Endodontic Implant Research Paper

2.8 Implant Surgery

Implants which are included in endodontics are endodontic implants and endosseous (osseointegrated) implants. [10]

Endodontic implant

Endodontic implant is a metallic extension which extends through the tooth passing through the apex into the bone. They have been used since 1960. Orlay and Frank are from the first that have used endodontic implants. They provide stabilization for the tooth by increasing the root to crown ratio. The indications for using an endodontic implant include bone loss due to periodontal problems, root resorption and a horizontal fracture affecting the apical part of tooth. [23] Figure 2 20 [23] preoperative x-ray Figure 2 21 [23] reamer placement Figure

Sometimes after the surgery the patient may experience pain, bleeding or swelling. To avoid the pain the dentist may prescribe medicine for the patient in order for them to be comfortable after the procedure. In case of post-surgical bleeding the patient may undergo bleeding 12 to 24 hours after the surgery. This is hard to keep under control, but the patient is advised to press a sterile gauze pad on the surgical area for up to 20 minutes. The patient may also experience interstitial bleeding, also known as ecchymosis. This is when blood appears in the superficial tissues in the face. It will disappear within 10 to 14 days and get back to the normal color of the patient’s tissue. Secondary bleeding can also happen; there will be an uncontrolled heavy bleeding usually caused by an injury or infection. The patient is given anesthesia and the flap is reflected and the cause of bleeding must be treated. The last form of post-surgical bleeding is when severe uncontrolled bleeding is present. The patient should be instantly observed and treated. Post-surgical swelling may sometimes be normal and could be prevented using an icepack after the procedure. However, in some cases there may be some problems such as the appearance of a hematoma. A hematoma is collection of blood leaked out of a blood vessel which can be found on the face, cheek or lips. However, a hematoma is not harmful. A

Before treating a patient a series of examinations should be done. It starts with extra oral examination with inspection and palpation that consists first of checking the symmetry of the patient’s face especially near the jaw area, then checking the TMJ for symmetry and absence of clicking sounds by asking the patient to open and close their mouth, followed by palpating lymph nodes (examined from behind the patient) which for healthy patients should be non-palpable, then checking the symmetry of the thyroid gland. After the extra oral examination is performed, a stomatooncological examination is done. This is done to check for any discrepancies that may be found in the tongue, buccal mucosa, gingiva, floor of the mouth, lips, hard palate and pharynx. If any discrepancies are found the dentist notes it down including its location, size, color and type. Then make an examination of the teeth with the help of a mirror and probe.