Methods of Treatment for a Single Missing Tooth

By Güzin Kırsaçlıoğlu, Md

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“Does a single tooth matter? I had 32 teeth, one of them going missing is no big deal. I still have 31.” We are now aware that such a mindset is wrong. Furthermore, we now know that the other teeth shift and slide to fill this space and even your spine may get affected by this sliding motion. Your teeth are like the cogs of the jaw bone, the loss of one of these cogs affects the entire system. For this reason, even when a single tooth is lost, the loss should be compensated. The first big molar teeth come out at age 6, when the child lacks the habit of brushing teeth and has a sweet tooth. These teeth get damaged between ages 6 and 8 without protective measures. At first, they decay and following the steps of fillings and root canal treatments, their condition gets worse and they may be lost. The first big molar tooth plays a great role for the teeth to be formed on a proper arc. This is why, when teeth are lost, the loss should be compensated artificially.

The options for treatment are listed below:

1. FIXED RESTORATIONS

The most traditional method for the missing first molars, other molars or frontal teeth is trimming the neighboring teeth to form a triple bridge. They are completed in just one or two weeks. This is the treatment option that is preferred for over 60 years for fulfilling functional and aesthetic purposes, as well as aiding speech.

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The durability of such restorations depends on the supporting teeth. Gum diseases forming on the neighboring teeth risks any fixed therapy attempt. The failure occurring in fixed restorations results in a repeated therapy, as well as the loss of one or two supporting teeth. There is a 30% rate of loss of the supporting teeth after 14 years.

2. SINGLE-TOOTH IMPLANTS

This method is the implantation of an implant that imitates the crown and the root one-to-one. Today, instead of having their teeth around the space trimmed and getting fixed prosthetics, most patients prefer implants. In the past, fixed restorations were preferred as they took less time to apply, but despite the disadvantage of time implants have been acknowledged as the most foreseen method. (Priest C.C., Goodcare CS., Bernal IG.)

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SINGLE-TOOTH IMPLANTS

In the event of missing posterior molar teeth, single-tooth implants are widely used. Goodcare and friends determined the success rate as 97% with researches made between 1980 and 2001. Today, although patients perceive it as a new method of treatment, it is satisfying to get such a great rate of success with implants. A point to note is that, in the report, no loss of teeth is reported. The advantages of single-tooth implants are:

* The success rate following 10 years of evaluation is over 97%. The 10-year percentage for fixed prosthetics that are not lost is 50%. * Problems of decaying teeth due to the neighboring teeth sliding into the space has been eliminated.

* It is easier to clean the side surfaces of neighboring teeth. For fixed prosthetics, a special dental floss is required.

* The protection of the bone underneath the tooth space is ensured, as the bone would thin out otherwise, allowing food residues to be trapped underneath.

* It has more advantages in the psychological sense. (Many patients state that the implants do not feel different than normal teeth and are really easy to use.)

Apart from these advantages, when compared with the fixed prothesis method, the only disadvantage of economic assessments turns into an advantage; as these prosthetics are replaced in 7 years while same implants remain in the mouth for longer periods. An implant treatment is longer-lasting.

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Resources:

* Goodcare CS, Bernal G. Runpharassaenp Ket al clinical complications with implants in implant protheses Prother Dent 90:121-132,2003

* Priest CC Single tooth implants and their rome in preserving remaining teeth: a 10 years survival study int Oral Maxillotac Implants 14:181-188,2003

* Günümüz diş hekimliğinde implamtoloji (CARLE MISTY)

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