenstein & Tarnow, 2006).…”

“…Ideally, 1.5 to 2 mm of bone should be present between an implant and the adjacent tooth. Furthermore, inspection of a radiograph with a guide pin at a depth of 5 mm will facilitate osteotomy angulation corrections (Greenstein et al, 2008). To prevent a latent infection of the implant from the potential endodontic lesion, endodontic treatment should be performed (Sussman, 1998).…”

“…The most common postoperative complication is wound dehiscence, which sometimes occurs during the first 10 days (Greenstein et al, 2008). Contributing factors of dehiscence and exposure of the graft material or barrier membrane include flap tension, continuous mechanical trauma or irritation associated with the loosening of the cover screw, incorrect incisions and formation of sequestration of bone debris (Park & Wang, 2005).…”

“…Once the diameter of the wound is large (2 to 3 cm) or the time elapsed is > 2 days, it is suggested that the margins of the wound be excised and resutured (Fig. 10.) (Greenstein et al, 2008 as cited in Sadig & Almas, 2004). If the suture is not possible, chlorhexidine rinses twice a day and/or systemic antibiotics should be considered.…”

Influência do desing, tratamento de superfície e densidade do substrato na estabilidade primária de implantes odontológicos. Análise por meio de torque de inserção, resistência ao arrancamento e freqüência de ressonância

“…Da mesma forma, Toyoshima et al(2011), comparando implantes cilíndricos e cilíndrico-cônicos, não obtiveram diferença estatística entre estes formatos, sugerindo como explicação para esses resultados e, que podem ser explanada para os nossos, o fato de terem utilizado somente a parte de osso esponjoso de crista ilíaca bovina, pois airmam que o osso cortical influencia mais nos valores de ISQ devido ao seu maior módulo elástico (Nkenke et al, 2003;Akkocaoglu et al, 2007 Isto reafirma a indicação deste formato de implante para aplicação em ossos pouco densos (Kline et al, 2002), devido às forças de compressão lateral que proporciona, o que leva a uma maior densidade local do substrato (O`Sullivan et al, 2000;Sakoh et al, 2006;Greenstein et al, 2008;Santos et al, 2009) (Santos et al, 2009;Bezerra et al, 2010;Rocha, 2010) Sakoh et al, 2006;Chong et al, 2009;Kahraman et al, 2009;Bezerra et al, 2010;Rocha, 2010).…”