Dr. Justin Moody reflects on two decades of implant placement
Much talk has been made about restorative success and implant success, but my question is, Can you have one without the other? How should we actually measure success? Is it by a beautiful PA showing no bone loss, or a clinical photo in which we are unable to tell the implant from the natural teeth, or is it all of the above at 5, 10, or 20 years?
I tend to practice with an eye toward the future because it’s not what the restoration looks like at the time of seating but rather what it will look like in 10 years. For me, that is the true test of time. Having practiced now for about 20 years, I can tell you that this is important to me.
There are other factors to achieving a successful implant outcome as well — it’s the clinician’s skill set at the time of treatment as well as the current technology available. I wish I could say that the implants I placed 20 years ago were all perfect, but I can’t. My clinical judgment and ability early in my career were neither what they are today, nor are the materials. I remember placing machined smooth titanium with polished collars and external hexes. Today, when you incorporate superior tread designs, surface treatments such as Laser-Lok® (BioHorizons®), and years more of research studies and literature to guide us in good surgical and restorative practices, I can’t help but think that even the procedures that I am doing now will be judged differently in 10 years.
Now that 20 years of implants are behind me, there are days when repair, replace, and restore are real and sometimes not a lot of fun. But I am a firm believer in doing the right thing 100% of the time. Sometimes that is not very profitable, and sometimes people are upset; but every time, I can keep my head held high knowing I did the best I could on that day under those circumstances.
My practice has gravitated toward subcrestal implant placement, screw-retained crowns when at all possible, and the use of Laser-Lok on the implants and the restoration for increased soft tissue volume and increased implant health.
Don’t be quick to judge but rather quick to learn — that’s what true success looks like!