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overview I implantology failures and complications. The fol- lowing images depict total implantological fail- ure—the loss of a purely implant-supported com- plete maxillary restoration caused by an infaust peri-implantitis (Figs. 15–17), leaving profound osseous defects. However, in line with the consistently positive evaluation of implants and the persisting promise that the use of implants would yield optimum re- sults always—and often publicised by the lay press—our patients’ expectations have increased considerablyinthepast15years.Patientsassumed that,regardlessoftheindividualsituation,heorshe would always receive the optimum results. In this regard, it seems reasonable to maintain a self-crit- ical attitude and to concede that we did not always contradict this general assumption vehemently enough. Andthenwhatwasboundtohappen,happened: attimes,theresultwasnotwhatthepatienthadex- pected.Anawkwardsituationariseswhentheden- tist,basedontheinitialdiagnosis,considersthere- sult to be successful and the patient considers it a failure. A long-time legal expert sums up this situ- ation accurately by stating that, “Two-thirds of all pending court proceedings were filed by patients whose expectations were disappointed.” Rather unfortunately,theincreasingnumberofcourtpro- ceedingsaremostlyrelatedtoimplantology.Itcan- not be by chance that the premiums for mandatory professionalliabilityinsurancehaveincreasedcon- siderably. _Emerging criticism German periodontists Dr Thomas Kocher re- ferred to implantology as “the red light district of dentistry”. Whether this evaluation is justified is a matter to be decided individually. Personally, I do not agree with this evaluation, but a grain of truth mightbefoundinitsreferencetoovertreatment.In this regard, the extraction of teeth in favour of im- plants,evenwhennotindicated,isaconcernvoiced increasinglybyperiodontistsandthoseinfavourof conservative treatment. We have to address this issue by individual eval- uationofeachpatient,aswellasthroughacademic discussion. Implant versus tooth preservation has beenafrequentdebateatconventionsandimplant symposia in recent years. In my opinion, this would not have been possible ten years ago. ® ® Minimize bone grafting procedures! Bicon Europe Ltd. Hauptstr. 1 55491 Buechenbeuren Germany Phone +49 (0)6543 818200 Fax +49 (0)6543 818201 germany@bicon.com www.bicon.com With Bicon´s SHORT® Implants you can: 3 Avoid vital structures. 3 Minimize bone grafting procedures. 3 Maximize implant placement possibilities. 3 Increase patient acceptance. 3 Offer single unit restorations without splinting. 3 Offer a clinically proven solution. 6.0 x 5.7mm 5.0 x 6.0mm 6.0 x 5.0mm5.0 x 5.0mm 4.0 x 5.0mm 4.5 x 6.0mm AD