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Toward Ideal Implant Placement
The dental implants first introduced by Dr. Brånemark were solely intended for oral surgeons. Since then, general practitioners and many other specialists, including periodontists, prosthodontists, and endodontists, have begun placing implants as part of their daily practice.
In the United States, there is currently no designated specialty for placing implants. In other countries such as Brazil, specific training is required to become an implant specialist. This has become the topic of debate amongst many dental professionals, posing the question: "Who should place dental implants?"
Every dentist has the license to perform root canals, extractions, orthodontics, and place dental implants, but does that mean that they should? If they have the necessary training and are able to do so properly, then I believe so.
In the past, many restorative dentists would get frustrated when the specialist to whom they referred a case would simply place the implant "in the bone" without any prosthetic reference. This sometimes led to difficult restorative treatment and unhappy patients and doctors. With the advances in bone augmentation today, this can be a thing of a past. If there is no bone at the optimal implant position, we can now employ horizontal or vertical ridge augmentation procedures to grow the bone and allow an ideal implant placement. The restorative doctor has the great advantage of always thinking of the end result. Through this type of "crown down" planning, implants can be placed in an optimal position to make the restorative aspect simple and effective.
General dentists have an amazing opportunity to include placing implants as part of their provided services, but should only do so with the proper training, practice, and dedication (Although, with no accreditation, it is difficult to say what "properly trained" truly means). For starters, any general dentist interested in placing implants should have a sound background in surgical training. They should also have extensive knowledge of involved anatomy, surgical flaps, incisions, and suturing in addition to their general dental knowledge. General dentists who place implants should also be familiar with using computed tomography scans, digital smile planning, great implant designs, and even guided implant surgery to maintain the highest level of care. Like other dental treatments, implants cannot be learned to be placed in a matter of days, but rather they take time to master. As a rule of thumb for all dental treatments, it is advised that the practitioner be able to perform at the same level as the specialist.
With proper surgical training and in-depth knowledge of implant restorations, the general dentist can be a leader in dental implant treatment therapy. He or she will always have the prosthetic plan in the back of their mind. When surgical expertise, prosthetically driven surgery, and the latest technology are combined, patients will benefit from the best care, no matter who is placing the implant.
About the author
Kyle Stanley, DDS
Beverly Hills, California