Effect of Dental Implant Therapy on the Preservation of Orofacial Tissues

Consensus statement 1: Patients rehabilitated with IODs or CDs present similar bone resorption values in the posterior region of the mandible of fully healed ridges as assessed in panoramic radiographs. This statement is based on a meta-analysis including four studies (three retrospective, one prospective; 324 patients) ([CI −0.04; 0.06], p> .05).

Consensus statement 2: There is less alveolar bone resorption on the posterior mandible in patients with CIFDPs compared to CDs and IODs. This statement is based on one retrospective study with 140 patients (p< .05).

Consensus statement 3: Partially edentulous patients who are rehabilitated with toothsupported removable dental prostheses (RDPs) present more tooth loss (mainly due to caries) than patients with implant-supported partial fixed partial dentures (IFPDs). This statement is based on three retrospective studies (410 patients).

Consensus statement 4: In fully edentulous patients using CDs, masseter muscle thickness increases after rehabilitation with mandibular IODs. The meta-analysis showed a significant benefit of IODs when compared to CDs. This statement is based on three studies (one RCT, one crosssectional, one prospective study; 108 patients). The effect size difference is 0.95 ([CI 1.53, 0.38], p= .0012).

1) In edentulous patients, does implant treatment reduce alveolar bone resorption as compared to CD treatment?

Yes. In edentulous patients, rehabilitation with an CIFDP or IOD is also beneficial to reduce alveolar bone resorption. The evidence does not favor one treatment modality over another. Regular maintenance appointments to ensure peri-implant health and occlusal stability of the prosthesis are also recommended to minimize alveolar bone loss.

2) When tooth replacement is indicated in partially edentulous patients, can IFDPs be recommended over tooth-retained/supported removable partial dental prostheses (RDP) to preserve the health of the remaining teeth?

In periodontally stable, partially edentulous patients, when tooth replacement is indicated, treatment with IFDPs is recommended over the provision of RDPs to preserve the health of the remaining teeth.

3) In fully edentulous patients, can IODs/CIFDPs be recommended over CDs in the preservation of masticatory muscle?

In fully edentulous patients, rehabilitations with IODs/CIFDPs are recommended to increase masseter muscle thickness compared to CDs. It is plausible to infer that this may have a positive effect on chewing.

1) Some of my teeth are missing, what will happen if I do not do anything?

It depends on how many teeth are missing and where— functioning and esthetics may be impacted. Your teeth might move, and it might make it more difficult to clean them. Some studies show that not replacing missing teeth leads to bone loss. Furthermore, it may reduce the health of the remaining teeth and cause further tooth loss. However, many patients are able to enjoy adequate function with some missing teeth.

2) I have complete dentures, and I heard about dental implants. I was wondering if those implants provide advantages related to the bone or the chewing muscles?

Yes, many studies show that in patients without teeth, dental implants offer the advantage of preserving the jaw bone, as long as the implants are healthy. In addition, your chewing muscles become stronger compared to full dentures.

3) I have many missing teeth in my lower right jaw, and I would like to replace them. What is my best treatment option? Should I get a partial denture or a fixed implant bridge?

Replacing the missing teeth with a fixed implant bridge will decrease the chances of further tooth loss when compared to a removable partial denture. With the partial denture in place, the remaining teeth are more prone to developing dental diseases. These partial dentures also require more maintenance. Therefore, I would advise you to get a fixed implant bridge.