Dr. Clarizio is a presenter on shortening the implant tooth restoration process at the annual meeting of the American Association of Oral and Maxillofacial Surgeons (AAOMS) at Florida's Orlando World Center Marriott, Sept. 12-15, 2001. Presentations on other implant advances include:

• Implants and youth-when kids are still growing, can implants work?
• Tooth extraction, immediate implant replacement and 12-year outcomes study.
• Advantages and predictability of surgical grafting (new product for FDA approval; "rhBMP-2," a bone morphogenetic protein, could replace bone grafting by "growing" deficient dental ridges and giving patients the necessary support for implants).

Thanks to these advanced restoration techniques, almost anyone in reasonable health is a candidate for dental implants, says Michael S. Block, DMD, an oral and maxillofacial surgeon at Louisiana State University School of Dentistry. Implants have successfully been placed in people from age 15 to over 100, including many with osteoporosis. And more than 90 percent of implants remain in place for 20 years or more.

Implants grow in popularity

Since their introduction in the United States in the early 1980s, dental implants have consistently grown in popularity, notes Jay P. Malmquist, DMD, a Portland, OR oral and maxillofacial surgeon and treasurer of the AAOMS. "With more than one million in place, implants have become the standard of care for replacing lost teeth."

Implants can be used to support a single fixed replacement tooth, several fixed replacement teeth or a full set of removable snap-on dentures. In all cases, implants offer significant advantages over more-traditional dentures and bridges.

Traditional full plate dentures are supported by gum and underlying bone tissue alone. Even when they fit well, they can bear only a small fraction of the chewing pressureborne by natural teeth. And because dentures do not directly place stress on the bone, asnatural teeth do, the jawbone tends to deteriorate over time, making it harder and harderto maintain a close fit. Loose dentures are uncomfortable, can cause sores in the mouth and interfere with speech.

Bridges generally require that adjacent teeth be ground down and capped to support replacement teeth. Removing the enamel of these undamaged teeth exposes them to premature decay. Bridges are often difficult to clean around, which promotes gum disease, and they must be replaced periodically. Dental experts say the life expectancy of a crown is 7 to 15 years. Many insurance plans will pay to replace them after five years.

Implants solve these problems. Because they are placed in the bone, much as a natural tooth root, they stimulate the jaw bone to grow and remain strong. And because they are rigid, dentures that snap onto them are much more stable than traditional dentures. Fixed replacement teeth supported by dental implants can take nearly as much of a load as natural teeth, about 800 pounds per square inch. That compares with about 40-50 pounds for dentures. Improved chewing and speech are among the benefits.

Implants also have a virtually unlimited life span. Once in place they are virtually indistinguishable from natural teeth. And you take care of them the same way - brushing, flossing and periodic professional cleaning are all that's needed."For most people implants are a superior tooth replacement option," Dr. Block notes.

Dental implant facts

• Over 95 percent of dental implants placed in the lower front jaw 20 years ago or more remain in place. In other parts of the mouth, 20-year success rates vary from the low 90s to the high 80s. Overall, more than 90 percent of implants last 20 years or more.
• Over one million dental implants have successfully been placed in the United States.
• Implants are made of titanium or titanium alloy. Bone grows around them, fusing the implant to the jaw. Rejection is extremely rare.

American Association of Oral and Maxillofacial Surgeons

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