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Implants: General Considerations

Dental implants are increasingly becoming the treatment of choice for missing dentition. Their indications include replacement of single teeth, partially edentulous ridges and fully edentulous arches. Implants are only the beginning of tissue engineering, and future research in genomics and proteomics will perhaps offer even greater benefits than titanium cylinders for the replacement of missing teeth.

Rationale and Indications

Dental implants are no longer an esoteric treatment modality limited to a few specialised practices. The last two decades have witnessed a burgeoning demand for dental implants which is now pervading general dental practices. Furthermore, innumerable studies and controlled clinical trials report encouraging mean survival rates of endosseous implants greater than 90% over 10 years, irrespective of the number of teeth replaced or the type of definitive prosthesis. Due to this high level of predicable success, and unlike other dental treatment modalities (both direct and indirect restorations), implant fixtures are potentially placed for a lifetime.

The rationale for implants to replace teeth, compared to tooth-borne fixed or tissue-borne removable prostheses are as follows:

• Maintenance of alveolar bone – bone requires stimulation to maintain its form and density. Tooth extraction leads to rapid absorption of the alveolar ridges, resulting in soft and hard tissue defects. For example, bone loss in the fully edentulous maxilla occurs in a medial and superior direction, while in the mandible the resorption is lateral and inferior. This results in a narrow maxilla, often tending to a class III skeletal relationship;
• Soft tissue support – edentulism also results in reduced support for facial soft tissues, causing premature ageing;
• Improved mastication – the bite force of imp/>
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