Idealizing Implant Sites

Whether teeth are lost directly as a result of disease or trauma or extracted as a planned part of treatment, their loss has a direct and often significant effect on the dimensions of the alveolar ridge as atrophic changes occur over time. In order to place an implant, the bone at the site must meet minimum biologic width and height requirements as well as present with sufficient density. Failure to adhere to these evidence-based guidelines can affect the ability to properly restore an implant as well as the esthetics of the restoration and result in a host of complications and failure modes, including the potential for fracture under load. Similarly, the soft tissue at an implant site requires a minimum amount of keratinized mucosa to be present in order to protect the implant/bone interface and optimize the esthetics. An insufficient quantity of keratinized mucosa can lead to recession and increase the recipient's risk of developing conditions such as peri-implant mucositis and peri-implantitis, which can ultimately result in failure of the implant.

Narrow diameter implants, angled abutment platforms, and other advancements have been developed to offer solutions in extremely challenging cases, but these products don't obviate the need for appropriate hard- and soft-tissue development when and where it is possible. To reduce the risk of complications and contribute to the long-term success of implant-retained restorations, a variety of protocols are available to clinicians to improve the quantity and quality of the hard and soft tissue at implant sites both in advance of and at the time of implant placement.