Dental News - Study: Improved implant surface and hygiene boost restoration success

Dental Tribune USA

Tue. 25 February 2014

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Should a person’s teeth be saved at all costs? During the last decade, the answer has shifted from yes to no in favor of replacing diseased and damaged teeth with implants. But treatment of patients with periodontitis, inflammatory disease of ligaments and bones supporting teeth remains controversial because artificial tooth roots are more likely to fail.

A recent article in the Journal of Oral Implantology looks at long-term treatment for a patient with severe periodontal damage. The authors anticipate that the higher risk of implant failure in this patient will be offset by coating the implants with a rough, oxidized surface called TiUnite and by emphasizing the need for diligent oral hygiene. They also expect that by using overdenture prostheses instead of conventional removable dentures, they will improve stability and function — and thus patient satisfaction.

Overall, increased use of implants has improved eating comfort and resulted in few complications after the surgery. However, pressure on implants is suspected to speed up loss of dense cortical bone in the jaw. Research has shown the TiUnite material stimulates bone growth, leading to faster fusion of implants and surrounding jawbone.

The current article is a case report on a 51-year-old patient who had been in a motorcycle accident and has a history of herpes, hepatitis, insulin-dependent diabetes and persistent recurrent tooth decay. The patient’s remaining teeth were composed of fractured crowns and older failing implants.

The surgeons removed all of his teeth and old implants followed by the immediate insertions of new implants and stabilizing overdentures. Provisional implants were used for support during healing. Five months later, the interim provisional implants and prosthesis were removed and fabrication of a final restorative prosthesis was initiated.

Despite the higher risk of implant failure because of his periodontal disease and diabetes, the patient’s implants have been in place for 12 years with no complications noted at routine checkups and cleanings. The patient has been instructed post surgery in proper use of floss threaders, deep-cleaning brushes and an oral irrigator. His daily efforts to practice good oral hygiene improved his overall dental health. The patient was pleased with the results one week after the provisional implants were placed and was still happy with the surgery 12 years later. Little care and maintenance of the prostheses have been necessary.

The authors concluded that in this case the prostheses have been effective, predictable, and reliable. They contend that such positive results were only possible because the patient changed his at-home oral care preventing plaque buildup and disease.

Note: This article was published in Implant Tribune U.S. Edition, Vol. 9, No. 2, February 2014 issue.

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