therefore, premature implant placement can result in the repetitive need to lengthen the
transmucosal implant connection resulting in poor implant-to-prosthesis ratio and the
potential for load magnification.
--Premature placement of an implant near the midline can create a mesiodistal spatial
disharmony secondary-to-median sutural growth, which accelerates at puberty.
--The placement of implants in the anterior maxillary region before age 15 in female patients
and age 17-25 in male patients should be attempted only to achieve unique treatment
planning goals and with particular emphasis on the determination of skeletal age, informed
consent and the possibility of future implant replacement.
Posterior maxilla6, 9
Large number of variations exist in the amount and direction of both sagittal and vertical
growth, and the unpredictability of the growth pattern adds to the difficulty of deciding when
it is safe to insert implants in that area.. Since the vertical growth occurs by apposition on the
alveolar aspect and resorption on the nasal or maxillary sinus area, an implant placed early
could be submerged oclusally and penetrate the sinus or nasal cavity. In partial edentulism,
implant infraocclusion may lead to long term esthetic problems for the implant and
periodontal damage around the adjacent teeth. So, implant placement can be recommended
only after the cessation of growth. Placement of osseointegrated dental implants in the
maxillary posterior quadrant is best delayed until age 15 in females and age 17(17-25) in
males. Particular care must be exercised when placing implants before skeletal maturity
because of the appositional and resorpt...
... middle of paper ...
way to restore function. Definitive orthodontics, oral surgery to reshape the dental arches,
alveolar bone grafting, selective tooth extraction, and periodontal surgery should be
considered to meet the needs of the particular patient. The prostheses and restorations, which
were part of earlier treatment, should be reevaluated. If complete dentures are contemplated,
both maxillary and mandibular prostheses are recommended since opposing dentures improve
both function and esthetics. Rigid fixed prostheses are appropriate since craniofacial growth
is complete. Comprehensive orthodontic tooth movement and selective extraction of teeth
will allow optimal prosthetic therapy. Implants may be used anywhere in the dental arches
and, if necessary, bone grafting prior to implants is appropriate. General anesthesia is not
recommended routinely for individuals in this group.
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