Every situation is unique. To create the most effective treatment strategy for each patient, the doctor must have a thorough awareness of all of their specific characteristics. Factors including parafunction, occlusion, periodontal disease, the size of the area to be corrected, and the patient’s budget all have an impact on even the most routine-appearing implant case.
Prior to proposing treatment solutions, professionals must consider these issues and pay attention to the needs of their patients.A fixed prosthesis with 10 to 14 teeth is supported by the four implants and is put in place right away, usually 24 hours after surgery. Let’s examine each of these factors in more detail and then examine how each could influence treatment considerations individually.
- Speech problems
Patients are very concerned about speech problems. For strength, implant-supported bridges need both vertical and horizontal mass. Various restorative materials have different vertical requirements, but most bridges need at least 15 mm of height.
Therefore, in order to obtain these measurements, physicians must replace more than simply the volume of the lost teeth. Even healthy bone and soft tissue volume must frequently be replaced. As a result, the volume of the bridge that is next to the soft tissue will be larger than the volume of the original bone and soft tissue it replaced.
- Adjusting to bridge bulk is difficult
Speaking may be impacted by bridge bulk, but there might be another drawback. Psychological adjustment for patients to the All on 4 dentures bridge’s altered feel can be particularly challenging. The transition from their soft tissue to their teeth is something they are accustomed to feeling.
- Proprioception
This is a significant one, and dual-arch approaches frequently neglect its usefulness. The periodontal ligament contains periodontal mechanoreceptors (PMRs), which make teeth responsive to light forces. Since there is no periodontal ligament around a dental implant, it takes around ten times more power to register the same proprioception as a tooth.
A dental implant’s proprioception is comparable to that of a tooth under local anaesthetic. Patients will therefore struggle to identify early or excessive occlusal interactions.
- Parafunction
Your choice of treatment may be influenced by parafunctional behaviours such bruxism, clenching, and irregular chewing cycles. Including a few natural teeth that have been saved in your treatment plan may help patients feel the parafunction better.
- Elevated caries index
A patient oftentimes appears with an upper full denture, or even an upper All-on-4, as well as decaying and missing bottom teeth. The patient desires an All-on-4 fixed bridge that is lower.
After receiving prior root canal therapy and crowns, teeth nos. 18, 19, and 30 have fractures that extend to the gum line. The furcation of tooth number 31 is involved, and it can move. The teeth Nos. 20 through 22 and Nos. 27 through 29 show limited bone loss and mobility, but teeth Nos. 23 through 26 have calculus build-up and 7 mm pockets.
Conclusion
So, we have discussed all factors to consider when creating your dental treatment plan.