Dental Implants


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Dental Implants

  1. 1. DENTAL IMPLANTS EXCEPTIONAL NOT EXPERIMENTAL By Lisa C. Wadsworth, CDA, RDH he practice of dentistry is ever changing, Dental implants as an area of expertise T with technology becoming more excit- ing and diverse each year. The practice of dental assisting is evolving into a special- will lead you to challenge your clinical skills as well as broaden your responsibilities in the practice by becoming an implant coordi- ized art! This is an opportune time to enter or nator. An implant coordinator is utilized expand your involvement within the dental within a periodontal setting as well as the arena. Embrace the emerging technique-sen- restorative practice. Together you and your sitive procedures in our field and separate dental assisting colleagues play a major role yourself from your col- in how smoothly a leagues while establish- patient proceeds through ing yourself as a leader. the process. A career in dental Question: How do I assisting now more get started? than ever can provide Answer: Take the time you with a lifelong to study and invest in learning experience. To yourself. take a quote from a Think about the type friend and fellow col- of dental practice that league, Dr. David excites you. Do you Resnik,“The Sky’s the want to be on the surgi- Limit.” Surgical suite during implant placement. Dr. cal team or, do you Dental implants are Alan M. Meltzer, periodontist, doing the surgery. enjoy being a part of the setting the stage for expanded treatment fabrication of the final restoration? If you are options. Experts who watch the implant mar- undecided, plan a visit to an implant special- ket say it is poised for major growth, expect- ist practice to observe an implant placement ed to double in the next ten years. Dental procedure. assistants will find that the ability to assist Ask questions of the team, including the both the dentist and the patient a rewarding surgeon. Remember that implant placement experience. is a technique-sensitive procedure; therefore, you may want to wait and ask your questions after surgery. Be patient and watch and absorb the actions of the surgical team. You Lisa C. Wadsworth CDA, RDH, is founder and president of will notice that the systems used to place Lisa C. Wadsworth Inc. dental consulting firm. She is an implants are very precise. Should you active member of the Speaking and Consulting Network decide to choose this path, many implant that serves the dental community. companies offer accredited courses for becoming a certified implant surgical assis-May/June 2006 The Dental Assistant 1
  2. 2. Before surgical flap for placement. Placement of titanium implant. Permanent crown placement.tant. Another way to obtain certifi- ing tooth! How many of your adult trauma, decay or periodontal dis-cation is by joining the Association patients are missing one tooth or ease. The reason for tooth loss isof Dental Implant Auxiliaries and more? Statistics suggest that at least important during candidate selec-Practice Management (www.den- 35 percent of the Western popula- tion for dental Although certifi- tion is missing at least one tooth. It is very difficult for even thecation is not a prerequisite for work- Conventional treatment in the past most experienced dentist to anchoring in a surgical or restorative set- has included the placement of a a partial to a solitary premolar withting, it is a certificate that will boost three-unit bridge. Practitioners success. Utilizing two free standingyour self-esteem and your position today must stop to evaluate the implants and securing a permanentwithin the dental community. need for reducing the teeth on fixed bridge achieves greater stabil- If you do not fancy the surgical either side of the space. Why sub- ity. This technique may even beaspects of the dental implant ject virgin teeth to “crown and beneficial in the esthetic zone (usu-process, find a restorative dentist or bridge” therapy when an implant ally canine to canine) due to theprosthodontist who is willing to may be the most viable option for availability of very narrow taperedmentor you. The restorative team has saving the natural dentition? be as precise with their proce- The greatest threat to natural Dental assistants should discussdures as their surgical counterparts. dentition is decay. The most com- these options with the implantThe final outcome of every case, no mon reason for crown failure is not team and keep abreast of the latestmatter how many implants are the crown but the natural tooth technology.placed, depends on the team’s abili- itself. Why subject natural tooth Fully Edentulous – It is importantty and dedication to working within structure to restorative dentistry that to recognize that approximately 11a multidisciplinary environment. could possibly be avoided through percent of the population is fully Having the good fortune to be the use of implants? edentulous. Prior to the success ofinvolved with the process from both Multiple missing teeth – How implants, what did we have to offervantage points during my career as many of your patients are wearing our edentulous patients? Thea dental assistant I can tell you that comfortable partial dentures yet answer, at best, was a well-fitting fullboth are rewarding and allow you still inquire at their continuing care denture that would allow daily func-as the dental assistant to bring very appointment about a permanent tion such as speaking and eating.different skill sets to the table. replacement? The ability to eat a Are these people happy with their good meal and avoid embarrass- full dentures? For some patients theQuestion: What restorative situa- ment while speaking are the pri- answer is “Yes,” but for many thetions might be ideal for dental mary concerns of our patients who answer is a resounding “No!”implants? wear partial dentures. StatisticsAnswer: There are several possi- indicate that over 40 percent of the Below are two examplesble circumstances in which population under 65 years of age of options for edentulousimplants should be included in a are partially edentulous. Patients patients:patient’s treatment plan. aged 65 and older are 50 to 60 per- Bar-Clip Removable denture: This The most common situation that cent partially edentulous. Teeth technique utilizes as few as twocalls for an implant is a single miss- may be lost prematurely due to implants with a stabilizing bar, overMay/June 2006 The Dental Assistant 2
  3. 3. which a denture housing a magnetis placed to stabilize the entire appli- Figure 1: Terminology of Dental Implantologyance. Or, if more stability is needed, Titanium: In alloyed form, titanium is fabricated under sterile and very specif-but monetary constraints must be ic standards to create the dental implant that will be placed during the surgicalconsidered, more implants may be stage of implant dentistry. The ability of titanium to “osseointegrate” is wellplaced while still utilizing the mag- documented and is the first step in the healing of a dental implant.netic over denture technique. Dental Implant: A titanium fixture used to replace a missing root. Fixed Bridgework: The most nat- Biocompatible with human bone, the titanium implant, often called a ”fixture,“ural feeling restoration would be to has the capability to osseointegrate if all biological factors are positive and theplace as many implants as needed patient has the ability to heal successfully.per arch to support “fixed” bridge- Osseointegration: A direct structural connection between living jaw bone andwork to span an entire arch. Each the surface of a titanium dental implant. The dental implant becomes “one”case is different, and many factors with the jaw bone. The implant is anchored into the bone, but does not shareplay into the decision. Some issues blood supply. The jaw bone accepts the titanium and when fully integratedmight include; the physical size of should not reject it.the patient, how far distal must thecase go to ensure an esthetic result, you alone to answer the remaining Exampleand are there teeth in the opposing questions? Much as you arrive to work inarch? Dental assistants play a vital and your street clothes, then changeDiscussion ongoing role in education and into scrubs, the patient is given a At this point in your reading treatment acceptance. Never disposable surgical gown to wearyou may be asking yourself, underestimate the impact of your during the procedure along with a“Why do I need to know treat- responsibilities as an educated hair net. A cover sheet (also sterile)ment planning information?” As a member of the team to enable is placed over the entire patientdental assistant you are a valu- patients to make life-changing after he or she is comfortably seat-able component in the treatment decisions about their health! Your ed in the dental chair. Once theplanning phase. Without a doubt, contribution to the process of suc- patient is draped for surgery he orif your wish is to be a leader in a cessful implant dentistry must not she will not be permitted to stopforward thinking team you will be underestimated! the procedure for personal the person whom the patient Therefore, it is your job as lead Question: As a surgical assistant, assistant to ensure that the patientrespects and confides in. Implant what will my role be?coordinators are the first link in is comfortable prior to the surgicalthe line of communication when Answer: Familiarize yourself draping procedure. Your role as thea patient presents for an implant with “Dental Implantology lead assistant is to mentally pre-consultation. terminology.” pare the patient for surgery. Some of the important terms are You are then in charge of setting The ability to discuss intricate outlined in Figure 1. These terms the surgical stage for the specialist.treatment plans with confidence are necessary to understand the sci- The visual experience of seeing aand enthusiasm is a skill. This skill ence of implantology. dental treatment room preparedis learned and practiced by thosewho want professional fulfillment Clinically, the role of a surgical for a surgical procedure is gratify-and endless growth potential. assistant will be to ensure that the ing, but understand that it requires patient is comfortable and aware meticulous thought and prepara- Your newfound expertise will that the procedure will be per- tion. The details for correctly drap-help patients make life-changing formed under sterile conditions. The ing and preparing a treatmentdecisions about their dental care dental assistant is the prime team room for surgery can often takeand how such choices may affect member to explain asepsis tech- longer than the placement of onetheir quality of life. How many niques. The surgical placement pro- dental implant!times have you heard the dentist cedure is performed according to Implant surgery preparation byoutline a treatment plan, ask the specifications that are similar to the implant coordinator varies frompatient if they have any questions, hospital operating room conditions. specialist to specialist. Be awarethen leave the room with you andMay/June 2006 The Dental Assistant 3
  4. 4. that all precautions are taken to ensure asepsis and clearly, and once you have made that determination, that all instruments used during implant placement do you along with the dentist will begin to educate the not come into contact with anything that is not sterile. patient about possible treatment options. Your role as The actual titanium implant must not come into con- an educator will enable you to serve your patient at a tact with anything but the jaw bone awaiting its arrival. new level. The successful setup and placement of a dental Your position as an Implant coordinator will implant for many implant coordinators is like being enhance your overall knowledge of patient manage- part of a three-act play. In the first act, you as the leader ment and bring you to the forefront of your profession. of the implant team prepare the surgical suite to very This new and exciting area of expertise brings with it specific protocol. Then along comes the second act, in many challenges and greater career satisfaction. which the patient is prepared for surgery. During this In conclusion segment the patient’s level of comfort is assured while I hope I have ignited your curiosity to investigate the maintaining a sterile field. In the third and final act, ever growing world of implant dentistry. Don’t ever let you are ready to assist the surgeon with the finest, state anyone tell you that implant dentistry is experimental. of the art technology in dentistry today. To the contrary, it is exceptional! Question: As a restorative dental assistant, what will I challenge you to pursue the education and expe- my role be? rience of implant dentistry. Exciting times await you in Answer: As a “restorative assistant” your clinical the dental profession. Find your niche and follow your skills are absolutely crucial. dreams. Should your dreams include the necessary During the beginning stages of treatment planning, education and training to become an implant coordi- you will be asked to take notes during a comprehen- nator, you will begin to practice at a very high level sive medical history review, take high quality radi- with practitioners who value and appreciate your ded- ographs, study models, possibly a bite registration, ication to the “Art of Dentistry.” master impressions and provisional restoration (if your state allows). The type of exam utilized to select poten- Photographs provided by: tial candidates is more intricate than a patient present- Alan M. Meltzer, DMD, MScD ing for a routine dental procedure. You will learn to Diplomate American Board of Periodontology, evaluate the dental IQ of your patients much more (856) 772-9444May/June 2006 The Dental Assistant 4