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Abstract
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The following report summarises the debate which took place during the How to approach the treatment of the patient with hopeless implants session, at the EAO’s 26th annual Scientific Meeting in Madrid, 2017.
Debate
How can we define a hopeless implant?
When does a failing implant become a hopeless implant? When it is not possible to be kept in the mouth, or when the best treatment decision is to remove it (because it cannot achieve health, function and aesthetics). Late biological failure is a multifactorial process, and even two implants which look similar may have different responses in different patients. Maybe ‘hopeless’ is a misleading term, and we should rather view success as the absence of complications. Patient satisfaction is also an issue, as there can be wide variations in patient acceptance rates. Having said that, this session focused on extreme cases where implants were undoubtedly hopeless and nothing could be done to maintain them; and on the subsequent problems which had been caused by a hopeless implant.How frequently do these problems appear?
About a third of implants may encounter complications over a five-year period, so failures are rather common. It is important that we describe complications as a part of the treatment. A history of periodontitis is a major risk indicator. Although still considered a risk factor, smoking currently appears to be less relevant than periodontitis.What should we do?
Complication prevention begins with a proper diagnosis, treatment planning and risk evaluation; it continues with well executed surgical and prosthodontic procedures; and ends with a proper maintenance protocol.A therapeutic dilemma?
Patient acceptance for implant removal is low. Patients tend to assume that implant failures are a result of treatment or operator error; they do not usually consider themselves or their circumstances as the cause of the failure. Therefore, we may be put under pressure to keep a hopeless implant to satisfy the patient. On the other hand, however, when dealing with peri-implantitis we still do not have an effective treatment which offers predictable outcomes. But we can now say that peri-implantitis is treatable and that good long-term stability can be achieved in some clinical situations.EAO Congress Scientific Report; (3), 104, 2018.
This summary was prepared by the EAO Congress Scientific Report rapporteurs. View the full publication at: www.eao.orgThe following report summarises the debate which took place during the How to approach the treatment of the patient with hopeless implants session, at the EAO’s 26th annual Scientific Meeting in Madrid, 2017.
Debate
How can we define a hopeless implant?
When does a failing implant become a hopeless implant? When it is not possible to be kept in the mouth, or when the best treatment decision is to remove it (because it cannot achieve health, function and aesthetics). Late biological failure is a multifactorial process, and even two implants which look similar may have different responses in different patients. Maybe ‘hopeless’ is a misleading term, and we should rather view success as the absence of complications. Patient satisfaction is also an issue, as there can be wide variations in patient acceptance rates. Having said that, this session focused on extreme cases where implants were undoubtedly hopeless and nothing could be done to maintain them; and on the subsequent problems which had been caused by a hopeless implant.How frequently do these problems appear?
About a third of implants may encounter complications over a five-year period, so failures are rather common. It is important that we describe complications as a part of the treatment. A history of periodontitis is a major risk indicator. Although still considered a risk factor, smoking currently appears to be less relevant than periodontitis.What should we do?
Complication prevention begins with a proper diagnosis, treatment planning and risk evaluation; it continues with well executed surgical and prosthodontic procedures; and ends with a proper maintenance protocol.A therapeutic dilemma?
Patient acceptance for implant removal is low. Patients tend to assume that implant failures are a result of treatment or operator error; they do not usually consider themselves or their circumstances as the cause of the failure. Therefore, we may be put under pressure to keep a hopeless implant to satisfy the patient. On the other hand, however, when dealing with peri-implantitis we still do not have an effective treatment which offers predictable outcomes. But we can now say that peri-implantitis is treatable and that good long-term stability can be achieved in some clinical situations.EAO Congress Scientific Report; (3), 104, 2018.
This summary was prepared by the EAO Congress Scientific Report rapporteurs. View the full publication at: www.eao.org{{ help_message }}
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