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Inside Dentistry
June 2016
Volume 12, Issue 6

Therein lies the quandary for already-practicing general dentists eager to add implant treat­ment to their service mix. As Schreiber points out, how well continuing education opportunities prepare dentists for placing implants and dealing with potential complications depends on their level of prior surgical training.

“They’ve gradua-ted with various levels of expertise and foundational experience—and may have never placed or restored implants before—so the best types of programs are didactic and clinical, hands-on continuum courses ranging from 12 to 18 months that cover topics spanning surgical to prosthetic aspects of implant dentistry,” Dillenberg says. “Because 90% of dentists practicing in the United States didn’t learn about implants in dental school, they must be aware of their own limitations and not attempt cases of advanced complexity early in their journey toward becoming competent with implant dentistry.”

That’s why, when seeking to elevate their competency, Sharon Bennett, executive director of the American Academy of Implant Dentistry (AAID), notes that dentists should look for dental implant education that is comprehensive and well balanced in its coverage to receive a well-rounded implant education, rather than one-time courses that provide a snapshot of a topic or treatment.

John C. Minichetti, DMD, a diplomate of the American Board of Oral Implantology and past-president of the AAID, agrees, adding that it’s essential for general practitioners looking to become involved with implant dentistry—as with any other dental specialty—to realize that education cannot be achieved in one or two weekends.

“Because there are so many treatment options, the AAID structures its education to cover multiple modalities,” Bennett says, adding that training should be practical, designed for practicing implant dentists, and enable dentists to learn something that he or she can incorporate into practice after the course is over. “The education should be available in a variety of delivery mechanisms to accommodate different learning styles so that doctors who learn differently can learn best.”

Therefore, when considering implant training and education opportunities, Schreiber advises dentists to look for programs that set reasonable goals and learning objectives for the time allotted for the course, are free of bias, and are ideally taught by a multidisciplinary team of expert specialists. To ensure quality educa­tion, Bennett encourages dentists to be sure that the education provider has been vetted or is accredited by an independent third party (eg, ADA CERP or AGD PACE). Ad­ditionally, for those seeking to achieve a credential in implant dentistry (eg, AAID’s Associate Fellow or Fellow), dentists should double check that the course(s) they are taking satisfy the requirements of the specific credentialing program.

Do You Have the Team to Support Implant Dentistry?

As more general dental professionals gain insight into implant placement and offer this service to patients, ensuring the successful integration of this treatment modality within the practice could be predicated on a team approach—a factor credited with contributing to the overall predictability of the final outcome. Many implant cases, in particular, require a collaborative approach and typically more than one person sitting in an office by themselves in order to be treated well, explains Frank Spear, DDS, MSD, founder and director of Spear Education and an affiliate professor of graduate prosthodontics at the University of Washington.

“One way to define the team is examining the types of cases that members feel competent treating and what cases they feel they probably shouldn’t be doing or may not want to do. In those situations, the team works very well,” Spear has observed. “Team members are well defined in the roles they each have, and they are also very clear about what needs to happen in terms of acquiring records, disseminating records and patient information, identifying the outcome(s) for the case, and who is responsible for what phase of treatment.”

In recent years, laboratories have played increasingly significant roles in collaborative teams, serving as technology-empowered resources and partners to help drive the planning, placement, and restorative workflows, explains Conrad Rensburg, owner and head of dental implants at Absolute Dental Services in North Carolina. Armed with implant-planning software, digital design and fabrication technologies, and the anatomical/biological and material expertise to support specific recommendations, laboratories are bringing a new level of value to the implant treatment team.

“It’s extremely important today for laboratories to be a kind of glue that [helps to] bind the surgical and restorative partnership,” Rensburg says. “We do have the knowledge of, and we do understand, where the implant needs to be and where [the surgical-restorative team is] going prosthodontically, so this collaborative approach between surgeon, technician, and clinician is now giving our patients a better outcome.”

When dentists are ready to move forward with implant treatments, Spear shares his own experience as an example of how to approach a collaborative model and, simultaneously, nurture ongoing skills development. Following a monthly study club model—where between six to eight general practitioners, laboratory technicians, surgeons, and orthodontists meet to collaborate on cases that each dentist is struggling with—provides a face-to-face opportunity to problem solve and treatment plan as a group. Spear says that a well-defined collaborative team requires identifying roles, determining how records will be disseminated, and agreeing how decisions will be made among team members. “Who performs treatment? What happens first? Who does it? What happens second, and who does that?”

“The best thing contributing to a great, collaborative team approach process is identifying patients who are predictable to treat versus those who may not be predictable or, in fact, who can’t be treated without extensive bone or soft-tissue grafting, orthodontic movement, etc.,” Spear observes. “Often, especially if it’s a surgical case, or a case involving orthodontics and implant restorations, the patient may see multiple different clinicians over the course of 6 months to 2 years before the final implant placement and final restorations.”

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