Dental Implantology Case Study

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‘Dental implantology is the field of dentistry that is concerned with the replacement of missing teeth and their supporting structures with artificial prostheses anchored to the jawbone (Association of Dental Implantology, 2012).’ It is an excellent way of replacing missing teeth without damaging the neighbouring teeth as done in the case of fixed bridgework. The success of dental implants largely depends on appropriate case selection.
To formulate an appropriate treatment plan, the following should be recorded:
• Patient’s chief complaint and needs along with Patient education and informed consent.
• Dental, medical and social history.
• Detailed extra-oral examination including lip and smile lines.
• Intra-oral examination including BPE
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Implant imaging is important as it provides accurate and reliable diagnostic information of the patient's anatomy, including the location of the inferior alveolar nerve and maxillary sinus. It helps to estimate bone quantity, height, buccolingual width and angulation of alveolar process including its long-axis, to detect any underlying pathological conditions, to establish jaw boundaries, and also to decide the length and width of the implant to be placed.
Routine projections include intra-oral (periapical, occlusal) and extra-oral (panoramic, lateral cephalometric) radiographs. More complex imaging techniques include conventional X-rays, computed tomography (CT), and cone beam computed tomography (CBCT). Multiple factors influence the selection of radiographic techniques for a particular case including cost, availability, radiation exposure, and patient's anatomy. The dentist aims to find a balance between these factors with an aim to minimize risk of any complications to the
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‘Clinical research has demonstrated that bone quality is one of the most significant prognostic factors in implant dentistry (Association of Dental Implantology, 2012).’
To ensure long term satisfactory results of implants, accurate determination of the available bone quality, density and volume is mandatory. Failure to do so may lead to poor bone support, leading to higher failure rates.
The SAC classification is a risk assessment tool, which categorises dental implant cases according to whether they are simple, advanced or complex (SAC). This will help to categorize the cases according to the level of expertise needed to carry out the case without any complications. It is adopted in the training standards guidelines published by the GDC/FGDP

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