Success with implants

The General Dental Council requires that all dentists placing implants have undertaken appropriate postgraduate training and to have had their competency assessed. Dentists must not just be specifically trained in implant system protocols, but should also be able to prove they are competent to deal with any immediate or long-term complications of the treatment provided. Those who find themselves in the unfortunate position of answering a patient complaint will have to demonstrate to the GDC they have received suitable training and have not practised implant dentistry beyond the limits of their expertise.

Demonstrating competency

Mentoring is a key element of a well-structured training programme and is important in developing competency in implant dentistry. This means a dentist who undertakes patient assessment, treatment planning and implant therapy with a suitably experienced supervising clinician.

This case demonstrates what on the face of it should be a straightforward case of replacing a missing tooth (fig 1). The basic principles of maximising implant length and diameter have been applied without regard to the final prosthetic outcome (figs 2 and 3). In order to accommodate the implant it has been incorrectly positioned too far labially resulting in a soft tissue deficiency. Although the implant has integrated, the final result has failed in terms of aesthetics and occlusal stability, the final crown frequently debonding (fig 4). The patient, a young woman, was very unhappy with the final aesthetic result, which was visible on smiling. It would be hard to justify such a result as it does not demonstrate competent treatment planning and is not what should be expected from modern implant restorative dentistry.