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Dental implant education is increasingly becoming part of predoctoral dental curricula. New York University College of Dentistry has developed a pilot dental implant program that trains students in implant restorations for single-tooth restorations and mandibular overdentures. Fourth-year students have the option of applying for an implant honors program, which can include surgically placing posterior implants. Eight students were selected for the implant honors program for the 2010-11 academic year. Seven of the eight students fulfilled the didactic and simulation requirements, performing forty-seven surgeries and placing fifty-two implants. Surgical protocol events were recorded: three implants did not achieve 35 Ncm torque at placement, and ten implants required a change in direction following the initial 8 mm pilot drill. All direction changes were successfully performed and resulted in implant placements. This pilot program suggests that predoctoral dental students can be trained to successfully place posterior implants, which are becoming the standard of care.

Objectives: The relative impact of innovative treatment concepts on the failure of surface-modified implants is not well understood. This retrospective study aimed to explore this using data obtained in a university postgraduate training center., Material and Methods: Patients treated with implants for a variety of indications over a 3-year period were included. All implants had been at least 1 year in function. Clinical records were evaluated for implant failure and in reference to implant length/diameter/location, time from tooth loss to implant placement, bone condition (native/grafted), surgical protocol (two-/one-stage), loading protocol (delayed/early/immediate), type of prosthesis (removable/fixed), surgeon's experience level (resident/trainee) and specialty (periodontist/oral surgeon). The impact of each covariate on failure was tested using the Fisher's exact test. Kaplan-Meier survival functions were constructed and Mantel-Cox log-rank tests were used to compare survival functions. To correct for possible interaction, Cox proportional Hazards regression was adopted., Results: Forty-one of 1,180 (3.5%) implants were lost in 34/461 (7.4%) patients (245 ♀, 216 ♂; mean age 51, range 18-90). Factors showing significant impact on failure on the basis of univariate analyses were implant location (p = .015), surgical protocol (p = .002), loading protocol (p = .002), surgeon's experience level (p = .035) and specialty (p = .001). When controlling for other covariates, only the loading protocol had a significant influence (p = .049) with early loading more prone to failure (p = .014) when compared with delayed loading. Immediate loading and delayed loading showed comparable implant survival (p = .311)., Conclusions: Implant therapy may be highly successful in a training center where inexperienced clinicians are strictly monitored and personally guided. Implant specific variables do not affect implant survival but early loading is a risk indicator for implant failure, whereas immediate loading is not., (© 2010 Wiley Periodicals, Inc.)

Purpose: With the increasing number of surgical procedures for osseointegrated implant placement, there has also been an increase in the number of professionals performing this procedure. Surgeons undergo different types of training, and this may influence their surgical experience. The objective of this study was to evaluate the effect of surgical experience on the osseointegration of dental implants., Materials and Methods: A retrospective study was conducted using clinical charts from 2002 through 2008, during which time 265 implants were performed in 110 patients by 2 professionals who completed a postgraduate program in implant dentistry in 2002. Cases were selected for degree of difficulty, avoiding those involving areas that required bone grafts for the placement of implants, with a regular platform (3.75) and a height ranging from 10 to 13 mm. The criteria for evaluating implant osseointegration included clinical and radiographic evidence observed for a minimum period of 1 year, in accordance with the success criteria proposed by Albrektsson et al:(1)1) individual, unattached implant is immobile when tested clinically; 2) radiograph does not demonstrate evidence of peri-implant radiolucency; 3) vertical bone loss is less than 0.2 mm annually after the first year postimplantation; and 4) individual implant performance is characterized by an absence of signs and symptoms such as pain, infections, neuropathies, paresthesia, or violation of the mandibular canal. Implantation was performed in 2 stages. To relate the osseointegration rate with professional experience, cases were arranged by increasing order of placement date and were then evaluated per year and region. They were then separated into 2 groups: first 50 implants performed and implants performed after the first 50., Results: The osseointegration rate of implants performed was 92.5%, with rates of 87.6% for those placed in the maxilla and 95.6% for those in the mandible. For the first 50 implants, the osseointegration rate was 84.0%, whereas in the implants performed thereafter, the rate was 94.4%., Conclusion: Surgical experience acquired during and after a postgraduate program in implant dentistry appears to influence osseointegration of dental implants, with a higher osseointegration rate found in implants performed by more experienced professionals., (Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objective: To describe the dental implant practice profile of Hong Kong general dental practitioners in 2008 and the trend since 2004., Materials and Methods: A self-administered questionnaire was mailed to 630 dentists through systematic sampling of registered dentists., Results: A total of 290 completed questionnaires were returned (response rate, 53%). Implant dentistry was practiced by 61% of the respondents. The survey also revealed that 84% of those respondents who own their private practice performed implant dentistry. About half of the dentists (49%) who performed implant dentistry placed or restored 5 or more implants per quarter. Among those dentists not practicing implant dentistry, the majority (85%) were interested in attending continuing education courses in dental implantology., Conclusion: There has been a significant increase in the number of general dental practitioners practicing implant dentistry in Hong Kong since 2004. By 2008, more than half of the general dental practitioners (61%) are practicing implant dentistry. Most of them not practicing implant dentistry expressed a desire to learn more about dental implants. This survey revealed a high demand for continuing professional development in implant dentistry in Hong Kong.

Recently, implant surgery has been introduced into postdoctoral prosthodontic programs; however, efficient training models to teach this have not been described to date. For training models to be effective and acceptable to all parties, a mutually beneficial situation must be created, and guidelines that can be followed easily need to be described. The purpose of this report is to suggest immediate loading of dental implants as an example for an interdisciplinary training model that integrates both the surgical aspects of implant therapy into the education of prosthodontic graduate students and the prosthodontic aspects of implant therapy into the training of periodontal graduate students. A flow chart of training steps is described for a patient treated with an immediately loaded mandibular fixed full-arch prosthesis on five interforaminal implants. Both the prosthodontic and the periodontal residents were involved in all phases of treatment. These postdoctoral students were in the final year of their program. Therefore, individual treatment steps could be taught interchangeably and accomplished by the student of the other specialty under the supervision of a clinical instructor. The unique characteristic of the immediate loading procedure, which includes surgical implant placement as well as immediate conversion of an existing denture into a fixed implant-supported provisional prosthesis, allows each postgraduate student to experience detailed surgical and prosthodontic treatment in a controlled environment on the day of surgery.

Unlabelled: SOURCE OF SUPPORT: The study was partially supported by Nobel Biocare, Denmark., Conflict of Interest: None., Aim: To evaluate the treatment outcome of implant-supported single-tooth replacements performed by dental students as part of their undergraduate dental curriculum after a mean follow-up period of 10 years (range: 7.5 to 12 years)., Materials and Methods: A total of 51 patients were consecutively treated by dental students with 55 implants supporting single crowns. The treatment was performed under supervision of dentists and oral and maxillofacial surgeons, all with special knowledge about oral implantology. Survival of implant crown, survival of implant, probing depth, bleeding on probing and peri-implant marginal bone level change were evaluated at the end of the follow-up period. In addition, biological and technical complications during the entire follow-up period were assessed., Results: A total of 45 patients with 49 implants were available at the end of the study. The survival of the implant crowns as well as the implants was 94%. The mean probing depth at patient level was 4.8 mm. The probing depth varied between 2 and 10 mm at the individual site. The mean bleeding on probing score was 0.57 at patient level and absence of bleeding around all sites of the implants was rarely observed. The mean bone level change was -0.14 mm (range: 1.2 to -1.1 mm) during the first year of loading and 0.16 mm (range: 1.4 to -1.8) after 10 years at patient level. Five episodes of peri-implant inflammation due to excess cement were registered in five patients. Moreover, a fistula was observed at two implants in two patients. Finally, five technical complications occurred in five patients., Conclusions: Implant-supported single-tooth replacements performed by dental students as part of their undergraduate dental curriculum were characterised by high survival rates as well as few biological and technical complications. It seems acceptable to include implant therapy in the clinical undergraduate dental curriculum, provided a focus remains on straightforward cases with substantial supervision by trained dentists and oral and maxillofacial surgeons.

Purpose: To present results of a survey on the status of implantology in Switzerland in 2006., Materials and Methods: A questionnaire was sent to all SSO (Swiss Dental Society) members asking for personal (anonymous) background data and their implantology concepts. Specific questions dealt with level of recognition of implants, use of implants, superstructures, success and failure rates, recall and training., Results: A total of 1568 (47.3%) of the 3315 questionnaires were returned. Straumann, Nobel Biocare, 3i, SPI and Frialit were the most commonly used implant systems in Switzerland. Almost two-thirds (63.8%) of the dentists placed more than 20 implants per year. Long-term prognosis was the crucial factor, whereas material costs played a minor role. The edentulous mandible was the indication of choice, whereas the edentulous maxilla applied less. Almost every dentist active in implantology followed continuing educations programs in the field., Conclusions: Compared to a study undertaken 12 years ago, the number of dentists engaged in implantology doubled, meaning at least one-third of non-hospital dentists in Switzerland were involved in dental implantology. Overall, willingness to extend the therapeutic range has greatly increased.

Purpose: To present results of a survey on the status of implantology in Switzerland., Materials and Methods: A questionnaire was sent to all SSO (Swiss Dental Society) members asking for personal (anonymous) background data and their implantology concepts. Specific questions dealt with level of recognition of implants, use of implants, superstructures, success and failure rates, recall and training., Results: Straumann, Nobel Biocare, 3i, SPI and Frialit are the most commonly used implant systems in Switzerland. Almost two thirds (63.8%) of the dentists place more than 20 implants per year. Long-term prognosis is the crucial factor, whereas material costs play a minor role. The edentulous lower jaw is the indication of choice, whereas the edentulous upper jaw applies less. Almost every dentist active in implantology follows continuing education programs in the field., Conclusion: Compared to a study undertaken twelve years ago the number of dentists engaged in implantology doubled, meaning at least one third of non-hospital dentists in Switzerland are involved in dental implantology. Overall the willingness to extend the therapeutic range has greatly increased.

Background: This study evaluates surgical outcomes and survival rates of implants placed in a multidisciplinary implant teaching programme., Methods: A retrospective review of all implant surgery performed over a 6-year period by accredited oral and maxillofacial surgery trainees at the Royal Dental Hospital of Melbourne was undertaken. Patients were reviewed for a minimum of 6 months post-implant placement. Implant survival was defined as those implants which were not removed, were clinically integrated as assessed by torque testing and in an appropriate position to receive a subsequent prosthesis. Kaplan-Meier analysis was used to assess overall survival and univariate factors affecting survival. Multivariate analysis used Cox proportional hazards models., Results: Over 6 years, 127 patients were treated. Follow-up data were present for 105 patients with 236 implants placed. Survival of implants at 1 and 5 years was 94 per cent and 92.8 per cent, respectively. The only univariate and multivariate factor which affected implant survival was perioperative bone grafting. All failed implants were single stage. Other factors such as patient age, smoking status, implant site, anaesthetic type, immediate or delayed placement, implant length and diameter, and medical comorbidities did not significantly affect implant survival., Conclusions: A satisfactory implant survival rate was found in a tertiary teaching centre. Perioperative bone grafting significantly increased the risk of implant failure.

The use of dental implants has increased substantially over the past decade, as have the number of implant-related complications. One of the contributing factors is inadequate training in the prevention, recognition, and treatment of complications. Comprehensive training on implant surgical procedures that includes patient selection, risk management, and complications allows dentists to incorporate implant placement into their practices with less risk to patients and less risk of serious legal consequences.

Objectives: To determine by anonymous survey whether the active membership of a particular dental society with variable training and clinical experience in dental implant insertion and restoration followed the published selection criteria for the pre-operative radiographic assessment of prospective dental implant osteotomy sites., Design: Postal survey., Subjects and Methods: A postal questionnaire was sent to all professionally active members of the British Society of Periodontology (n = 560) during July 2005. The mailing was repeated in September 2005., Results: Four hundred and fifty-nine questionnaires were returned a response rate of 81.5%. One hundred and seventy-nine (39%) respondents were not involved in placing or restoring dental implants and were excluded. Of the remaining 280 (61%), 15 (5%) clinicians limited themselves to placing implants, 85 (30%) limited themselves to restoring implants, while 181 (65%) both placed and restored their own implants. Two hundred and twenty-eight clinicians (80.8%) did not follow UK selection criteria for single sites; 217 clinicians (77.5%) did not follow the criteria for multiple sites. Two hundred and sixty-three clinicians (94%) did not follow USA selection criteria. There were no statistically significant differences in compliance based on clinical experience or the number of implants placed. The only statistically significant difference was as a result of training those clinicians who had attended formal training courses were more likely to comply with published selection criteria. Significant differences also existed between the groups in the specific cross-sectional imaging modalities chosen., Conclusion: Over 80% of respondents are not following the UK or USA selection criteria for pre-implant imaging assessment. The results of this survey call into question the clinical relevance, usefulness, or knowledge of existing selection criteria. There is a need for new selection criteria developed by both radiologists and experienced implant clinicians.

Purpose: An elective program on implant dentistry was started in the summer of 1994 at the University of Detroit Mercy School of Dentistry (UDM). The program provides comprehensive didactic and clinical training in implant dentistry to a select group of senior dental students. This study describes the program and clinical results of the first 11 years of the elective program in implant dentistry at UDM., Materials and Methods: The program is 1 year long and is offered to a group of 10 senior students out of a class of 72. In addition to a one-semester lecture course offered to all dental students, students in the elective program participate in a one-semester seminar which includes literature review and "hands-on" surgical and prosthodontic components. Patients are assigned during the summer term to students who work in pairs. Students actively participate in diagnosis and treatment planning, assist in surgery, and accomplish the prosthodontic procedures. Prosthodontic services include single-tooth restorations, multiple-unit fixed restorations, overdentures, and full-arch fixed prostheses. A retrospective analysis of the patients treated in the first 11 years of the program was conducted., Results: During the first 11 years of the program, 159 implants were placed in 70 patients. There were a total of 10 failed implants in seven patients (failure rate 6.3%): eight implants prior to loading and two following loading. Minor complications included gold screw loosening, gold screw fracture, porcelain fracture, and soft tissue inflammation, which occurred in less than 5% of the patients., Conclusions: The rates of implant failure and complications in the first 11 years of the elective implant program at UDM appear to be within an acceptable range when compared to other educational programs and studies reported in the dental literature.

Aim: The purpose of this study was to assess the knowledge, attitude, and practice of dental implantology among dentists practicing in Nigeria., Materials: Self-administered questionnaires to assess the knowledge, practice, and attitude of dental implantology were sent to dentists practicing in all the 6 geopolitical zones of Nigeria (i.e., all tertiary dental institutions, and selected general and private hospitals within the zones). Data collected were analyzed and presented in descriptive and tabular forms., Results: The response rate was 77%. Only 2 (1.3%) of the respondents claimed to have employed implant(s) for dental restoration in their practice, while 152 respondents (98.7%) have never used implants as a method of tooth/teeth restoration. Of the latter, 46.1% have suggested implants for full/partial denture patients, 31.8% have suggested dental implants to patients needing single-tooth replacement, and 89.6% were ready for dental implant placement if equipment and materials for dental implants backed up with adequate training were provided. Of respondents, 83.1% also believed that implantology is a multidisciplinary approach, and 42.9% rated implants as the best option for dental restoration., Conclusions: The practice of implant dentistry is presently very low in Nigeria. Clearly, there is a need for dental implant education for Nigerian dentists to increase their knowledge and proficiency in dental implant dentistry. In addition, all efforts should be made to include implant education and practice in dental curricula in undergraduate and postgraduate institutions in Nigeria.

Purpose: This study evaluates dental implant survival rates in cases where surgery was performed by oral and maxillofacial residents and determines whether the level of resident training influenced the outcome of dental implant treatment., Patients and Methods: Retrospective review of all 2-stage implants placed between July 1, 2002 and June 30, 2004 by oral and maxillofacial surgery residents-in-training at the Washington Hospital Center was carried out. Patients were seen for follow-up at 1-week, 1-month, and 6-month intervals after implant surgery. The criteria for implant success in this study were based on clinical and radiographic evidence of implant osseointegration during the follow-up period. We evaluated implant survival rates and used Cox proportional hazards modeling to analyze whether level of resident training or location of implant placement influenced implant survival., Results: This study included 175 implants placed in 54 patients. The overall survival rate of implants placed by oral and maxillofacial surgery residents at all levels of training was 91%. No statistically significant difference in implant survival rates was observed as a function of the level of training of the resident surgeon (P = .89) or location of implant placement (P = .93)., Conclusion: Survival rates for implants placed by surgeons in training are comparable to rates reported in the literature. There was no statistically significant difference in survival rates when a comparison of level of training was taken into consideration. To our knowledge, this study is the first to examine implant survival rates as a function of surgeon experience in the setting of an oral and maxillofacial residency program and suggests that predictable outcomes in implant treatment are attainable by surgeons in training.

In response to interest by dental students and patient needs, an elective program in implant dentistry was started at the University of Detroit Mercy School of Dentistry (UDM) in the summer of 1994. The 1-year program is offered to a group of 10 senior students out of a class of 72. Implant treatment is provided to selected edentulous and partially edentulous patients. Predoctoral students participate in diagnosis and treatment planning, assist in surgical placement, and perform the prosthodontic procedures. A survey was sent to 160 UDM graduates, and 90 responded. Out of the 90 respondents, 35% had participated in the elective implant program and 65% had not. A Pearson correlation matrix was used to analyze their responses. A stronger positive correlation with offering and restoring implants was seen in graduates who had completed the elective program in implant dentistry., (Copyright 2002 by The American College of Prosthodontists.)

Contemporary standards of care, as well as ethical and legal issues, dictate the incorporation of dental implants into the general dental practice. Given the simplicity of current implant systems, most general dentists already possess the clinical expertise necessary to provide basic implant restorative services to their patients. However, due to the restricted manner in which dental implant training was propagated in the United States, and perhaps due to its foreign origins, many competent dentists seem unaware of this greatly beneficial innovation. There are a variety of educational resources available for the uninitiated dentist to gain proficiency in basic implant dentistry. The ideal education in implant dentistry provides supervised hands-on clinical training on live patients as well as didactic instruction by recognized teachers in implant dentistry. Such education may or may not be devoid of commercial bias. This paper will describe many of these opportunities.

The success of osseointegrated dental implants has forever changed dentistry and, thus, undergraduate dental education. With the tremendous clinical acceptance and increased patient demand for dental implants, dental school educational programs must prepare students to treat patients with this modality. The purpose of this article is to provide an overview of the predoctoral dental implant educational program at the University of California at Los Angeles School of Dentistry.

A survey of participants in a continuing education course in osseointegrated implants was carried out to determine dentists' attitudes toward such courses and how they were integrating implants into their everyday practice. The results indicated, despite the intense program, very few general dentists who attended such a course chose to actively participate in implant placement and a moderate number chose to carry out prosthetic restoration. Those who attended such courses appeared satisfied with the course content, appreciated the difficulties involved with implant placement and restoration and generally chose to refer such cases to appropriate specialists for management. This pilot study confirms dental implants are a popular and accepted mode of therapy. However, general dental practitioners who take the time to undergo specific training in osseointegrated implants appear to be less inclined to actively participate in the placement (surgery) of implants. Following appropriate training, many general practitioners felt comfortable in performing the restorative/prosthetic aspect of implant treatment for single tooth rather than partial or full denture cases. In conclusion, while continuing education courses in osseointegrated implants are becoming increasingly popular, this survey indicates participants become aware of the complexity of the procedures involved and tend to actively participate mainly in the prosthetic reconstruction of simple cases.

A survey of Australian and New Zealand Dental Schools was carried out in 1993, aimed at assessing time allocation and curriculum content in relation to dental implants. Considerable variation was evident at both undergraduate and graduate levels. Continuing education courses in single-tooth implant surgery are available for general dental practitioners under carefully controlled circumstances. At the postgraduate level a formal University Diploma course in oral implants is now available at the University of Sydney. Dental educators must continue to react to the changing community scene in restorative dentistry, in terms of both need and demand. Educators must also be cognizant of the rapidity of change occurring in the area of implant dentistry. The provision of high-quality implant treatment and service is dependent on continual review of training and education at all levels of the dental profession.