Introduction
The prerequisites for the long-term success of osseointegrated dental implants are healthy bone and gingiva.
Through this examination, the practitioner makes sure there are no issues that could jeopardize the success of the implant.
1. Intraoral examination
- Good oral hygiene is an essential requirement for the success of the procedure.
Bad hygiene could lead to an infection and thus put at risk the implant.
- Smoking increases the risk of failure of the dental implant.
Nicotine affects blood flow and bone cell growth, which are essential for osseointegration.
- Sufficient space for the implant and prosthesis:
* Distance between the edentulous site and the opposing dentition ≥ 7 mm. (for the prosthesis)
*Distance between 2 adjacent implants ≥ 3 mm.
*Distance between an implant and a tooth ≥ 1,5 mm. (for the interdental gingival papilla)
- The thickness of the buccal cortical bone must be > 2 mm.
It guarantees sufficient bone support even after lysis in the first months, which stabilizes the soft tissues surrounding the implant.
- The height of the alveolar bone crest must be sufficient to place the implant while respecting the safety distance from the surrounding anatomical structures.
- Occlusal analysis
An untreated occlusal dysfunction (bruxism, parafunctional habits… ) could compromise the success of the implant.
The occlusion of the patient is thoroughly evaluated to determine the amount of stress that will be put on the implant during normal function. Furthermore, it allows the practitioner to plan the position and number of implants.
- Esthetic assessment
Numerous factors need to be taken into consideration to achieve the best esthetically pleasing result:
*The laugh line
*The interdental gingival papilla
*The gingival biotype: It is the thickness of the gingiva in the faciopalatal dimension.
Thin and transparent gingiva is aesthetically unfavorable.
2. Extraoral examination:
The range of the mouth opening needs to be a least 4 cm.
It ensures the feasibility of the procedure, especially in the case of a posterior gap.
Various types of imaging modalities are used for dental implant imaging:
- Periapical radiography
- Panoramic radiography
- Occlusal radiography
- Cephalometric radiography
- Computed tomography (CT scan or Cone beam)
Conclusion
A thorough examination allows the practitioner to select a suitable patient and treatment plan, which increases the success rate of the implant.
