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58 — issue 2016 Interview INTERVIEW with — Dr. Stavros Pelekanos Q:Dr.Pelekanos,whatistheroleofesthetics in dental implantology today? A: Implantology in the 1980s and 1990s was bone-driven.The Albrektsson criteria for a successful implantation back in 1986 did not even refer to esthetics and were followed for many years to come. Nowa- days, prosthodontists start the treatment and perform backwards planning, always keepinginmindthecorrectpositioningof the tooth or teeth to be replaced. Q:Patients’expectationsregardingesthetic results are growing with the emergence of new technologies and materials. However, have these innovations trulyarrived in every dental office? A: Well, in continuation of myresponse to your first question, there are two major problems that the dental community has been facing in recent years, incorrect im- plant positioning and periimplantitis both being difficult to resolve. As patients be- come more aware ofthese complications, they expect and demand more esthetic andpredictableresults.Newtechnologies such as high-resolution CBCT, CAD/CAM abutment manufacture, abutments pro- duced using new zirconia technologies, and digital planning are already widely in useineverydaydentistry,minimizingrisks, as well as enhancing esthetics and treat- ment workflow. Q: Have digital solutions changed the way dental restorations and full-mouth rehabil- itations in particular have been performed over the past several years? A: Digital planning, intra-oral digital im- pressions and CAD/CAM technologies have really changed implantology today. Firstofall,preoperativeplanningisahelp- fultoolforensuringcorrectimplantplace- ment, for both novice and experienced surgeons. Furthermore, more conserva- tive (sometimes flapless) surgical ap- proachesresultinmuchlesspostoperative swelling, facilitating greater patient ac- ceptance.Thedigitalworkflowinprostho- dontics facilitates milled abutment con- structions or even same-day teeth when immediate loading or provisionalization is chosen in the treatment planning. CAD/CAMlaboratoryproceduresreduce human error, providing more robust and accurate frameworks and final recon- structions. Q: In your experience, what is the best way toachieveanatural-lookingimplantcrown? A: Irrespective of the digital revolution, the hand skills of a talented dental tech- nician are indispensable, especially in the caseofasingleimplantcrownnexttonat- uralteeth.Machineswillneverreplacethe human hand, as individual perception of every case, the knowledge of biology and anatomy are of the greatest importance. The factors that determine the success and natural appearance of an implant crown are accurate implant positioning, meticulous bone and soft-tissue handling, and a skilled dental technician. Q:Thenumberofimplantsplacedworldwide is expectedto double overthe next fiveto six years.Consequently,educationeffortshave todoubletooinordertoensurethatdentists are adequately trained in implant place- ment. Do you agree with this statement? A: Of course; however, and I say this al- thoughIamafacultymemberoftheSchool of Dentistry of the University of Athens, which provides education at the highest level, students are still unfortunately not adequatelytrained in implants. Postgradu- ate studies in a university environment or very well-organized implant master pro- gramsarenecessaryforadentisttobeable to place or restore implants. Q: We have seen quite a few different con- cepts emerging overthe last several years in estheticdentistry,suchasbio-emulationand smile design. Which concepts will have the most impact in the future and change the way esthetic dentistry is performed? A: Well, as a prosthodontist, I have to say there is nothing new in these concepts. Basic esthetic rules are to be applied in every prosthodontic case, such as tooth positioning, proportion, occlusion, color anddesign.However,digitaltechnologyis a very helpful tool, especially for the novice dentist, for implementing these rules and simplifying the treatment work- flow. The same applies to bio-emulation. Biological concepts, improved materials andtechniquesarealwaystheretosimplify clinical dentistry and reduce potential er- rors and complications. Q: What is the position of esthetic dentistry in the development of dental specialties in your opinion? A: Esthetic dentistry is not a recognized specialty generally, falling mainly under prosthodontics. I do not think esthetic dentistry should be a stand-alone specialty. Being trained in a periodontic-prosthodontic environ- ment (University of Freiburg, Germany, under Prof. J.R. Strub), I believe that a modern restorative dentist should be ad- equately trained in more than one main area. Periodontics, prosthodontics and restorative dentistryall constitute what is considered esthetic dentistry. “As patients become more aware of these complications, they expect and demand more esthetic and predictable results.” Interview_Pelekanos_00-00.qxp_Layout 1 02.03.16 21:04 Seite 1 Interview_Pelekanos_00-00.qxp_Layout 102.03.1621:04 Seite 1