Submitted by: Bruno Mcarthy

Today, dental problems can be solved with the assistance of dental implants. It is a prosthetic device of alloplastic material inserted into the oral tissues beneath the mucosal or periosteal layers to provide support and retention to a partial or full denture. Basically, dental implant is a screw-in-tooth.

Completely edentulous patients now enjoy the security and function of a fixed restoration in the form of implants. Patients missing posterior teeth can enjoy the benefits of a fixed restoration with dental implant. Trauma victims who are missing teeth and bone can be successfully rehabilitated with fixed restorations. Even patients missing only a single tooth can receive a restoration similar to the missing natural tooth. Similarly, patients with the available bone can receive complete fixed implant rehabilitation.

The implants had their beginnings around the middle of the twentieth century. Early types of dental implants came into common use during the 1960s, because of patient demand. Although until then little or no scientifically sound research has been done to characterize the success rate of implants. In May 1982, a conference was held in Toronto, where a Swedish research team led by Branemark, introduced the world of dentistry to a new concept for implant placement known as Osseo integration. This is the direct attachment of bone to the surface of implant such that the bone cells can be seen on an electron micrograph to be growing on the implant surface. This new concept is based on a traumatic implant placement and delayed implant loading. These factors contribute to a higher success rate of implants than that was previously possible.

In 1988, a national institute of health consensus conference was held in Washington DC. This conference evaluated the long term effectiveness of dental implants and established the indications and contraindications for various types of implants. By using the criteria established by this conference, a success rate of 85 percent at the end of 5 year observation period and 80 percent at the end of the 10 year observation period was seen. It has been proved that if implants survive the first 2 years, there is a 98 percent success rate with dramatic improvement in all functional parameters. However, implants are more successful in the mandible than in the maxilla because of the difference in bone quality of both jaws.

Implants are made of different materials. The usual materials are titanium or hydroxyapatite-coated titanium. Bioceramic and gold are less commonly used. Dental implants have different components such as implants, which is in the form of threaded or non-threaded cylinder, cover screw, healing cap abutment, impression post and prosthesis retaining screw. Although implant can be successfully used for most edentulous patients, it has certain contraindications. For example pregnancy, acute or terminal illness, uncontrolled metabolic disease, lack of operator experience etc.

The surgical procedure for dental implant is highly equipment-dependent and the surgeon needs to be trained in the particular technique used. Joint planning between an oral surgeon and restorative dentist is essential for success. The conventional denture modification should have been tried, a balanced occlusion should be created and a high standard of oral hygiene is mandatory. Sometimes, dental implants fail to function properly because of certain complications such as improper angulation of implant, perforation of maxillary sinus, mandibular fracture, wounding of soft tissues etc. Therefore, appropriate measures should be taken by the oral surgeon to avoid these complications and to increase the success rate of implants, so that more benefits can be taken from this dynamic development of dental science.

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