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easy: compared to an often long-lasting and painful periodontal therapy, implant therapy features the advantage of a singu- lar, minimally-invasive implant insertion. In addition, implants are claimed to be life- long restorations. From the dentist’s point of view, this estimation of implant therapy can neither be confirmed nor supported without restrictions, as it should predomi- nantly be based on long-term results. Long-term success of implants The experiences of the last three years regarding the insertion of artificial dental piers and their treatment with dentures are positive. Independently of the kind of in- sertion, implants show very good long- term success rates. This long-term success is slightly less evident in the maxilla than in the mandible and yet compared with other forms of treatment the loss rate is low. Risk factors Limiting the long-term success are for example life-style factors (nicotine con- sumption), incorrect insertion techniques, shortcomings of the aftercare, oral hy- giene as well as unrestored periodontal diseases. Learning curves Cases 1 to 3 confirm the positive experi- ences previously made in implant therapy, if an optimal indication is given, insertion is done carefully and there are regular check-ups. Even after two decades, pa- tients are content with their implant-pros- thetic restorations and there are no signif- icant negative tendencies. From the author’s point of view, it seems impressive that long-term stability seems a given even if the patient does not fulfil all require- ments, for instance the low compliance in case 2. If, however, the patient disposition is mainly characterised by negative prop- erties (insufficient compliance, bad oral hygiene, non-restored periodontal dis- eases, nicotine abuse), implant therapy can become a tragedy, as can be seen from case 5. Severe complications can also be traced back to inadequate operation techniques. Hence, only one step of the treatment chain in case 4 was imperfect: the aug- mentation ali loco (sinus lift). Whereas the CBCT findings were inconspicuous, the newly-created implant site was insuffi- cient and unable to support the inserted implants for more than a year. This resulted in the loss of three implants and the supra- construction as well as a significant defect —a total failure! Personal résumé One thing is certain: Implantology epito- mises the crucial development that has been taking place in dentistry over the course of the last 30 years. Thanks to the current state of implantology and the op- tions it presents, we can now treat patients successfully that in the past were given conventional, not implant-based dentures that left them unsatisfied. Due to much improved implant surfaces and honed insertion techniques, implan- tology has become established and turned into a reliable and secure procedure. Early complications that were much feared during the initial stage of oral implantology, have now become a rarity. However, implantology still holds both highlights and lowlights. Besides the indi- vidual abilities of the implantologist and his limitations, aspects such as the correct classification of the degree of severity and the assessment of the patient and his com- pliance, carry a growing importance. Furthermore, due to its large degree of invasion, the incurred costs and the fact that to place an implant is always a proce- dure based on choice, implantology must be—per se—committed to sustainability. Also, implantology is not as easy as it is often conveyed. It entails triumphs as well as risks._ Author details contact Dr Georg Bach Fachzahnarzt für Oralchirurgie Rathausgasse 36 79098 Freiburg/Breisgau, Germany doc.bach@t-online.de D A overview | visio.lign® nics IMPLANTOLOGY MEETS BIONICS The SKY® fast & fixed Therapy Train the bone – save the tissue with Bionic framework and veneering materials. 10 years success in immediate full arch restoration. • Easy to use • Aesthetic results • Increase proit Call (+49) 0 73 09 / 8 72-4 41 to get more information about the indications and the versa- tility of the SKY® fast & fixed therapy. bredent medical GmbH & Co. KG | Weissenhorner Str. 2 | 89250 Senden | Germany