Indication, Contraindication

By Vishaal on Thursday, December 6, 2007 with 0 comments

Indication and contraindication to the use of dental implants is closely connected with ways of implanting them to the jawbone. Even though dental implants present a significant and irreplaceable improvement in dental care, they are not a method that could be used under all circumstances, for all patients. It is still considered to be a non-standard treatment which can be chosen only under certain conditions. Several viewpoints are to be considered. The basic characteristic of an implant is creation of an artificial dental pillar at jaw’s alveolar tissue which allows for further mounting of a denture assuring full teeth functions. However, dental implants should not be used for the sake of themselves without taking into an account the state of other teeth, implant’s expected lifetime, and other local and general medical conditions. Installing dental implants should not lead to premature loss of natural teeth or to decrease in dental care, under any circumstances. Implantation into jawbone’s alveolus is a large or small surgical intervention into an organism and has to be respected as such.

Introduction of a dental implant has to be performed lege artis, with proper expert erudition, after a special training, with special instrumentation and equipment. It should be performed under a local or general anesthesia, after appropriate anamnesis and analysis of a patient’s general health condition and local conditions as well.

Indications may be as follows:

  • single gap in the alveolus after a lost tooth

  • large gap at frontal or distal parts of the alveolus where an implant would serve as an inserted pillar either alone or linked to adjacent teeth

  • shortened dental arch at which an implant is used as a complementing independent pillar or an end pillar for bridges

  • a toothless jaw, where implants are utilized as pillars for a bridge or hybrid removable denture.

In general, blade-like, metal, extension implants are used mainly at narrow alveoli. Cylindrical, screw-like implants find their use at stronger alveoli of toothless jaws.

Contraindications from the local point of view:

  • insufficient strength of alveolus

  • mucous inflammation or fibrous alterations that do not assure an implant’s stability

  • unsatisfactory topographical and anatomical dimensions, e.g. position canalis mandibularis, relatively large jaw cavity, extreme alveolus atrophy, anomalous occlusal intermaxillary conditions, defects of jaws, macroglossia.

Contraindications in terms of general health conditions can be either relative or absolute.

Relative contraindications:

    • ongoing infectious states

    • chronic pathological states of decompensation

Absolute contraindications:

    • systemic bone diseases

    • endocrinologic diseases

    • diseases of the hepatopoietic system

    • rheumatoid diseases

    • heart conditions

    • nephritis or nephrosis

    • liver cirrhosis

    • allergies

    • immune system disorders

Among other important factors are a patient’s psychological condition, motivation, ability to cooperate during the implantation preparation phase, as well as further caring of dentures (fixed or removable) carried by dental implants.

Without a perfect anamnesis, local analysis and without meeting all requirements for indication or contraindication, it would not be possible to utilize dental implants successfully for the treatment of dental defects.

Category: Dental Materials Notes



Post a Comment