August 1, 2000
by Blake Nicolucci, BSc., DDS
I was dismayed, recently, to hear that a female patient of mine had been on a holiday south with her friends, and had the opportunity to be introduced to an Orthodontist – a friend of one of her friends who happened to be along on the same trip.
My patient was discussing the orthodontic treatment that her children had completed over the years to the Orthodontist, and she then naturally started to discuss her plans to have some implants placed in her mandible. She became very dismayed to hear the newfound friend say that he “wouldn’t have an implant ever!” and that he would definitely “choose a bridge or a partial denture over implants!” He told her that the prognosis for implant supported prosthesis was no better than “50-50”.
The patient showed up for her surgery the day after returning from her holiday as planned, and sitting in the chair she recounted the story of my “Colleague” and his account of what implant dentistry was all about.
I was very lucky that the patient had been at my office as a patient for over twenty years, and she felt very confident in my decision to place implants where her posterior bridge had failed. We discussed the possible complications again before commencing with the surgery, and I had managed to restore her faith in the decision to continue with this particular treatment plan. I must say that the added stress of convincing her to continue with implant treatment, and avoiding any complications – as well as the mandibular canal – became a heavy burden during the surgery.
The surgery has been done for several months now, and the implants were placed with no complications, and have healed well. They are now ready to be uncovered for the prosthetic phase of treatment. The patient has no regrets with her choice to continue.
This brings me to a couple of facts that should be emphasized as a result of this little anecdote. I’d like to indicate some facts from recent studies done in the U.S.
Insurance Bureau Statistics indicate that abutment tooth loss for partial dentures is 23% at 5 years and 38% at 8 years.
The Glating Study indicated that with cemented bridges, there was a 2% failure after 5 years and a 12% failure after 10 years.
Creugers Study on the life span of fixed bridges indicated 74% success at 15 years. That’s 26% lost, or 1 in 4!!!
Finally, a Veteran Affair Study on bridge abutments indicated 3% loss at 5 years, a 13% loss at 10 years, and a 30% loss at 14 years.
These studies bring to mind the following:
The total life span of an implant-supported prosthesis has been documented to be over 90% for many years. These figures can be increased to the 98% level and higher from recent data and studies. This can be seen from some of the articles that follow in this implant issue.
A bridge requires the reduction of adjacent teeth, whereas an implant is a ‘stand-alone-element’ requiring no help from the existing dentition.
A partial denture also requires support and retention from adjacent dentition, and can, in fact, initiate caries from the ‘clasp retention’ on these teeth. This can case tooth mobility and periodontal problems as well.
As all of us are already aware, partial dentures interfere with speech, and taste – both in a negative way, not to mention anything about aesthetics.
I wonder how many dentists are aware of these facts?
This brings me back to that very helpful colleague who (armed with a little misinformation) managed to throw the ‘Fear of God’ into a trusting and confused patient. I wonder how many of you have had patients change or decide against a treatment plan (which you have in all your confidence and wisdom drawn up for a patient) just because someone has made an ‘off-the-cuff’ remark to highlight their wisdom – or lack thereof?
Implants are here to stay! – GET USED TO IT!!