Kate Scheer looks at ways to improve your results.
Continued advances in dentistry mean that patients can now enjoy the benefits of cutting-edge restorations such as dental implants. These restorative solutions have advanced to such an extent that many of the latest implant systems provide exceptional function and aesthetics comparable to a natural tooth. With an impressive survival rate of 94.6 per cent or more after a 20-year follow-up, it’s no wonder that dental implants are a popular alternative to traditional restorations. Of course, as with any other dental surgical procedure, there are some key factors to consider to ensure the success of implant treatment.
Patient health
The overall health of any patient seeking dental implants should be thoroughly assessed prior to treatment, taking into account behavioural habits (such as smoking), systemic conditions, the use of medications, and the health of the patient’s periodontium. Heavy smoking habits, systemic diseases such as diabetes and their associated medications, and a presence or history of untreated periodontitis are all factors that can influence the outcome of implant treatment.
Therefore, it is important that any existing diseases are brought under control so as to maximise the chances of success. Smoking cessation may also be advisable, but this should be part of discussions with the patient about their ongoing role in the treatment process. Patients must understand and appreciate their responsibilities in maintaining their dental implant through effective oral hygiene to ensure an enhanced result, free from complications such as peri-implantitis.
Bone quantity and quality
Another key factor that can impact the long-term survival and success of an implant is the condition of the bone in which it is placed. As such, comprehensive patient examinations should be carried out to confirm that there is sufficient bone quality and quantity to support implant placement. This involves taking 2D and 3D radiographic images to evaluate the width, height and shape of the jawbone, as well as to determine how closely different structures – including teeth, nerves and sinuses – lie to the area of proposed implant placement.
Some patients with inadequate bone may require complex bone grafting procedures but be aware that this could necessitate further surgical interventions, thereby extending the overall duration of treatment. Zygomatic dental implants offer suitable patients an alternative to bone grafts, as they do not require as many surgical procedures or as long a recovery time. Moreover, zygomatic implants are well suited to immediate loading protocols, enabling clinicians to provide patient with near-instant function and aesthetics once placed.
Choice of implant
It makes sense that the dental implant selected can also influence the outcome of treatment. With so many solutions currently available on the market and numerous manufacturers claiming that their product is superior, it can be difficult to decide which implant system to invest in. Ideally, however, clinicians should choose one that is backed by evidence-based studies and a proven track record of success.
As with any other dental product, you pay for the quality you receive, so if the price of an implant seems too good to be true, it is vital to carry out your research before making any investment. Assess the type of materials the implant manufacturer uses and the various implant widths and length available, as these characteristics have been shown to influence implant predictability and success. It can also be worthwhile seeking out colleagues and peers for their advice and recommendations.
Skill of clinician
The success of implant treatment is also partially contingent on the surgical and restorative skills of the treating clinician. Dental implantology is viewed as part of general dental practice in the UK. However, according to Training Standards in Implant Dentistry, published by the Faculty of General Dental Practice (UK) and supported by the General Dental Council, “dentists placing implants must be competent in carrying out these procedures”. Moreover, clinicians “must have undertaken suitable postgraduate training which has included mentored clinical implant placement and/or restoration”.
It is important for implant dentists to understand their limitations, work within their professional remit and refer where appropriate. By taking advantage of reliable technology that can facilitate and support the dental implant workflow, clinicians can further ensure the success of treatment. For example, the W&H Implantmed surgical unit – combined with the W&H Osstell ISQ module or the Osstell Beacon – is specifically designed for use in dental implantology. It is compatible with an extensive range of surgical handpieces, including the new SZ-75. This is optimised to enable the safe placement and restoration of zygomatic dental implants.
Dental implant treatment undoubtedly provides one of the most predictable and effective methods of replacing teeth that have been damaged or lost. If implants are placed and restored correctly, and looked after to a high standard, they have the potential to last far longer than other restorative solutions. As such, understanding the various factors that can contribute to the long-term success of implant therapy is vital to ensure the ideal result is achieved.
References available on request.