Subscribe!
Implant Abstracts
Implant Cases
Ask UsDr. Aggar asks:
My periodontist has recommended using a dental implant fixture with a
machined (smooth) collar in patients who have chronic periodontal
disease.
He says these will work better than dental implant fixtures which have a surface coating up to the platform. This seems to be true in cases where there is periodontal disease. Are any of you making this distinction and treatment planning this way? What has been your experience?
Featured Sponsor
Free Daily Email Alert Click Here>>
Get OsseoNews.com Comments delivered daily! Click Here to subscribe.
Fri July 04 2008
FREE Weekly Email
Keep current on the latest dental implant discussions! It's Free!
>>Click Here to Subscribe to OsseoNews.com Now!
-
Hot Topics
-
Editor Picks
-
Patient Issues
- Cone Beam CT
- Mini Implants
- Bone Grafting
- Oral Bisphosphonates
- Sinus Lifts
- Implant Complications
- Immediate Loading
- Overdentures
- Nobel Biocare
- >>See All Main Topics
6 Responses to “ Machined Collar Implants ”
Please remember that perio disease is a tooth disease not an implant one… there in no ligament to grow bacteria on….
Having said that, Everybody has that thing hanging in the back of the mind in perio patients but to tell you the truth in well managed patients, with good quality abutment and good load distribution you shouldnt have problems.
In the uncertainty abstain … so use a smooth collar ifthat makes you more calm at night.
It must be remembered that the same gram negative facultative anaerobic bacteria that populate the natural dentition also populate the dentition containing oral implants. The implant surface certainly is more resistant to periodontopathic bacteria if a polished collar is present as a rough surface, either titanium alloy or HA-coated, accumulates pathogens more rapidly. The most important consideration for implant placement to avoid any episodes of peri-implantitis is to engender in all patients the necessity of excellent oral hygiene prior to any implant placement of any type and to be certain to have all periodontal pathology completely eradicated prior to any implant therapy.
FACT: The same bacteria that causes periodontal disease are the same found about infected dental implants. Implants should be treated as roots of teeth, they do and will have the same problems as teeth and the same disease, just a different name.
I fully agree with Dr. Dwyer.
If patient is still suffering from chronic periodontitis. why do you want to place implants.
eradicate pockets with regenerative or resective procedure. bring periodontium to acceptable health and then worry about collar. rough surface always are more prone to harbour plaque if exposed to oral environment than polished surfaces.
One more important aspect is abutment stability. Micromotion of the abutment can be directly correlated to the degree of inflammation and percentage of matrix metalloproteanases. Implant systems with NO polished collar but the MOST stable abutments display the LEAST amount of peri-implant inflammation. The concept of the role of a polished collar is about to go out with the bath water.
Implant designs currently have a range of 5mm of polished collar all the way down to 0 mm. Each manufacturer make claims supporting the amount or lack of polished collar. The trend today seems to be going towards having less or no polished collar. My own observation is that if the implant is placed flush with the crest of the bone a polished collar is probably disadventageous. If it is placed somewhat supracrestally then a polished collaar may be adventagous. There are at leasst 10 theories as to the reason crestal bone loss develops and the polished collar and it’s proximity to bone may play a role.
Leave a Comment
Note: Please refrain from ad hominem attacks, and promotional comments. Outside links are not permitted in comments. Though we require an email to route questionable comments to our editors, we will NEVER publish your email or use it for any other purpose. Thank you for your understanding.
Note: At times your comment may not appear on the website immediately, because it has been sent to our editors for approval. Once approved, we will publish the comment. There is NO need to resubmit your comment, if it does not appear on the website immediately.