today EAO Madrid October 06, 2017

Teeth within an hour: A ticking time bomb By EAO presenter Dr Göran Urde, Sweden (cid:132) In my lecture at this year’s EAO meeting, attendees received an over- view of over 50 years of working with implants and why we did it in certain ways back then and why we do it dif- ferently today. When I started placing implants, they were only for special- ists in oral surgery and prosthetics. Periodontists were not even allowed to listen to our lectures. One also had to be thoroughly trained if one wanted to purchase implants. Compa- nies kept records of the clinician’s success rates and if he or she had a higher than normal failure rate, they showed him or her the door to ﬁgure out alone what had gone wrong. In some instances, the warranty did not even apply if the dentist was not very good. I wish we had a similar system today to save patients from less skilled peers. Later, everyone was allowed to take a course and to place implants. Often, these were just weekend courses after which the dentist was AD supposed to be a fully qualiﬁed sur- geon and prosthodontist and knew everything, including single-tooth restoration, full-arch rehabilitation of severely resorbed jaws with bone grafts and immediate loading con- cepts. It was totally absurd. To place implants, one needs to be well trained—learn to walk before one starts to run. To my delight, I see that more and more implant companies are aban- doning weekend courses and instead offering high-quality courses over a longer period. Attendees have to treat patients under supervision and com- panies even offer mentor support, which means clinicians are receiving guidance in conducting their treat- ments. The best courses are of a gen- eral nature, where the sole purpose is to train dentists to place implants and do this well and not how to do it with a speciﬁc implant system. One thing that worries me a great deal is all the copy-cat versions 6 26th EAO Annual Scientiﬁc Meeting news In my opinion, this is a ticking time bomb. It is just a matter of time before patients will come back with problems like peri-implantitis and fail- ing implants. Who is going to sort that out? In the good old days, patients had to cooperate ﬁrst and then we placed the implants. Maybe this was a bit harsh, but success rates were higher then and fewer patients ended up with problems. One does not have to be a rocket scientist to understand that, with a mouth full of pathogens, the success rates will go down. like I have been heavily involved in “Tooth developing concepts Now”, according to which a tooth is extracted and immediately replaced with an implant and loaded with the ﬁnal abutment and a temporary (cid:22)Dr Göran Urde is the director of the Futurum Clinic at the Malmö University’s Faculty of Od- ontology. On Thursday, he presented a paper ti- tled “Evolution of surgical protocols in implant dentistry” as part of this year’s EAO 2017 scien- tiﬁc programme. of implants that are being marketed to less experienced dentists who cannot determine what a good prod- uct is. I always tell my audience to never treat patients differently to how they would treat their own fam- ily. The unfortunate thing is that I often see members of the audience looking down because they feel ad- monished. They do not understand that they get what they pay for and crown, with extremely high success rates when it comes to both implant survival and even more so the aes- thetic outcome. Therefore, I am not against immediate loading at all, but case selection is very important. That is why good training courses con- ducted over longer periods are so im- portant. Guided surgery is both good and bad. The saying of “garbage in, gar- that failures are very costly and can hurt both their reputation and pa- tients. Another topic that gets me going is the marketing of new teeth in an hour. Patients that for decades have not taken care of their natural denti- tion are now being treated in accord- ance with concepts like immediate loading. Within an hour, any remain- ing decayed teeth are removed and replaced with implant-supported crowns and bridges in the belief that the patients will start taking care of their new teeth. Unfortunately, this is not realistic. bage out” is apt in this regard: if one has the wrong information or inter- prets the digital information incor- rectly, one might get into trouble if a fully guided surgical template is based on that. I do not agree with fully guided surgery as it is today, as I be- lieve our brain needs to be connected instead of just computers. Do not get me wrong, I love to work with digital planning tools like NobelClinician (Nobel Biocare) to optimise my treat- ments, but instead of fully guided I prefer to use simpler surgical and/or pilot bur guides that do not force me to drill in a certain way. (cid:26)

today EAO Madrid October 06, 2017

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