implants0112

I overview _Trouble-shooting concepts Unexpected complications, such as implant frac- tureandfailureofimplantsupra-structureconnec- tions(Figs.18–21),necessitatedthedevelopmentof surgical and prosthetic trouble-shooting concepts and modification of constructions in implant and abutment design. However, these were not readily availableandhavenotyetbeenfinallyagreedupon. In other words, they cannot be said to be common knowledgeinimplantology,atleastnotinthetreat- ment of peri-implantitis. Similar statements can be made with regard to pre-implantology arguments, where a pleasing variety of surgical techniques and materialsislisted,butnogenerallyvalidschemehas been agreed upon. The fact that the need to develop and convey thesetrouble-shootingconceptsisgenerallyrecog- nised today and that these concepts are yet widely supported by the participants on the implant mar- ket is gratifying. The specialist press has made a valuablecontributionhereandcontinuestodoso— numerous articles that received a great deal of at- tentionduringthepast15yearsarethosethatdealt withimplantologyandimplant-prosthetictrouble- shooting. _Digital implantology I consider the establishment of 3-D diagnostic imaging, with all associated possibilities, to be the significant development during the 15-year obser- vation period. It is true that only implantologists used the new 3-D technology during the initial phase of dental volume tomography (because they made up the group of dentists who could actually afford this expensive equipment); nevertheless, 3-D technology constituted a quantum leap for dental diagnostic imaging as a whole. Today, we have almost unbelievable possibilities at our disposal that even the greatest optimists would not have considered possible 15 years ago: highly complex patient cases can now receive min- imallyinvasivetreatmentandhaveimplantsplaced even without the need for augmentation. Ourfirstcaseshowsahighlyatrophiedmandible, inwhichfourimplantscouldbeplacedwithoutany prioraugmentationowingto3-Ddataandplanning (Figs. 22–24). Three-dimensional diagnostics are sometimes also employed to clarify facts when complications have arisen, for example neural le- sions after implantation (Figs. 25 & 26) and bone necrosis after administration of bisphosphonates, and erroneously diagnosed as peri-implantitis (Fig. 27). _My personal conclusions It is difficult to draw a conclusion regarding the developmentofimplantologyoverthepast15years because it has been so multifaceted and rapid. To conclude, I would therefore like to quote my aca- demic teacher and former supervisor, Prof. Wilfried Schilli, who, as a founding member of the Interna- tional Team for Implantology, was undoubtedly among the pioneers of implantology and has con- tributed to improving implantology through his universitywork:“Whowouldhavethoughtthatim- plantology could develop like it did in less than twenty years.” This very true statement encompasses many as- pects: the admiration and appreciation of what has beenachieved,thesatisfactionwithhavinginitiated aprocedurethatisconsideredtobethesafestinthe entire field of medicine, and some criticism regard- ing any development in oral implantology that did not turn so well or went off course._ 12 I implants1_2012 Fig. 24 Fig. 25 Fig. 26 Fig. 27 Dr Georg Bach Rathausgasse 36 79098 Freiburg/Breisgau Germany Tel.:+49 761 22592 doc.bach@t-online.de _contact implants