1. Is Implant The Best Choice For Missing Teeth? Kuang-min Chang, BDS, DMD, Ph.D Department of Periodontics Rutgers School of Dental Medicine Newark, NJ

2. Should I Consider Implants For My Lost Teeth? Kuang-min Chang, BDS, DMD, Ph.D Department of Periodontics Rutgers School of Dental Medicine Newark, NJ

3. Causes of Tooth Loss Oral Diseases – Caries – Periodontal disease – Tooth fracture, very common after middle age Congenital missing Trauma Orthodontics

5. Dental caries

7. Causes of Tooth Loss Oral Diseases – Caries – Periodontal disease – Tooth fracture, etc. Congenital missing Trauma Orthodontics

8. Periodontal Disease: Destruction of supporting bone

10. Causes of Tooth Loss Oral Diseases – Caries – Periodontal disease – Tooth fracture, very common after middle age Congenital missing Trauma Orthodontics

11. Should lost teeth be replaced? Functions – Chewing Prevention of future problems – Periodontal disease – Malocclusion – Extraction – Difficulty in prosthetic work Speech – Musicians, singers Esthetics – Dental – Facial: wrinkles, loss of vertical dimension, profile change, etc. Others – Saliva splash

12. How to replace lost teeth? Removable partial denture (RPD)/Complete denture Fixed bridge Implants/implant-supported RPD/overdenture

13. Removal partial denture/Full denture

14. Advantages of RPD/Full denture Low cost Usually requires no surgery Minimal trauma to existing teeth Fast process

15. Disadvantages of RPD/Full denture Functionally compromised Dental ridges continue to shrink Inconvenience Sometimes compromised esthetics May jeopardize adjacent teeth Malodor Periodic adjustment or replacement

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17. Advantages of Fixed bridge Functionally good Convenience Esthetics Fast process

19. Disadvantages of Fixed bridge Higher cost Severe mutilation of supporting teeth High risk for caries of supporting teeth→ shortened life span Difficult cleaning

20. Era of Implants

24. Advantages of Implants Best function Independent of existing teeth. No mutilation to adjacent teeth Esthetics Convenience Caries-free

25. Disadvantages of Implants High cost Unfavorable time frame Surgical trauma/pain

27. Dental esthetics is determined by teeth and gingiva

28. Bone is the foundation of implants Adequate vertical & horizontal spaces Ridge be sufficient in width and height Strong enough ********* Prepare the bone to meet the above requirements

29. PLANNING AN IMPLANT Consequences of tooth extraction Bone resorption Space narrowing/ Malalignment of teeth

30. PLANNING AN IMPLANT Steps of Implant Placement Planning prior to extraction Extractions, Pre-implant surgeries Interim teeth for edentulous areas Implant placement Uncovering/healing abutment Restoration

31. Common pre-implant surgeries Socket preservation – Soon after extraction – To prevent bone resorption Ridge augmentation – Long after extraction – Multiple surgeries to achieve sufficient size Sinus lift : for maxillary posterior implants

39. Frequently asked questions Can I have implants? How long can implant last? How fast can implant be made? Is implant risky? Whom should I approach for implants? Why are implant advice/consultations conflicting and confusing? Implant brands matter? Dental implants as part of medical tour in Taiwan

40. Can I have implants? Finance Time frame Surgery Age Systemic health – Diabetes – Bisphosphonates

41. Preparations for implants Pre-plan implant placement prior to tooth extraction Requirements of the ridge for implants – Adequate dimensions in height, width, & hardness Make the ridge ready for implants – Socket preservation – Ridge augmentation

42. How long can an implant las t? Less than 20 years of current products in the market Implant failure (< 10%) – Fail to osseointegrate – Periimplantitis (Inflammation, bone loss) – Mobility – Fracture of the fixture – Implant crown problems

43. Is implant risky? Common surgical complications Systemic health Sinus symptoms Mandibular nerve damage

44. How fast can an implant be done? Quality & durability are not always compatible with expedition ( 欲速則不達，魚與熊掌不可兼 得 ) Healing period – Socket preservation/Ridge augmentation: 4-6M – Osseointegration: 4-6M Implant placement – 6M to 13M for regular case – May require more time for complex cases

45. Whom should I approach for implants ? General dentist Periodontist Oral surgeon Others

46. Why are implant advice/consultations conflicting and confusing? Diversities in philosophy Training background Timetable Finance – Science-driven – Patient’s benefits-driven – Dentist’s benefits-driven

47. Do implant brands matter? European USA Korean Israeli ********* Size Design

48. Dental implants as part of the tour in Taiwan Time factor Liability Dental orphans

49. THANK YOU FOR ATTENDING