Dental Implants or Teeth?

Dental Implants or Teeth?

Patients often ask if dental implants or teeth are better. The simple answer is if the teeth are structurally sound and have a good long-term prognosis, teeth are always better as they are part of your body.

However, there are situations where the teeth are severely broken down or have catastrophic structural or biological issues. The prognoses of these teeth are poor and they require removal.

Implants are the next best thing to teeth. They can restore the function and aesathetics of the missing tooth. However, even though they look like the tooth, it is not the tooth. As with most things, the devil is in the details. The profile is different from natural teeth, which may result in occassional food impaction. Furthermore, the implants do not feel like natural teeth when you bite down - some patients describe a hollow sensation.

The most important fact is that the dental implant is a foreign body that is embedded in the jaw bone. The success rate of implant therapy is very high, but there is always a chance of rejection. The teeth will not be rejected by the body!

If you have to choose between dental implants or teeth, unless the teeth have a catastrophic problem, the choice is always teeth! They are what God or Nature gave you, and are superior in function and aesthetics.

Implant Fracture – Flange Fracture – Case Study

Implant Fracture – Flange Fracture – Case Study

Michael* presented at our clinic complaining that the dental implant crown on the lower right side of his mouth  was rotating. The implant had been placed and restored 4 years previously. Clincial examination revealed the presence of a screw retained crown on #46 that had rotated anti-clockwise, resulting in a gap between #46 and 45. We did not initially suspect an dental implant fracture.

Radiographic examination revealed the presence of a gap between the impant crown and the fixture platform. There was angular bone loss on either side of the implant, but was more pronounced on the mesial aspect of the fixture.

There also appeared to be a delamination of part of the implant below the mesial part of the fixture platform. We had not expected that the rotation of the crown was due to an implant fracture.

The screw-retained implant crown was removed and the fixture platform was exposed. There was complete fracture of about 40% of the lip of the fixture platform flange on the mesial part of the implant.

There was also a partial implant fracture of about 20% on the lingual aspect of the implant fixture. A flap was raised and the fractured portion of the flange was removed and the fixture was smoothened.

The flap was closed with a resorable suture and the screw-retained crown was then reconnected and the occlusion was adjusted to ensure there was no uneven occlusal contacts.

The abutment screw was tightened to the torque prescribed by the manufacturer and the access cavity was filled.

The patient was aware the implant fracture severely afftected the prognosis of the dental implant, and the dental implant would need to be removed if another implant fracture occurred.

*Not his real name.

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