During a recent session at the European Association for Osseointegration’s Digital Days, Kristin Heimisdottir, an Associate Professor and Head of Orthodontics at the University of Iceland, shared her expertise on the challenges and considerations of placing dental implants in growing individuals. This topic, critical for both practitioners and patients, delves into the intersection of dental development and implant technology.
Understanding Growth and Dental Implant Timing Heimisdottir emphasized the importance of timing when considering dental implants for younger patients. The primary rule is to delay the placement of implants until growth has ceased to ensure that dental developments do not adversely affect the implant’s position and functionality. However, real-world scenarios often require balancing ideal conditions with the practicalities of patient needs, such as the long-term use of removable retainers or provisional solutions that can affect quality of life and dental health.
Identifying Growth Completion Identifying when a patient has stopped growing is crucial for implant timing. Traditionally, practitioners relied on height measurements and hand-wrist radiographs to gauge growth. However, Heimisdottir discussed a more contemporary and equally effective method involving the maturation assessment of the third cervical vertebra via profile radiographs taken at six to twelve-month intervals. These assessments help ensure that growth has stabilized before proceeding with implant placement.
Choosing the Right Areas for Implants Heimisdottir also highlighted that even when a patient reaches adult growth levels, certain areas of the mouth remain more susceptible to changes than others. The anterior region of the lower jaw, for instance, undergoes significant transformations that could influence the long-term success of an implant placed too early. The discussion included strategies for managing these changes, such as possible prosthetic adjustments to accommodate natural dental shifts over time.
Aesthetic Considerations and Challenges The aesthetic implications of placing implants in growing individuals cannot be overstated. Heimisdottir pointed out that while the aesthetic region might seem less complicated when dealing with bilateral congenital absences (like missing lateral incisors), unilateral absences pose greater challenges due to potential asymmetrical dental shifts. In such cases, waiting as long as possible for a more stable condition is advisable to reduce the need for future corrective procedures.
Practical Advice for Implant Placement In discussing the practical aspects of implant surgery, Heimisdottir underscored the importance of bone grafting when necessary and the considerations for maintaining or adjusting vertical dimensions during implant placement. She stressed that while dental professionals might be eager to address aesthetic or functional issues sooner, understanding the growth patterns and waiting for the right moment are crucial for ensuring the longevity and success of the implants.
Conclusion Concluding her session, Heimisdottir reminded attendees that while age can be a guideline for when to consider implants, it should not be the sole determinant. Individual growth patterns, the stability of dental development, and aesthetic considerations must all guide the decision-making process. Her insights provide a nuanced understanding of how to approach dental implants in growing individuals, ensuring both the immediate benefits and long-term success of such significant dental interventions.