[Periodontal requirements in osseointegrated and biointegrated implantology]

Osseo or bio-integrated implantology has become the turning point in modern dentistry and every decision regarding treatment planning should take into consideration the possibility of implant, and combine the knowledge of specialists such as periodontists, implantologists and prosthodontists. The psychological, medical and local evaluation will decide about the choice of the right patient for implant in order to resolve a unit, partial or full edentation. The periodontal therapeutic of the residual teeth will be realized before any insertion of implants and will focus more on elimination of the periodontal diseases on teeth that should be maintained, that on the maintenance on the arches of teeth with poor prognosis. The early extraction of these teeth and their immediate replacement by implants are recommended on certain conditions. The two step procedure in surgical implantology should respect the biological principles in order to obtain and maintain the osseo or bio-integration. The objectives of the post-implantology periodontal treatment will not be limited only to the elimination of the pocket around the implant, but will also create an optimal environment of keratinized attached gingiva around the collar of the implant, necessary for functional and esthetic purposes. The prosthodontic treatment on implants will be conducted with care and according to the perio-occluso prosthetic principles. It is finally essential to preserve the gingival health around the implant and to prevent a gingivitis to become a peri-implantitis, by a regular maintenance and evaluation.