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In the last two decades if one thing that has revolutionized dentistry and the treatment planning it has been the evolution of dental implants with a very high degree of predictability and prognosis. Ever since the breakthrough turning point discovery of titanium and its Osseo-Integration property by prof. Branemark ,if their is one field of medicine that has benefited the most that has been restorative dentistry.

Even as a prosthodontist we need to accept that there are certain anatomic conditions, individual preferences and some systemic conditions for the fully and partially edentulous [distal extensions] where conventional removable prosthesis do not give satisfactory results to patients and also to dentist. These patients have also been coined as dental cripples by us.

Today where conservation is the rule and more and more venners and partial crowns are being advocated against conventional crowns ,conventional fixed partial denture treatment needed more rationalisation with a lot more patients preferring artificial roots for replacement of their teeth to bridges which undermine their healthy natural adjacent teeth.

Implant surgery and implant prosthodontics have seen dramatic advances in the form of atraumatic extractions for socket preservation either for immediate or delayed implant placement to CAD CAM guided surgery for immediate replacement/function. sinus augmentation procedures, block grafts from intra oral and extraoral sites, nerve repositioning have become the order of the day today. Now dentistry has been gaining popularity with advances in implant surfaces to take up immediate load and the advent of single piece implants.

Although their has been such a drastic change in dentistry with implants unfortunately their has been inadequate education in this field both in under graduation and post graduation level. Majority of General dentist who have graduated just a couple of years ago and who have graduated probably a decade ago are still ignorant about complete science and rehabilitation using implants. This has led to a huge gap to be filled between the patient demands for a better prosthesis and a lot of dentists unable to meet up to their needs. Our effort to bridge this long gap has been the implantation of the school of dental implants , an advanced surgical and prosthetic training programme.

-Innovation technology and research

Innovation, and technology need to be in sync with research and development and this R&D is motivated by demands and needs / wants of dentists and patients alike. Just being back from the IDS, Cologne we implantologist were anxiously looking for any major implant manufacturer who has dared to take on the zirconia implant adventure. Their presumed biocompatibility and excellent aesthetic shade would make these implants highly desirable in the esthetic zone, provided they can withstand functional loading.

We are facing an almost endless proliferation of synthetic bone replacement materials today. Some materials serve as placeholders for natural bone formation, while other types of materials are designed to replace autologus bone grafts. How well proven and how successful are products such as procine collagen matrix straight from the pack designed to replace autologus connective tissue grafts in covering recession and augmented soft tissue ?

In addition to these developments in dental materials , new digital devices are coming more and more into focus with dentists – in diagnostics and therapy alike. Products range from 3D x ray units and computer guided implant placement all the way to optical scanners replacing conventional impression taking and even automated dental technology procedures.

CAD- CAM procedures for manufacturing implant supported restorations include opto – digital processes that dispense with plaster casts altogether. Single session chairside restorations using scanner technology could be the future. Custom components which now require manual fabrication could be produced this way.

Doubtlessly recent innovation within oral implantology has now been driven in large part by scientific progress and by the products developed by the dental industry. Prompted by an ever increasing demand by dentists and their patients, new products , new processes and improved therapeutic methods have been brought into the market for many indications – from new approaches to bone augmentation and novel procedures in laser technology to newer materials , not least the already familiar zirconia. Coming from a high level of achievement and extremely high success rates compared to other medical procedures, ever better results and shorter treatment times are not easy to attain. There are limits as to what nature will allow us to do. In the light of this realization, it is all the more important for dentists and implantologists to avail themselves of opportunities for continuing education – to keep up with technical innovations and new materials, for the benefit of patients and their own.

-Prof. Dr. Vikas Gowd
M.D.S., FICO oral and maxillofacial prosthodontist and implantologist


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