Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2018-02-22, 10:39:24 | version 1.38.0
Dental Tribune Middle East & Africa Edition | 2/2017 ◊Page D2 IMPLANT TRIBUNE D3 Given that ceramic implants are a viable alternative to titanium, why do many den- tal professionals still regard them with skepticism? The early stages of ceramic implants were so difficult and controversial so much so that a stigma regard- ing their viability and functionality still persists. I would rather ask this question: “Why aren’t there more dentists placing ceramic implants despite evidence of their viability?” This is the case for a few reasons. Metal implants have a very strong background and the cost of manu- facturing zirconia is still pretty high. All of the major implant manu- facturers (with the exception of Straumann) do not have a ceramic implant on the market, let alone in development. Furthermore, the cost of production and pricing of titani- um implants have decreased, mak- ing them more accessible to dentists and patients. I would also add that dental materi- als are evolving very fast and dental schools and graduate programs are lagging in educating their students on the capabilities and applications of these new materials. I often have conversations with dental academ- ics, professors and new graduates and unfortunately, for the most part, there is a distorted view and misun- derstanding of zirconia. To many, accepting zirconia as a restorative material is an easier exercise than recognizing it as an implant and im- plantable material, but I have seen this changing rapidly over the last couple of years. oral environment. Galvanism is the most important, but often ignored problem. All dentists are taught in dental school not to mix dissimilar metals in the oral cavity—neverthe- less, this rule is consistently violated with implants. We have implants connected to all kinds of alloyed abutments, screws, crowns and cop- ings even when they come from the same manufacturer. Galvanic corro- sion occurs and studies have shown that in the process, metal ions get released into the surrounding soft tissue, bone, lymph nodes and even distant organs. Corrosion also come from mechani- cal functional stresses that induce cracks and pitting of the metal and breaches in the oxide layer. Zirconia ceramic implants, alternately, do not conduct electricity or heat, are non-corrosive and retain very little biofilm and plaque in comparison to metals. Furthermore, studies have also shown better vascularization, soft-tissue health and apposition with zirconia in comparison to tita- nium. What is the success rate of ce- ramic implants? Ceramic implants today, in my expe- rience and for many fellow ceramic implantologists, have the same success rate as titanium implants. They are now as versatile as metal implants thanks to the evolution in design, surface enhancement proto- cols and biomaterial improvements. Various treatment modalities are ap- plicable with ceramic implants. Im- mediate placement, immediate tem- porization, full-arch and full-mouth rehabilitation can be performed with excellent and predictable outcomes. I, however, believe that adopting ceramic implants should be accom- panied by a minimum amount of training or shadowing from an ex- perienced clinician, even if one has experience with titanium implants. Dr. Sammy Noumbissi is the founder of the International Academy of Ceramic Implantology. (Photograph: Dr. Sammy Noumbissi) free alternatives for teeth repair or replacement. Dental attitudes and understanding of zirconia and bi- oceramics are slowly, but steadily evolving, with a definite shift toward biological and inert materials. There has also been a shift in the healthcare industry towards wellness, wellbeing and providing therapies that have little to no side effects. As I previ- ously mentioned, some of the larger players in the implant industry are incorporating or have already adopt- ed ceramic implants in their product line, either by development or by corporate acquisitions. A quiet, but major shift is happening in implant dentistry. The other primary objective was to reach out and help our colleagues better understand bioceramics and realize that metal-free implants are a viable and proven alternative. With the help of our supporters and through our other educational activ- ities, we plan to establish a research fund in 2017 to support graduate dental students and residents who elect to conduct projects involving ceramic implants. The IAOCI will be hosting its Sixth Annual World Congress in Miami, Florida. What can dental professionals expect from the event? We are fortunate, honored and privi- leged to have Prof. Sami Sandhaus, a pioneer and forefather of ceramic implantology, as our keynote speak- er. The theme of our congress in February 2017 is “Evidence-Based Ce- ramic Implantology – Where Are We Today?” For three days, the congress will host a gathering of the world’s foremost authorities in ceramic im- plantology and dental bioceramics. Our speakers will share data gath- ered over 10, 15 and even 20 years re- garding ceramic implants. They will also cover zirconia as an implant ma- terial, its behavior under function, its biocompatibility, immunocompat- ibility and superior hygiene proper- ties, and the lack of galvanic activity, corrosion and ion release in ceramic implants. We will also be offering surgical and prosthetic workshops on implant systems from the top three indus- try players. This is a great opportu- nity for current users, non-users and even skeptics to come and listen to 15 world-renowned and published ex- perts present and share their experi- ences and expertise around ceramic implants. Thank you for the interview. Where do you see the field of ceramic implantology head- ing? The future of ceramic implants is really bright for many reasons. Pa- tients increasingly ask for safer, less invasive solutions, as well as metal- What prompted you to es- tablish the IAOCI? The IAOCI was created to provide a platform where ceramic implant adopters and believers can exchange ideas, experiences and engage in clinical and scholarly conversation. Interview: “Implant failure is a failure for both the dentist and the patient” By Marc Chalupsky, DTI Originally from Syria, Dr Iyad Es- toiny obtained his master’s degree in fixed and removable prosthodontics in France before moving to Dubai in 1997. An implantologist and general dentist at GMCClinics in the heart of Dubai, Estoiny also focuses on pros- thodontics and aesthetic and laser dentistry. In an interview with Den- tal Tribune Middle East, the implant specialist spoke in favour of proper oral hygiene and individual prophy- laxis training, two areas of dental care that are essential for long-term implant success. Dental Tribune Middle East: You are originally from Syria. How was the dental training at your school? Dr Iyad Estoiny: I received my DDS in 1991 from Tishreen Univer- sity in Syria. There are four dental schools in Syria, along with many practitioners. A number of Syrian dentists have moved to the UAE be- cause of their good dental knowl- edge. The dental education is still excellent in Syria. Can you summarise the state of oral health in Dubai? As Dubai is a multicultural city, one sees problems from all over the world. Some patients are highly mo- tivated in terms of their oral hygiene, while one has to put in a great deal of effort with some others. In terms of oral hygiene, I have seen that peo- ple have started to become aware of dental problems and products. In the last five years, people have become more focused on beauty and aesthet- ics, which in turn has led to a higher interest in healthy teeth. We also have an overwhelmingly young population in this country; consequently, there are only a few older dentists here. Eighty per cent of expats are young. This means that one does not see any advanced periodontal problems, but one does increasingly see stress-related brux- ism, which in turn leads to periodon- tal problems. How would you evaluate the market for oral hygiene in this region? The market here is competitive and small. We do not sell the products, but give it to patients. If they like it, they can buy it at the pharmacy. This has worked well. For us, it is impor- Dr. Iyad Estoiny, GMCClinic (on the left) tant to ensure that patients have the correct interdental brush size. This means that we tell them what size they need. A dental hygienist or peri- odontist usually gives instructions and explains everything. One always needs to determine the correct sizes and give proper instructions. As an implant specialist, what do you think about prevention? There does not seem to be a strong connection between implantology and prevention at first, but just look at the problem of peri-implantitis. One needs to treat peri-implantitis as a bacterial problem and thus one must give clear instructions for cleaning, which involves interdental brushes and mouthwashes. Preven- tion is always the golden rule for any implant. If I do not see good oral hy- ÿPage D4