Implants are not for everyone – Phillip Silver Solvay

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  Posted by: The Probe      3rd April 2019

Considered an effective and predictable method for treating tooth loss,[1],[2]around 130,000 dental implants are placed each year in the UK.[3]Dental implants function and look like natural teeth and can also help to preserve the structure of the face by preventing atrophy from bone loss.[4]In healthy patients success rates range between 90 and 95 per cent3and a recent review evaluating the long-term survival and success rates of dental implants after 10 years, affirms that dental implants are safe and present high survival rates

It has been stated that almost anyone that has lost one or more teeth can have dental implant surgery to restore function and aesthetics. However, as clinicians are aware, in order to ensure the best possible chance of a successful result each case must be assessed and the risks analysed very carefully to ensure that the patient is suitable for this type of surgery. Of course, the mouth should be healthy and stable with any pre-existing decay or disease treated and controlled well before implants are placed. Similarly, it is important that the patient understands that the success of dental implants depends on their commitment – to carry out a thorough and effective oral health routine and to attend maintenance appointments. Anatomically, there must be sufficient bone quality and quantity present to accommodate the implants and, the patient’s medical history and lifestyle must also be considered comprehensively to ensure that the patient does not have any local or systemic contraindications to therapy.

Certain medical conditions and the medications used to treat them are listed as “absolute” contraindications to implant therapy, these include a recent heart attack and/or heart valve surgery, stroke, immunosuppression, bleeding issues, active treatment of malignancy, drug abuse, psychiatric illness and intravenous bisphosphonate use.[5]“Relative” contraindications that can increase the risk of implant failure, influence surgical success or impair normal healing include: adolescence, ageing, smoking, uncontrolled diabetes, history of periodontal disease, HIV, cardiovascular disease, osteoporosis and hypothyroidism.[6]Some disorders when controlled, allow implant survival rates to match those of healthy patientsand some clinicians may conclude that one single factor may not influence the risk significantly. However, a combination of multiple independent factors such as a systemic condition, prescribed medication and reduced salivary flow in an older patient for example, may have a considerable impact.[7]

The other point to consider is the patient’s disposition; even though modern techniques have evolved to make dental implant procedures less invasive and lengthy, there are still some individuals that are reluctant or simply too anxious to undergo this type of surgery. Furthermore, the patient’s financial situation needs to be taken into account particularly because studies reveal that a high proportion of patients are hesitant to consider dental implants for the replacement of missing teeth as they feel that they are too expensive.[8],[9]

Certainly, dental implant therapy is not suitable, desirable or available for everyone. Therefore, clinicians need to be able to provide patients with alternative solutions that replace missing teeth effectively and deliver in terms of function, comfort and aesthetics.

A bridge may be a suitable option to replace one or two teeth, but removable partial dentures (RPDs) are widely used in clinical practice because they are a non-invasive and reversible treatment option, which offers a balance of comfort, functionality and value. RPDs are usually manufactured with a base of acrylic, metal alloy, or a flexible nylon,which fits over the remaining bony ridge with prosthetic teeth attached to fill the gaps in the arch. Carefully crafted to match the remaining natural teeth, most RPDs are retained with clasps on or surrounding the undercuts of the abutment teeth.

Largely, patient satisfaction and acceptance to removable partial denture treatment is good.[10]However, one of the most common complaints from RPD users is about aesthetics and partial dentures with metal frameworks are of particular concern if metal clasp arms or wires are visible when the patient smiles or speaks.[11]Although not as strong, flexible nylon RPDs are frequently used as an alternative material and show acceptable results in terms of aesthetics, performance, comfort and cost. Moreover, recent studies reveal a significant difference in patient satisfaction between metal and flexible RPDs.[12],[13]Nevertheless, to match the advancements in digital denture design and production, Solvay Dental 360®have custom-developed a new generation material, specifically for the fabrication of RPDs. Ultaire®AKP is a high performance, millable polymer that bridges the gap between flexible and metal denture materials to offer patients a strong, lightweight, biocompatible alternative. Ultaire®AKP is highly compliant with bone like properties to offer increased comfort but it does not distort or feel flimsy. Furthermore, with specially designed clasps for a ‘snap in fit’ and without any metal in sight, RPD frames created with Ultaire®AKP enhance aesthetic appearance.

Although people are living longer, they still lose teeth and the demand for discreet, comfortable and cost-effective RPDs continues to rise. Now is the time to explore digitally designed and manufactured RPDs so that you can offer your patients the most advanced dental treatments and range of solutions.

 

To book a Solvay Dental 360®Professional Lunch and Learn or to find more information about Ultaire®AKP and Dentivera®milling discs,
please visit www.solvaydental360.com

 

References

[1]Graviria L. et al. Current trends in dental implants. J Korean Assoc Oral Maxillofac Surg. 2014 Apr; 40(2): 50–60. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4028797/[Accessed 12th December 2018]

[2]V. Moraschini et al. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review. International Journal of Oral and Maxillofacial Surgery. March 2015.44 (3)  377-388. https://www.ncbi.nlm.nih.gov/pubmed/25467739[Accessed 11th December 2018]

[3]Association of Dental Implantology (ADI) 2012. A Dentist’s Guide to Implantology. http://www.adi.org.uk/profession/dentist_guide/a-dentists-guide-to-implantology.pdf[Accessed17th December 2018]

[4]American Academy of Implant Dentistry (AAID). Press Room: About Dental Implants. https://www.aaid.com/about/Press_Room/History_and_Background.html[Accessed 17th December 2018]

[5]Hwang D, et al. Medical contraindications to implant therapy: Part I: Absolute Contraindications. Implant Dent. 2006 Dec;15(4):353-60. https://www.ncbi.nlm.nih.gov/pubmed/17172952[Accessed 12th December 2018]

[6]Hwang D, et al. Medical contraindications to implant therapy: Part II: Relative Contraindications. Implant Dent. 2007 Mar;16(1):13-23. https://www.ncbi.nlm.nih.gov/pubmed/17356368[Accessed 12th December 2018]

[7]Bornstein M.M et al. Systemic conditions and treatments as risks for implant therapy. The International Journal of Oral & Maxillofacial Implants 24 Supplement, 2009. 12-27.

https://pdfs.semanticscholar.org/1ecf/ec0db1314ee61f1ab05ec0ec3441700db6db.pdf [Accessed 12th December 2018]

[8]Santhosh Kumar M.P. et al. Knowledge and awareness among patients about dental implants. J. Pharm. Sci. & Res. Vol. 8(5), 2016, 351-354 https://www.jpsr.pharmainfo.in/Documents/Volumes/vol8Issue05/jpsr08051617.pdf[Accessed 12th December 2018]

[9]Research by The Implantium Network. Not a lot to smile about – 109 million missing teeth for Brits. 16th Jun 2010. http://www.dentalsupportuk.com/dental-news/2105-not-a-lot-to-smile-about-109-million-missing-teeth-for-brits[Accessed 12th December 2018]

[10]Shams A. et al. Patient satisfaction and complication rates after delivery of removable partial denture: A 4 year retrospective study. SRM J Res Dent Sci 2015;6:225-9

 http://www.srmjrds.in/article.asp?issn=0976-433X;year=2015;volume=6;issue=4;spage=225;epage=229;aulast=Shams[Accessed 17thDecember 2018]

[11]Khan S.B. et al. Aesthetic clasp design for removable partial dentures: A literature review. SADJ June 2005: 60(5)190-194. https://pdfs.semanticscholar.org/aa77/6a1abf530f5b4db24c43c753e236a094411e.pdf[Accessed 17th December 2018]

[12]Aljabri M.K. et al. Removable partial dentures: patient satisfaction and complaints in Makkah City, KSA. Journal of Taibah University Medical Sciences Dec 2017: 12(6) 561-564. https://www.sciencedirect.com/science/article/pii/S1658361217300495#bib8[Accessed 17thDecember 2018]

[13]Polyzois G. et al. Flexible Removable Partial Denture Prosthesis: A Survey of Dentists’ Attitudes and Knowledge in Greece and Croatia. Acta Stomatol Croat. 2015 Dec; 49(4): 316–324. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945339/[Accessed 17thDecember 2018]

 

 


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