Implant indications

When the remaining teeth can be maintained healthily and they are suitably distributed around the arch, tooth-supported reconstructions can provide a predictable solution, even in cases with periodontally reduced abutments. The speaker presented an impressive case which had been treated over 30 years ago involving full-arch prostheses in the upper and lower jaw, supported by five roots each.

The speaker stated that Ante’s law (Ante. 1926) is an old and outdated opinion: it is completely useless in today’s landscape. Since Ante’s law was published, it has been clinically demonstrated that even a reduced periodontium has the capacity to support fixed bridges (Nyman & Ericsson. 1982; Lulic et al. 2007). It has been shown in a number of systematic reviews that the ten-year results of prostheses on teeth with reduced periodontal support were better than those of implants.

“Give teeth a chance”

The speaker said that the eagerness of some clinicians to place dental implants (termed the ‘euphoria for dental implants’) often led to the mutilation of periodontally affected dentitions. They would often extract teeth which could have been used as abutments in order to place implants.

“The patient’s capacity to take care of their teeth is a prerequisite for long-term results”

The speaker concluded his presentation by cautioning the audience: treatment plans should be carefully discussed with patients. Clinicians should also take care to bolster their patients’ motivation for maintenance, since this is a key factor in the therapeutic decision. The patient’s capacity to take care of their teeth is a prerequisite for long-term results and this often demands a change of lifelong habits.