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Dental Implants: Ideal Tooth Replacement
Tischler Dental Woodstock, NY 6793706 Michael Tischler DDS
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Michael Tischler, DDS Board Certified American Board Of Oral Implantology
Diplomate International Congress Of Oral Implantologists
Fellow Misch International Implant Institute
Fellow Academy Of General Dentistry
Associate Fellow American Academy Of Implant Dentistry
Certified /NYS Conscious Sedation
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Patient Education At The Tischler Dental
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Conscious Sedation Relaxation and cooperation while maintaining responsiveness.
Medical history is important
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Reasons for tooth loss
1. Trauma Injury
2. Gum DiseaseLoss of supporting structures of bone
3. Genetic CausesMissing teeth, history of gum disease
4. Severe Decay Allowing decay to progress
5. Failed Root Canal
6. Cracked tooth from biting stress
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Age is directly related to indicators of tooth loss. (Marcus et al)
1965 average life span 65 years old
1990 average life span 78 years old
Population above 50 in 1995 68 million
Population above 50 in 2020 115 million
Average 65 year old in 1995 will live to
81 years old, and this is increasing! Misch C.E Contemporary Implant Dentistry Mosby 2 nd Edition
Statistics of Tooth Loss
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NIH/NIDR Study ( 19881991)
10.5% of US adult population totally edentulous (18 Million People)
17% of US adult population edentulous in one or both arches (30 Million People) Not found to be gender specific.
45 million US adults are missing posterior teeth in one or more quadrants
Statistics of Tooth Loss Cont’d
Misch C.E Contemporary Implant Dentistry Mosby 2 nd Edition
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Tischler Family Dental Center Woodstock, NY 6793706
Consequences of tooth loss 1. Loss of width and height of bone
2. Decrease in facial height, loss of muscles of facial expression and negative facial esthetic skin changes, increased length of upper lip.
3. Lessened chewing ability leading to decreased nutritional uptake
4. Shifting of remaining teeth, negative esthetics and change in bite
5. Higher susceptibility to decay and gum problems in remaining teeth
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Tischler Family Dental Center Woodstock, NY 6793706
Consequences of tooth loss
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Psychological Consequences Of Tooth Loss
Source Misch C.E Contemporary Implant Dentistry Mosby 2 nd Edition
20% of edentulous patients don’t wear both removable prosthesis all the time. (NIH Oral health of US adults national findings Publ No 87 1987) 7% of edentulous patients are not able to wear their dentures at all (NIH)
88% of denture wearers have difficulty with speech (Misch LS Misch CE Denture Satisfaction: a patients perspective, Int J Oral Implant 1991)
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Psychological Consequences Of Tooth Loss Cont’d
Source Misch C.E Contemporary Implant Dentistry Mosby 2 nd Edition
62.5% of mandibular denture wearers had awareness of movement (Misch) 50% of denture wearers avoided certain food (Misch) 17% of denture wearers masticated better without prosthesis (Misch) 16.5% of mandibular denture wearers never wear denture (Misch)
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Misch C.E Contemporary Implant Dentistry Mosby 2 nd Edition
1.Average bite force in first molar area 150250 PSI with electronic strain gauge studies and edentulous person with dentures 50PSI ( Howell, 1948)
2. 32% less masticatory efficiency with natural teeth compared to complete dentures(Rissen et al J Prosth Dent 1978)
Disadvantages Of Removable Dentures
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Misch C.E Contemporary Implant Dentistry Mosby 2 nd Edition
“Compromised dental function may favor systemic changes creating illness and lower life expectancy” (Chen and Lowenstien JADA 1984)
Disadvantages Of Removable Dentures Cont’d
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Misch C.E Contemporary Implant Dentistry Mosby 2 nd Edition
4.Tissue borne dentures yield: Increased bone loss, increased caries on rest teeth, increased mobility of rest teeth, increased bleeding upon probing, greater plaque retention, non compliance of use, speech inhibition, taste inhibition.(Vermeulen A et al:Ten year evaluation of removable partial dentures:survival rates based on retreatment, not wearing and replacement, J Prosthet Dent 1996)
Disadvantages Of Removable Dentures Cont’d
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PROSTHETIC REPLACEMNT ANALOGIES
Hip replacement 80% 10 year survival
Knee 50% need to be replaced in 10 years
Dental Implants 90% success rate over 10 years
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What is a dental implant? “ Titanium structure surgically inserted into the remaining bone to support teeth for function and esthetics”
Dates back thousands of years Chinese, Egyptians, Incas
Titanium Biologically compatible, integrates with bone
Can support a single tooth, multiple teeth, or dentures
Different designs are available through various companies
Surgically placed in bone and bone grows around it
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Options with Dental Implants:Single tooth replacement (continued)
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What is a dental implant?
Mandible found in Honduras from A.D 600 Pieces of shell.
Peabody Museam, Harvard
Ring M Abrams
Modern Dental Implant
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Misch C.E Contemporary Implant Dentistry Mosby 2 nd Edition
Advantages Of Implant Prosthesis
Bone maintenance of height and width
Bite height dimension maintenance
Ideally esthetic tooth positioning
Improved psychological health
Regained biting awareness
Increased stability in chewing
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Misch C.E Contemporary Implant Dentistry Mosby 2 nd Edition
Increased retention
Increased phonetics
Increased Biting force
Increased success rate of prosthesis
Eliminates need to involve adjacent teeth
Advantages Of Implant Prosthesis Cont’d
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Options with Dental Implants:
Single tooth replacement
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Options with Dental Implants:
Implant Supported Bridge
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Options with Dental Implants:
Implant Supported Dentures
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Comparison of Tooth Replacement Options:Dentures
Full dentures Creates further bone loss and will need to be relined
Inhibits speech, and taste ability
Partial dentures Loosen teeth they are attached to as bone is lost
Inhibits speech and taste ability
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Comparison of Tooth Replacement Options :Crowns and Bridges
1.Necessitates removal of healthy
tooth structure
2.Can create need for root canal
3.Can have decay on supporting teeth
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Rational For Single Tooth Implants
Misch C.E, J. Implantology, Vol 2 1999
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Summary:
Rational For Single Tooth Implants Cont’d
Misch C.E, J. Implantology, Vol 2 1999
Success rate 5 yr Success rate 5 yr Prosthesis Prosthesis
97.2% 97.2% Implant Implant
79.3% 79.3% Conventional Conventional Bridge Bridge
64% 64% Resin Bonded Resin Bonded Bridge Bridge
83% 83% Removable Denture Removable Denture
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Benefits Of Dental Implants 1.Prevents further bone loss through stimulation of bone
2. Increases retention and stability of dentures
3. Reduces denture size less palate on full denture
4. Does not compromise adjacent teeth
5.Offers biting awareness
6. Offers improved psychological health
7. Improved esthetics ideal tooth placement
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Benefits Of Dental Implants
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Benefits Of Dental Implants
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Benefits Of Dental Implants Before
After
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Benefits Of Dental Implants Before
After
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Benefits Of Dental Implants
Before
After
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Bone levels for implants There must be sufficient bone to place a dental implant or else bone must be added
Determined by XRays and or CAT Scans
Bone grafts
Sinus augmentation
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Bone levels for implants
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Implant Treatment at The Tischler Family Dental Center
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Platelet Rich Plasma
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Bone levels for implants
Bone can be added through a variety of bone grafting procedures.
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Bone levels for implants Sinus Grafting
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Sequence of treatment
1. Initial Exam XRays, Study Models, Health History, CAT Scans
2. Treatment Planning/Forms
3. Surgical Appointments
4. Restorative Appointments
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Questions?
FAQ's
How long will implants last?
Does it hurt?
How much will it cost?
Does insurance cover implants?
Now your questions: