Soft Tissue and Esthetic Considerations in Implant Therapy

  • A. G. Sclar
Surrey: Quintessence, 2003 price £176, pp 288 ISBN 0867153547 | ISBN: 0-867-15354-7

This book presents surgical techniques to manage peri-implant soft tissues. The text is 280 pages and lavishly illustrated with intraoperative clinical colour photographs of individual problem cases which the author has treated in a step by step fashion. It targets both novice and expert implantologists and contains practical guidelines as well as detailed information necessary for comprehensive surgical management of relevant clinical problems encountered in practice.

The books starts with a discussion of the rational and biological basis for creating a stable peri-implant environment. This section addresses the concept of osseointegration and the importance of peri-implant soft tissues representing an introduction to the text but being basically an overview of information well known to implantologists. A systematic approach to patient evaluation of the various adverse clinical conditions that may affect or compromise implant treatment then follows. After assessment of the clinical situation, specific surgical maneuvers are presented for the management of each. From there, a classification system for alveolar ridge defects specific to implant therapy is defined. Each defect is subsequently correlated with appropriate treatment options later in the book.

Surgical instrumentation, optimal flap designs, soft tissue considerations, guidelines for surgical maneuvers, and case types are presented in detail. Indications for use of periodontal soft tissue grafting and its techniques are provided, with guidelines for patient care. Most of these are useful, time-tested, techniques many of which I use myself. Techniques for augmenting tissue around implants and natural teeth, as well as large volume hard tissue grafting procedures for extensive defects of the maxilla are also presented.

The final section of the book presents a comprehensive approach to implant therapy combining both prosthetic and surgical considerations to enhance outcomes such as the use of custom healing abutments, laser soft tissue sculpting and resurfacing, and platelet rich plasma. Finally, a conceptual framework for esthetic implant site development is presented to give the implant surgeon an understanding of the sequence and timing of procedures. In addition, the appendix has treatment algorithms that help the reader navigate the challenges of treatment planning for individual cases in an abbreviated, easy-to-follow, fashion.

The many clinical cases presented throughout the book can be used as a reference for the implant surgeon treating similar cases. The author has compiled documented cases from his practice to demonstrate the techniques and convey his experience to readers. This information can help clinicians master techniques that will benefit their patients.