Treatment Goals and Planning For Dental Implants

The primary goal of dental implant treatment is to achieve functional and aesthetic restoration of missing teeth. To accomplish this, meticulous presurgical planning is essential, focusing on restoration-driven implant placement.

Personalised Treatment: Each patient presents unique needs, desires, and expectations regarding dental implants. Understanding these individual factors is crucial to delivering a realistic, predictable, and satisfactory outcome that meets their anatomical, functional, and aesthetic requirements. During the planning phase, consider the patient’s expectations and financial situation, and offer various options with different materials, procedures, risks, and benefits. Ensure the patient is well-informed and educated, as this is essential for obtaining valid informed consent. It’s important to note that while dental implants are often the preferred option, alternatives such as no treatment, dentures, and bridges may also be suitable depending on the patient’s specific circumstances.

 

Essential Steps in Diagnosis and Treatment Planning:

• Patient’s presenting complaint, desires, and expectations
• Record of dental, medical, and social history
• Extra-oral examination, including lip and smile lines
• Intra-oral examination, including full periodontal charting
• Diagnostic imaging
• Clinical photography
• Diagnosis and treatment plan
• Written treatment plan and cost estimate
• Patient education and informed consent

 

Prosthetically Driven Placement:

Dental implant placement should be prosthetically driven. This means that treatment planning begins with the desired final restoration, which guides the selection of the appropriate implant type, position, angle, and depth. This approach ensures that the implants are optimally placed to support the final prosthesis, enhancing both functional and aesthetic outcomes. It also helps assess whether there is sufficient bone and soft tissue structure for implant placement or if additional procedures, such as grafting, are necessary.

 

Implant Types and Planning:

• Soft-Tissue Level Implants: These implants, often referred to as "one-piece" implants, have a polished collar above the rough surface that protrudes from the bone, aiding in the attachment of peri-implant soft tissue.
• Bone Level Implants: Designed to be fully submerged beneath the bone, these implants facilitate soft tissue attachment through an additional component, typically a screw-retained abutment.

 

Preoperative Preparations:

• Articulated Study Models and Diagnostic Wax-Up: These are essential for analysing prosthetic space and fabricating a surgical stent to guide correct implant positioning and angulation.
• Radiographic Stent: Using radiopaque denture teeth during imaging helps establish the position of planned implant-retained crowns relative to the available bone, often employed in computer-assisted implant planning.

 

Success Factors:

Long-term success of dental implants depends on several factors:

• Buccal bone thickness and interproximal bone levels for soft tissue stability
• Selection of the correct implant type for a favourable emergence profile
• Precise surgical manipulation
• Achieving pink and white aesthetic harmony
• Design of the prosthesis
• Consideration of ongoing maintenance

Utilising advanced technology and reliable techniques in diagnosis and treatment planning, including high-quality imaging, enhances the ability to deliver outstanding results in dental implant therapy.