Incidence and primary prevention of complications related to the placement of dental implants

: Despite high success rate with endosseous titanium implants, failures inevitably occur. At an early stage, lack of primary stability, surgical trauma, peroperative contamination and occlusal overload seem to be the most important causes of implant failure. Many authors have reported that implant failures after primary healing and osseointegration are mainly due to peri-implant infection and/or excessive occlusal stress. Like periodontal disease, peri-implant inflammatory lesions develop as a result of plaque accumulation and exhibit similar clinical and microbiological signs as encountered for periodontitis. Clinicians should therefore enforce preventive measures to decrease the prevalence of such causative agents. Therapeutic attempts should have their rationale in the restoration of a biomechanical and/or host-bacterial equilibrium. The major limitation at this point seems to be the detection of a pathological process. Aside from clinical evaluation, the interpretation of radiographic images is one of the most frequently applied diagnostic procedures in patients with osseointegrated implants. Post-therapeutic maintenance care is an integral part of the entire implant treatment approach.