Teaching practitioners how to place implants appropriately and well is complicated.
One of the main reasons for this is that we try to teach dentists to place implants in areas where the appearance and aesthetic outcome is not as crucial as the front of the mouth in someone with a high smile line.
Placing implants in the anterior aesthetic zone is complicated. There are many factors that can influence the final result and many of these are risks that the patient brings with them which cannot be corrected by the practicing clinician. I think this is the real difficulty that people do not understand. It is not always possible to get the perfect result and we must be able to tell this to the patient before we begin. In order to do this, we must understand the situations which have to be in place for the perfect result to be achieved and if we don’t understand this ourselves, we can’t possibly advise the patient how likely they are to get a good result or not.
An example of this is vertical bone loss. The correction of vertical bone loss is unpredictable full stop. Its not that some practitioners are better at doing it than others, it is that it is unpredictable therefore you cannot promise a patient with vertical bone loss the perfect result.
The difficulty with teaching people to bring implants into their practice is that invariably, once they buy the equipment, the first case that walks through the door (or the first 10) are in the aesthetic zone.
If we don’t give our trainees and GDP’s the tools to assess these patients properly, the skills to deal with them and the courage to say no if it is difficult, both the GDP’s and the patients are in for a rough time.
This is why I work with the ITI. The ITI has a clear prescription for this and it is called the ITI Treatment Guide Volume 1.
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