Algorithmic Approach to Reconstruct Major Implant and Dental Complications.

Purpose: Patients with failing implants or teeth may require multiple procedures to correct their problems. The purpose of this article was to describe an algorithmic approach for clinicians to use to simplify the restoration of the patient.

Methods: The topics for this article were used to search for references using PubMed. Topics included the effect of thickening thin gingiva to promote stable soft tissue margins, the use of different bone graft materials for sockets and for ridge augmentation, and methods to use digital technology for efficient planning. Other sources were book chapters, which had an extensive reference section including multiple case series and clinical trial results. Based on the search results, references were chosen that would verify the techniques suggested to be used for these problems. For this narrative, diagnostic information is described using virtual digital methods rather than analog methods to develop the final prosthetic plan, which guides the surgical procedures. The surgical phases are described in detail.

Results: The gingiva needs to be healthy and thick to support a hard tissue graft. The timing of procedures begins with assessment of the quality of the soft tissue and the loss of both soft and hard tissues. The operative procedures should be based on the final prosthetic plan, created digitally, to provide information that is required to properly position soft and hard tissue grafts and the implants.

Conclusions: This organized, algorithmic approach can be used for many situations that clinicians are seeing in their daily practice due to complications that can occur.