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Bone level versus tissue level... Again

Colin Campbell
by Colin Campbell on 23/05/19 18:00
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Generally, I don’t pay too much attention to analytics for our blog, but Tom decided to have a look at stuff recently and sent me some figures.

 Last year, the blog was viewed nearly 57,000 times, which is not so bad when you think about it.

One of the interesting things about the blog is that some stand out and keep getting hit, time and time again and you would least expect which ones they are.

In 2012 I wrote a blog called bone level versus tissue level; you can read it here.

Last year it was viewed 2473 times and already this year it’s been viewed 1523 times. That’s crazy! For something that is now getting on for 7 years old (the power of the back catalogue) it’s worth updating the thoughts around that. 7 years further on in relation to dental implants and whether they have a collar, which is polished and supposed to be kind to the tissues, or whether they just sit at bone level.

Clearly this is a blog for dentists doing implants.

Things have moved along massively since 2012 and the designs of implants spiralled out of control and exponentially since then. We have now moved to a market saturated with cylindrical implant, tapered implants, aggressively designed thread pitched implants for primary stability, implants designed for immediate placement. Mini implants, short implants and narrow implants to name but a few, if you are not working in this field, every single day and reading up on the new developments, every single week, how could you possibly know what to do and what to use?

Bone level versus tissue level though, is an age-old discussion which still rages on and confuses people left, right and centre.

Referencing back to the blog in 2012 I talked about Shakeel’s commitment to place tissue level implants in the anterior and he has still continued with this and has not stopped, because he knows the position to place those implants and how to get the best out of them.

In his hands and with his research, he has proven that it is perfectly acceptable, (perhaps even more than acceptable) to place tissue levels in the aesthetic zone and in our practice, we place tissue level only most exclusively in the posterior region (at least I do).

The key with dental implants is to understand why you are using what you’re using and know the data and know which clinicians are producing that data and where their bias lies.

It’s about trust and it’s about assimilation of information on a continual basis.

We know that to use a cylindrical bone level implant in the correct way, will produce long term, stable results. Our own research at our practice shows that.

We know that cylindrical tissue level implants with polished collars do the same.

We’re not too sure about the new designs, because as more implants arrive, there is less and less data, because the ability to do research is scattered across a wider platform.

If it’s not broken, then why fix it?

If you don’t understand the difference between the options for the implants you are placing and the other opportunities or possibilities, then I would politely suggest that you need to spend more time studying you subject and if you don’t have that time, your attention is probably scattered across too many disciplines.

Learn the straight forward aspects of the fundamental implant dentistry, before you move on to anything else and until you have grasped and nailed that, then stay where you are and train and work hard and be safe.

That’s the long game and that’s what works in the end, the guys that I know who have done that, have prospered and become successful and the other guys on a tendency to provide work that their probably less than proud of.

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Colin Campbell
Written by Colin Campbell
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