​Management of Implant Complications in the Esthetic Zone: Classification & Surgical Solutions

Paul Pao-Ying Lin DDS, MS

Management of Implant complications in the esthetic zone is by far the most challenging tasks in implant dentistry. Current classification of biologic com-plications mainly focused on disease progression, extent or etiology.

However, there is very little report about the classification in the esthetic zone let alone the provision of standardized solutions for managing the biologic complications. The goals of this presentation are to establish a classification system for the biologic complications in the esthetic zone according to the degree of difficulties and to provide surgical solutions for its practical and predictable management.

Cases will be firstly determined whether the involved implants can be rescued or removed. For rescued implants, 4 classes will be utilized to differentiate the defects on mid-facial, interdental, or complex (involving adjacent teeth) or multiple (more than one implant). In each class, further sub-classification will be utilized to differentiate the implant from diseased (presence of probing depth), deficiency (loss of soft tissue) or both. As for the removed implant, 2 classes will be utilized according to the restored plan, either pontic or implant. In each class, further sub-classification will be utilized to differentiate the im-plant from single, complex or multiple. So there are 12 categories of rescued implants (a1-a12) and 6 categories of removed implants (b1-b6) according the degree of difficulties.

Only following proper diagnosis, analysis and classification of the defects can one successful managed the cases with esthetic pleasing results.

Participants will learn:

• Understand how to determine the criteria for rescued and removed implants
• Learn how to classify the esthetic implant complications according to the degree of difficulty.
• Learn how to establish a simple and straightforward treatment proto-col for management of each classification.
• Know how to distinguish the needs for soft and/or hard tissue man-agement and the best surgical approach for peri-implant deficient sites.
• Choose proper surgical techniques according to your learning curve on periodontal regeneration with plastic surgeries and modify them to solve your existing cases.