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Dental Implant Placement: What You Need to Know

Dental implants are a true game-changer for those with missing or failing teeth. They replace tooth roots, providing a stable and secure base for high-quality replacement teeth and reversing the natural jawbone loss that occurs when a tooth is lost. Yet the success of dental implants is determined by many factors, including the knowledge, skills, and experience of the dentist placing them. Here is what you need to know.

Predicting Success

Although across the board success rates are better than 95%, and a skilled implantologist whose patients faithfully follow aftercare instructions can achieve a success rate of more than 98%, surgical outcomes are never guaranteed. We consider a successful implant as one that integrates with the jawbone as expected while also providing the desired functionality and aesthetics for the patient.

We clinically analyze all the factors that could contribute to the success or failure of your implants. This includes a thorough evaluation of the quality and quantity of bone and soft tissues and the condition of neighboring teeth, as well as your medical and dental health history. We use CAT scans and cone beam scans as well as wax modeling of your existing teeth with the proposed replacement teeth added. We consider any preparatory procedures you may need such as bone or gum grafting, and we work hard to plan the ideal placement for each implant.

We will then sit down with you for a frank discussion of our findings, the risk factors you face, and our plan for treatment. We cannot predict everything, but we can provide our expectations based on your unique situation and our clinical expertise.

Which Dental Specialty Is Best Prepared to Place Implants?

The position of the American Association of Oral and Maxillofacial Surgeons (AAOMS) is that dental implant placement is a surgery and, therefore, oral and maxillofacial surgeons are uniquely qualified to perform the procedure. However, this only tells part of the story.

While it is true that these surgeons are highly skilled and trained, the same is true of periodontists. We are uniquely skilled in the regenerative procedures designed to save teeth, such as bone grafting and soft tissue augmentation, that are also frequently needed in preparation for dental implant placement.

In addition, in a robust periodontal training program, students devote three years to studying anatomy, risk evaluation, the principles of healing, and the factors that affect proper dental implant placement. This means that we can accurately predict the likelihood of success, and we know how to both prevent and treat implant complications. Research shows that about 50% of implants will have some sort of complication within 10 years, so choosing a practitioner with extensive, specialized training in dental implants only makes sense.

Should Implantology Be a Recognized Specialty?

There has been some debate within the dental community as to whether implantology should become a recognized specialty by the ADA (American Dental Association), but the truth is that as things stand now, there is no standardized training for these procedures. Many dentists take a weekend course, or a course that lasts over several weekends, and then start placing implants. Are they “implantologists”? It’s difficult to say.

It stands to reason that anyone who places an implant should be trained to a high level of competency. It’s far more than simply inserting a screw, because there is a whole person at the other end of that screw. No general physician would think of performing hip or knee replacement surgery or a heart transplant based on an abbreviated training course, and we owe it to our patients to ensure that their health and well-being are at the core of everything we do.

Regardless of dental specialty, training to competency in dental implants involves learning to plan treatments, assess risks, and read scans, as well as a full understanding of the biology related to implant placement and osseointegration, soft and hard tissue management, proper methods of implant placement and maintenance, and how to address complications both during and after placement. If any of that comprehensive training is missing, the patient is at risk.

At the New York University Department of Periodontology and Implant Dentistry, we offer a full-time two year course in implant placement and restoration. It is part of the standard three-year certification course for our periodontal students, but it is also available independently for those who want to become fully trained in dental implants.

We believe that general dentists who perform dental implant procedures, or any procedure that is also performed by specialists, should undergo the same level of training and possess the same knowledge, skills, and experience, as the specialists who perform that procedure. Otherwise, we strongly believe in a team-oriented, collaborative approach in which each member of the team does what he or she does best.

The most common avoidable implant complications we see are implant malposition, peri-implantitis, and unaesthetic implant restorations. These can be avoided by practitioners with a high level of knowledge and skill, along with proper implant monitoring and maintenance.  Treatment of these problems require additional skills. I lecture around the world on how to treat and correct these complications.

Assessing the Difficulty of Implant Cases

There are a couple of different references that practitioners can use to categorize the difficulty of a particular implant case. However, the reference guides assume a high level of competency in placing implants. For those who are not adequately trained, even a relatively simple case could become complex. Therefore, it is extremely important for all dentists who place implants to undergo rigorous training rather than relying on a reference guide to tell them which cases to take.

Ready to Start?

If you are ready to get started with a compassionate and extremely skilled periodontist, we invite you to contact Dr. Stuart Froum 212-586-4209 today to schedule your first appointment.


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