Implants – Immediate Loading with NO Patient Selection

At EAO 2017, Dr Göran Urde presented a paper titled “Evolution of surgical protocols in implant dentistry” as part of the scientific programme. Dr Göran Urde, is the Program Lead for Tipton Training’s PG Certificate in Dental Implantology and is the Director of the Futurum Clinic at Malmö University’s Faculty of Odontology in Sweden. Extracts from his presentation are below.

In the good old days, as he put it, implants were only placed by specialists in oral surgery and prosthetics. One had to be thoroughly trained to even purchase implants. Companies kept records of the clinician’s success rates and if someone had a higher than normal failure rate, they showed up at their door! This obviously has changed now as technology and consequently education of dental implants has evolved.

Over the years he has been involved in developing concepts like “Tooth Now” or Immediate Loading, according to which a tooth is extracted and immediately replaced with an implant and loaded with the final abutment and a temporary crown, with extremely high success rates for both implant survival and aesthetic outcome. He appreciates the benefits of immediate loading, but, warns that patient selection is very important and often not appreciated.

Consider this, patients for decades have not taken care of their natural dentition are now being treated in accordance with concepts like immediate loading. Within an hour, any remaining decayed teeth are removed and replaced with implant-supported crowns and bridges in the belief that the patients will start taking care of their new teeth. Unfortunately, this is not realistic!

In his opinion, this is a ticking time bomb. It is just a matter of time before patients will come back with problems like peri-implantitis and failing implants. Who is going to sort that out? Think litigation! That is why training courses are so important. Placing implants is a great skill and income generator, however, there is no substitute to Patient Selection and Treatment Planning.

Written by Vivek Gupta in discussion with Prof. Göran Urde

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