Category Archives: Conventional

Dental Implant connection to Natural Teeth

Dental implants are rigid compared to natural teeth and if an attachment is used between the prosthesis and and natural tooth, the stresses generated from occlusal forces are primarily loaded onto the implants. As a result, the following could be present:
1. The implant fixture may be overloaded resulting in failure.
2. The natural teeth may undergo disuse atrophy, affecting the supporting tissues more rapidly than under conditions of proper loading.
3. It is also possible that the natural teeth are overloaded, leading to extraction type forces that result in tooth loss.

Osseointegrated implants

Osseointegrated implants

Placement of Dental Implant or RCT

Extraction and placement of implant to replace endodontically compromised teeth has become common in recent years. It is an important option in cases of severely damaged teeth with hopeless prognosis.

Root canal treatment represents a very realistic opportunity to restore most teeth with infected pulp. Dental implants must not be misused because an RCT may appear complicated. Root canal treatment has reached a level of sophistication in recent years that clinicians with proper training can carry out RCT with high rate of success.

Placement of a dental implant.

Placement of a dental implant.

Dental Implants in Removable Partial Denture Treatment

Implant was placed mesial to tooth number 22 (FDI Two-Digit Notation).

Incorporation of dental implants is viable and possibly cost effective treatment modality in partially edentulous patients. The advantages with incorporation of implants are as follows:

  • Improved esthetics by the elimination of visible clasp assemblies.
  • Ability to change fulcrums in the arch providing more favorable biomechanics.
  • Minimizing rotational and lateral forces on direct and indirect abutment teeth.
  • Controlled additional vertical support especially significant in partially edentulous patients with distal extensions.
  • Provide additional retention and stabilility to the prosthesis by incorporating an attachment mechanism.
  • Simplify prosthesis design and base extension.
  • Highly predictable treatment.
  • Easy to maintain depending on prosthesis design and attachment system.
  • Minimize excessive pressur and trauma to soft tissues and supporting ridge with alteration of the biomechanical forces.

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Impression in Implant Dentistry

Titanium Implant Abutment Component

Whether the partially or fully edentulous condition is to be restored, it is important to understand all of the prosthetic steps necessary to complete the implant treatment. While there are differences between natural teeth and implant fixtures, conventional prosthodontics techniques and concepts are the foundation for proper implant supported reconstruction.

The success of implant supported prostheses is directly dependent on the passive fit between the connector of the prosthesis and the implant itself. Therefore, impression and transfer of the exact positions of the implants to the working cast should be accurate.
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Dental Implants Cost and Implant Dentistry

Dental Implants Cost

The cost of dental implants depends on several factors like: the number of implants to be placed, implant system to be used, the fee of dentists performing the procedure and the location where the implant placement restoration is performed. These are only the major ones that have a big impact on the final cost.

Other factors are: how much bone is left in the patient’s upper or lower jaw, specialization of the dentist, difficulty of the case and fees charged by dental technologist/dental laboratory

Single implants may range in cost from $1,000 to $3,000 while the cost of full-mouth implant restoration can range from $6,000 to $100,000.

Dental implant treatment is usually not covered by dental insurance.

Advantages of Dental Implants

A dental implant replaces the root of your missing tooth. It is basically an artificial root placed by an oral surgeon or a periodontist. Dental implants will hold or support the denture or dental crowns cemented or screwed on top of them. With dental implants, you will still wear a denture. The difference is your prosthesis is more stable and secured.

Dental implant restoration is conservative if you compare it to traditional fixed bridge. Traditional bridgework requires reduction to adjacent teeth for them to hold the prosthesis. While in implant dentistry, the adjacent teeth will remain intact because the dental implant will hold the crown or denture in place.

Implants offer a long term solution to tooth loss. If maintained correctly, dental implants are stable and functionally durable.

Dental Implant Candidate

If you are allowed to undergo tooth extraction in the past, you are normally a good candidate for implants. If not, you should consult a dentist offline. Choose a dentist who has undergone an extensive training on Implant Dentistry.

In implant dentistry, periodontists tend to understand tissue better while prosthodontists can make the most ideal restoration. The concept in the practice of dental implant is prosthodontic driven and not bone driven.

Dental Implant Treatment Indications

Indications for dental implant treatment
1. Edentulous patient.
2. Partially edentulous patient with difficulty in wearing removable partial dentures.
3. Patient with missing dentition requiring long span dental bridge.
4. Patients refusing to use a removable denture.

Dental Implant Treatment Contraindications

Absolute contraindications to dental implant treatment
1. High dose irradiated patients.
2. Patient with psychiatric problems like psychoses, dysmorphophobia.
3. Hematologic systemic disorders.

Relative contraindications to dental implant treatment
1. pathology of hard or soft tissues,
2. patient with drug, alcohol or chewing tobacco abuse
3. Low dose irradiated patients.

Radiation therapy is defined as the therapeutic use of ionizing radiation. In irradiation of implants in bone, it is recommended the removal of all abutments and superstructures and closure of skin and mucosa over the implants prior to radiation. Medical conditions, like active diabetes, cancer or periodontal disease, require treatment before a dental implant procedure can be performed.

Factors to Consider in Dental Implant Treatment

1. How does the patient feel about surgery?
2. Is the patient prepared to pay the costs involved in implant theraphy?
3. Does the patient have sufficient bone to place dental implants? Bone grafting may be required and this could be a barrier to treatment.
4. If bone grafting is required, is the patient prepared to accept this?
5. Is the patient prepared to accept the burden of maintenance associated with implant retained prosthesis?

Success of Dental Implants

Based on recent studies, dental implants have 96% success rate. Bone quantity and quality influence success rates of the Implant Procedure. The upper anterior region has less bone quality and lower bone quantity when compared to the lower anterior region. A fully implant supported prosthesis in the maxilla has a lower success rate than in the mandible due to different bone densities.

Standards for Success of Implants

1. That an individual, unattached implant is immobile when tested clinically.
2. That a radiograph does not demonstrate any evidence of peri-implant radiolucency.
3. That vertical bone loss be less than 0.2 mm annually following the implant’s first year of service.
4. That an individual implant performance be characterized by an absence of persistent and/or irreversible signs and symptoms such as pain, infections, neuropathies, paresthesia or violation of mandibular canal.
5. That in context of the above, a success rate of 85% at the end of a 5 year observation period and 80% at the end of a ten-year period be a minimum criterion for success.

Dental Implant Risks

There are 2 main reasons why implants would fail: poor oral hygiene and wrong prosthodontic treatment (denture component). Sound prosthodontic principles are important to osseointegrated dental implants. Poorly restored occlusion in osseointegrated dental implants could result in deleterious effects to the prosthesis and supporting bone.

Good plaque control is important in preventing complications such as peri-implantitis around dental implants. Periimplantitis is a disease that is similar to the development of periodontitis.

Hygiene maintenance is tedious and requires considerable effort.

Mini Dental Implants

Mini Dental Implants are small diameter implants that are designed to stabilize the lower denture. MDIs should not be used as conventional dental implants. Read the mini dental implants post for more info.

Granstrom G, Tjellstrom A, ALbrektsson T: Postimplantation irradiation for head and neck cancer treatment. Int J Oral Maxillofacial Implants 1993;8(4):495-500.
Albretsson T, Zarb G, Worthington P, Eriksson A: The long term efficacy of currently used implants. A review and proposed criteria of success. Int J of Oral Maxillofac Imp, 1:11-25, 1986

Written by:
Jesus Lecitona+, DMD, MScD-Prosthodontics

Bone Repair in Dental Implantology

Dental Implant placement is determined by available bone present in the alveolar ridge. The bone present also determines if there is proper soft tissue contour necessary for an optimum esthetic result. Oftentimes there is insufficient bone to provide a proper foundation for the dental implants resulting to insufficiency of soft tissue contour.

Bone Graft Procedure on buccal bone plate. Photo credit: Oris Neobiotech

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Dental Implants in Esthetic Zone

The establishment of optimum and predictable esthetics is one of the most important and challenging aspects of rehabilitation with dental implants. Rehabiliation of esthetics has to be predictable. There is no rejection with dental implants. Only the maintenance of height of crestal bone and esthetic outcome is yet to be universally successful. While there are multifactorial factors to this, the implant abutment connection has an influence to the esthetic zone. The atrophic ridge remains to be a challenge in the placement of implants in the esthetic zone.

Dental Implants in the Esthetic Zone, or anterior maxilla.

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Implant Therapy

Dental Implant Therapy constitutes the principal technique in dental rehabilitation. Nowadays, it is not imaginable to exclude dental implantology from the daily dental practice. According to a accredited data in international literature, one can attain success rates of more than 90% in 10 years. Scrupulous selection of patients and the formulation of a correct implant prosthodontic plan allows high predictability and implant success.

A good implant prosthetic treatment plan allows high dental implant success rate.

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Implant Supported Complete Denture

Implant Supported Complete Denture is an optimum solution for Completely Edentulous patient. Implant Supported Denture virtually eliminates slipping and movement. Patients will be able to laugh and speak with confidence and eat food with ease.

Dental Implant supported complete denture have the following advantages:

  • It increases comfort and stability.
  • It restores a secure biting ability.
  • Maintains integrity of facial structure.
  • It eliminates need for adhesives.
  • It improves facial appearance.
  • It improves eating.
  • Improves speech and confidence in speaking.

Multiple Dental Implants

Implant Supported Bridge is an optimum solution for multiple missing teeth. Implant supported dental bridge stays secure and strong. It is comfortable, natural and look like natural dentition.

Dental Implant supported bridge have the following advantages:

  • It looks, feels and performs similar to natural teeth.
  • Sound adjacent teeth are not compromised to support a bridge.
  • Preserves sorrounding bone.
  • Dental bridge attached securely to dental implants.
  • It prevents resorption of bone.
  • Recurrent wear around abutment is eliminated.
  • Seld esteem of the patient is improved.

Dental Implants will maintain surrounding bone and soft tissue, as well as replace missing teeth.