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| Teeth in a Day |
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Dental implants have already been in use for over 30 years, but the
technology continues to evolve apace.
10 – 30 years ago the standard protocol was to place the implants and wait six months before loading them with the “final” teeth as it takes some months for the bone to grow on to the surface of the implants; we call this “biological integration”. It has now become quite common practice to load implants with temporary restorations on the day that the implants have been placed, or soon after.
The ability to load an implant so soon depends very much upon the degree of fixation of the implant in the bone. Obviously a long implant inserted into hard bone will be better anchored and more capable of withstanding biting forces early on than a short implant inserted into soft bone.
If a poorly anchored implant is loaded early, before the biological integration of the fixture, the implant may fail. However if a well-anchored implant is loaded immediately the outcome will usually be very similar to that of a patient who has waited for six months. This sort of treatment is particularly useful for patients missing all the teeth in one jaw. The accompanying Images illustrate the example of one patient who had implants placed one morning, and received a long term provisional implant bridge 3 hours later, in the early afternoon of the same day; and another patient, who had a failing crowned tooth removed and immediately replaced with an implant provisional tooth half an hour later.
Scientific documentation has shown that implants that have survived the first three months in the mouth are most unlikely to give problems later on, i.e. if there is going to be a problem with an implant, it is very likely to be early on in treatment. For this reason we prefer to wait a few weeks or months before making the transition from temporary crown and bridgework to definitive restoration when loading
an implant immediately.
The fact is that although in carefully selected situations early implant loading is a great way to treat our patients, there is always a small decrease in the predictability of treatment, and this needs to be considered and offset against the benefits of being able to immediately function on fixed teeth, and perhaps avoiding having to wear a removable denture or live with a “gap”.
Apart from the slightly reduced predictability, the main drawback to this type of treatment is the increased cost, which is a function of the need to rapidly produce a long-term temporary restoration in the laboratory.
Our practice has been heavily involved with this kind of ground-breaking treatment for many years. In the year 2000, we received Millennium Product status for devising and patenting a drill unit incorporating proprietary technology, which allowed the implant surgeon to assess the potential for an implant to be immediately loaded. The “Osseocare” drill unit was represented at the Millennium Dome. |
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