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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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