Older people with dental health problems have benefitted from dental implants, particularly implant overdentures, which have a proven record of long-term success and survival.

POOR oral health, particularly dental, has become more prevalent among the elderly who are inclined to suffer from high levels of tooth loss.

To address this, Normah Medical Specialist Centre (NMSC) maxillofacial and oral surgeon Dr Adam C Miller said implant overdentures had proven effective in helping older people with dental health problems.

“An implant overdenture uses dental implants to permanently ‘lock’ and support the denture in your mouth,” he explained.

Dr Miller, from the US, and also medical director for the Centre for Aesthetic Health and Dental Medicine at NMSC, told thesundaypost dental implants were discovered by Swedish Professor Per-Ingvar Brånemark who found that titanium could be successfully fused into the bone when osteoblasts grow on and into the rough surface of the implanted titanium.

“This forms a structural and functional connection between the living bone and the implant.”

According to him, Brånemark had originally considered the first work should centre on knee and hip surgery before deciding that the mouth was more accessible for continued clinical observations.

The clinically observed adherence of bone with titanium was termed ‘osseointegration’.

In 1965, Brånemark carried out the first titanium dental implant on a volunteer and over the next 14 years, published many studies on the use of titanium in dental implantology.

In 1978, he entered into a commercial partnership with Swedish defence company, Bofors AB, for the development and marketing of his dental implants.

Today, more than seven million Brånemark System implants have been carried out.

Before a dental implant procedure, Dr Miller said patients needed to be clinically assessed in terms of finance, dexterity, bone volume or health, esthetic and functional expectations, hygiene and periodontium as well as shape of the ridge.

“For dental implant procedure to work, there must be enough bone in the jaw, and the bone has to be strong enough to hold and support the implant.

“If there is not enough bone, more may need to be added with a bone graft procedure,” he said, adding that natural teeth and supporting tissues near the implant must be in good health.

Before the surgery, careful and detailed planning is required to identify vital structures such as the inferior alveolar nerve as well as the shape and dimensions of the bone to properly orientate the implants for the most predictable outcome.

“To facilitate the placement of the implants, patients will also be given a cone beam computed tomography (CBCT) or 3D X-ray, which Normah is the first medical centre in the state to own,” Dr Miller said.

A basic procedure of the implant requires preparations into the bone in the jaw, and by allowing it to grow on the surface of the implant, a tooth or teeth can be placed on the implant.

“In the case of over-dentures, the lower denture, for example, is most commonly supported through two to four implanted locator attachments underneath it. The denture is held in very firmly but it can still move slightly,” he explained.

Dr Miller said the locator attachments were made of commercially pure titanium and shaped like small screws (to resemble the root of a tooth) with either tapered or parallel sides.

On whether dental implants also applied to single tooth implant, he advised that patients opt for immediate implant placement, if possible.

“This strategy is to preserve the bone and reduce treatment time. In some cases, a prosthetic tooth can be attached to the implants at the same time as the surgery to place the dental implants.”

Miller, who has carried out about 1,000 dental implants in the US, said a single implant procedure usually took 45 minutes to an hour, depending on the treatment required.

At Normah, Miller has so far performed five dental implants, including that for a 16-year-old who had her tooth knocked out in an accident. All were successful.

“Dental implants, particularly implant overdentures, work and have a proven record of long-term success and survival. Edentulous patients who have undergone this procedure are living longer and more active lives,” he noted.

Since restorative dentistry could be expensive, Dr Miller advised putting emphasis on oral health care.

“Oral health is an overall component in your health and the reality is that dental hygiene and dental care here is behind the emphasis on medical care.

“There’s no better investment than your oral health in terms of protection for your mouth. Preventative dentistry is not expensive — it starts with just a toothbrush, toothpaste and dental floss,” he said.