Basic Principles for Dental Implant Placement
Dental implants are titanium screws that are surgically placed in the upper or lower jaw to replace the root of a missing tooth. After a period of osseointegration lasting approximately 3 months, a custom-made restoration is placed on the implant, which should look and function like a natural tooth.
To ensure both aesthetic and functional success in implant treatments, it is essential to follow these basic principles when placing implants:
1. Adequate Bone Height and Width
It is essential to have sufficient bone height and width, leaving a minimum of 1.5 mm of bone around the implant’s contour. This helps prevent the development of recessions at the gingival margin caused by the loss of cortical bone. This principle is particularly important when placing implants in the anterior region.
2. Avoid adjacent anatomical structures
It is necessary to avoid anatomical structures such as the maxillary sinus, the nasal cavity, the dental nerve, and other vascular structures. This prevents surgical complications, improves the postoperative recovery, and reduces the risk of unwanted side effects.
3. Proper Implant Placement
The implant must be placed in an appropriate position in all planes of the oral cavity. It is important to consider the apico-coronal depth of the implant. If there are adjacent teeth, the implant should be placed 2–3 mm below the amelocementary line of these teeth.
In edentulous patients, the gingival margin serves as the reference point, with the implant ideally placed 3 mm below this margin (although in most cases, placement between 2–4 mm is acceptable).
4. Distance Between Implants and Teeth
It is essential to maintain a distance of 1.5 mm between the tooth and the implant, and 3 mm between implants. This ensures that during the remodeling of the biological space following implant placement, the interproximal bone will maintain an adequate height without compromising the implant’s bone support.
5. Proper Drilling Based on Bone Density
Proper drilling is key to achieving good primary implant stability. The prognosis for the implant, both in the short and long term, is directly related to the primary stability achieved during surgery. Therefore, it is crucial to adapt drilling to the different bone densities encountered to always ensure good primary stability.
By adhering to these principles, the success of dental implant treatments can be maximized, ensuring both their functionality and aesthetics.
