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implantology section

5. Soft tissue problems
Pain can result from non-resorbable
sutures that are cut too short, as they
can be sharp and irritate the adjacent
tissues (Figure 3). However, resorbable
sutures are not a suitable alternative as
they tend to attract plaque. Incisions
should be closed with tension-free
suturing, otherwise exposure of the
membrane used in bone augmentation
can occur and granulation tissue forms.
This can lead to failure of the bone
material and infection.

RestoRative complications
1. Problems with temporary
restorations
It is essential that a patient’s temporary
restoration does not impinge on the
Fig 8a: Radiographs showing progressive bone loss around UL1 implant. The patient had diabetes surgical site, as excessive mucosal
pressure can lead to wound breakdown,
loss of bone graft material and
potentially implant failure. A patient’s
denture must be relieved and ideally
not worn for a few days following
surgery. The authors find patients are
very satisfied with Rochette bridges
as temporary restorations, although
occasionally they can debond.

2. Overgrowth of soft tissue
A minor complication can occur if, after
exposing a dental implant and fitting a
healing abutment, the surrounding soft
tissue grows over the healing abutment
before the patient’s next appointment
for impressions. This means that
local anaesthetic and an incision are
required in order to remove the healing
abutment, followed by placement of a
larger one. This may result in a delay of
Fig 8b: Probing depths were taken (which were over 10mm) for clinical control and assessment
subsequent restorative stages as the soft
tissue needs to reform around the new
healing abutment.

3. Unable to fit restoration
Occasionally, an implant crown cannot
be fitted: this can be related to tight
interproximal contacts or soft tissue
obstructing its seating. Adjustment
of the crown mesially and distally
may be needed, or manipulation of
the soft tissues. It is important to take
Fig 8c: A surgical approach a radiograph of the fitted implant
was required to treat the area restoration to ensure full seating and to
40 Dental Practice i July-August 2023 i Vol 19 No 4