Tooth Fixation and Stabilization Using Transdental Implants

Objectives: The objective of this study was to evaluate transdental implantation in treating highly compromised, mobile teeth with a poor prognosis. Material & Methods: In our study 46 teeth out of 39 patients of all ages and sex were observed for a period of over seven years. The criteria for choice of patients, was based only on the indications for this procedure: All teeth that had undergone the treatment had an unfavourable 1:1 crown/root ratio, a poor prognosis and otherwise would have been extracted. The pathology that was present, included periapical or periodontal involvement, or both. The surgical procedure used on all patients was the open method, allowing for direct control of placement of the Straumann transdental implant. Periodontal tissues were treated and splinting of the teeth for 6 weeks followed the implantation procedure. Evaluation of results was done according to principles of evaluating successful osseointegration: the tooth should not be visibly mobile; there is no translucency around the implant in the periapex; the loss of supporting bone is less than 0,2mm annually and; an 85% success rate up to five years. Results: One patient lost his implant soon after the operation due to postoperative infection resulting from an endo-perio communication with destroyed junctional epithelium, which was not observed duly. Two other implants were lost due to a road traffic accident after a period of three years, and were excluded from this study. All other transdental implants that were placed proved to be successful according to our set principles. Conclusion: This method provides a safe and reliable treatment of highly compromised teeth that would otherwise be indicated for extraction, provided a proper indication has been made.