Speaking of implantation, we often think that the work’s main burden lies on the surgeon, and the orthopedist and the dental technician seem to recede into the background. We think: what is so special about their work? They neither “cut” the patient, nor listen to his post-operative complaints! What they really have to do is just to select the proper abutments and good luck. They even don’t have to do much grinding and preparing of the materials.
This opinion is absolutely wrong. It is the knowledge and skills of the orthopedist, and the dental technician’s creative attitude that a long-term result of the entire work depends on. Then be sure to try and build up an effective team among you.
The highly-trained orthopedist and dental technician can always provide long-term problem-free functioning of the entire implant-supported prosthetic construction. And vice versa, lack of attention and a formal approach could botch the most reliable work of the surgeon with the best implants applied. As we remember, the stage of prosthetic procedure starts since the moment when the surgeon installs the healing cap. It is at this stage when the first orthopedic problems may occur. The patient always tends to hurry and is ready to run and get his tooth impressions on the same day when the healing caps are installed.
If in the X-ray image you see that the implant is short and the interocclusal distance is large, try to unload this implant by decreasing the number of occlusal contacts to the minimum, or exclude them from the chewing process completely. Remember that a large number of teeth does not mean that many occlusal contacts are used. Redistribute them carefully. Put more load on the stable supports and unload the unstable ones.
Don’t let yourself be persuaded, and don’t make haste! The soft tissues around the healing cap need time to restructure and mature! During the first several days, these tissues are very vulnerable and non-resistant to any external aggression, they can become inflamed even because of damage caused with a food bolus [4.9-1]
The process of the mild tissues formation cannot take less than 5-7 days. Moreover, the deeper under the gingiva the implant is installed, the more time this period will take. Sometimes, it can take more than 15-20 days.
► If after removal of the healing cap you see that the gingiva is bleeding, put some Solcoseryl ointment on the healing cap, screw it in back the implant, and postpone the procedure of taking impressions by a few more days.
► Completely well formed soft tissues around the implant look like this.