Shortened Dental Arch Concept
Anon. asks:
I have seen numerous examples of the ‘shortened dental arch concept’ in lectures and courses I have taken on implant dentistry. Many speakers tend to limit their patients to premolar occlusion. Is this to avoid the potential for complications by placing dental implants in the posterior maxillary and mandibular regions? I have also seen this done many times with natural teeth and bridges. What is the consensus on premolar occlusion for bridges on natural teeth or dental implants? Are any dental schools teaching this?
3 Comments on Shortened Dental Arch Concept
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DERSOT- Perio - France
9/5/2007
Even if nature gave us 52 teeths (20 + 32), there is no paper, book, lecture or consensus conference which assume that we need to replace all teeth til the wisdom tooth. Often, even with natural teeth or with implants, shortened arches including the first molar are a good solution.
It allow chewing function and a good esthetics.
Dr. Ben W. Eby
9/7/2007
My personal experience is, 2nd bicuspid occlussion is a minimum to maintain the TMJ and gives about 80% or more natural chewing ability. Restoring with implants can generally be done up to and including 1st molar occussion. There is an inherent potential risk with mandibular 2nd molars. That is not to say, it is impossible. Shortened arches including the first molar, is often the most reasonable solution.
Joseph W. Como OMS
9/8/2007
I agree with the above doctors. First molar occlucion is adequate for function and in most cases esthetics. I feel that the only time to place an implant into the second molar region is if there is an opposing tooth. Replacing the missing second molar that has an opposing tooth has the benefit of preventing hyperuption of the opposing tooth and allowing the patient to have an even bite. This is all good if the patient has the height and the width to place an adequate sized implant to withstand the occlusal forces in the posterior region. If the case is an edentulous one, first molar occlusion would be the standard treatment, pending the patients bony anatomy
