As per prosthesis planning most of the times bone is not available to accomodate implants in bone leading to it's failure
In the early 1980s, Albrektsson describe the factors that were responsible for Osseo integration. He described an appropriate implant material, a suitable host, gentle surgery and atraumatic prostheses.
Today I still believe that these concepts remain true.
This question appears to take a broad philosophic question and respond to it with a straightforward answer. I think the risk is that the answer will oversimplify the response. The scientific understanding of the process continues to grow over time. Rather than narrowing the areas that influence outcomes, we should probably be expanding our knowledge.
Both factors are important, sufficient bone volume and bone quality and good prosthetic planning for proper function and occlusion are essential to achieve a long-standing favorable outcome.
the key consideration is to ensure that an implant is restrorable, and then trying to ensure that bone is available. the understanding is that horizontal bone augmentation procedures are very predictable and vertical bone augmentation such as sinus lift as also predictable. The question itself can be answered in many ways, but with the key consideration, the insertion prosthesis should be the first consideration and if bone cannot be augmented, then the position may be changed using the CBCT planning.
Sir it's all about treatment plan and it's implementation yes I agree that sometimes one in a blue moon case treatment plan don't match with clinical conditions but with advances in the field implantology you must change you plan accordingly .
Dear Satish Narula,
Thanks for the interesting topic and participation of each dein. A healthy horizontal bone, a very good preparation for the biocompatibility of the vertical implant, and good health of the human body are required to achieve the longevity of the vertical implant in the oral cavity. These factors are often examined by different groups of doctors, doctors, researchers, engineers and more. Combining them into a team and considering the complete task of vertical implant placement will produce very good results.
As is known with increasing age, the bones weaken. Therefore, the first sign of this is the loss of teeth in the oral cavity. Taking measures to improve the bone system prematurely will delay the oral cavity for a longer period of time.
The administration of each vertical implant in the oral cavity is related to the difference between bone tissue. Which is different for every organism. The complex task is the responsibility of us as scientific teams.
I am personally in favor of penative medicine for extending the life of teeth in the oral cavity.
Dear Satish Narula,
The first issue to be considered for implant theraphy is the presence of available bone in quantity and quality (Lekholm U, Zarb GA. Patient selection and preparation. In: Brånemark PI, Zarb GA, Albrektsson T, editors Tissue-integrated prostheses: osseointegration in clinical dentistry. Chicago: Quintessence Publishing Co.; 1985. p. 199–209.).
However many techniques of bone grafting, including the use of blood concentrates as platelet rich fibrin (PRF / I-Bone), and different implant designs are changing these paradigms.
Best wishes
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