In the last two decades if one
thing that has revolutionized dentistry and the
treatment planning it has been the evolution of
dental implants with a very high degree of
predictability and prognosis. Ever since the
breakthrough turning point discovery of titanium and
its Osseo-Integration property by prof. Branemark
,if their is one field of medicine that has
benefited the most that has been restorative dentistry.
Even as a prosthodontist we need to accept that there are certain anatomic conditions,
individual preferences and some systemic conditions for the fully and partially
edentulous [distal extensions] where conventional removable prosthesis do not
give satisfactory results to patients and also to dentist. These patients have
also been coined as dental cripples by us.
Today where conservation is the rule and more and more venners and partial crowns
are being advocated against conventional crowns ,conventional fixed partial denture
treatment needed more rationalisation with a lot more patients preferring artificial
roots for replacement of their teeth to bridges which undermine their healthy natural
Implant surgery and implant prosthodontics have seen dramatic advances in the form of
atraumatic extractions for socket preservation either for immediate or delayed implant
placement to CAD CAM guided surgery for immediate replacement/function. sinus
block grafts from intra oral and extraoral sites, nerve repositioning have become the order of the day
today. Now dentistry has been gaining popularity with advances in implant surfaces to take up immediate
load and the advent of single piece implants.
Although their has been such a drastic change in dentistry with implants unfortunately their has been
inadequate education in this field both in under graduation and post graduation level. Majority of
General dentist who have graduated just a couple of years ago and who have graduated probably a decade
ago are still ignorant about complete science and rehabilitation using implants. This has led to a huge
gap to be filled between the patient demands for a better prosthesis and a lot of dentists unable to meet
up to their needs. Our effort to bridge this long gap has been the implantation of the school of dental implants ,
an advanced surgical and prosthetic training programme.
BEYOND JUST IMPLANTS:
-Innovation technology and research
Innovation, and technology need to be in sync with research and development and this R&D is motivated by demands and needs / wants of dentists and patients alike. Just being back from the IDS, Cologne we implantologist were anxiously looking for any major implant manufacturer who has dared to take on the zirconia implant adventure. Their presumed biocompatibility and excellent aesthetic shade would make these implants highly desirable in the esthetic zone, provided they can withstand functional loading.
We are facing an almost endless proliferation of synthetic bone replacement materials today. Some materials serve as placeholders for natural bone formation, while other types of materials are designed to replace autologus bone grafts. How well proven and how successful are products such as procine collagen matrix straight from the pack designed to replace autologus connective tissue grafts in covering recession and augmented soft tissue ?
In addition to these developments in dental materials , new digital devices are coming more and more into focus with dentists – in diagnostics and therapy alike. Products range from 3D x ray units and computer guided implant placement all the way to optical scanners replacing conventional impression taking and even automated dental technology procedures.
CAD- CAM procedures for manufacturing implant supported restorations include opto – digital processes that dispense with plaster casts altogether. Single session chairside restorations using scanner technology could be the future. Custom components which now require manual fabrication could be produced this way.
Doubtlessly recent innovation within oral implantology has now been driven in large part by scientific progress and by the products developed by the dental industry. Prompted by an ever increasing demand by dentists and their patients, new products , new processes and improved therapeutic methods have been brought into the market for many indications – from new approaches to bone augmentation and novel procedures in laser technology to newer materials , not least the already familiar zirconia. Coming from a high level of achievement and extremely high success rates compared to other medical procedures, ever better results and shorter treatment times are not easy to attain. There are limits as to what nature will allow us to do. In the light of this realization, it is all the more important for dentists and implantologists to avail themselves of opportunities for continuing education – to keep up with technical innovations and new materials, for the benefit of patients and their own.
-Prof. Dr. Vikas Gowd
M.D.S., FICO oral and maxillofacial prosthodontist and implantologist