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Dental implants in the 21st century.

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The year 2014 marked the passing of one of the pioneers in dental implant research and development when Dr. Per-Ingvar Branemark died on December 20 in his hometown of Gothenburg, Sweden. Dr. Branemark was a medical researcher in the 1950s studying the anatomy of blood flow when he attached an optical device housed within a machined titanium framework to the bone tissue of rabbits. When it came time to remove the device from the specimen, he found that the bone and the titanium had become inseparably fused.

In a subsequent study of microcirculation, approximately 20 students who volunteered to have titanium instruments inserted into their arms for several months showed no signs of rejecting the titanium-enclosed optics. At that point Dr. Branemark changed the direction of his work to investigate the body's ability to tolerate titanium. He coined the term osseointegration to describe the rigid fixation of the metal within the bone.

In 1965, Dr. Branemark treated a patient with a deformed jaw by fitting four cylindrical titanium implants, which remained solidly fixed within the bone until the patient's death in 2006. The implants permitted the use of various oral prostheses, which provided the patient normal function, speech and appearance for more than 40 years.

Recent Developments in Dental Implants

Building upon the fundamentals established by Dr. Branemark and his colleagues, various implant manufacturers collaborating with clinical dentists across the globe have developed implant solutions for nearly every conceivable instance of missing teeth, making it one of the fastest-growing cosmetic dental procedures in the country. Currently, the success rate for implants is 97 percent over 10 years, according to Carl E. Misch's Contemporary Dental Implants, 3rd edition, published in 2007. In recent years computer-aided design and manufacture (CAD/CAM) technologies have greatly increased the predictability of the implants and the prosthetic components attached to them.

Single-Tooth Implants. Single teeth can be replaced using a solo osseointegrated implant, which can be thought of as the replacement root of the tooth. Depending upon the quality of the bone into which the implant is inserted there is a variable time span for osseointegration to occur, and attaching the prosthetic tooth to the implant usually is delayed until osseointegration can be confirmed. In some cases patients with dense bone might be able to get the attachment immediately, while patients with less dense bone may require several weeks for permanent fixation of the titanium cylinder, during which time the patient uses a provisional replacement for the missing tooth. Periodontists have developed sophisticated techniques to ensure that the prosthetic tooth looks as much like a natural tooth as possible.

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Implant-Supported Bridges. Patients who are missing multiple teeth can receive implant-supported bridges that might take the place of removable partial dentures, which most patients find less-than-ideal. Missing teeth are replaced with permanent fixed prosthetic teeth that feel and function more like natural teeth instead of a removable prostheses. This level of care provides much greater quality of life for the patient.

Implant-Supported Dentures. Patients who have no teeth at all traditionally have had to make do with removable complete dentures, which lack stability and can be uncomfortable. By adding implants to the treatment, these removable dentures can be snapped firmly into place, or even permanently attached with multiple implants. Patients can clean the dentures on their own, and they look and feel just like natural teeth and gums.

Implants for External Facial Structure. Osseointegrated dental implants are also used to rehabilitate patients whose external facial structures, such as noses, cheek bones or ears, are missing due to birth defects or disfiguring surgery or trauma. Planning the selection and placement of the actual implants is very precise and predictable using sophisticated radiological techniques such as computer aided tomography scans (CAT scans) and cone beam computed tomography (CBCT). Combining these technologies with CAD/CAM, the surgical implant steps and all of the restorative components including the prosthetic tooth or teeth can be preplanned, designed and fabricated for a predictable and beautiful final result.

The Future of Implant Technology

Use of computer planning, design and manufacture will continue to improve outcomes for implant prostheses. Continued research and development of the design, surgical techniques and restorative options will ensure a solid future for improving patients' quality of life.

By: Douglas Ashman, DDS
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Title Annotation:Featured STORIES
Comment:Dental implants in the 21st century.(Featured STORIES)
Author:Ashman, Douglas
Publication:Utah Business
Date:Oct 1, 2015
Words:715
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