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CAD/CAM - international magazine of digital dentistry

I opinion _ implantology must be generated so that these investments can be made—andtheyarestillmade,albeitdecliningowing to the economic crisis. Still,theimplantmarketisbooming.Althoughthe consistently two-digit annual growth rates some implant manufacturers had started to become used to have become more moderate today, a great deal of money can be made with implants. As a result, an ever-increasing number of implant suppliers and systems make it impossible for the individual user to keep track. Aside from new systems, an increasing number of generics are being launched on the market. _Focus on red-white aesthetics The President of the German Society for Dental Implantology (Deutsche Gesellschaft für Zahnärztli- cheImplantologie),Prof.FrankPalm,aptlyremarked, “What was celebrated as a triumph for some col- leagues 20 years ago is today taken to court.” Den- tists who practised implantology were not prepared to find themselves confronted with a debate that had spread from North America to Europe: that of red–white aesthetics. This new focus on achieving the highest possible aesthetics for implant-pros- thetic treatments was linked to implantology and distanced itself from surgery, which had been domi- nant up until that time. Intheearlyphaseofimplantology,themainfocus was on safe placement and the best possible place- ment in the bone, sometimes even at the expense of subsequent prosthesis treatment owing to unfav- ourable placement of the artificial abutment teeth. Now, however, prosthetic standards and issues havebecomethecentreofthediscussion.Placement techniques were modified and new techniques were established in order to satisfy these requirements. Patients no longer, or only occasionally, accept de- manding and complex cases like the following case. Both implants in the anterior maxillary region were placed too far buccally, and there was a gap of 5.5 mm between the implant shoulder and the cemento-enamel junction of the adjacent teeth (Figs. 8–10). Treatment with a long-term temporary restoration would only have yielded an unsatisfac- toryaestheticresult.However,undercertainsurgical and dental conditions—as shown in our second ex- ample—superior results and stability for a period of ten years can be achieved even with challenging ini- tial situations. In 1999, an immediate implant was placed in region 12. The following images show the stepsoftreatment(Figs.11–13).Thelastimageshows the condition after ten years (Fig. 14). This development was made possible mainly by massiveimprovementsintheareaofaugmentations, which can now be performed with significantly higher predictability. This development was further enhanced by a considerable improvement in the training of implantologists. These improvements are significant for both undergraduate study and post- graduate training. Thus, the universities and profes- sionalassociationswhohavecontributedimmensely in this area deserve much credit in this respect. 18 I CAD/CAM 1_2013 Fig. 11 Fig. 12Fig. 10 Fig. 14 Fig. 15Fig. 13