Implants In Dentistry…The Present & Future!
Dental implants have become a very common treatment protocol offered and practiced by restorative dentists worldwide. Due to the vast improvements in dental research and an ongoing increase in the sophistication of the treatment modalities, dental implants are a routine procedure practiced today by able dental surgeons. Dental Implants are titanium screws, which can be surgically placed in the jawbone over which a suitable form of artificial tooth replacement can be independently, or in combination, be constructed to replace the missing dentition. The surgery is not an extensive procedure, which can be performed under local anesthesia and the patient can resume his normal day-to-day activity from the very same day or the day after.
Prior to the advent of the implants, the various forms of tooth replacements, which were available, included removable & fixed partial dentures and removable complete dentures. Most of the removable forms in use are deemed hopeless by many unsatisfied patients, particularly because they do not meet the patients’ expectations in terms of comfort and functional efficiency. Furthermore their daily maintenance itself is a meticulous procedure and this itself is a turn off for the millions unsatisfied. For single and multiple tooth replacements the most popular and commonly advocated option is the use of fixed ceramic bridges. Ceramic bridges can be fabricated if the edentulous area (the area of the missing teeth) is bound on either side with natural teeth. These adjacent healthy teeth are ground and capped, between which an artificial tooth is suspended. Hence a bridge is only possible if there are natural teeth on either side of the edentulous area, otherwise only some form of removable denture was possible.
Today even complete dentures can be fixed with the use of implants. Depending on the situation, appropriate numbers of implants can be placed in the jawbone and the resultant artificial dentures can be fixed on these. For single and multiple teeth loss, just the required number of implants can be placed and independent crowns can be fabricated or implant supported bridge can also be made. This prevents any non-judicial grinding of healthy natural teeth and preserves them. Situations wherein bridges were absolutely not possible to fabricate can be now made with ease making use of implants. Implants, which in the past were regarded an experimental treatment modality, now is a routinely performed procedure.
The procedure is not a complicated one. Based on preoperative work ups, a complete treatment plan is carefully sketched prior to the surgery, which include: - number of implants, implant size, & implant position etc. All these parameters are however controlled by the available bone. The bone factor decides most of the parameters. This varies from patient to patient and sometimes is the single deciding factor whether placement itself is possible or not. Once all these are decided, implants are surgically placed into the jawbone and left to heal for a brief period of time. Usually six months for the upper jaw and three months for the lower jaw, after which the implant heads are exposed (second stage surgery) and tooth reconstructive procedures can be initiated and completed. During this healing period the implant becomes a part of the jaw. With newer implant systems available in the market today, this waiting period and a second stage surgery can be totally eliminated. Ideally an implant system with two stage procedures and delayed loading are preferred by a majority of implant practitioners because of their known significances; but opinions differ on this regard and is one frequently argued upon. But whatever ever the system practiced the success rates of the implants, irrespective of the brand, is quite high and depends on strict surgical protocols and biomechanics. In other words, the surgical placement is an important factor, where governing rules and protocols have to be strictly adhered to. Following which a properly designed prosthesis must be fabricated which does not compromise the underlying implant in any way. This will ensure the longevity and functional efficacy of the resultant implant supported prosthesis.
Implants have come a great distance in dentistry and are here to stay for a long time. They have almost substituted all forms of conventional replacement methods and definitely perform a degree better than the others. In terms of function and form they are now unparalleled in the field of artificial tooth replacements.
Dr. Murali Srinivasan, MDS.
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