Extra Wide Implants for Immediate Placement: Any Experience with These? | OsseoNews Discussions on Dental Implants
Extra Wide Implants for Immediate Placement: Any Experience with These? | OsseoNews Discussions on Dental Implants: "*
December 15th, 2009
Dear osurg,
“Iatrogenic”, according to Webster’s is defined as, “induced inadvertently by a physician”.
When we insert a dental implant into the bone and gums, we create a pocket around the neck of the implant as it traverses through the gum and into the oral cavity. This pocket is different from the normal gingival sulcus that is found around a normal tooth. When the gingival sulcus become diseased due to infection, trauma or abnormal immune response……it becomes inflamed and deeper and the diseased state is then called a pocket. I call the corresponding sulcus around the dental implant as it emerges into the mouth a pocket because it is not normal but a pathology. In this case the pathology is physician-induced and therefore iatrogenic!
If we examine the pocket around the implant histologically, it is a vast difference from that of a normal gingival sulcus. There are no true fibrous attachment like on a real tooth, only a pseudo-attachment and connective tissue that contains a higher number of defense cells than normal.
Yea, everytime we place a dental implant, we create a pocket….. a pathology…yep…..a diseased state. It is a fact that we must recognise so that we will use dental implants judiciously….only when we are convinced that the new pathology is better than the pathology it is replacing….to put it bluntly. Remember the first maxim of the Hippocratic Oath….first do not make it worse…err to paraphrase “do no harm”.
All well integrated dental implants possess pockets… thus what you say is true, “If you have pockets when your implant is healed you have a problem.” Every dentist who places implants should recognise that they have created problematic pockets that they must check regularly and maintain at status quo as far as possible. It is not nonsense, it is a histologic fact that we self enthroned “implantologists” should accept and therefore treat responsibly. The alternative would be neglect with the accompanying consequences.
Regards.
Dr K.F.Chow
*
December 15th, 2009
Dear osurg,
“Iatrogenic”, according to Webster’s is defined as, “induced inadvertently by a physician”.
When we insert a dental implant into the bone and gums, we create a pocket around the neck of the implant as it traverses through the gum and into the oral cavity. This pocket is different from the normal gingival sulcus that is found around a normal tooth. When the gingival sulcus become diseased due to infection, trauma or abnormal immune response……it becomes inflamed and deeper and the diseased state is then called a pocket. I call the corresponding sulcus around the dental implant as it emerges into the mouth a pocket because it is not normal but a pathology. In this case the pathology is physician-induced and therefore iatrogenic!
If we examine the pocket around the implant histologically, it is a vast difference from that of a normal gingival sulcus. There are no true fibrous attachment like on a real tooth, only a pseudo-attachment and connective tissue that contains a higher number of defense cells than normal.
Yea, everytime we place a dental implant, we create a pocket….. a pathology…yep…..a diseased state. It is a fact that we must recognise so that we will use dental implants judiciously….only when we are convinced that the new pathology is better than the pathology it is replacing….to put it bluntly. Remember the first maxim of the Hippocratic Oath….first do not make it worse…err to paraphrase “do no harm”.
All well integrated dental implants possess pockets… thus what you say is true, “If you have pockets when your implant is healed you have a problem.” Every dentist who places implants should recognise that they have created problematic pockets that they must check regularly and maintain at status quo as far as possible. It is not nonsense, it is a histologic fact that we self enthroned “implantologists” should accept and therefore treat responsibly. The alternative would be neglect with the accompanying consequences.
Regards.
Dr K.F.Chow
*
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