The Possible Effects of Splinting Natural Teeth to Dental Implant Restorations - Literature review Example

The possible effects of splinting natural teeth to dental implant restorations A person who has just lost a tooth or two are not aware that they have lost not only a part of their bodies but also one of their personal aspects: their smiles. Many people become so conscious about this matter that they lose much of their poise and also follows some pretty embarrassing situations. Aside form this, muscle pains, speech impairment, headaches and other nuisances can be experienced during certain activities such as eating, smiling, talking with other people and just about anytime that we need to use our dental features ("Dental Implants, 2005). Modern dental implants help these dentally challenged people who have lost their teeth in some unfortunate way. Dental implants are so realistic that they are virtually identical to real teeth in form, sense and purpose. Dental implants allow these persons to eat normally again and are rest assured that their facial structures are back in line. The implants are actually miniature titanium posts, planted in the gaps where a tooth or a set of teeth should be. Once these are in place, these posts act as anchors and as tooth root replacements. The jawbone then bonds with the titanium, providing a base for the new tooth ("What are Dental Implants"). According to surveys, there are a lot of Americans suffering from oral deficiencies (Meskin & Brown; Harvey & Kelly). Implants are seen as appropriate alternatives to other oral correction aids, with about 300,000 to 428,000 implants performed each year (Seckinger et al). Osseo integration (Branemark) or functional ankylosis (Schroeder et al) are the formal terms for bone anchorage attributing to the sound success of dental implants. Osseointegration works at the microscopic level and it involves the bond between the bone and implant (Branemark). There are no unstable soft tissue connection between the bone and implant, and this implant bonds at an amazing level of efficiency. Electron microscope photographs show that the bone and implant are only about 20 nanometres apart (Listgarten et al). On metal implant surfaces, the oxidation reaction between titanium forms an oxide layer (3 to 5A) on the surface of the implant (Albrektsson). This oxide layer is highly desirable as it has a ceramic -like feel to it and is resistant to water and most forms of corrosion and is entirely organically attuned (Hansson et al; "Dental Implants in Periodontal Therapy"). History shows that implants were performed ever since people learned how to replace teeth in some way. The ancient Mayans have performed dental implants as evidenced in their obsidian carvings. In the recent eras, gold and other precious metals , ceramics , rubber, stainless steel were used at some point and has proved to be effective ("Implant history"). In 1952, Per-Ing-var Branemark, based in Sweden made a breakthrough discovery resulting in dental implants using various techniques and tools in dental technology. It turns that the metal titanium can bond with organic material well and when placed surgically in a jawbone, it facilitates anchorage and also the full recovery of gums. Thus the term "Osseo integration" was born ("Implant history"). Osseo integration was actually discovered accidentally by Dr. Brnemark. Dr. Brnemark observed that titanium can combine with bone tissue, a fact that is in contrast with modern scientific facts. He showed that under certain conditions, titanium can be incorporated into living tissue with much success and with out the hassles of tissue swelling or tissue rejection Dr. Brnemark as the discoverer of this occurrence' was also the one who first coined the term "Osseo integration" ("History of dental implants"). 1965 saw the birth of the new screw-shaped implants, but these types of implants wer subsequently improved until 1985. after this time that dentists were confident of this process and it has been used ever since. Throughout those 20 years, there has been many types of dental implants but none has ever equaled the sensation of the Brnemark system. ("Implant history"). Thus, the Brnemark system was the landmark into which other dental implant systems are measured it is through Professor Brnemark's breakthrough that most of our dentally impaired fellows a second lease in having full-function dentals ("Dental implant", 2006). Subperiosteal, transosteal, and endosseous implants are among the many types of implants available today and they are classified according to shape and bone housing compatibility. The most common are endosseus implants which come in a variety of sizes, shapes, coatings, and prosthetic mechanisms. The length and width of these implants can be adjusted to the person's personal measurements such as tooth angles, tooth size and more ("Dental Implants in Periodontal Therapy). Normally an implant consists of a titanium screw with a rather jagged surface done by plasma spraying, engraving or sandblasting to add to the incorporation factor of the implant. A so-called "pilot hole" is dug in beneficiary bone, the place where the missing tooth should be. Care must be taken not to disturb the delicate structures particularly the inferior alveolar nerve within the mandible. Drilling and widening of the pilot hole is done wide increasingly wide dental drills. Also the bone tissue or osteoblasts are taken in consideration as they are easily destroyed by heat. The cooling process is done by spraying saline solution spray which keeps the bone temperature to a constant -47 degrees Celsius. The implant screw is then positioned and screwed into place at a specific torque level so that the surrounding bone wil;l not be disturbed. Then a cover screw is placed and the whole jaw is left to heal for a few months so that Osseo integration can take place. The implant is then exposed and some healing preparations are applied with a transitory crown placed on the tooth. This stimulates gum growth rembling normal gums. After this the overall form of the tooth is finalized and a permanent crown is placed on top of the implant ("Dental implant", 2006). Journals on dental procedures show that dental professionals are separated into different school of thoughts in the performance of dental implants. Teeth are sensitive, and implants must take on the role of real teeth after the procedure. Some problems rise from the deep immersion of real teeth, making a space between he fixed partial denture crown margin and the prepared tooth. Some schools of thoughts suggests that the placements of dental implants and real teeth should never be associated while some suggests and insists that that dental implants and real teeth can be joined with attachments made of unbending materials but not with attachments that non-bendable also known as precision attachments ("Dental Implants: Connecting Natural Teeth"). There is limited data today about the possible results of tooth splinting from dental implants ("Dental Implants in Periodontal Therapy). Findings form various dental cases indicate that splinted teeth from the loss of teeth material around the abutments are potentially dangerous, but findings also show that 8 out of 10 patients with this case experience no negative effects on their dental features (Ericson et al). Good indications from combining implants to real teeth in a fixed prosthesis were also reported (Astrand et al; Gunne et al; Kay). For example, a 5 year progressive research has shown that in the assessment and comparison of dental bridges sustained exclusively by implants with bridges sustained by both implants and natural teeth from the same patient showed no threats or risks of dental failure for tooth exclusive fixed bridges in contrast with bridges supported by implants (Olsson et al; "Dental Implants in Periodontal Therapy"). No negative effects has been reported form the attachment of keratinized tissues to an abutment or machine exterior implants (Wennstrom; Mericske-Stern et al). Now about the apposition of surrounding soft tissue, there are no proofs that there are Sharpey fibers involved between implants and jawbone but a certain breadth of periimplant mucosa is compulsory to permit epithelial-connective tissue formation. Such breadth is synonymous to the natural breadth of real teeth. Also the placement of the microscopic space between the abutment and the corona of the implant will also dictate the height of the corona of the bone (Hennann; "Dental Implants in Periodontal Therapy"). In a 10 year research titled: "The Harmony of ITI Implants and Natural Teeth", Dr. Takayuki Takeda showed many significant findings of his own. He observed that the connection distance has an impact to the teeth. He also found out that if the connection distance was 6.3+-3.2mm for case with a change in teeth while a connection distance of 3.8=-4mm was noted for patients who had no change. These findings indicate that in order to connect two implants, the two must have at least a distance of 10mm or so ("Dental Implants: Connecting Natural Teeth). There should be considerations in the rehabilitation of partial endutulism with implant and tooth-supported dental aids and in whether both implants and real teeth are to be splinted using what method. Analysis of factors especially stress that there are high stress areas present near and around the implant's "neck". A number of shock absorbers and redistributors that lessen the stress concentrations around the implant neck. The implant neck is important because this is the site of bone restoration. Analysis has shown that these forms of "stress absorbers" are effective only when their resistance is of the same strength as that of the peridontal alignment. (Gross). According to statistics there are no adverse effects from splinting that can come from the combination of dental implant and tooth restoration. Unfortunately these findings were made predominantly on short term information sources and as of current note, are still questionable. Tooth root interference poses very risky and dangerous situations especially in non-rigid connections (Gross). A newly installed tooth-supported denture restoration would last good in the first five years of service with a projected success rate of 95%. But as time passes by this figure drops from 85% to 68% after the fifteenth year of service (Lindquist; Valderhaug; Walton). Now according to the combined study of Creugers and Scurria of 7 and 8 other studies, denture restorations like these indicate a 74% and 69% success rate after 15 years (Creugers et al; Scurria et al; Johnson). As Goodrace have compiled data from the studies of Creugers and Scurria and some more studies, the main causes of fixed prostheses failure was 33% due to caries, 26% due to neglect of restoration, 26% for periodontal loss, and 4% from abutment failure. This same study also indicated the increased failure was also due to teeth splinting, longer edentulous spans, cantilevered pontics, endodontically treated teeth, and fixed partial dentures in both the front and back teeth (Goodacre; Johnson). For the last 10 years, another breakthrough in dental science, specifically in the field of implants and peridontics are endosseous dental implants, which also changed the way teeth are supported. There has been great concern about the affectivity and predictable factors regarding this type of implant. In the treatment of endutulism, one of the most possible option is the is this kind of implant, and it has been a permanent fixture in most dental procedures. There also other dental procedures today, all of them have their pros and cons. This only shows that no implant system is utterly flawless. Studies about edentulous sites with inadequate bone for dental implants, splinting of implants to real teeth, long-term effects of microbial and occlusal stresses, the prevention and treatment of implant infection and disease, effects of implants on alveolar ridge maintenance, and routine maintenance protocols are needed to be executed to heighten our level of knowledge of these procedures. As of now only a few of these topics are undergoing actual research. (Tolman; Lorenzoni et al; Ten Bruggenkate & van den Bergh; "Dental Implants in Periodontal Therapy"). The mouth and other dental parts are most important not just because we use them for eating and speaking but also for aesthetic purposes such as smiling. The real importance behind dental implants is in the restoration and repair of our dental features. However, little is still known about whether these procedures can affect tooth splinting and each other procedure. Dangerous risks have been detected in these procedures, so a little knowledge on how we can make these safer is truly important. With this in mind, even though dental implants and other dental procedures are effective in repairing and restoring our dental capacities it is not without flaws. If these risks and flaws are not fixed then there might be a chance that dental implantation might be abandoned altogether. Lucky for us, research is on the way to continually improve our knowledge of these procedures, ensuring us of safe dental care in the future. Bibliography Albrektsson T. Bone tissue response. In: Brnemark PI, Zarb G, Albrektsson T. eds. Tissue Integrated Prostheses: Osseointegration in Clinical Dentistry. Chicago:Quintessence; 1985;129-143. strand P, Borg K, Gunne J, Olsson M. Combination of natural teeth and osseointegrated implants as bridge abutments: a 2-year longitudinal study. Int J Oral Maxillofac Implants 1991;6:305-312. Binon PP. Implants and components: Entering the new millennium. Int J Oral Maxillofac Implants 2000;15:76-94. Brnemark PI. Introduction to osseointegration. In:Brnemark PI, Zarb G, Albrektsson T, eds. Tissue Integrated Prostheses: Osseointegration in Clinical Dentistry. Chicago: Quintessence; 1995;11-76. Creugers NHJ, Kayser AF, van't Hof MA, A meta-analysis of durability data on conventional fixed bridges. Community Dent Oral Epidemiol 22:448-452, 1994. "Dental Implants." 2005. Floss.com Inc. 25 March, 2006 "Dental Implant" 15 February 2006. Wikipedia. 25 Marc h, 2006 "Dental Implants: Connecting Natural Teeth" 2005. OsseoNews Blog. 25 March, 2006 "Dental Implants in Periodontal Therapy". Position Paper. J Periodontol2000; 71:1934-1942. Ericsson I, Lekholm U, Brnemark P-I, Lindhe J,Glantz PO, Nyman S. A clinical evaluation of fixed-bridge restorations supported by the combination ofteeth and osseointegrated titanium implants. J Clin Periodontol 1986;13:307-312. Goodacre CJ, Lecture, Odontic Seminar, USC Continuing Education, San Diego. Gross M, Laufer. LinksSplinting osseointegrated implants and natural teeth in rehabilitation of partially edentulous patients. Part I: laboratory and clinical studies. J Oral Rehabil. 1997 Nov;24(11):863-70. Gunne J, strand P, Ahln K, Borg K, Olsson M.Implants in partially edentulous patients. A longitu dinal study of bridges supported by both implants and natural teeth. Clin Oral Implants Res 1992;3:49-56. Hansson H-A, Albrektsson T, Brnemark PI. Structural aspects of the interface between tissue and titanium implants. J Prosthet Dent 1983;50:108-11 Harvey C, Kelly JE. Decayed, missing and filled teeth among persons 1-74 years, United States. Vital and health statistics. National Center for Health Statistics.US Department of Health and Human Services 1981; Pub No 81-1673, series 11, No 223. Hermann JS, Cochran DL, Nummikoski PV, Buser D. Crestal bone changes around titanium implants. A radiographic evaluation of unloaded nonsubmerged and submerged implants in the canine mandible. J Periodontol 1997;68:1117-1130. "History of Dental Implants." 2005. Prosthodontics Intermedica. 25 March, 2006 "Implant history." West End Private Dental Practice. 25 March, 2006 Read More