Written by Dr. Chung-Wei Chen (Dr. Richard Chen)
First and foremost, it is essential to emphasize that dental implantation is an advanced and continually evolving field of dentistry. It is not something that can be mastered quickly; it requires ongoing learning and practice to be able to perform clinical procedures effectively. Speaking from my own experience, I have been studying dental implantation since 2016, and I continue to learn and update my knowledge regularly.
Christina is a 7-year-old female Russian Blue cat who suffered fractured maxillary canines (104 and 204) due to fights with other cats at home and a fall from the top of a wardrobe. Her owner brought her to our hospital for evaluation and treatment. After a thorough assessment by me, it was determined that the natural teeth could not be preserved, and dental implants were the best solution for restoring her fractured teeth. Given Christina's smaller size, mini implants were chosen for the procedure, which are smaller than traditional implants and can be clearly distinguished through dental X-rays.
After 9 months of treatment, I successfully completed the dental implants for Christina's two maxillary canines (104 and 204). The implants integrated well with the alveolar bone (osseointegration), and Christina adapted to the fitted all ceramic crowns without any issues, allowing her to use her new teeth normally.
I'd like to take this opportunity to share some fundamental concepts about dental implants. I will also provide more details on my YouTube channel, ”Dr. Chen Talks About Teeth and Oral Cavity” , for those interested in learning more:
1. How long does dental implantation take? A complete dental implantation procedure typically takes about 4 to 6 months and includes the following steps:
(1) Implant placement, waiting for osseointegration to occur. In some cases, immediate implant placement (IIP) can be done right after extraction, shortening the treatment time.
However, executing this for dogs and cats is more challenging, and the detailed reasons will be shared in a YouTube channel video.
(2) Placement of a healing cap (healing abutment), which can be done concurrently with step (1).
(3) Taking impressions.
(4) Installing the all ceramic dental crowns.
In this case, it took 9 months to complete due to the different timings of teeth fractures and treatment initiation.
2. Is dental implantation more comfortable than extraction? It has been confirmed that dental implantation is less painful and causes less swelling compared to extraction. You can refer to my previous article for more information: https://reurl.cc/ed97mM (Yao et al., 2017, Reference 5). It's important to note that this study was conducted on humans, who are much more sensitive to pain than dogs and cats. Therefore, dental implantation is even less likely to cause discomfort in dogs and cats.
3. How strong are dental implants? According to the latest research from the American Academy of Implant Dentistry (AAID), dental implants are as strong as endodontics and can achieve 80-90% of the natural teeth's strength. Endodontics have now been proven to be applicable in veterinary dentistry for dogs and cats, and the strength of dental implants is certainly suitable for long-term use in these animals. However, it's important to note that the study also emphasizes that healthy natural teeth are always the best option, and dental implants are recommended only when natural teeth cannot be preserved (AAID, 2022, Reference 1).
4. How long can dental implants last? In human dentistry, successful dental implants are defined as those that allow patients to use them comfortably for 10 years, rather than being indefinitely usable for a lifetime, after this period, patients need follow-up treatment. This means that regardless of whether it is successful or not, almost all patients who receive dental implants will need to undergo follow-up treatments, after all, with the increasing average lifespan of modern individuals, using dental implants for more than 10 years is commonplace (French et al., 2021, Reference 3). On the other hand, while the average lifespan of pet dogs and cats has extended to around 15 years, it is still considerably shorter than that of humans (Science, 2015, Reference 4). In such circumstances, successful dental implants are sufficient to cover 2/3 of their overall lifespan, ensuring that dogs and cats don't have to worry about the consequences and complications of missing teeth for most of their later years. In contrast, for humans to achieve similar benefits, dental implants would need to last for 35~40 years, requiring numerous follow-up treatments. Successful dental implants provide far greater oral health and functional benefits for dogs and cats compared to humans.
5. What are the differences between dental implants in dogs, cats, and humans? Dental implants in dogs and cats prioritizes functionality and ease of cleaning over aesthetics. The focus is on restoring tooth function rather than appearance. In Christina's case, her canines had a natural structure "vertical groove" (bleeding groove), an evolutionary adaptation for hunting that is no longer necessary for modern indoor cats, they can make cleaning difficult and lead to the accumulation of plaque and calculus. Therefore, in this case, we did not recreate the vertical groove, even though they can be easily recreated.
Modern medicine advances rapidly, with significant updates occurring approximately every 5~7 years. Once the publication date of literature exceeds this timeframe, it is essential to carefully assess which content remains applicable and which has become outdated. During my studies at the Graduate Institute of Oral Hygiene at Kaohsiung Medical University (KMU), professors even required students to select literature published within the last 5 years for their seminar presentations.
Veterinary dentistry has gained increasing attention in recent years, and various dental treatments that preserve natural teeth, such as endodontics, guided tissue regeneration (GTR), and guided bone regeneration (GBR), etc., have been gradually evolving. However, the concept of dental implants has remained stagnant for three decades. To date, there is still a lack of relevant research and literature in this area. Only by dedicating more effort to enriching the technology and database of dental implants for dogs and cats can we break through this stagnation, enhance the quality of veterinary dental care, and improve animal welfare. Those interested in learning more can refer to my previous article: https://reurl.cc/ed97mM (Anthony et al., 2013, Reference 2).
Thanks to the attentive communication of “Hung Kuo Medical Instrument Co., Ltd.”, this case was successfully completed.
References:
1. American Academy of Implant Dentistry [AAID] (2022). How Strong are Dental Implants? [Online forum comment]. Retrieved from: https://connect.aaid-implant.org/blog/how-strong-are-dental-implants
2. Anthony J., Mele R., & Bergman H (2013). Dental Implants In Small Animals [Online forum comment]. Retrieved from: https://www.veterinarypracticenews.com/dental-implants-in-small-animals/
3. French, D., Ofec, R., & Levin, L. (2021). Long term clinical performance of 10 871 dental implants with up to 22 years of follow-up: A cohort study in 4247 patients. Clin Implant Dent Relat Res, 23(3), 289-297. doi:10.1111/cid.12994
4. Science (2015). Feature: A dog that lives 300 years? Solving the mysteries of aging in our pets [Online forum comment]. Retrieved from: https://www.science.org/content/article/feature-dog-lives-300-years-solving-mysteries-aging-our-pets
5. Yao, J., Lee, K. K., McGrath, C., Wu, Y. N., Li, K. Y., & Mattheos, N. (2017). Comparison of patient-centered outcomes after routine implant placement, teeth extraction, and periodontal surgical procedures. Clin Oral Implants Res, 28(4), 373-380. doi:10.1111/clr.12794
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