Permanent Implants the Permeant Solution to Losing Teeth?

Dental implants are a reliable and successful method of replacing missing teeth in the adult dentition helping to improve function, aesthetics and mental well-being. Some patients describe it as life changing and their self-esteem greatly improves. Teeth have become not only a functional but aesthetic concern. As dentists, we must be prudent not to develop a mindset of outlet aesthetics for teeth at the detriment of the natural dentition. The survival rate over 10 years is in the range of 96.4% according to Howe, et al., [1]. The prediction intervals were between 91.4% and 99.7%. The over 65 age group had a lower success rate than the younger age groups partly due to the slower healing response. Howe, et al., found a survival rate of 85% in implant retained full arch patients with an average pre failure functional load of 7 years. Clinicians and patients often expect dental implants to integrate successfully on the first attempt though this is not always achieved. They also expect implants to be complication free for many years without maintenance. This is not the case. Sometimes uncomfortable conversations with the patient must be had on several occasions to ascertain that they are fully aware of the lifespan and maintenance required to increase longevity of a dental implant. Implant survival is not the same as implant success. Implant survival is purely the implant still present intra orally. Implant success represents lack of signs and symptoms of pain, inflammation and bone loss. Research has shown that 22% of all implants placed experiencing peri-implantitis at 5 years [2]. The estimations for this can vary, depending on baseline bone probing depths and implant morphology and is complicated by patient factors such as oral hygiene routines, manual dexterity, underlying systemic disease (diabetes) and lifestyle choices such as smoking and vaping. Given the fact that implants are susceptible to gum disease or periodontal issues and occlusal overload, the importance of maintenance and regular oral hygiene, appointments with hygienist, therapists or dentist will help increase the lifespan and decrease the likelihood of implant failure [2].