Monday, March 16, 2009

The Evolution of Implant Success

The 7th Annual Spring into Dentistry seminar was held on March 6th, 2009 in Mesa, AZ. The guest lecturer was Dr. Robert London of Seattle, Washington. Dr. London is currently a clinical professor and director of graduate periodontics at the University of Washington. Prior to his work at UW, Dr. London was director of graduate periodontics at NOVA Southeastern and at University of Southern California.
Dr. London's presentation was entitled, "Enhancing Dental Outcomes".

While a good portion of his presentation had to do with implant treatment planning and preparation of implant sites, he made some comments that I found fascinating.

He used an analogy of a pendulum to describe the acceptance of dental implants into mainstream dentistry. Early on, there was some resistance to accepting them into everyday practice. Like the swinging of a pendulum, treatment with dental implants then became the solution to every situation. Now that the pendulum has swung to both extremes, we are now hopefully settling somewhere in the middle.

He also discussed the changing definition of success with implants. Early on, successful implant therapy meant osseointegration. If the implant was not loose, it was considered a success. In endodontics, success has always been defined very strictly as the complete resolution of signs and symptoms and complete healing of bone. With two such different definitions of success, it is no wonder that there has been misinterpretation regarding the treatment outcomes of the two different treatments.

Dr. London pointed out that what was once considered a successful implant (osseointegration alone) may no longer be an acceptable treatment outcome. Successful implant therapy now requires getting the implant to integrate in the right position, where it can support a prosthesis and look like a natural tooth. This is a major difference from simple osseointegration.

Dr. London stressed how important it was to have an interdisciplinary approach to dental treatment so all specialties are included in the best treatment approach for each patient.

We were pleased to have Dr. London come and share some of his expertise regarding periodontal bone grafting and implant treatment. We hope that the balanced approach to endodontics and implants which he described continues to gain momentum.