Esthetics Are Everything
The days of judging implant success exclusively by osseointegration are long behind us. Today, implant treatment is esthetically driven. If it looks bad, it's a failure. My former partner started placing implants in 1971 using a freehand technique. Currently, I use a guided protocol. From milled to 3D-printed, surgical guides have evolved along with implantology; however, the characteristics essential to their success, such as a passive fi t with excellent stability, are largely the same. When the design is free from error, a properly fabricated surgical guide can make implant placement "easier," but it is never "easy." Guided surgery still requires the clinician to possess excellent freehand skills to perform the procedure, especially for situations in which the guide must be abandoned to accommodate a necessary change in angulation. In some ways, a surgical guide can function like an autopilot-but you still have to be able to land the plane!
For Inside Dentistry's annual implants issue, this month's cover story examines how advances in virtual planning and surgical guidance, including stereolithographic guides and dynamic navigation, have made implant treatment outcomes more predictable. Other articles include a CE that discusses centering implants with the gingival zenith to improve esthetics, a case involving delivery of a full-arch, implant-retained zirconia prosthesis, a full mouth rehabilitation using a multidisciplinary mix of short-term orthodontics and implant restorations, and a perspective on zirconia implants. I hope that you enjoy the issue. As always, your insights and feedback are welcome. Feel free to contact me at the address below-I look forward to hearing from you!
Robert C. Margeas, DDS
Editor-in-Chief, Inside Dentistry
Private Practice, Des Moines, Iowa
Department of Operative Dentistry
University of Iowa, Iowa City, Iowa