By Scott D. Ganz, DMD
Prosthetics & Implant Dentistry
By Scott D. Ganz, DMD
Measuring ISQ has become a critical component in my implant treatment, as it provides objective information about the stability of the implants I place. Based upon the initial implant stability or ISQ value, I determine the loading protocol and timing of restoration (immediate, early, delayed).
In my daily practice as a prosthodontist I treat young adults between 18-25 years, with implants. There is not much available in the literature about implants for young adults and the little that exists is mostly about infra position of the implant crown or case reports. Instead, I want to share some thoughts and highlights around the actual treatment procedure. Aside from a small amount of available literature, there are not really any other sites or forums either - at least which I know of – with information and discussions about this specific topic. There are only a few Q&A’s about it online, and the answers are quite old.
So what I am sharing here is based upon my own thoughts and my own experience, and it does not mean that I “invented” it in the first place. I however really try hard to create this type of clinical environment on a daily basis, and I am passionate about achieving this. Please do not hesitate to get in touch with me or share your comments below!
Missing teeth in young dentitions are generally caused by congenital absence of tooth germs (aplasia) or by trauma and are mostly located to the anterior maxilla. Most of the patients, missing one or maybe two teeth, are treated with single implants but there are also patients with larger traumas or multiple aplasias that needs implant bridges. The implant sites in patients suffering from aplasia or trauma often have very restricted bone volume and many of these young patients have high smile lines showing the whole implant crown including the papillas and soft tissues (fig 1). In contrast to implant treatment in adults the challenge with young patients is also that the treatment is expected to last for a very long time, in most cases at least 60 years. During these years continued growth and changes in the face occurs which causes the positioning of the implant crown to change over time1-4. Due to all of the above mentioned, these cases need to be planned and performed as optimal as possible both when it comes to implant placement, implant stability, emergence profile and shape and shade of the crown5.