What is the secret of a long lasting implant?
We all wish for a surviving rate of 10 years and more for all our implants. But how do we achieve that? It is already clear that a successful integration of the implant in the bone is not enough. This is maybe one of the missing complements in the equation. The other components of this equation are less visible, but as much as significant.
Every thing starts from planning. It is proven by many researches that a minimum distance between the implants, and between implants and teeth should be kept. Too lingual or too buccal position of the implant resulting soft tissue trauma or hygiene problems. The solution is guided surgery. A surgical guide produced from a CBCT allows to use maximum of the bone by placing bigger implant in length and diameter with better capacity to withstand heavy load.
The next challenge is to create a restoration that has a passive fit. Monitoring marginal seal and absence of micro-gap using a simple x-ray is not a serious approach.
Up to this moment, there is no mean to check a fit of a framework of fixed restoration in vivo. The only way to achieve a passive fit and a marginal accurate seal is to eliminate from the working process bad factors that were proven, in vitro, and found to be harmful for the accuracy. These factors are: impression transfers, impression copings and lab analogs.
Direct impression using gingival retraction for implants, eliminates these three elements assure a passive fit.
Finally, the preservation of the Peri-implant zone from contamination with remains of cement is very important. Using the gingival retraction for implants, prevents the cement from going into the peri-implant area and prevents peri-implantitis.