Stuart J. Froum, DDS, is a Diplomate of American Board of Periodontology, Clinical Professor Department of Periodontology and Implant Dentistry, New York University Krieser Dental Center, Director of Clinical Research at the Department of Periodontology and Implant Dentistry, NYU Dental Center, and maintains a Private Practice limited to Periodontics & Implant Dentistry in New York City. Dr. Froum is Past President of the American Academy of Periodontology. He lectures nationally and internationally, has authored over 100 published research articles, and has authored and contributed to several books related to periodontics and implant dentistry.

List of contributors xiii

Foreword xvii

Myron Nevins

Introduction xix
Stuart J. Froum

1 Implant complications: scope of the problem 1
Stuart J. Froum

Introduction 1

Etiology 1

Prevention and treatment 6

Acknowledgments 7

References 8

2 Implant complications associated with systemic disorders and medications 10
Louis F. Rose and Brian L. Mealey

Introduction 10

Etiology 10

Prevention 24

Treatment 36

Take-home hints 41

References 41

3 Complications of drug prescribing in implant therapy 49
Mea A. Weinberg

Introduction 49

Etiology of drug prescribing complications 49

Types of drug and drug prescribing complications 49

Prevention of drug prescribing complications 51

Antibiotic prescribing in dental implant therapy 52

Analgesic prescribing 60

Steroid prescribing 63

Conclusions 63

Take-home hints 64

References 64

4 Complications associated with implant planning: etiology, prevention, and treatment 68
Hans-Peter Weber and Panos Papaspyridakos

Introduction 68

Etiology 68

Prevention through careful diagnosis and risk assessment 71

Prevention of complications through careful treatment planning 81

Take-home hints 98

Acknowledgments 98

References 99

5 Implant complications associated with two- and three-dimensional diagnostic imaging technologies 102
Scott D. Ganz

Case 1: Complications due to scanographic templates 103

Case 2: Long-term complications due to nerve perforation 104

Case 3: Sinus augmentation complications diagnosed by three-dimensional imaging 109

Case 4: Complications related to improper surgical technique, diagnosis, and free-hand implant placement 118

Case 5: Complications in the mandibular symphysis - related to diagnostic imagery 122

Conclusions 129

Take-home hints 129

References 129

6 Implant fractures: etiology, prevention, and treatment 132
Steven E. Eckert, Thomas J. Salinas, and Kivanç Akça

Introduction 132

Incidence 132

Etiology 133

Treatment of the fractured implant 142

Conclusion 142

Take-home hints 143

References 143

7 Implant naturalization: restoring osseointegrated dental implants with damaged platforms and connections 145
Dennis E. Waguespack and Brian C. Butler

Introduction 145

Etiology and prevention 145

Etiology 147

Treatment 149

Take-home hints 152

Acknowledgments 152

References 152

8 Implant failure: prevalence, risk factors, management, and prevention 153
J. Kobi Stern, Emily E. Hahn, Cyril I. Evian, Jonathan Waasdorp, and Edwin S. Rosenberg

Introduction 153

Definition and classification of implant failure 153

Incidence of implant failures 155

Etiology and risk factors 156

Prevention of implant failures 162

Treatment for implant failure 162

Take-home hints 167

References 167

9 Peri-implantitis: etiology, pathogenesis, prevention, and therapy 170
Niklaus P. Lang and Maurizio S. Tonetti

Etiology 170

Microbiological aspects 170

Pathogenesis of peri-implant diseases 172

Diagnostic aspects 175

Prevention: prophylactic procedures 178

Treatment: therapeutic strategies 179

Conclusions and clinical implications 183

Take-home hints 184

Acknowledgments 184

References 184

10 Complications related to cemented implant restoration 187
Chandur P.K. Wadhwani

Introduction 187

Advantages of the cement-retained implant restoration 187

Problems associated with cemented implant restorations 187

Cementing restorations onto teeth versus implants - why the difference? 188

Etiology 193

Prevention 197

Treatment 201

The future of cement-retained implant restorations 203

Take-home hints 206

Note 207

References 207

11 Esthetic complications due to implant malpositions: etiology, prevention, and treatment 209
Stephen T. Chen and Daniel Buser

Introduction 209

Etiology 210

Prevention of implant malposition 217

Treatment of esthetic complications due to implant malposition 223

Conclusions 230

Take-home hints 230

References 231

12 Prosthetic-related dental implant complications: etiology, prevention, and treatment 233
Charles J. Goodacre and Mathew T. Kattadiyil

Introduction 233

Etiology and timing of complications and failure 233

Mechanical complications 234

Phonetic complications 245

Esthetic complications 245

Biologic complications attributable to the prosthesis 253

Conclusions 256

Take-home hints 257

References 257

13 The loose implant restoration syndrome 259
Harel Simon

Introduction 259

Scenario 1: Loose implant restoration emergency 259

Etiology of the loose implant restoration syndrome 263

Treatment protocol 263

Scenario 2: Loose screw-retained crown 263

Scenario 3: Loose cement-retained posterior crown 269

Scenario 4: Loose cement-retained anterior crown 272

Scenario 5: Loose anterior implant crown: screw-retained or cement-retained? 275

Scenario 6: Loose screw-retained fixed partial denture 280

Treatment considerations 284

Contributing factors and prevention of screw loosening 288

Take-home hints 295

References 295

14 Management of complications associated with single-implant esthetics 298
Oswaldo Scopin de Andrade, Dario Adolfi, Maristela Lobo, and Maurício Contar Adolfi

Introduction 298

Possible failures, prevalence, and etiology 299

Targeted strategies for implant success in the esthetic zone 300

Tooth extraction: an important factor in avoiding complications 301

Key elements in implant placement and resolving esthetic complications 302

Case report: step-by-step clinical procedures to resolve an implant complication in the esthetic area 305

Conclusions 312

Take-home hints 313

Acknowledgments 313

References 313

15 Esthetic complications with adjacent implant restorations 316
Dennis P. Tarnow, Sang-Choon Cho, Stephen J. Chu, and Stuart J. Froum

Complications 316

Etiology 317

Prevention 318

Treatment 320

Case report 322

Conclusions 326

Take-home hints 330

References 330

16 Complications of autogenous bone grafting 332
Craig M. Misch

Introduction 332

Donor sites 332

Recipient site complications: early healing complications 344

Recipient site complications: late healing complications 350

Take-home hints 357

References 358

17 Complications in guided bone regeneration 362
Filippo Fontana, Isabella Rocchietta, and Massimo Simion

Introduction 362

Literature review 363

Prevention of complications: surgical technique 364

Clinical management of GBR complications 370

Conclusions 379

Take-home hints 380

References 380

18 Avoiding complications of alveolar segmental osteoperiosteal flaps 383
Ole T. Jensen

Alveolar distraction osteogenesis 383

Sandwich osteotomy 386

Alveolar width distraction 388

Island osteoperiosteal flap 390

Book bone flap 392

Major orthognathic distraction procedures 393

Summary 395

Take-home hints 395

References 395

19 Complications in lateral window sinus elevation surgery 396
Stephen S. Wallace and Tiziano Testori

Introduction 396

Intraoperative complications 396

Take-home hints 399

Take-home hints 413

Postoperative complications 413

Take-home hints 421

Conclusion 423

References 424

20 Complications with transcrestal sinus floor elevation: etiology, prevention, and treatment 427
Michael Toffler and Paul S. Rosen

Incidence 427

Etiology 430

Prevention 437

Management 445

Take-home hints 450

References 451

21 Implant complications related to immediate implant placement into extraction sites 457
Barry D. Wagenberg and Stuart J. Froum

Introduction 457

Etiology and prevention 457

Immediate tooth replacement (non-occlusally loaded) at the time of extraction of the natural tooth 463

Procedures to prevent failure using the immediate implant placement protocol with a non-loading provisional 467

Treatment of maxillary molars with the IIP protocol 468

Treatment of mandibular molars 470

Prevention 474

Treatment of complications 478

Take-home hints 479

References 479

22 Complications associated with flapless surgery 481
Thomas G. Wilson, Jr.

Introduction 481

Definition of flapless surgery 481

Goals of therapy 481

Etiology 481

Prevention 482

Treatment 490

Summary 493

Take-home hints 493

Potential conflicts of interest 493

References 493

23 Complications related to immediately loaded dental implants 495
Jeffrey Ganeles and David Grossberg

Failure to achieve osseointegration 495

Surgical complications related to immediate loading 499

Esthetic complications 502