Prosthodontic and periodontal considerations for implant-supported dental restorations

In the past two years, many reports concerning the outcome of treatment using dental implants have included more detailed data which allow insight into prosthodontic and periodontal considerations that affect success. It has become evident that unique biomechanical sequelae reflect the screw-joint character of the dental implant prosthesis. The relative stability of the screw joint and the biomechanical integrity of the components and prostheses themselves are new issues to contend with for restorative dentistry. The biologic sequelae of maintaining the implant-supported prostheses are revealed by bone maintenance and peri-implant mucosal health. The microbiologic similarity of tooth and implant-associated plaque at inflamed sites suggests that infected teeth are sources of potentially pathogenic bacteria at implants. However, the pathogenesis of inflammatory disease at implants is not fully defined. The evaluation and prognostic criteria of peri-implant inflammation remain controversial topics. The present aggregate data indicate that the long-term evaluation of implant-supported dental prosthesis must be performed with cautious optimism and attention to general biomechanical and biologic factors.