Dental implants are becoming increasingly popular, as more people begin to learn about this treatment option. However, most will be unsure as to the exact benefits it could provide and may have very little knowledge about dental implants. If your clinic provides dental implant treatments, you already know that patients expect the very best esthetic results from this procedure, especially given the cost compared to other options. Careful management of these expectations is important, and every patient must be properly evaluated for their suitability.
A successful implant treatment involves many skills. A close collaboration with your dental lab, for example, is essential for ensuring all prostheses are properly designed for excellent esthetics and to ensure occlusal function is restored. It is vital that you carry out a thorough assessment of the patient’s oral and medical health when deciding if they are suitable for implant treatment. Any existing problems, including carious lesions and periodontitis must be treated prior to implant placement, otherwise the risk of implant failure is high. It’s also important to assess why the patient lost teeth and determine how any dental conditions or concerns with oral hygiene will be managed in the future.
Many clinicians now prefer for their patient to have a CT scan prior to treatment because of the detailed information, which is crucial for proper treatment planning. Digitally planning your implant treatment may also make it easier to gain patient acceptance of any plan. A CT scan is a particularly vital tool for assessing the edentulous ridge. While the ridge can be visually assessed and palpitated, this technique is open to error. A CT scan will determine if bone augmentation is required to optimally place the dental implants. Technically examining the ridge allows you to closely assess the soft tissue thickness, which is also important for esthetics.
Often people will have originally lost teeth due to poor oral care and may be unaware of the need for excellent oral hygiene to maintain healthy implants. Where this is the case, patients will need proper education in looking after their implants and avoiding implant failure or complications. They must realize there is a small chance of implant failure, no matter the precautions taken.
If the patient smokes or has advanced periodontitis, they may not be an ideal candidate for implant surgery. If they decide to go ahead with the procedure, they must be aware of the risks. Bruxism is another risk factor that may mean treatment is unsuitable. Sometimes there may be several different options for implant treatment, but you will almost certainly have one preferred choice. Take the time to explain why you feel this is the best option and the advantages it provides over other choices. Also, encourage and answer any questions. Improving the patient’s understanding of treatment will help encourage realistic expectations.
It’s likely that esthetics will be most important to the patient when replacing anterior teeth, but sometimes implant treatment will not provide the best outcome. It’s important to consider the coverage of anterior teeth during normal function and smiling, and if necessary provide the patient with a diagnostic wax-up or set-up showing how their new restoration will appear. This will help them have reasonable expectations about the outcome of treatment. Another advantage of providing a diagnostic wax-up is that, if necessary, it can be used as the basis for a temporary restoration that can then be fully assessed in the mouth and adjusted until you have a happy, comfortable patient.
Once the patient receives the final restoration, they will almost certainly want to know how long it will last. It’s worth being cautious when discussing the longevity of implant treatment and you should base your views on personal experiences.
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References:
https://www.nature.com/articles/sj.bdj.2010.1033