Dental Implantology is not a specialty yet. It is not correct to call a dentist as Dental Implant Dentist.
With adequate training, any dentist can perform a dental implant procedure.
A general dentist can perform basic dental implant surgery only if he has acquired the skills to do such procedure. A general practitioner can also carry out bone grafting, but he must have an additional training first.
Bone grafting is not a simple procedure. It requires special training and clinical experience before doing this procedure correctly in the patient’s oral cavity.
A Prosthodontist is one of the most qualified specialists to carry out a dental implant procedure. His specialty lies in dentures. Prosthodontics is a specialty that requires 2 to 3 years of university based or dental school based education. It is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. He is the most qualified to do the the prosthetic aspect of the dental implant treatment.
The direction indicators are inserted into the dental implant site to check and maintain parallelism during preparation.
Poor fixture alignment
If the angle with adjacent fixture is less than 35 degrees, there will be not be a major problem prosthetically.
Direction indicators are inserted after each twist drill procedure is completed to verify parallel fixture sites. Photo credit: Oris Neobiotech
Copious saline irrigation is required in the use of any drilling instruments. A surgical splint is used to determine dental implant fixture insertion site. In the maxilla, a fixture for 11 or 21, is placed 3 mm from the midline suture line.
After pilot drilling is done, the fixture site is enlarged using a 3.0 mm diameter twist drill. The procedure is important for preparing the implant fixture site to proper depth. The indicator mark on the drill should be level with the bony margin.
Use the twist drill to finalize enlargement fo dental implant fixture site. Photo credit: Oris Neobiotech
Following dental implant surgical sequences and protocols, drilling should follow the desired RPM with copious irrigation preferably with an NSS refrigerated the night before surgery.
Bone quality for the 3rd implant is assessed under the raised full thickness flap. Drilling should follow the same desired RPM ang copious irrigation preferably with an NSS refrigerated the night before the surgery.
Bony defect near the site for the middle implant body
According to Dr. Sherwin Villareal – NYU, “The establishment of optimum and predictable esthetics is one of the most important and challenging aspects of rehabilitaion with dental implants.” Esthetic rehabilitation has to be predictable implying reproducibility and stability of the outcome in both short and long term. Achieving these characteristics depends on the interactions between multiple valuables namely biological, surgical, prosthetic and implant design.
Drilling procedure done on implant site.