Improved Implant Surface and Hygiene Boost Restoration Success

Should a person’s teeth be saved at all costs? During the last decade, the an­swer has shifted from yes to no in favor of replacing diseased and damaged teeth with implants. But treatment of patients with periodontitis remains controversial because artificial tooth roots are more likely to fail.

An article in the Journal of Oral Implantology looks at long-term treatment for a patient with severe periodontal damage. The authors anticipated that the higher risk of implant failure in this patient would be offset by coating the implants with a rough, oxidized surface called Ti­Unite and by emphasizing the need for diligent oral hygiene. They also expected that by using overdenture prostheses instead of conventional removable dentures, they would im­prove stability and function—and thus patient satisfaction. Research has shown that the TiUnite material stimulates bone growth, leading to faster fusion of implants and surrounding jawbone. This case reports on a 51-year-old patient who had been in a motorcycle accident and has a history of herpes, hepatitis, insulin-dependent diabetes, and persistent recurrent tooth decay. The patient’s remaining teeth were comprised of fractured crowns and older, failing implants. The surgeons re­moved all of his teeth and old im­plants followed by the immediate insertions of new implants and sta­biliz­ing overdentures. Provisional implants were used for support during healing. Five months later, the interim provisional implants and prostheses were removed, and fabrication of a final restorative prosthesis was initiated. Despite the higher risk of implant failure due to his periodontal disease and diabetes, the patient’s implants have been in place for 12 years with no complications noted at routine checkups and cleanings. The patient has been instructed post-surgery in proper use of floss threaders, deep-cleaning brushes, and an oral irrigator. His daily efforts to practice good oral hygiene im­proved his overall dental health, and little care and maintenance of the prostheses have been necessary.

The authors concluded that in this case, the prostheses have been effective, predictable, and reliable. They contend that such positive results were only possible because the patient changed his at-home oral care, preventing plaque buildup and disease.

(Source: Journal of Oral Implantology, 2013, Volume 39, Number 6)