Smoking
increases the risk of implant infection, but is not a strict
contraindication. A smoker
also generally has more loss of bone and risk of infection around their
natural teeth. (Kerduongbundit
and Wikesjo J. Periodontol. March 2000)
Age
may prevent placing implants in young people before they complete
physiologic growth. This
would be about sixteen for girls and
seventeen or eighteen for boys.
(Renouard, Rungert. Risk
Factors in Implant Dentistry)
The
scientific basis upon which modern implant dentistry rests is the result
of research by Professor P. I. Branemark and co-workers which
began in 1952 in Sweden. Dr.
Branemark was an orthopedic surgeon who began animal studies to
investigate what type of metal should be used to make bone screws to
stabilize bone fractures. These
studies produced thirty-five Ph.D. theses on various aspects of wound
healing. Bone was found to
have a great affinity for titanium.
In
1966, Dr. Branemark began to place titanium screws in humans.
He and co-workers reported a ten year follow-up on these cases in
the Scandinavian
Journal of
Plastic and Reconstructive Surgery.
(Branemark P.I. :Osseointegration and its experimental
background. J. Prosthet
Dent. 1983; 50: 399-410.)
The
past ten years has brought many improvements in the implant shapes,
surfaces, and in techniques to graft bone and soft tissue to sites that
need implants.
Sinus
Augmentation
Placing implants in the
posterior of the upper jaw can be a problem if bone loss there is severe
or the sinus has expanded too much in the bone space.
The lack of bone volume can be overcome with a bone graft in the
lower part of the sinus by an access opening through the lateral wall.
The implants are usually placed four to six months after the
sinus graft. The graft
itself is replaced by the patient’s own bone cells and the resulting
healed graft is dense and strong. Dr.
Hilt Tatum originated this graft technique in 1975. See below for
the x-rays of one of Dr. Ruff's cases.
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