Battling biology
Featured Products Promotional FeaturesPosted by: Dental Design 18th September 2022
Dental implantology is now a booming industry. There are very few contraindications for this treatment in the modern day, due to the impressive advancements made to various materials, techniques and technologies. As a result, patients seeking a solution to full or partial edentulism can have their confidence and comfort permanently restored.
The success of the treatment depends largely upon biology, as a healthy site is vital to ensure long-lasting stability and reduce the potential for infection. However, due to the nature of biological complications, there are issues that are unlikely to be fully eradicated.
Fortunately, dental professionals can equip themselves with the knowledge needed to minimise the risks and manage them should they arise. One way to be prepared is to keep abreast of the current trends and research in the field, as well as investing in products that will help to achieve outstanding outcomes in every case.
Gingival recession
Gingival recession is a biological occurrence that can cause aesthetic concerns, hypersensitivity and could potentially increase the risk of plaque formation and root caries.[i] If a patient desires dental implants, having considerable gingival recession could put the treatment at risk due to a significant loss of support from the gingival tissue. Unfortunately, gingival recession is not only a common side effect of general aging, but it can also be triggered by a poor brushing technique and/or oral hygiene, bruxism and smoking.v As such, it is a common sight in the dental surgery.
Mucogingival surgery can be performed to restore the periodontium to a healthy and functional state. These procedures include connective tissue grafts, which are considered the “gold standard” in mucogingival surgery,[ii] and include a free epithelialised gingival graft, subepithelial connective tissue graft and a coronally advanced flap. Deciding the most appropriate treatment pathway requires a thorough understanding of the aetiology, prognosis and treatment options for the condition, in order to be able to provide the best possible care to patients.
Peri-implantitis
Peri-implant complications are perhaps the most well known biological issues that follow dental implant treatment. It is believed that nearly half of patients with dental implants develop peri-implant mucosistis, with over a fifth of that group eventually developing peri-implantitis.[iii]
It has been noted that non-surgical methods of treating peri-implantitis may lack the required efficacy needed for a successful treatment,[iv] especially in more advanced cases.[v] Surgery is therefore often required. There are several possible approaches, including regenerative surgery, osseous respective surgery and apically repositioned flap surgery.[vi]
The prevalence of peri-implant complications is a big topic of conversation within the profession, as they are generally considered to be the main risk factors for dental implant failure.[vii] Fortunately, dental professions are better equipped now more than ever to catch problems early and potentially save the dental implant.
Atrophic maxilla
Atrophic maxilla is a common biological complication that occurs largely in older populations.[viii] The causes are well documented, and range from periodontal disease, trauma and/or extractions.[ix] Fortunately, surgical techniques have been developed so patients with an atrophic maxilla can still undergo treatment. These surgical procedures include bone grafts, guided bone regeneration and maxillary sinus floor elevation. However, as further surgery is required for these augmentation techniques, some dental professionals may be reluctant to put their patients through further procedures. In recent years, the mechanical properties of certain dental implants have been refined, allowing dental professionals to place implants in atrophic maxilla patients without further surgery. Zygomatic implants are one such development, and have grown in popularity, demonstrating that they are a highly suitable solution for patients with an atrophic maxilla.[x]
Be well equipped
Dental implants have been enhanced over the years to last longer, resist fracture/breakage and deliver more aesthetic outcomes. The issue of biological complications, however, remains a potential threat to not just dental implant treatment, but to all dental procedures. Unfortunately, they are unlikely to ever be prevented entirely. Therefore, dental professionals have had to continuously improve their skillsets and invest in products that help them to overcome these challenges, in order to continue delivering excellent results to their patients.
The NeoArch® Immediate Fixed Full Arch Solution from Neodent®, a Straumann Group brand, has revolutionised dental implantology. This innovative implant system is designed to restore function and aesthetics in a range of patients – including those with severe atrophic maxilla – immediately. The Neodent® NeoArch® meets a variety of clinical needs, such as full-arch rehabilitations requiring anything from 4 to 8 implants, long implants and zygomatic implants.
As dentistry moves steadily into the future, biological complications still remain the bane of the profession. Fortunately, dental professionals can utilise the high-grade solutions available on the market to ensure their patients can enjoy a beautiful and functional dentition for the all the years to come.
For more information on the Neodent® NeoArch® Immediate Fixed Full-Arch Solution, visit https://www.straumann.com/neodent/gb/en/professionals/treatment-concepts/treatment-solutions/neo-arch.html
[i] Pradeep, K., Rajababu, P., Satyanarayana, D. and Sagar, V. (2012). Gingival Recession: Review and Strategies in Treatment of Recession. Case Reports in Dentistry, [online] 2012, pp.1–6. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3467775/ [Accessed 8 Jun. 2022].
[ii] Bueno Rossy, L., Ferrari, R. and Jamil, S. (2015). Treatment of recession and mucogingival defects using connective tissue grafts on teeth and implants. Odontoestomatología, [online] 17(26), pp.35–46. Available at: http://www.scielo.edu.uy/scielo.php?pid=S1688-93392015000200005&script=sci_arttext&tlng=en [Accessed 8 Jun. 2022].
[iii] Investigation: Combating peri-implant disease. (2016). British Dental Journal, [online] 220(2), pp.48–49. Available at: https://www.nature.com/articles/sj.bdj.2016.46 [Accessed 8 Jun. 2022].
[iv] Schwarz, F., Jepsen, S., Obreja, K., Galarraga-Vinueza, M.E. and Ramanauskaite, A. (2022). Surgical therapy of peri-implantitis. Periodontology 2000, [online] 88(1), pp.145–181. Available at: https://pubmed.ncbi.nlm.nih.gov/35103328/ [Accessed 8 Jun. 2022].
[v] Renvert, S., Hirooka, H., Polyzois, I., Kelekis‐Cholakis, A. and Wang, H. (2019). Diagnosis and non‐surgical treatment of peri‐implant diseases and maintenance care of patients with dental implants – Consensus report of working group 3. International Dental Journal, [online] 69(S2), pp.12–17. Available at: https://pubmed.ncbi.nlm.nih.gov/31478575/#:~:text=Non%2Dsurgical%20mechanical%20therapy%20and,used%20to%20treat%20peri%2Dimplantitis. [Accessed 9 Jun. 2022].
[vi] Sarmiento, H.L., Norton, M., Korostoff, J., Ko, K.I. and Fiorellini, J.P. (2018). Surgical Alternatives for Treating Peri-implantitis. The International Journal of Periodontics & Restorative Dentistry, [online] 38(5), pp.665–671. Available at: https://pubmed.ncbi.nlm.nih.gov/30113606/ [Accessed 8 Jun. 2022].
[vii] Do, T.A., Le, H.S., Shen, Y.-W., Huang, H.-L. and Fuh, L.-J. (2020). Risk Factors related to Late Failure of Dental Implant—A Systematic Review of Recent Studies. International Journal of Environmental Research and Public Health, [online] 17(11), p.3931. Available at: https://www.mdpi.com/1660-4601/17/11/3931/htm [Accessed 10 Jan. 2021].
[viii] Rodríguez-Chessa, J.G., Olate, S., Netto, H.D., Shibli, J., de Moraes, M. and Mazzonetto, R. (2014). Treatment of atrophic maxilla with zygomatic implants in 29 consecutives patients. International journal of clinical and experimental medicine, [online] 7(2), pp.426–30. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931599/ [Accessed 8 Jun. 2022].
[ix] Baj, A., Trapella, G., Lauritano, D., Candotto, V., Mancini, G.E. and Giannì, A.B. (2016). An overview on bone reconstruction of atrophic maxilla: success parameters and critical issues. Journal of Biological Regulators and Homeostatic Agents, [online] 30(2 Suppl 1), pp.209–215. Available at: https://pubmed.ncbi.nlm.nih.gov/27469570/ [Accessed 8 Jun. 2022].
[x] Balan, I. (2017). TREATMENT OF SEVERE ATROPHIC MAXILLA WITH ZYGOMATIC IMPLANTS: A CASE SERIES. Oral & Implantology, [online] 10(3), p.317. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735395/ [Accessed 8 Jun. 2022].
