Implantology Lecture 3 (reviewing articles, ect)

lecture given 2/12/2026

according to tarnow: placing the implants closer together will result in the loss of interdental bone height (crest), resulting in…

loss of interdental papilla, poor esthetics

what does tarnow assume?

there is an average of 1.2mm marginal bone loss from the first thread during healing and the first year after loading

in contrast to the bone loss during the first year, there was an average of only 0.1mm bone loss annually thereafter

tarnow assumes that this is the case for all implants

what are the contradictions between hermann and tarnow?

hermann demonstrates no bone loss on implants where the interface of rough and smooth machine polished surface

tarnow assumed there would be bone loss

what assumptions does hermann make?

the animal model is applicable to humans

platform switching

a method used to preserve alveolar bone levels around dental implants

the concept refers to placing screwed or friction fit restorative abutments of narrower diameter on implants of wider diameter, rather than placing abutments of similar diameters, referred to as platform matching

when the distance between the crest of bone to the contact point of the teeth is 5mm or less, the papilla completely filled this space almost _____ of the time

100%

when the distance between the crest of bone to the contact point of the teeth is 6mm, the papilla completely filled this space almost _____ of the time

55%

when the distance between the crest of bone to the contact point of the teeth is 7mm, the papilla completely filled this space almost _____ of the time

25%

what are associated risks with post extraction sites and implant placement?

medical risk factors, smoking, dental risk factors, anatomic risk factors

what are medical risk factors for post extraction sites?

radiation therapy, diabetes, bleeding disorders, poor health, bisphosphonate use

what impact does smoking have on post extraction sites?

increased risk of unsuccessful osseointegration and also premature loss of implant

what are dental risk factors for post extraction sites?

patient expectations, lip line, tissue biotype, shape of adjacent tooth crown, bone level of adjacent teeth, local infection at implant site, restorative status of neighboring teeth (subgingival margins of existing restorations), width of edentulous space or multiple missing teeth (papilla), soft tissue and bone defect at implant site

what are anatomic risk factors for post extraction sites?

sinus, blood vessels, nerve

what are the treatment options for post extraction sites?

immediate implant placement

delayed implant placement (with soft tissue healing or partial bone healing)

healed (late) placement

alternative restorations (bridge, RPD)

what are the advantages of immediate placement implants?

1 surgical procedure, reduced overall treatment time

but not always

what are the disadvantages of immediated placement implants?

morphology of socket may lead to compromised implant position

morphology of socket can compromise initial implant stability

lack of soft tissue volume for primary closure

increased risk of recession

complexity of procedure is increased

how long do you wait after extraction to take a CBCT scan?

minimum of 3 months but depends on the defect, could be 4 months or longer