Implants for Single First Molar Replacement: Important Treatment Concerns

Implants for Single First Molar Replacement: Important Treatment Concerns
Implant Dentistry: Volume 13(4) 2004 pp 328-335
Carvalho, Waldimir CD*; Casado, Priscila Ladeira CD*; Ca??la, Andr?© Luis CD, MScDÇƒÜ; Barboza, Eliane Porto CD, MScD, DScDÇƒ?
Lippincott Williams & Wilkins
Abstract
The success rates of implants placed in the posterior region of both jaws are less than the anterior segments. Anatomic features, mastication dynamics, and adequate implant selection are all significant for long-term prognosis in the molar region. This article discusses important aspects in planning the use of dental implants in the areas of first molars.
The first molars are the first permanent teeth to erupt in the mouth and unfortunately are often the first teeth to be lost as a result of decay. They are important teeth for maintenance of the arch form and for proper occlusal schemes.1 Nonetheless, the loss of a single molar is regarded as a common cause of a nonphysiological occlusion resulting from tipping of neighboring teeth and extrusion of opposing teeth. In visible sites, esthetic concerns also play a role in the treatment plan.2
Differences in anatomy, biomechanics, and microbiology make the treatment of partially edentulous jaws substantially different from that of totally edentulous jaws.3 In the past, options for replacement of a missing first molar involved either a removable or a fixed partial denture. A fixed bridge denture has been a well-accepted treatment modality. However, today it may be contraindicated to prepare healthy teeth proximal to an edentulous space for crowns.
The survival of implant restorations in partially edentulous patients has been within ranges similar to those for implant survival in totally edentulous patients.5 The use of endosseous osseointegrated implants has continued to expand as a treatment option for a missing first molar. In many instances, the implant has emerged as the treatment of choice. A number of applications have evolved, and clinical and laboratory procedures continue to undergo refinement.6 However, the rehabilitation of the first molar region using dental implants has limited long-term clinical documentation and is still a challenge for those who practice implant dentistry. This requires a treatment plan based not only on the surgical aspects such as the distribution of the mesiodistal space related to implant diameter, but also on biomechanics.
This article discusses important aspects to plan a rehabilitation, using dental implants, in the area of first molars.
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