Implant dentistry in today's highly esthetic environment

By Edgard El Chaar, DDS, MSFor the past 35 years, dentistry for the most part has been a repair business with patients and dentists primarily interested in replacing or fixing teeth, removing cavities, and/or treating oral diseases. Today, dentistry has evolved into a broader field, driven by esthetics, beauty, and style, with images of models and sparkling smiles covering the pages of our magazines.A few summers ago, I was lecturing in South Carolina and I read the state’s motto on a license plate, “Smiling faces, beautiful places.” It was perfect timing as this was the essence of my lecture — how dental professionals can integrate implant dentistry into today’s heavily esthetically driven cosmetic dentistry. The most successful dental work I have seen happens when the patient and dentist work together as a team. For many patients, dental implants are often the best solution. With a dental implant, your patient can truly enjoy the freedom of permanent teeth. From simple flossing and better oral hygiene to a more natural look, dental implants are a great choice in making your patient 100% satisfied.Patients who lose teeth from an infection may experience surrounding bone loss. The bone and soft tissue that surrounds the dental organ after extraction can lose its volume and shrink, which can lead to “ridge deficiency.” With the advent of novel surgical grafting materials and advanced surgical techniques, the risk of ridge deficiency has now been reduced to nearly zero. Today’s grafting materials have evolved from the conventional particulate to moldable putty that can fill the entire space the tooth once occupied. New solutions, such as growth factors, can be used as a substitute to bone graft, or there is also a naturally occurring protein that exists in the bone called recombinant human Bone Morphogenetic Protein-2 (rh-BMP2), which can accelerate human bone formation by attracting stem cells and transforming them into bone-forming cells. Another cause of tooth loss can be tooth fractures that don’t have any loss of supporting bone around it. As such, rather than grafting the site, a dental implant can be used and placed immediately (and even implanted with a temporary crown) the day of the surgery. This is a highly successful and commonplace technique these days. The advantages here are many; the procedure preserves the normal aspect of the gum contour, provides a temporary crown that looks like a natural tooth, does not impede on the neighboring teeth, and also is a time savings by having the final crown in four months instead of waiting six to 12 months.Case showing dental implants for a failed root canal —

AfterThe possibilities are endless with dental implants, especially in today’s esthetically demanding dentistry. The most important part in achieving both your and your patient’s goals is clear and ongoing communication. This means taking the time at the patient’s initial consultation to study the case carefully and gather all of the needed information either by dental models, cone beam tomography (radiographical digital 3-D image), or clinical images. The next step is evaluating all the information together and showing the patient a mock-up, called a “wax-up,” that can give the patient a better idea of what to expect and projected results. Patient understanding is important in these cases, as these procedures are both expensive and time demanding. This is why I am an advocate of further education for dentists and patients to improve their knowledge base of dental implants and how they can help.I established the EEC Institute for continuing education for this sole purpose — to give dentists access to continuous education including peer case review. This enables the dentists to master this treatment and return to their practices and where it is applied to their patient. This experience proves my theory that “the more details are covered in communication, the better execution.” For more information and/or upcoming EEC Institute courses, please visit: http://www.eecinstitute.com/.