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Dental Implants

Prof. Dr. B. Srinivasan

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Replacement of teeth require the fitting of artificial set of removable partial or complete dentures or crowns and bridges. Attempts have been made sucessfully by using dental implants as root analogues for tooth replacement. These anchored root implants in the jaw bone provide a stable foundation on which replacement of teeth are firmly attached. Before illustrating the various techniques, it is necessary to analyse the indications for placing dental implants.

Predicament of edentulousness:

The first phase of edentulousness is a natural phenomenon in the new born. If this persists beyond 9 months ofage, the patents of the child become anxious seek dental opinion. Similarly, between the ages of 7 and 12, deciduous dentition is replaced by permenant dentition. If the second phase of edentulousness (partial) extends beyond 13 years of age, Orthodontist has an important role to restore the dentition. Due to various reasons,if the natural dentition is lost, the dental surgeon has to provide the dental prosthesis. In spite of satisfactory maintanance, loss of teeth occurs sooner or later. This is considered as an “aging process”. With the increase of life expectancy from 45 to 70 years of age, the need for dental prosthesis also increases. Irrespective of chronological age, aging is viewed in different forms. Some view it as a biological process, while others look at it as a pathological process. While aging represents the passage of time, physiologically, it is considered as a progressive loss of functional capabilities. Therefore, preservation of natural dentition is considered as one of the effective methods of slowing down the aging process in terms of the orofacial region. That is why, in the event of losing natural dentition, the dental profession has been in search of a satisfactory method of reconstructing the dentofacial region. It is in this direction, Dental implants are considered as one of the viable alternatnive treatment options of managing edentulousness.

Dental implants – How?

Unfortunately, most of the conventional prosthetic options remain unpredictable. Absence of any reliable “prediction tests” for the maladaptation of the prosthesis associated with increased longivity of life have made the management of edentulous aging patients very challenging. To avoid insecure feeling, patients prefer fixed bridges even though, grinding of the natural teeth is necessary.

In the past two decades, there has been a revolution in atleast one aspect of dental practice: namely – development of a relaible implant system to provide anchorage to the prosthesis. The main aim is to provide long term stability abd high level of acceptance by the patient. Formerly, the dental surgeon attempted to simulate the tooth attachment by providing a soft tissue interface, very similar to periodontal ligament. During 1970’s, Branemark and Schroeder demonstrated that osseointegration is essential for the long term success of the implant. Prerequisites for achieving the osseointegration are as follows:

  1. Implant material must be biocompatible.
  2. Establishing the primary stability of the implant.
  3. Atraumatic surgical procedure.
  4. Optimal loading of the implants.
  5. Life long maintanance of the peri-implant tissues.

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