On Thursday 19th April, the MUDRSoc held the third event in its Dental Fundamentals series. This lecture was given to us by Dr Neil Patel, Specialist in Oral Surgery. Dental implants are becoming a more refined technology, as well as an increasingly used technique for treating patients with various needs.
Dr Patel began his talk by listing the three things that are needed for good implants: careful treatment planning, meticulous surgery and precise prosthetics. After a quick refresher of implant terminology, he talked through the stages of implantation including osseointegration (factors affecting bone and implant type).
Implants have many uses, including replacing missing teeth and restoring aesthetics, function and occlusal stability. While the advantages are plentiful, cost can be an issue and success criteria is high but differences between patients can affect this majorly.
In terms of patient selection, a more detailed examination is needed, which includes skeletal patterns and facial profiles. Treatment planning includes photographs, study casts, wax-ups, imaging and planning, and – most importantly – gaining written consent. Dr Patel then demonstrated how to alter dentate trays to take implant impressions for the crown to be inserted into the arch. The complications are, of course, many including surgical errors and prosthetics issues. However, if all of the above goes well, the implant must then be maintained correctly. Patient self-care includes brushing teeth and daily flossing around the implant while the dentist’s responsibilities include 6 months to one year recalls with radiographs annually.
The most common pathosis associated with implants is peri-implantitis, which is progressive loss of crestal bone around an implant. Dr Patel explained that this is a poorly understood condition and is hard to detect due to it being asymptomatic in early stages. This can be treated by debridement, antibiotics or, unfortunately, implant removal.
Thank you again to Dr Neil Patel for taking time out of his busy day to talk to us!
Selected slides can be found below: