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									    Rationale for Dental Implants

                Dr Anas Alibrahim
            BDS (JUST, Jordan, 2007)
MDSc Prosthodontics (Dundee, United Kingdom, 2010)
Outline

   Why are dentists moving to dental
    implants ?
   Successful dental implant.
   Indications for dental implants.
Cont …
   Advantages of dental implants:
   Preservation of tooth structure.
   Preservation of bone.
   Provision of additional support.
   Retrievability.
   Resistance to disease.
   Increased confidence.
   Improves aesthetics, function and speech.
   Conclusions
   References.
Why are dentists moving to
dental implants ?
1.   Address patient’s
     needs and requests.
2.   High success rate.
3.   Progressive
     development of new
     implant systems,
     Diagnostic procedures,
     and the introduction of
     novel surgical
     techniques.
Cont …
4.   Advancement of
     technical procedures
     (CADCAM).
5.   Many training courses
     are offered by
     universities,
     professional societies
     and implant
     manufacturers.
6.   Profitable.
Successful implant
   Successful Osseointegration.
Successful implant
   Restoration of normal contour,
    aesthetic, function and speech.
Successful implant
   Clinically:
   Immobile.
   No persistent pain, infections,
    paresthesia or neuropathies.
Successful implant
   Radio-graphically :
   No peri-implant radiolucency.
   Vertical bone loss should be less than
    0.2 mm annually following the implant’s
    first year of service.
Indications for dental
implants.
1.   Intolerance to removable dental prosthesis.
2.   Need for long span fixed prosthesis with
     questionable prognosis.
3.   Single tooth loss that will make it necessary
     to prepare sound adjacent teeth for a fixed
     prosthesis.
4.   Unfavourable condition, location and
     number of abutment teeth.
Advantages of dental implants
1.    Preservation of tooth structure.




     Fixed bridge                 Implant
    Cont …
  Fixed partial dentures   Single tooth implants
• Significant reduction  • no need for
in the amount of tooth preparation of adjacent
structure is necessary teeth.
• long term survival:    • Long term survival:
87% at 10 yrs, 69% at 15 yrs   96.5% at 11 yrs
•   Less expensive             •   More expensive
Advantages of dental implants
2.   Preservation of bone.

 loss of teeth →
Lack of stimulation to the residual bone →
 Decrease in bone density, height and width.
Bone resorption after extraction
Bone resorption in edentulous
patients
   Most of the bone loss occurs in the first year
    after extraction.
   Continued bone loss for more than twenty
    years.
   Four fold greater in mandible than in maxilla.
Cont …
   Upwards and medially in maxilla,
    downwards and laterally in mandible.
Cont …
    Teeth stimulate bone → maintain bone.
    Implants stimulate bone → maintain bone.
    Complete and partial dentures don’t
     stimulate bone →
     Bone resorption, acceleration of bone
     resorption if ill fitting →
1.   Decreases the surface area available for prosthesis
     support.
2.   Eliminates favourable anatomy for retention.
3.   Results in unfavourable denture bearing areas.
Cont …
   Always inform your patient of the anatomical
    consequences of tooth loss.
   Always inform your patient of the preventive
    nature of dental implants.
Advantages of dental implants
3.   Provision of additional support.
    Dentate patient can exert up to 1000 psi of
     bite force.
    Edentulous patient ( complete denture
     wearers) can only exert up to 50 psi of bite
     force.
    Transitioning a patient from complete
     denture to an implant supported prosthesis
     will result in a dramatic increase in bite
     force.
Cont …
   Tooth and mucosa borne dentures :
   Can’t re-establish posterior support.
    Why ?
Advantages of dental implants
4.   Retrievability : reservicing,
     replacement and salvaging of the
     restoration.
Advantages of dental implants
5.   Resistance to disease.
    Implants are resistant to caries,
     natural teeth are not.
Cont …
   Consider extraction of teeth and place
    implants if :
   The patient has poor manual dexterity,
    and hence can’t maintain good oral
    hygiene.
   The patient has Xerostomia due to
    medications (root surface caries).
Advantages of dental implants
6.   Increased confidence.




6.   Improved aesthetics, function and speech.
Conclusions
   Single tooth implant is the most predictable
    and conservative method of tooth
    replacement.
   Use of removable prosthesis will not allow
    patient to recover normal function,
    aesthetics, speech and comfort.
   Implant supported prosthesis allow patient to
    function with confidence and enjoy better
    quality of life.
Amazing implants
References
   Jivraj, S. and W. Chee (2006).
    "Rationale for dental implants." British
    Dental Journal 200: 661-665.
   Handout.

								
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