The big plan
It's a cliché that if you 'fail to plan, you'll plan to fail' but, in my opinion, it's a mantra that should never be ignored in the world of implant surgery.
Planning is without doubt one of the most important parts in the implant process. In my clinic we are so strict about the planning process we created bespoke tick-box surgical sheets so that every single detail in the patient's implant journey is minuted and monitored in a fashion that we feel is the best.
Currently the Training Standards for Implant Dentistry require that we audit outcomes of all implant work. As well as the clinical notes I use our comprehensive, bespoke tick-box report form which is then scanned into the patient's notes. Information contained is then inserted into the Association of Dental Implantology UK's audit programme as well – thus ensuring we know what we do works.
Patient focus
The patient is our priority in everything we do and I believe it's important to fully examine the patient journey – checking how they found you, ensuring the website information is current and helpful. It's important that the team is educated to ensure that information they share with patients is spot-on at all times. Ensure that informed consent is obtained for every stage of treatment.
Requesting patient feedback is key to reinforce either that you're doing things correctly or identify any aspects that may need fine-tuning.
Equipment advances
Once we've established the patient relationship is sound then we can focus on our equipment in the clinic. I believe it's important to keep fully abreast of all technological advances – some of the latest equipment can help in achieving success in implant surgery.
Technological advancement and evidence base are important to essentially keep a dental implant dentist up to date and to ensure all treatments are carried out with the best equipment and knowledge that's available. It is worth noting that there are some technological advances that can help and there are some aspects that are not so beneficial.
The effective and appropriate use of Cone Beam CT Scanning can, for example, revolutionise many aspects of pre-surgery planning to ensure planned surgical/restorative treatment is possible and accurately reproduced. In addition, using the information gained from the CBCT scans, we can produce 3D models of a patients bone and surgical guides to enable computed assisted planning and design for implant placement in difficult areas. This is made possible using the image software ability to be input into most third-party planning software programmes.
Team work
When setting up my team I considered each person's strengths and focused on how they could support, if the occasion arose during implant planning and treatment. Any dentist is only being honest when he or she admits they can't be good at every sphere of dental work. For example, I am not overly enthusiastic about root canal treatment so am more likely to refer a patient to a colleague in the clinic who has a particular interest in this field. I'm competent in advanced bone grafting and sinus-lifting procedures so in turn will often have patients referred to me by other dental implant dentists in order to complete their treatment plans. By using someone who's an expert in specific fields you'll ensure comprehensive planning and execution at every stage of the treatment.
As well as ensuring your clinic team works at its optimum, it's important to associate yourself with a suitably experienced technician who is well acquainted with the construction and manufacture of the prosthetic superstructure(s) that will be used to restore dental implants.
Dental implant treatment should be planned from a restorative viewpoint and as such the diagnostic/planning work together with surgical stents should be formulated from the proposed definitive set up. This ensures that the surgical treatment will be appropriate to attain the desired restoration. There are very few 'shortcuts' and poor restorations can lead to the loss of implants.
Network with experts
When the team and the technician are in place, don't be afraid to integrate with medical colleagues. Creating a network of medical colleagues is of great benefit when faced with complex medical histories, which can entail the use of polypharmacy. Local radiology, maxillofacial, ENT consultants have so much to offer in treatment planning such cases and are keen to assist with patient care to ensure successful outcomes.
I'm a great fan of networking and mentoring and I believe both are important steps when it comes to exploring the world of implant surgery. I mentor several dentists throughout the country and can share my experience and knowledge with them. I am also in regular contact with some of the leading implant advocates so I can obtain advice and information whenever the need arises.