Originally Published in:
PDA Explorer No. 33 Vol. 11 May-AUgust 2010 Page 7
To say that Dental Implants is becoming a fast trend in the world of Dentistry is really an understatement. The Science of replacing not just the coronal portion of a tooth has long been the thrust of every human being in the history of mankind. In fact, being the second oldest discipline in dentistry, second only to surgery-extraction, which dates back to the time of the ancient Chinese, man has continually searched for a replacement of his or her teeth. The discovery of titanium as a viable material with excellent biocompatibility to human tissue has certainly led to a series of studies and researches that brought about a revolution to know more about dental implants.
Today, we have now established a lot of surgical and prosthodontic protocols that has standardized the way we manipulate dental implants and maximized its use on our patients. Long term studies and observations have already been proven and have been generally accepted already. The numerous books on Dental Implants, Guided Bone Regeneration, Bone Grafts, Journals and the development of machines such as the Dental CT Scans is a testimony on how far we have already gone.
The idea that only those who practice surgery can place implants is also slowly diminishing. It is for a fact that all General Practitioners should have a good grasp on what this not so new discovery is and how it can both benefit the patients and dentists as well. Simply put, it should already be a part of the STANDARD OF CARE in all Dental Office. In fact, it should already be a part of Dental Curriculum in Dental Colleges. It would be very sad to know that a General Practitioner would miss out on an information that is simply sweeping the world even as this article is written. Each day, a new technology emerges that is why it is important to understand at least the concept of Dental Implants.
Much of the researches today stems from the idea of reducing the time of osseointegration. Normally a patient has to wait for at least 3-4 months on a lower arch and 6-7 months before loading the implants. Much so for those that has undergone grafting procedures especially if the graft is not autogenous in nature. Researchers have dwelt on reducing the inconvenience on the part of the patient and the clinician by targeting either to improve the surface of the implant or developing new techniques for faster bone and soft tissue healing. As far as tissue healing is concern, the PRP or Protein Rich Plasma system would seem to be the most promising of them all. It is in fact already used not just in Dental Medicine but also in other Medical fields as well, like Dermatology, Plastic Surgery and Sports Medicine similar to what Tiger Woods has for his left knee and achilles.
The next generation of this treatment procedure actually sounds more promising. PRF or Platelet Rich Fibrin Glue is fast becoming a viable product as a Graft Membrane. The whole concept is actually simple to understand, the more natural the source of the graft and the membrane, you get better healing adhesion, soft tissue healing with less inflammation, and lesser pain and discomfort on the part of the patient. What seems to be the downside from this would be the financial aspect of the treatment which would definitely increase the responsibility on the patient. But with proper patient education, the whole concept could be understood and hence accepted by the patient.
Another potential study which unfortunately is only in its preliminary part is to develop a synthetic graft material that also has excellent biocompatibility next to an autogenous bone graft. This would hopefully minimize tissue morbidity on the donor area and give more time to the clinician. The best benefit for the patient of course is the decreased cost of the materials and procedure involved.
Surgical Implant Placement has also evolved with the use of dental CT Scans. The ability to process and manipulate data from a Dental CT Scan through a workstation has helped clinicians dramatically in locating the perfect spot for implants. Avoiding anatomical landmarks such as the Inferior Alveolar Nerve for the Mandible and the Maxillary Sinus for the upper posterior teeth before rely on the use of Panoramic, Periapical and other type of radiographic diagnostic tools. Today, the use of three-dimensional imaging systems and a radiographic stent has helped clinicians configure the implant in both length and diameter for a specific place in the jaw.
The use of piezotome or piezo surgery in implant dentistry particularly in harvesting bone grafts and and during sinus lifting procedure has also helped ease the clinician’s surgical approach. Preserving the soft tissue while cutting through bone has helped a lot in lessening the morbidity of both the donor and recipient site of the graft.
Implant Dentistry has certainly evolved throughout the years. This giant leap caused by many researches and findings have contributed to the advancement of this discipline in Dental Medicine.