The Dentist speaks to Ionuț Leahu about implant systems.
How did you choose your dental implant system?
When you start with dental implants, as you naturally lack experience, it is essential that the system you choose is reliable and also helps you grow confidently. Before embarking on the journey, I did read lots of materials from different companies and also interacted with many. Florian Obadan from bredent really stood out as he stayed by my side and showed me everything I needed to be able to start on clinical cases.
We are now placing about 6,000 implants a year with the bredent Sky fast & fixed.
What has been your experience of these implants over the years?
In a recent study, we looked at 24,000 implants placed in a period of five years and we concluded that only 140 implants led to some issues. However, these actually occurred within the first six months of the integration and were linked with major grafts where we encountered complications and needed to replace the implant. After two years, only two of these 24,000 implants failed.
How has the Sky fast & fixed evolved in your experience?
I started using the Sky fast & fixed in 2010 and have definitely seen an evolution in the system.
We provided feedback on the products and how some areas could be improved. When we felt the micro thread design of the implants was somewhat limiting, bredent came up with copaSky as a solution. The new design is ideal for softer bone and opened up more avenues for us. The multi-unit abutments also have a smaller diameter too.
Whoever you choose as your implant company needs to give you some reassurance that they will still produce spare parts for decades and won’t disappear overnight. We chose bredent and their support is second to none. They are local to us and it makes a huge difference. We sometimes place 60 to 90 implants in a day and stock is crucial to us. We can then decide which implant is best for a case, as opposed to choosing an implant because it is in stock. The company also offers a mentorship programme and, if someone struggles with a case, ideas are exchanged and you will always receive support and guidance.
I have sadly witnessed people who made a start on treating with implants and were mainly guided by prices. When you place implants, your patients end up with you for the next 20, 30 or 40 years. The way you start in dental implants will determine how your clinical life is going to pan out.
Would you please describe your workflow?
We do some digital planning for specific cases with a single implant in really tiny spaces like a lateral incisor in the upper jaw. Our lab is fully digitalised but for fixed cases, we take the conventional impression. From then on, everything is digital.
How have you integrated the fast & fixed with your patient base?
When you start with implants, you need to understand the mechanical requirements of the case and then you need to grow from there. Our protocol has changed a lot in the past six years. We do a lot of bone grafting because when you are treating an edentulous patient who has a removable prosthesis, once you go fixed, the upper lip support will be lost if you don't do any graft. This is something we introduced in 2013 with patients of all ages. The responsibility is huge with these cases as we have to factor in the rebuilding of the lip support, and not just place implants.
How do you see your future?
We are religiously monitoring our cases and the data will help build our future. We have done 2,500 fast & fixed cases and they are brilliant as references. We follow the cases up and try to predict what is going to happen in ten years.
We are also doing a lot of soft tissue grafting so we augment the soft tissue around the implants to keep periodontitis away, having that fixed skeletonised tissue alongside our multi-unit abutments and a screw retained prosthodontics. The protocol we have put in place has reached a plateau and I cannot really foresee doing anything better or faster.
What is unique about your protocol?
With our protocol, we actually place six implants in the lower jaw and potentially eight in the upper jaw. When you deal with younger patients, which also translates into more natural available bone, you then have a bigger responsibility to give back those soft and hard tissues, and not just look at restoring teeth. I am placing more implants than other doctors would anticipate, using the multi-unit abutment and immediate loading to deliver the final prosthesis.
I am always looking for minimally invasive treatment for my patients and a fixed solution for their entire life. I am not suggesting that a new starter should go straight into bone grafts, but these techniques can be learnt, after which patients should definitely be offered it when considering the Sky fast & fixed implants.
