CAD/CAM - international magazine of digital dentistry

opinion _ implantology I I 17CAD/CAM 1_2013 _The end of dogmas While implantology was marked by many dogmas fromitsbeginningandthemid-1990s,thishadchanged atthetimewhenour15-yearobservationperiodbegins. However,implantologywaslatercalledintoquestionin itsentirety.Whetheritwashealingtimes,waitingtimes afteraugmentationorprostheticconcepts—everything underwent scrutiny. On the one hand, some of these dogmasdidinfactprovetobenolongersustainablebe- causeofremarkabledevelopments,especiallyimprove- mentsinimplantsurfaces.Ontheotherhand,themark was at times overshot in the elimination of other dog- mas,creatingtheneedtoback-track.Thiswasapainful experienceforbothpatientsandimplantologists. Onedogmathatweencounteredintheobservation periodwasthatofastrictrefusalofimmediateimplant placement.Thereisgeneralconsensustoday,however, that under suitable conditions an immediate implant placementcanbeahighqualityandsustainablealter- native to established procedures. One clinical case shows an immediate implant placement in the maxil- lary anterior teeth: the extraction and the immediate implant placement of a maxillary anterior tooth that was not worth preserving under the guidance of a drillingtemplateandimplantposition(Fig.1),transfer into the oral cavity (Fig. 2), and the condition immedi- atelyafterinsertionoftheimplantcrown(Fig.3). _The prospering of the implant market Awelcomevarietyofnewimplants,implantforms and prosthetic options has become a reality in the past 15 years. Special implants were developed for special indications so that now even a mandibular molar can be replaced by a corresponding sized im- plant, followed by insertion of a corresponding sized implant crown. Figures 4 to 7 show the clinical and dental appearance of these in a patient. Implantolo- gists who placed several hundred implants annually were considered the big players on the implant mar- ket in the 1990s. Achieving the mark of 100,000 im- plants placed per year in Germany signified that the peak had been reached. This was not the case, since the one-million mark was also reached within the scope of a rapid, almost unimpeded development. While the increase has been slower in recent years and global economic developments even caused a brief decline, today we can assume that the implant market will continue to grow. The maximum growth phase falls into our observed period. _Development in the eyes of implant manufacturers From manufacturer to global player—this would be an accurate description of the development of some implant manufacturers. The development of some of these companies over the past 15 years, the size of their companies and the number of their employees today are indeed impressive. And these prosperous companies share other characteristics as well: the acquisition of products and entire firms inordertoexpandorsupplementtheirproductport- folio and their pressing on to the field of digital dentistry(CAD/CAM,planning,etc.),intowhichthese global players invest large sums of money. Revenues Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9