“Change or rot in the past.”

The above expression is applicable and especially true when looking through the lens of how implant treatment has evolved over 50 years. We could never have envisioned that the stainless steel screws that were created for denture retention in severely atrophic mandibles by an orthopedic surgeon would have completely altered the way we practice. Implants are now the standard of care for replacing teeth, stabilizing prostheses, and anchorage for facial prosthetics. We never would have thought a 3-unit bridge would not be the ideal treatment. 

Most of the profound changes have been the modifications in implant design. Connection interfaces evolved from external to internal, and platform switching became an accidental finding that seemed to improve crestal bone retention. Probably the most profound improvement was the change to a roughened surface that produced a significant decrease in healing time and more predictable integration. Now nano surfaces have improved predictable integration and long-term success.  

My office has maintained an implant study club for over 25 years, with guest speakers in oral surgery, prosthodontics, periodontics, and restorative dentistry. The current shift has been away from treatment planning and prosthetic design and is now focused on repairs and saving cases with screw and abutment fractures. Peri-implant disease has also been a popular topic.  

The next paradigm shift in how we practice will be the incorporation of AI learning into implant treatment planning and prosthetic design. The RealGUIDE® planning software (ZimVie) has already empowered AI in its latest iteration. There is robotic guidance to facilitate precise placement of implants. Surgical guides, restorations, and abutments can be milled in-office. All of these changes were not available 15 years ago. It is a true testament to our commitment as a profession to continually try to improve treatment outcomes.   

The next important area that needs improvement is in implant record-keeping.  Too many patients now require treatment of old implants, and the records and information are not available. Fractured screws, broken abutments, and restorations have become a large part of dental practice. There is a continual stream of posts on Facebook dental groups of doctors trying to identify implants that need treatment. The common factor is the dentists need to know the type and size of the implant. Patients frequently don’t remember who or where the implant was placed, making identification and ordering the correct parts almost impossible.   

I have solved this pervasive problem for my patients by registering their implants on a dentist-only dental implant database. The patients understand the value and appreciate us anticipating their future needs. There is a $10 fee per implant to cover data storage costs. This becomes a registration fee of $20/implant for the patient. This solves a huge problem in the dental implant industry and provides passive income for the practice. It is one of the simplest and best solutions to this issue and will soon transform how we all store and share our patient implant information. The site is Lumifi Dental. 

I challenge you to continually strive to improve how you diagnose, treatment plan, and execute implant procedures. Be honest about how you define success. Learn from cases that weren’t perfect. Don’t be afraid of change. We will all benefit from a willingness to analyze our successes and failures. How we practice in 10 years will be different. Let’s all enjoy the present but maintain a hopeful anticipation of the future of implant treatment.