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Implantologists and Board Certification

I downloaded the following page from a dental group. I find their analysis of "Implantology" offensive so I am taking this opportunity to respond to it.... My responses will be in dark red....

"THE IMPLANTOLOGIST"

THE QUALIFICATIONS AND THE CHOICE OF THE BEST IMPLANTOLOGIST FOR YOU:

UNFORTUNATELY, NOT ALL THOSE WHO CALL THEMSELVES IMPLANTOLOGISTS ACTUALLY HAVE THE QUALIFICATIONS WORTHY OF THAT TITLE. (I certainly agree with that one...)

    • AN IMPLANTOLOGIST MUST BE A DENTIST! (Well, an Implantologist, must be a Dentist! But, a dentist does not have to be an Implantologist to work with dental implants. As a matter of fact, "Implantologist" is a made up name implying some sort of specialty status in the use of dental implants. Implantology is NOT a specilaty!)
    • QUALIFIED DENTISTS HAVE EITHER THE DDS (DOCTOR OF DENTAL SURGERY) OR DMD (DOCTOR OF MEDICAL DENTISTRY) DEGREE. (ok)
    • AN IMPLANTOLOGIST MUST HAVE TRAINING IN IMPLANTOLOGY! (No such animal as an implantologist.... what they really mean is that the dentist who is either placing or restoring dental implants should have training in that discipline....)
    • TAKING A COURSE IN IMPLANTOLOGY IS NOT ENOUGH TO QUALIFY A DENTIST AS AN IMPLANTOLOGIST. EXPERIENCE, EXPERIENCE AND MORE EXPERIENCE IS VERY NECESSARY. (Of course experience is important. Why do you think they call it the "practice" of dentistry? Just remember, everyone starts from some place. I have seen trained individuals such as oral surgeons or periodontists do a beautiful job on their first implant placement and I have seen some so called implantologists who do hundreds of implants do them all really poorly!)

      BEFORE YOU DECIDE ON AN IMPLANTOLOGIST, ASK A FEW QUESTIONS:

    • ARE YOU A MEMBER OF (AAID) THE AMERICAN ACADEMY OF IMPLANT DENTISTRY? (The AAID is an organization of dentists who like to do implants. So is the Academy of Osseointegration and the American Academy of Implant Prosthodontists and several other organizations. None of these organizations have any official status in Dentistry nor does membership impart any special ability or training.)

      CREDENTIALED MEMBERSHIP REQUIRES PROOF OF MASTERY OF SEVERAL IMPLANT SYSTEMS AND THE COMPLETION OF RIGOROUS WRITTEN AND ORAL EXAMINATIONS. (This is not proof because there is no definitive academic program that participants must follow.)

    • APPROXIMATELY HOW MANY IMPLANTS HAVE YOU DONE? (We know that there is a significant learning curve in this field, but after the first 50, research shows a fairly constant result. And again, specialty trained individuals usually pick this field up quite rapidly. It is not important how many you have done, just how well you do them....)

      THERE IS NO SUBSTITUTE FOR EXPERIENCE, SO BEWARE OF THE IMPLANTOLOGIST WHO HAS DONE ONLY A FEW IMPLANTS. (Experience does NOT assure Quality!)

    • WHAT TYPE OF IMPLANTS DO YOU DO?

      THE IMPLANTOLOGIST MUST KNOW ABOUT ALL THE PROVEN TYPES OF IMPLANTS......BEWARE! (Absolutely ridiculous!. Think about it for a minute. I would much rather go to someone who has mastered one implant system and does it real well than to some "jack of all trades". Besides, research has shown that endosseous root form implants have the highest success rates in all applications so why would anyone want to go into the lesser systems....?)

    • DO YOU BELIEVE IN IMPLANTS ONLY AS A LAST RESORT?

      AN INEXPERIENCED IMPLANTOLOGIST WILL ALWAYS FIND REASONS FOR NOT DOING THE IMPLANT PROCEDURE NO MATTER HOW BADLY YOU NEED IMPLANTS, BECAUSE THEY HAVE NOT MASTERED THE ART OF IMPLANTOLOGY YET. (Hold onto your hat... Except for the "Implantologist" part, I agree with this statement. The biggest problem with this technology is that there are not enough dentists trained in it. That will correct as time goes by...)

    • DO YOU GUARANTEE THAT MY IMPLANTS WILL LAST?

      BEWARE OF THE IMPLANTOLOGIST WHO CLAIMS THEY CAN DO EVERYTHING AND GUARANTEE THEIR IMPLANTS WILL WORK FOREVER. ( I also agree with this statement although, you should be assured that the dentist performing the service stands behind it.)

      FINALLY, DO YOUR HOMEWORK AND HAVE A LIST OF QUESTIONS READY BEFORE YOUR APPOINTMENT. IF HE REFUSES TO ANSWER ANY OF YOUR QUESTIONS, GET A SECOND AND THIRD OPINION. TO BE SAFE, GET ALL THE FACTS BEFORE YOU DECIDE. (I agree with this as well.)




      I practice in an area of the country where there happens to be a fairly large number of dentists who refer to themselves as "implantologists". My impression has usually been that their work does not live up to the standards of dentistry utilizing dental implants that many specialists would uphold. Of course there are specialist who can not do this phase of dentistry real well either. If you want to find a dentist that is competent in this area of dentistry, you could look at the following points:

  • Does the dentist providing the specific procedure have a good reputation for this type of work?

  • Are there other dentists who would recommend this individual?

  • Does the dentist have specialty training?

  • Is the dentist certified by a legitimate specialty board? (Check with the American Dental Association if you are not sure.

  • Have you talked to other patients of this dentist who have had the same procedure?

  • Are you comfortable with this dentist?

  • Do you feel reasonably assured that this dentist will stand behind his or her work?

  • Did you get another opinion?

teeth in a Day

Competition among dentists has resulted in developing ways in which we can make dental implants more attractive to our patients. Dentists have come up with things such as "Teeth in a Day", "Teeth Today" and even "Teeth in an Hour". The goal of all of these protocols is to get the patient their "Teeth" fast and efficiently. The problems with these protocols are that they are directly against the original Branemark protocols that gave us the first really successful dental implants and they bypass the basic tenants of sound implant placement and good prosthodontic judgment.

True these procedures do work out in some cases but they always carry a higher failure rate and a greater overall expenses. They may lead to an actual time of treatment that is much longer than more consevative protocols. Over the years, I have done a number of these cases with fairly good results. I picked my patients very carefully to use only the ones who I felt would lend themselves to these techniques and have generally avoided the failures that some of my collegues experience.

 When all is said and done, I recommend to my patients to do this with the tried and true conservative method which while it takes a little longer, always results in a superior restoration and a happier patient.

Mini Dental Implants

I get a lot of emails asking me the difference between "Mini Dental Implants" and "Regular Dental Implants" so I would like to address the differences. . .

When we refer to a regular dental implant, we are referring to an implant that is approximately 4.0mm in diameter and is placed in a prepared site in the bone. These are the implants that were first introduced in the mid 1980's and they were the first implants to show successful, long-term support for dental restorations. These implants actually come in a variety of shapes and sizes but they all require drilling of a site and placement of the implant into that site. Bone will eventually bond to the surface of the implant and the implant will become a "permanent" fixture in the jaw bone. We have a tremendous amount of research and study on how this process works and verified statistics indicating excellent long-term success.

Mini Implants have a diameter of about 2mm. They are placed in bone as a self tapping entity which means that a site is not prepared. These implants seem to rely on mechanical stability and there are no studies that show any integration with the bone. As a matter of fact, there are no studies at all on these implants since they were merely designed to be used as temporary implants to be removed at a later time. In some instances, mini implants can last a very long time and they are very useful in stabilizing a lower denture, especially in an older patient who might not be suited for surgery.

There are lots of dentists out there saying that mini implants work just as well as regular implants. Most dentists use mini implants the way they were meant to be used, cautiously and in very specific situations. Others use them for everything that regular implants are used for and get into lots of trouble with the failures. The bottom line is that mini implants are best used to stabilize a lower denture in a very economical manner.

If you are over 70 years of age, in poor health and need some stabilization of your lower denture, you might consider mini implants. If not, stick with the real thing. SRD

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