Dr Martin Wanendeya ponders aesthetic outcomes for dental implants
As the demand for dental implant therapy continues to rise, so too does the need for products and techniques that optimise the aesthetic outcome of treatment. After all, patients don’t just want their restorations to function like natural teeth – they want them to look like natural teeth as well. While the design and fabrication of the implant-supported restoration can play a part in the final aesthetics, there are ways of optimising the surgical procedure as well.
When teeth are removed or lost, there is inevitably resorption of the surrounding hard and soft tissue. In the aesthetic region of the mouth, this means we usually have to start with a deficiency, which can influence the aesthetic outcome. The severity of the defect will depend on the amount of resorption that occurs.
We therefore need to consider a strategy for before, during and after taking out a tooth in order for us to optimise our chances of achieving good aesthetics. A systematic approach is needed from diagnosis through to atraumatic extraction, implant placement, augmentation, healing, temporary and permanent restoration.
It is necessary to consider more than just the position of implant, although this remains essential. Other factors such as the volume of surrounding soft tissue can have a huge impact on the final aesthetics, which should be addressed from the start of treatment in order to prevent issues later.
We need to know what procedures are available to us that will facilitate the very best aesthetic results. There are various tried and tested techniques for everything from tissue preservation to tissue augmentation and other methods of masking aesthetic deficiencies.
We then need to incorporate those techniques that are most suitable for the individual case within the treatment plan – I believe 95% of aesthetic complications can be avoided or significantly reduced with good planning. Whether this involves digital or analogue methods, it remains a crucial aspect of dental implant treatment.
That said, it’s important for clinicians to realise that it is not always possible to achieve an ideal aesthetic result. For some patients, certain limitations will make it near enough impossible to get a perfect outcome.
However, by completing a comprehensive assessment and treatment plan, we can identify these patients early and predict when an aesthetic complication may arise. As long as we communicate potential compromises to patients from the very beginning, we can work with them to find a way of achieving results that are acceptable to them.
Aesthetics isn’t a scientific area – there’s not a definitive right and wrong, or only one way of doing things. It is about using the evidence-based materials and techniques we have at our disposal to achieve the best possible outcome for our patients.
For information about the ADI and upcoming ADI Study Clubs, please visit www.adi.org.uk/studyclubs
Dr Martin Wanendeya, Principal of Ten Dental +Facial will be sharing his extensive experience in the field of dental implants and helping colleagues to improve aesthetic outcomes in ADI Study Clubs this year.
He will cover some of the biology and science behind how dental implants behave and explore techniques to maximise aesthetics in single and multiple tooth rehabilitations. To find out more, or to book, visit the ADI website www.adi.org.uk/events/.