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January 2010 | Dental Products Report A place at the table Making the case for regular dental implant coverage in DPR and the integration of dental implants in the general practice. The set-up “Welcome to the Dental Products Report Clinical 360° Dental Implants column! My teammates, Drs. Lee Gause, Michael Tischler, and Joyce Warwick, and I are excited to be able to provide you with timely, state-of-the-art information about topics of critical importance to dentists and their teams. All four of us are in full-time clinical practice, with an emphasis on implants and implant continuing education. I am confident that you will find our collective perspective to be real-world and in the trenches with you.”—Dr. Brien Harvey. Team Lead The question arises, though, why implants? Why has Dental Products Report added a team on dental implants? Well, the numbers are compelling. The American Dental Association, in its 2007 Survey of Current Issues in Dentistry, found that 16% of all practicing dentists had surgically placed an implant in 2006, and the number of practitioners doing so was increasing steadily. Given this finding and trend, coupled with the United States Department of Labor Bureau of Labor Statistics projection that there will be 176,000 practicing dentists in 2016, it is easy to anticipate that there will be as many as 40,000 dentists placing implants in the next 5 years, and it goes without saying that essentially all restorative dentists will be involved with implant-supported prostheses. The emergence, development and refinement of osseointegrated dental implants over the last three decades, particularly in terms of simplified, ‘tooth-like’ prosthodontic treatment options, leaves the practicing dentist with no option but to consider dental implants when tooth replacement is necessary. In fact, the situations during which implants can and should be considered the treatment of choice for tooth replacement are becoming the rule rather than the exception. Better dentistry, happier patients Not too many years ago, it seemed that having virgin adjacent, potential abutment teeth, along with lacking abutments posterior to the edentulous sites, were the only clear indications for implants in partially edentulous patients. And patients completely edentulous in one or both arches might have a recommendation for implants only if they complained of severely compromised function. Now, though, the perspective on the role of dental implants in fixed and removable prosthodontics has changed, and I suspect we can all agree this perspective has changed dramatically. There is compelling evidence that using implants in edentulous arches both slows the rates of alveolar ridge shrinkage and improves patient perceptions concerning comfort and function, leading to an improved quality of life. In fact, using implants to support a complete mandibular prosthesis imparts such a positive effect that offering a minimum of two implants to a patient who is (or is soon to be) edentulous in the mandibular arch is considered the standard of care. For those of us doing implants over a long period of time, the improved quality of life attributable to implants that is routinely experienced by our edentulous patients comes as no surprise. For our partially edentulous patients, the benefits of using implants rather than conventional tooth-supported partial prostheses might be seen as less life-changing, and yet the arguments in favor of considering and offering implants are nonetheless compelling. Who amongst us would still consider a conventional 3-unit fixed partial prosthesis (FPP) to be a reasonable treatment option in an otherwise esthetically pleasing and functionally intact segment when using an implant would allow replacement of the missing tooth without adversely affecting unrestored adjacent teeth? CONTINUED ON NEXT PAGE
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