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implantology section

Service evaluation of implant-related • Campbell C, Hare K (2022) Utilising audit in clinical practice.
complicationS Clinical Dentistry 2(1): 12-14
All the terms described so far in this article are useful for retrospective • Heitz-Mayfield LJA, Salvi GE (2022) ITI Treatment Guide.
classification of complications, but it is through gathering data from Volume 13. Prevention and management of peri-implant diseases.
your own practice that you can begin to proactively recognize potential Quintessence Publishing, Berlin Sheridan RA, Decker AM, Plonka
areas for concern and consider any preventive action. AB, Wang HL (2016) The role of occlusion in implant therapy: a
In the last year, more than 500 implants were placed at the authors’ comprehensive updated review. Implant Dent 25: 829-838
practice. They also accepted many referrals for problems with existing
implants that had been placed outside the clinic, thus expanding
the broad range of issues to contend with. A service evaluation to MY TAKE
monitor implant related complications was set up, considering any
unplanned attendance or episode of care as a complication. From this Dr. Ajay Sharma
data collection, the most common implant-related complications were Complications in oral implantology can happen at
recently reported (with most frequent first) as: any stage of the dental implant procedure includ-
1. Suture related ing during surgical phase or prosthetic phase and
2. Loose/lost implant bridge can happen with any clinician irrespective of his
or her expertise. But a good clinician is one who
3. Pain can detect them and treat them timely in a professional manner. In my
4. Loose/lost temporary bridge clinical experience including 25 years of oral implantology, the most
5. Loose/lost crown common complication is placement of dental implants that are too
6. Mucositis close to each other or too buccal or labial aspect leading to unaes-
7. Failed implant thetic clinical outcomes.
Beginners generally make sinus perforation or enter the mandibu-
8. Chipped ceramic lar canal as most clinicians are not getting the CBCT done in planning
As a result of this evaluation, it is emphasized to patients in their phase. Uncontrolled bleeding, displacement of dental implant in maxil-
post-operative instructions that their sutures will feel long, and if they lary sinus or sub mandibular region and perforation of adjacent teeth
are cut too short, they may feel sharp. Previously, a loose/lost temporary are some of the more severe complications.
bridge was the most common presenting complication. The practice Most dental implant training programs should train the clinicians
undertook changes in the design of bridge wings and cement and since in handling these surgical or prosthetic complications. Common
prosthetic complications are abutment screw or abutment fracture or
this change there has been a decrease in the number of these problems. prostheses fracture during or after prostheses delivery.
This does, however, put some perspective into implant-related Selection of a good implant system along with good clinical training
complications: the majority are minor issues that, while we would and continuous learning of new techniques and procedures can
seek to avoid altogether, are on the whole, relatively straightforward reduce the implant complications in one’s practice though they cannot
to correct. be completely eliminated.
Dr. Ajay Sharma is a Senior Consultant Prosthodontist and Oral Implantologist,
concluSion Head-Department of Dental Sciences, Max Group of Hospitals, New Delhi. He is
Founder and Director of Focus Dental which is one of the fastest growing chain
Dental implants can significantly improve a patient’s function, of dentalclinics in India.
aesthetics, and quality of life. However, this is an elective and complex
dental treatment that will always carry with it risk of complications.
Good assessment processes will mitigate these as much as possible, aBoUt tHe aUtHoRs
especially restorative driven planning and pre-operative hygiene anGela coWell qualified in dentistry
appointments, as well as long term maintenance. from the University of Newcastle-upon Tyne
Communication with the patient is essential. While patients should in 2002 and was awarded the Diploma in
consent at the start of treatment and understand that complications can Implant Dentistry from the Royal College
occur, an effective system for handling unforeseen circumstances will of Surgeons, Edinburgh in 2021. She works
help maintain a good relationship with the patient while complications at the Campbell Clinic and is a committee
are managed. member of the UK and Ireland branch of
Key to remedial treatment is prompt identification of problems the Women’s Implantology Network (WIN).
before they escalate, and systematic analysis of complications after they
occur. This may involve providing explanations to the patient, follow- BeatriZ SancHeZ-iniGo qualified in
up appointments, evaluating the root cause of the problem, reflection, dentistry from Barcelona University in 2008
and discussion with colleagues. and gained an MSc in clinical implantology
from the University of Central Lancashire
References (UCLAN) in 2017. She practices exclusively
• Bragger U, Heitz-Mayfield LJA (2015) ITI Treatment Guide. Volume in oral surgery and dental implants. She is
8, Biological and hardware complications in implant dentistry. an implant mentor, lecturer and manages
the content of postgraduate implant
Quintessence Publishing Co, Ltd teaching courses
42 Dental Practice i July-August 2023 i Vol 19 No 4