Dis-Integration

I am often asked by undergraduates, what has been the biggest change in clinical dentistry since I qualified over 30 years ago. While there have been many, perhaps the increasing use of osseo-integrated implants during this time has been transformative for many patients and clinicians alike. While an essay on replacing missing teeth 30 years ago would have focused on dentures and destructive fixed bridges, the increasing use of osseo-integrated implants has transformed dentistry.

Having placed my first implant in 2003, I was struck by the utility of implants in replacing teeth. And in my first placement, under close mentorship, the procedure appeared simpler than many other areas of dentistry, or so I initially thought. One could easily be lulled into a false sense of security, much as on a weekend course where drilling into a plastic mandible, all seems rather straightforward. However, as my surgical and restorative implant experience grew, I became increasingly aware that implant placement and restoration was not without significant challenges, and the adage ‘horribly easy or easily horrible’ seemed rather apt. As with many other areas of dentistry, the day you think it will be an easy procedure, will be the day something surprises you and you swiftly transition to the easily horrible zone. Prior preparation and planning with due consideration of potential complications before they occur remains key.