In the early 1980’s, Dr. P.I. Branemark and others introduced osseointegration and a predictable endosseous implant system to the North American continent(1,2). To say that dental therapy was dramatically changed would be an understatement and yet, the benefits of Dr. Branemark’s research have not reached as great a segment of the population as was originally estimated. The introduction of a predictable implant system was followed by a period of general confusion resulting from the emergence of many different competing implant systems. Next followed a period of re-evaluation with a review of failures in technique and patient expectations. Today, practitioners involved in dental implants have become more wary in their prosthodontic goals and expectations.
The Branemark implant system was initially recommended for edentulous patients and used “hybrid” prostheses supported by five or six implants in the anterior region of either the maxilla or the mandible. Many patients were disappointed with the appearance and function of the original hybrid prostheses. Furthermore, the Branemark implant system was not initially recommended for partially edentulous patients. Demand for alternative restorative forms stimulated the competitive nature of practitioners, technicians and manufacturers, and fostered new prosthetic designs.
There exists on the market today no fewer than 10 major endosseous implant systems and numerous clones of the major systems. Manufacturers want to sell their products to dentists, and their claims are sometimes ludicrous in the description of the “advantages” of their system. Professionally, there is competition between oral surgeons and periodontists to provide the surgical phase of implant treatment. Dental implants can make a major financial contribution to surgical practices and many specialists have provided the surgical phase of implant treatment for general practitioners who are not well versed in the prosthodontic phase. It might be said that for the past eight years in North America, endosseous dental implant treatment has been surgically driven, and has not always been in the best interests of the patients.
It is time to analyze what has occurred since the introduction of Branemark’s research. Dentistry should look at how implant patients are treatment planned and informed of the benefits and risks associated with implant treatment. It is no longer appropriate to promise unlimited success and happiness for all implant patients.
Read More…