Dentistry Essay Sample: Epidemiology and Etiology of Tooth Extraction

When a tooth is lost, then a physiological resorption process starts. The alveolar crest of the jaw starts to decrease. The degree of resorption depends on the nature and cause of extraction; however, it is predominant in case of periodontal diseases. Other cases include bad dentures worn for an extended period. Tooth extraction may lead to the distortion of the underlying and adjacent tissues, which could affect the alveolar ridge and triggers a high rate of resorption. Therefore, in most cases, a corrective measure is needed for the restoration of the desired functionality and dental aesthetic. The most notable historical method that was commonly used in dental reconstruction was the use of dental dentures that could be removed when required. An additional surgical enhancement was also carried out in some cases (Toneti et al., 2017). The inconveniences that came with this method was sufficient enough to warrant poor patient outcome and low satisfaction levels. However, based on the limitations associated with this approach the patient outcomes indicated the need for an advanced approach to the treatment and rejuvenation of dental functionality after extraction or infection.

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A global analysis indicated that with advanced technology and increasing clinical trials, solutions to extractions and dental surgery had been established. Nevertheless, many people cannot access the best dental surgery because of the high cost and lack of access to dental insurance covers. Many people are edentulous, but the number is decreasing with increase in innovation and affordability of the surgical costs (Toneti et al., 2017). Techniques such as osseointegration using implants or a combination of bone grafts and implants are widely practiced to eliminate the edentulous cases and provide the patients with the standard dental structure even after tooth extraction. The guidelines associated with the existing bone grafting techniques and implant placement have been established in line with the clinical outcomes to determine the best method for each of the dental cases. On the other hand, increased research is expected to impact the clinical practice by improving awareness, increasing knowledge, and setting practice standards (Chiapasco et al., 2009). Nevertheless, the factors that determine the techniques that will be used for dental reconstruction and augmentation still depends on the patient variables.

Delayed and Immediate Implant Placement

The extraction of a tooth required a replacement. Recommendations for immediate prosthetic replacement have been founded on the evidence that it is advantageous for the patient and the dental surgeons. Patient satisfaction is a critical element of dental treatments, and therefore it is considered that taking advantage of the time reduction and immediate restoration associated with the decision to replace the extracted tooth with prosthetics will improve the level to which a patient will be satisfied. Another essential factor that dental practitioners are keen to observe is the rate of bone resorption (Toneti et al., 2017). Extraction triggers the resorption of the alveolar bone. It is ascertained that immediate placement of implants and graft materials reduced the rate at which the resorption is triggered. Such a move is considered to enhance the preservation of the quality and quantity of the jaw bone. In fact, studies pointing out that immediate placement of implants could reduce the need for augmentation materials and techniques have been documented.

While some scholars have supported the essence of immediate placement of implants, other proponents have been keen to table their critic postulates regarding the need for delayed implants. The first limitation that is always tabled is the fact that immediate implant placement has been linked to surgical complication. Clinical results have linked immediate implant placement to would complications and excessive bleeding. In some instances, the implants could fail thus affecting the desired outcomes. Moreover, it is believed that the use of this method cannot lead to outcome certainty because the success of the implant cannot be predicted. While other scholars have pointed out how the approach decreased alveolar bone resorption, chances of the graft material that was integrated during the placement of the implants being partly or entirely resorbed cannot be ruled out. Worth pointing out is that the existing knowledge regarding the comparative assessment of immediate and delayed implant placement is limited. One of the reason is that most researchers have been unable to draw a clear distinction between the actual difference (Toneti et al., 2017). Moreover, most studies have been linked to biases because of the methods adopted to compare and evaluate the outcomes of each group. Other reasons for lack of clarity is the existence of other external factors that impact dental surgery outcome that is independent of the material and techniques that have been used. Nevertheless, regardless of the existing disparity, it is essential to determine what will work best for each case rather than adopting a universal approach and recommendation that could jeopardize the patient experience and affect the clinical outcomes.

Clinical Perspective Volumetry of Bone Grafts

Comparative assessment regarding the rate of resorption of the alveolar bone as well as the bone graft material has been studied to examine the diverse clinical outcomes. Clinicians are in a position to examine the vertical and horizontal changes in length, using longitudinal studies and CT-techniques, based on the initial metrics of grafts and the residual bone. Bone gain after distraction is also part of the measures that are assessed to determine the graft volumetry. While limited studies exist regarding the resorption rates associated with inlay and only grafts, scholars have confirmed that when block bone grafts are used, then the rate of resorption is reduced. Block bone grafts have been found to be more resistant to resorption. The use of particulate sinus inlay grafts is also not apparent since the scholarly outcomes are skewed, and no clear trend has been established. The precise bone volume changes based on the computerized tomography outcomes have not been established. Understanding the changes in bone volume is important because it provides the decision baseline for selecting the most preferred technique and material for different dental cases. In most cases, dental recommendations have considered grafts with limited resorption rates for extremely resorbed alveolar bone. Another aspect that has been subjected to debate, as noted in the previous section, is whether the use of immediate placement of implants could offer clinical advantages that could lead to decreased bone resorption and long-run success results for patients (Toneti et al., 2017). Nevertheless, the use of implants and grafts have also been founded on other factors apart from the quality and quantity of the alveolar bone (Att et al., 2009). For example, vertical and horizontal augmentations have attracted specific being grafts techniques, and the two methods cannot be interchanged. Currently, comparative studies have become the most popular approach to evaluating the different bone volumetry in line with the rate of resorption.