Canine Dental Implants
Advances in veterinary dentistry are being made, still about 20 years behind of human dentistry.
By Drs. James Anthony, Rocco Mele and Harold Bergman
Implant dentistry and bone grafting in small animals today is where it was in human dentistry 20 years ago. Dental implants have been well proven to maintain alveolar bone and avoid alveolar collapse, improve mastication and bone density, avoid orthodontic problems and prevent canine alveolar collapse, which may avoid lip catching.
It has also been well documented that the majority of implant failures occur in humans during the first year after implant placement. The main reasons for implant failure during the first three to six months prior to prosthetic replacement generally is poor surgical technique, poor patient selection or inadvertent overloading of the implant during osseointegration. The main reasons for failure of an implant after implant restoration is generally poor treatment planning or overloading of the implant during remodeling of the bone.
Figure 1A: Tooth sectioned
Courtesy K9 Implant solutions
Figure 1B: Osteotomy being performed
Figure 1C: Implant being placed
After the first year, it is well documented that success rates are close to 100 percent due to the body’s individual ability to adapt its support to being sufficient for the loading.
Implant dentistry in small animals is expensive because multiple separate procedures are required, each requiring general anesthetic with its attendant costs. The multiple procedures include the tooth extraction (if necessary), probable bone grafting, implant placement, implant uncovering and impression taking, and finally the placement of the restorative crown or bridge. Each of these steps (unlike in humans) must be performed under general anesthesia.
As a result of the increased costs, implant dentistry in animals has received limited use unlike the widespread use that is found with humans. Some believe that more widespread use of implants among veterinary dentists would occur if clients were aware of this option.
Dental implants have also been well proven in humans to restore esthetics by allowing for the use of crowns or bridges attached to the implant. Although it has not been documented, one of the authors has successfully placed and restored more than 200 implants in dogs with six failures due to advanced periodontal disease.
A number of veterinary dentists have expressed a concern about the ethics of placing implants into small animals for esthetic reasons. It is our understanding that it is unethical to restore the appearance of “show dogs” and “breed dogs” if the tooth was genetically missing. If the tooth was extracted or fractured or diseased beyond repair, it is ethical to restore the appearance and function.
In conversation with several veterinarians who have placed a small number of implants into small animals, we have learned that some have experienced an inordinately large percentage of failures while others have had no failures. On further questioning, it appears that many failures were due to placement of mini-implants and using uncoated implants in areas where larger, conventional implants could have been placed, and/or by breaking basic rules on implant placement and restoration. We believe many of these failures were due to inadequate training in implant dentistry.