History, studies and importance:
- First implant placed in 1965 – Prof Branemark discovered osseointegration and introduced dental implants to the world.
- 1982 – Albrektsson et al published the success criteria for dental implants.
- 3 mm is a key number to remember – El Chaar et al 2011 found that the average amount of buccal bone loss that occurs when taking out anterior teeth in the first 6 months is over 3 mm. This is relevant to us when thinking of placing implants. If a case needs to be assessed for possible implant treatment – try to refer with tooth in position if possible.
- It is your duty of care and legal obligation to offer ALL the treatment options to your patients, which includes implant treatment.
- Quality of life can massively improve with implant dentistry!
Steps for implant assessment:
- For any case follow a set of clear steps: data collection, planning, implementation, monitor results, compliance and audit.
- Data collection – comprehensive and contemporaneous notes are imperative. Discuss the patient concerns and their expectations of treatment in depth. Don’t forget to also include the: medical history, dental history, social history, extra and intra oral findings, differential diagnosis followed by definitive diagnosis, treatment options and treatment plan.
- Special tests for implant assessment cases may include: vitality testing, medical e.g. full blood count, CT with radio-opaque markers, stents, articulated models and diagnostic wax ups.
- Treatment plan should be conducted in phases.
- Start with the end in mind – plan your final aims and objectives of treatment at the start.
- When planning of complex or multi-disciplinary cases, stick to the KISS rule – Keep It Simple Stupid – address the disease, remove hopeless teeth, periodontal control, and assess compliance.
Implant treatment stages & practicalities:
- There are defined stages for implant treatment. These include: surgical planning/stents, implementation, temp planning, diagnostic wax ups, temporary denture/same day prosthesis, healing 4-6 months and thereafter prosthetic protocols.
- Implant dentistry requires an aseptic protocol.
- There are many challenges to implant dentistry including the problem of lack of bone in certain cases. There are also many advanced techniques that can be utilised such as sinus lifting.