South African Dental Association Gauteng South Branch

Implant Surgery and Restoration undertaken by a general dental practitioner.

Implant Supported Restorative Dentistry started in the 1960’s – ‘70’s with the Bränemark era of Implantology. Implants were mainly used to restore totally edentulous upper and lower jaws with hybrid superstructures attached to ± 8 smooth machined Titanium Screw Implants. A strict protocol of two stage surgery with an osseo-integration waiting period of six months in the upper arch and four months in the lower arch was mandatory. In this era it was accepted that implant placement was largely surgically driven i.e. Implants were placed where the bone was of adequate quantity and quality with the prosthetic rehabilitation made to fit these implant positions.

As the Implant designs and surface enhancements evolved with shorter Implants, so the protocols of the surgical placement of Implants changed to allow for one stage placements with shorter osseo-integration healing times. (3 to 4 weeks early loading) In the mid ‘90’s to early 2000’s Implants were being more frequently used for single tooth replacements and implant-supported bridges replacing partially edentulous areas of the jaws. It is this viability of replacing single missing teeth with implants and the vast changes in the science of Implantology that has made Implant Dentistry more preferable and affordable as the treatment modality of choice to patients.

The progressive and modern general dental practitioner has had to further his knowledge in the field of Implant Dentistry to be able to successfully provide his patient with this option of treatment. It is therefore essential that the general dental practitioner attain post-graduate qualifications in Implantology and the associated oral surgical techniques necessary to predictably provide such treatment. The surgical aspect of implant placement is already part of the undergraduate curricula at some leading University Dental Schools in the USA and Australia.

In the past, where Implants were mainly surgically driven, prosthetic restorative complications frequently occurred with poor aesthetics being the prime concern. It makes good sense that the dental practitioner restoring the implant also surgically place the implant to enable prosthetically driven implant placement becoming the norm.

This in itself comes with many challenges involving three dimensional implant placement especially in the “Aesthetic Smile Zone”. The benefits to the patient are numerous and include optimal implant placement and aesthetic restorative rehabilitation outcomes.

The “In-House”, placement and restoration of an implant by the same practitioner simplifies the whole procedure, protocol, costing, time-delays and responsibilities for the patient.

The benefits to the practitioner include the ability to offer such and in-house service, to ensure a more controlled and predictable result and the enjoyment of placing crowns on your own implants. In this instance the restorative practitioner is happy carrying “the can”, as he becomes appropriately responsible for the entire procedure. The end result is a happy patient.