Sports Medicine


Oral Prosthodontic Rehabilitation Thomas J. Balshi, DDS, FACP Current Therapy in Sports Medicine, Third Edition 1995 by Torg/Shephard Mosby Yearbook, Inc.
	90% OF SPORTS INJURIES IN THE MOUTH OCCUR IN THE ANTERIOR REGION
	Implant prosthodontic treatment has been available for the replacement of missing teeth for several decades. The benchmark of scientifically studied implants is the Brånemark titanium screw, which has proven that osseointegrated fixtures (implants) provide excellent long-term favorable prognosis for fixed bone-anchored replacement teeth. The use of osseointegrated Brånemark implants for patients who have sustained traumatic tooth loss takes on some very special considerations. The entire procedure of osseointegration is based on a biocompatible coexistence between living tissues and titanium components that these tissues were never genetically coded to accept. Osseointegration relies on a situation where we create a predictable tissue to titanium interface through a very carefully controlled surgical procedure. ETIOLOGY OF TOOTH LOSS Contact sports such as football, basketball, hockey, and boxing have produced a myriad of dental problems, the most serious of which is the loss of natural dentition. Other more genteel sports such as tennis, golf, horse back riding, and swimming have also led to inadvertent tooth loss. A recent review of our clinical data on sports related injuries indicate that 90% of tooth loss occurs in the anterior part of the mouth. In most of these situations the injury occurs on impact when the player is moving toward an inanimate object or receives a blow from an oncharging competitor. CHARACTER OF INJURY A traumatic blow to the anterior part of the mouth creates a variety of hard and soft tissue lesions. Facial lacerations frequently cover deep seated fractures of the teeth and/or alveolar bone. If the impact is of sufficient magnitude, avulsion of anterior teeth is the most frequent form of permanent trauma. With severe impact, fractured roots and compound fractures of the alveolar bone are more complicated and create biologic devastation and post trauma prosthodontic challenges. Social implications are worthy of note in as much as unreplaced tooth loss is viewed as a social stigma. next page
		Figure 1 Temporary removable partial denture, constructed of acrylic, provides interim esthetics but limited function. (Courtesy of Nobel Biocare, Yorba Linda CA)

		Figure 2 Traditional fixed partial denture firmly replaces a missing tooth but requires the removal of enamel from adjacent healthy teeth. (Courtesy of Nobel Biocare, Yorba Linda CA)

		*Figure 3* A resin bonded fixed partial denture relies on the bond strength of resin between enamel and the base metal alloy. (Courtesy of Nobel Biocare, Yorba Linda CA)




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		*Figure 4* State-of-the-art replacement of a traumatically lost tooth relies on osseointegration of a Brånemark implant in the alveolus followed by the placement of a ceramic crown. (Courtesy of Nobel Biocare, Yorba Linda CA)
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