Dental Tribune United Kingdom Edition

September 12-18, 201122 United Kingdom EditionClinical Dental Direct UK Ltd. +44 (0) 203 532 8631 info@dentaldirectuk.com www.dentaldirectuk.com M andibular incisors can be vulnerable to early loss due to their inherently weak periodontal support and high prevalence with respect to periodontal disease. What are the most common treatment options for missing mandibular incisors? Aside from removable pros- thetic options, the restorative options for a fixed prosthesis include a conventional bridge, a resin-bonded bridge (Mary- land Bridge) and implants. For a case in which one or two mandibular central incisors are missing, a three- or four-unit bridge has often been the treat- ment of choice. A resin-bonded bridge, in these cases, can be a reasonable alternative to a conventional bridge; whereas implant treatment, more often than not, is not suitable due to insufficient space. When more than two incisors are missing, the implant option may become the first choice for most clini- cians these days. Preparing mandibular inci- sors for bridge abutments is an extremely delicate procedure that often leads to root-canal treatment due to pulp damage that might occur during the procedure. Even without the risk of pulp damage, it is still quite a challenge to recreate natural contour and shade on such tiny dentition. Dental implants have, in many cases, become the treat- ment of choice for restoring missing teeth and have been documented to have a high degree of success. With im- plant therapy, the preparation of healthy teeth adjacent to the edentulous area can be avoided. An additional advan- tage to the implant restoration is the maintenance of the al- veolar bone, which otherwise would undergo resorption with other restorative options, hence, often complicating aesthetics. What’s happening? What’s happening in the real world? Are we comfortable enough placing implants in the mandibular anterior re- gion? In spite of understand- ing both the disadvantages of conventional fixed bridgework and the advantages of implant restorations, we often make the treatment choice for miss- ing mandibular incisors in fa- vour of the bridge. Why is that? What hinders us from provid- ing an implant option for pa- tients in such cases? Restoring mandibular incisors with im- plants can be one of the most difficult dental treatments to perform due to the limited amount of bone and interden- tal space. Placing implants in What makes you hesitate? Dr Chonghwa Kim discusses restoring missing mandibular incisors with implants ‘Dental implants have, in many cases, become the treat- ment of choice for restoring missing teeth and have been documented to have a high degree of success’