I wonder what was holding me back from placing implants in some of the ideal cases that I’ve come across. Today, we have well-defined guidelines and protocols supported by long term evidence. We have many tools, including CT Scans, surgical guides, simplified implant kits and more. Maybe, I just need to get the necessary education, follow the stricter-than-ever protocols, and know my limits.
Once implant dentistry became more restorative-driven, it paved the road for general dentists to consider placing implants. Recently (or finally), I made the decision to pursue implant dentistry and I am very excited!
Find the right course and the right instructor
I have attended bits and pieces of implant lectures over the years, both surgical and restorative, and I have been restoring implants since I started practicing 10 years ago. But getting to a position where I can surgically place a single implant in an ideal case required a comprehensive and well-organized implant course. It started with a lecture, then moved to placing implants in pig-jaws. After watching live surgeries, we finally placed an implant in a patient’s jaw under the close supervision of an instructor.
I wanted to stick with one instructor initially throughout the whole course, from lectures through hands-on. I looked for an instructor who would encourage me, but would also set limits for me, and be open to meeting my specific needs as long as they were within reason. I openly expressed my expectations at the beginning of the course.
I asked the instructor to give me a detailed protocol from the initial assessment to the final follow-up. I asked for the black-and-white, not for the gray. At dental school, I only did things one way, the way my instructors told me to. This provided me the ability to perform predictable and successful dentistry with confidence and without confusion. After finishing school, I was hit with lots of gray and an abundance of options. But by then, I was equipped to make reliable choices for materials, equipment and techniques. There is nothing more confusing than attending a course where multiple options are presented and you are told to choose whichever you are comfortable with when you are just starting. That works well at intermediate and advanced levels, but not for beginners.
My goal was to finish the course with adequate basic knowledge to place single implants in ideal cases. For now, I will stick with the black and white, and later venture into the gray. The fact that my instructor is within an hour of my office is an added bonus. By default, he will probably become my mentor.
Find the ideal first case
This took me back to the days of my board exam. My patient was very healthy and the implant site had plenty of hard gum tissue and bone. I planned the implant placement on a CT scan, and planned my incision on the model. Consequently, the surgery went very smoothly. I did not have a surgical guide, but I cannot even imagine how much smoother this could have gone if I’d had one.
Finalize the commitment
Purchasing the equipment finalizes the commitment. There are many implant companies out there and they should be evaluated thoroughly. In addition to the well-known criteria of effectiveness, efficiency and safety of an implant system, I need regular access to the local rep. Fortunately, I had the chance to know him closely before committing to his company because he lives in my small town.
Keep the momentum
Signing up for a comprehensive surgical implant course did not mean that I would start placing all kinds of implants on Monday! I did not have a line of patients waiting for me. I did not even start looking for the surgical case for the course until I attended the course lectures because I was not sure of what to expect. I was not discouraged or concerned at all, but I knew that I needed to move slowly initially so I would feel comfortable and safe.
I will not let the excitement fade away. I am on a mission to identify these simple implant cases. This will also be a lifetime commitment to CE.
Implant complications and undesired outcomes can happen even in the hands of the best surgeons and even when ideal protocols are followed. But they mostly happen when something is overlooked, either by us or by the patient. That is why sticking to protocols is of the utmost importance. However, I believe that it is more about how often complications happen and what I will do to make it up to my patients when an undesirable outcome arises
Samer Alassaad, DDS