posted in Dental Implant Complications, Treatment Planning & Complications, Dental Implant Contraindications
« Use of Surgical Guides | Oral Bisphosphonates »
Print This PostDr. Abrams asks us:
I am planning on placing two dental implants to
replace the lower right first and second molars in a patient with a long history of bruxism.
The history bruxism has resulted in a completely
flat occlusal plane, i.e. the curve of Monson is flat. Would a screw-retained or cement -retained superstructure be better?
I am aware that an occlusal nightguard is imperative. Any advice would be appreciated.
FREE Webinar: Dental Implants and Bone Grafting in the Esthetic Zone
4 Responses to “ Dental Implants and Bruxism ”
I have done a signigicant number of implants on patients with bruxism. Your main concern is fracture of components including abutment screws and even implants. I would suggest you use an implant witha minimum diameter of 4.1 mm–4.8mm, and use cement retained prosthetics.
A wide diameter implant with a deep thread profile would be best. Progressively load the implants PRIOR to definitive restoration to increase mineralization and bone to implant contact. Finally, a plane of occusion that matches his habitual bite.
40 yr old lady, heavy bruxism, missing #19 due to vertical root fracture/endo/posts extraction and loss of #18 {unknown cause}wants #19 implant. I advised her that her level of bruxism is heavy and contraindicates an implant for #19. What is your opinion. This lady wants reimbursement for the “failed endo” #19 done in ‘97 and extracted in 2007. {Abscessed and vert. root fracture} with the history of 2 broken files left. Is this request reasonable and fair? jim hales, dds thurs. 19 Nov 09
Dear Jim, I would tell this lady nicely that tires, shoes, tooth brushes and root canal treatment does not last forever. I would also refer her to Eugene McCoy’s web page www.toothcrunch.com. This will educate her about bruxing. Keep your money and refer her to some deserving doc that has irritated you in the past. Remember “People In Hell Want Icewater”. She has unrealistic expectations. If you go to the hospital emergency room and die——Your family gets a bill and it has to be paid! We dentist have to change this and take a lesson from our medical buddies.
Leave a Comment
Comment Guidelines: This is a forum for dentists for intelligent discussion. No insults. No outside links. No promotional comments. Though we require an email to route questionable comments to our editors, we will NEVER publish your email. Patients: Please do NOT post dental questions here. Instead Ask Us or Find a Local Dentist.
Note: At times your comment may not appear on the website immediately, because it has been sent to our editors for approval. Once approved, we will publish the comment. There is NO need to resubmit your comment, if it does not appear on the website immediately.