Full-arch dentistry – are you prepared?

28th July 2021

5 minute read

With increased awareness around full-arch dentistry amongst today’s patients and implant clinicians alike, Dr Toheed Hamid addresses some of the challenges clinicians face when becoming involved in this treatment.

It’s estimated that 6% of the population (England, Wales and Northern Ireland) are edentulous (1). That’s 2.7 million people living without their natural teeth and experiencing a decreased quality of life. But as our aging ‘edentulous’ population evolves, so too will their expectations.

Attitudes towards edentulism, and satisfaction with conventional dentures, are being influenced by new trends, and soon won’t be enough to satisfy their lifestyles and aesthetic needs. Immediate load, full-arch rehabilitation is a one such trend, with high patient acceptance and long-term data showing excellent success at 99.2% (2). The challenge to maintaining these long-term success rates and patient satisfaction levels relies heavily on user experience, careful patient selection and skilled case planning.

Experienced implant clinicians for full-arch dentistry

Undertaking full-arch implant cases is not something for the newly qualified implant dentist to rush into. You would expect someone to consider getting involved in this treatment when they’re competent and placing 50-100 implants a year. It’s at this point, once they’ve had the experience of working on a high volume and variety of implant cases and become familiar with identifying and addressing potential complications, that full-arch becomes a natural progression and growth opportunity.

However, this number shouldn’t be a deterrent to the ambitious implant dentist, but instead act as a target to work towards before commencing full-arch training.

Finding the right partner to structure their implant education pathway and complementing this with the support of an experienced mentor is a must for any clinician looking to expand into full-arch dentistry. Training that focuses on developing their theoretical and practical knowledge and understanding of the full-arch, immediate-load protocol and the teamwork required to predictably provide this treatment modality are essential course requirements.

Patient selection and setting expectations for full-arch dentistry

Thanks to intensive marketing and increased commercial awareness, patients are well-informed of the ‘same day teeth’ approach and it’s not uncommon for them to specifically request full-arch treatment. Those with a significantly failing dentition understand they can have their remaining teeth removed and replaced with a fixed full-arch prosthesis in one appointment.

Nevertheless, although they think they might be an ideal candidate for full-arch treatment, it doesn’t mean it is always in their best interest. There are numerous factors to consider when assessing the patient for full-arch treatment, including their speech, bulk bridge adaptation, parafunction (bruxism, clenching and chewing), high caries index as well as bone quantity and quality to name but a few. Alongside this is determining their level of motivation for implant maintenance and ongoing care both at home and in-practice.

There isn’t a ‘one-size-fits-all’ solution to addressing the challenges of today’s (and tomorrow’s) edentulous patient’s and being able to offer multiple full-arch restorative options and assess the best individual options is key to case selection, long-term success and patient satisfaction.

Case planning – no longer an administrative burden

Reconstruction of edentulous ridges generally require anywhere from four to six implants (or eight to 12 implants for dual-arch cases) and when undertaking those cases, especially your first few, it can be a logistical and administrative strain.It’s not uncommon for clinicians to feel uncertain about which implants and prosthetic components to order. This can often lead to over-ordering on stock and unnecessary invoicing and product returns, all of which can be time-consuming and stressful for both the clinician and their team.

To help ease the pressure of ordering in advance for full-arch cases, clinicians can now benefit from specially produced full-arch implant boxes such as the TICK Box, (TeethXpress^® Implants & Components Kit Box), from BioHorizons Camlog. Specifically developed as a handy loan box to provide implant clinicians with the full suite of tools and components required for full-arch treatment ahead of surgery, the TICK Box supports implant dentists and their team through:

Simplicity in pre-surgical preparation
Flexibility in treatment planning
Clinical versatility
Improved efficiency and organisation
Stress-free procedures

Simply place one order, receive one box, and gain immediate access to an extensive surgical and restorative portfolio with everything you need for same-day full-arch treatment. You only need to use what you require and are only invoiced for what you use. So not only can you take the pain out of advanced surgery, but you can now reduce both your stock and stress levels too.

Full-arch rehabilitation – join the ranks of the elite

It’s expected to be some time before edentulism becomes a thing of the past, and the burden of maintenance of heavily restored dentitions will remain a major requirement for the dental profession for many years to come.

By meeting the rising challenges of edentulous patients with full-arch treatment, clinicians can expand their offering and help make dental implants a viable choice for more of their patients.

See BioHorizons Camlog full-arch solutions at www.theimplantrevolution.co.uk or discover the NEW TICK Box (TeethXpress¨ Implants & Components Kit Box).

References

1 – Mather, H., Thomason, M. & Ellis, J. (2018) Are UK graduates equipped with the skill set required to meet the demands of the UK’s edentulous population? Br Dent J 225, 15–18

2 – Maló P., Rangert B., Nobre M., All-on-Four’ Immediate-Function Concept with Brånemark System Implants for Completely Edentulous Mandibles: A Retrospective Clinical Study. Clinical Implant Dentistry and Related Research. 2003;5: 2–9

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Article Author

BDS (Bristol 2008) DipImplantology (Bristol 2018) Toheed graduated from the University of Bristol in 2008 and limits his clinical time to implants and oral surgery only. He has developed a reputation for being an empathetic, thorough and well-mannered dentist. Over the past 5 years, Toheed has held the role of Foundation Dentist Trainer with great enthusiasm. In this role he is responsible for training, mentoring and guiding newly-qualified dentists during their transition from university to general practice. Toheed has furthered his postgraduate education by undertaking 2 years of the MSc in Dental Implantology course at the University of Bristol as well as attending numerous advanced implant training courses. He has been placing implants since 2014 and spends most of his time travelling between practices placing and restoring implants. Toheed provides a full range of implant treatments, including full-arch treatments and complex hard and soft tissue grafting. He also mentors dentists who are new to dental implantology and helps their development and growth through his own ‘starter’ course for dental implantology - www.learnimplants.com.