New implant designs and improved surface chemistry

This Nobel Biocare sponsored dental implant supplement presents seven scientific papers describing and discussing novel implant and abutment innovations. These innovations provide enhanced dental implant improvements that will ultimately lead to improved bone and soft tissue health adjacent to dental implants. The studies in this supplement demonstrate that scientific research is the basis for clinical improvements in implant dentistry as well as in medicine. It has become apparent that there is a rush to redesign and publish new implant designs, surfaces and supporting instruments without necessarily providing the public with assurances that these new implants and instruments are safe and effective. (The time may be approaching when governments will need to assure the safety of new dental implant innovations.) It is imperative that implant dentistry, just as does medicine, provides carefully designed animal and clinical research prior to public marketing. Change for change's sake is not always necessary. Changes to improve quality and patient experiences are virtuous. Research reported in this supplement indicates that changes in surface chemistry, surface roughness and color provide major improvements for the newest generation of dental implants. This implant generation will have chemistry and physical assets that enhance esthetics, maximize tissue biocompatibility with implant surfaces and possibly reduce soft tissue inflammation adjacent to the next generation of implant abutments. Recent trends in implant dentistry seem to encourage the idea of designing and marketing new implant designs and components with the so-called “newest materials” without providing documentation for the validity and safety of these new implant designs. Studies in this supplement yield valid data indicating the reliability for the next generations of dental implants. Long-term studies are needed to prove their validity. It is time for the implant industry, innovators and customers to look back and study how the industry evolved. P-I Brånemark did not come up with the idea for dental implants one day and start marketing a few weeks later. He understood the importance of carefully documented research, short- and long-term patient and implant follow-up and publication of study results. I worked as a close collaborator with Brånemark for many years and also with colleagues such as Adell, Lekholm, Jemt and others who were early pioneers and innovators. Together we worked hard to turn an idea into an industry, based on careful scientific and clinical research. This takes time, interest in improving patient care and yes, needs to be at an affordable cost. There are also implant components. Sometimes it seems that new instruments and materials are designed for problems that have not arisen or rarely exist. Our combined research efforts over the years have resulted in finding that mucositis and marginal bone loss need not automatically be regarded as disease-caused problems.1 Modern, documented, moderately rough oral implant systems work excellently over periods of 10 years or more with only 1-4% failures at the implant level.2 The drug industry is undergoing a revolution. Costs for many medications are outrageous and possibly beyond innovation expenditures. The revolution has spilled over into the dental implant industry. Minimal regulations have resulted in a plethora of new implant designs, materials, shapes, shades and seemingly something special for every different bone type, tissue color, bone quality, quantity and patient. New implant companies seem to pop up on a monthly basis. Is cheaper necessarily better? We think not. The research and innovations reported in this supplement are patient-oriented, innovative, reasonable and hopefully will improve implant and restorative longevity and improve short- and long-term patient care. Patients must be able to access the advantages of dental implants at affordable costs. The indigent, elderly and less advantaged must be able to participate in the wonderful advantages of dental implant tooth replacements.

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