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 biological integration period of 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 certain basic principles when placing them:
1. Adequate Bone Height and Width
It is crucial to have sufficient bone height and width, leaving a minimum of 1.5 mm of bone surrounding the implant’s contour. This helps prevent the development of recessions at the gingival margin resulting from the loss of cortical bone. This point is especially important when placing implants in the anterior region.
2. Avoiding Adjacent Anatomical Structures
We must avoid anatomical structures such as the maxillary sinus, the nasal cavity, the dental nerve, and other vascular structures. By doing so, we avoid surgical complications, achieve a better postoperative outcome, and reduce the risk of unwanted side effects.
3. Placing the Implant in the Correct Position
It is important to place the implant in the correct position in all planes of the oral cavity. We must take the apico-coronal depth into account when placing the implant. If there are adjacent teeth, the implant should be placed 2–3 mm below the amelocemental junction of those teeth.
In cases of edentulous patients, the gingival margin serves as the reference point. Ideally, the implant should be 3 mm below this margin (although in many 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, as well as a distance of 3 mm between implants. This ensures that during the remodeling of the biological space following implant placement, the interproximal bone is maintained at an adequate height, preserving the implant’s bone support.
5. Proper Drilling Based on Bone Density
Proper drilling is key to achieving good primary implant stability. The implant’s prognosis, both short- and long-term, depends on the primary stability achieved during surgery. Therefore, it is important to adapt drilling to the different bone densities encountered to ensure good primary stability at all times.
These principles are fundamental to ensuring the success of dental implant treatments, from both an aesthetic and functional perspective.
