Every day we see dental clinics advocating “Dental Implants in a Day” in bold letters on various social platforms. Most of us are confused because there are also some doctors/sites which warn of high failure rates with such treatment plans. So what’s the true story. Are dental implants in a day a feasible option and are they reproducible with equal success by all doctors and in all patients.
With advanced technology and 3D treatment planning, dental implants In a day have become a reality where they can consistently be given to patients with great success rates. There are three broad categories which determine the success rate of these procedures.
1. Patient selection –
a)If a patient is a diabetic the HBa1c should be under 7.2
b)Blood pressure should be under control.
c)Smoking should be avoided during the first four months of placement.
d) A patient shouldn’t be on bisphosphonates
e) Should not have any bone disorders like osteoporosis.
f) There should be adequate bone volume and the quality of bone should be good.
2. Advanced technological aids
a) CBCT – AÂ cbct is a volumetric analysis of the quality and quality of bone available to place implants. It gives an idea of the amount of bone available so the implants are centrally placed within the boundaries of bone without causing any damage to any vital nerves or vessels.
b) Guided surgery can be done for patients using cad cam. Various proprietary software is available today for doing this. One example is the “Noble Guide” software by “Nobel Biocare” company. This involves reverse planning the placement of implants based upon the final position of the teeth. This helps in good prosthetic planning with a good distribution of forces which further helps in the long-term success of immediately loaded teeth. The teeth which are delivered to the patients immediately after the surgery can also be fabricated/ milled using this software allowing for more accuracy and a precise fit.
When guided surgery is performed the surgical stent allows the placement of the implants without needing any extensive cutting of the gum tissue allowing the implants to be placed through small keyhole surgery. This helps in minimal postoperative inflammation and minimal pain allowing more comfort to the patients postoperatively.
c) Intraoral welding – Dentsply company has come out with a unique concept of welding the abutments (attached to the implants ) allowing for the most passive and strong immediate full jaw prosthetics. This increases the success rate of the prosthesis delivered.
d) Multiunit attachments – these attachments to dental implants allow them to be placed within a good bone volume but at the same time allowing for angular corrections up to 45 degrees. Owing to these attachments on dental implants it is now possible to place dental implants in a good bone volume but still do corrections to give immediate prosthetic results. The all on four concepts relies on this tilted dental implants concept.
3) Patient Compliance-
a) Taking medication during the healing period on time.
b) Good Hygiene maintenance is key to implant success in the long run.
c) Soft diet during the healing period – The patient is allowed to ear with the teeth but very hard food items like nuts act need to be avoided.
To summarise while immediate dental implants cannot be guaranteed to all patient but with good patient selection and following of protocols set into place for such procedures, they are a reliable treatment modality.