Dental implants are the ultimate restorative solution for edentulous patients. The ability to provide patients with this gold standard[i] solution will enable them to enjoy the benefits of excellent functionality and natural looking aesthetics, which are generally harder to achieve with removable prostheses.[ii] This is in addition to the oral hygiene benefits of cleaning around the implant retained prosthetic as you would a natural tooth, simplifying long term care.

However, when a tooth is extracted (or lost by other means), patients are likely to experience bone atrophy to varying extents. This bone reduction is irreversible and involves loss of both the width and height of the hard and soft tissue. In some cases, this means that extensive reconstruction is needed to create sufficient space for implant placement. Because of this, in some cases, patients are unable to access this restorative solution. To maximise the opportunities for patients to receive dental implant treatment, professionals must often explore the options to limit alveolar bone resorption and undertake procedures to maximise bone volume.[iii]

Challenges presented by reduced bone volume

Where insufficient bone volume in unavoidable or already an issue, this may mean that implants are much more difficult, risky, or at times not possible to place. In certain situations, for example when a patient has poor dental hygiene, bruxism, or unstable periodontal disease, dental implants may be contraindicated.[iv] Instead, clinicians may recommend removable prostheses to enable patients to retain some function, and achieve a relatively aesthetic outcome.

In other situations, bone and soft tissue grafts may be necessary to gain sufficient volume for implant placement.ⁱⁱⁱ This requires additional time and expense for the patient and the clinician.

What factors impact alveolar ridge resorption?

There are a number of factors which might affect the amount of bone lost after an extraction or tooth loss. If a patient has already lost a tooth, you can expect more extensive bone loss the longer it has been missing, and it is likely that bone grafts will be required to maximise bone quality and/or volume prior to implant placement.[v]

In any case, the extent of bone loss could be impacted by the shape of the socket, the number of adjacent teeth lost or being removed and the gingival biotype. This is in addition to external factors such as systemic illnesses, whether or not the patient is a smoker, and the patient’s oral health compliance.ⁱⁱⁱ

When possible, clinicians should first consider the best ways to preserve alveolar bone post extraction, facilitating effective dental implant placement without the need for extensive bone grafting procedures.ⁱⁱⁱ

Alveolar ridge preservation for ideal conditions

Where alveolar ridge preservation (ARP) is appropriate, it can be successfully employed to retain as much of the natural bone structure as possible while the site is healing.ⁱⁱⁱ When compared to extraction alone, ARP procedures are shown to be effective in reducing the amount of alveolar ridge resorption seen. Research suggests that treatment can result in an average retention of 1.89 mm in buccolingual width, 2.07 mm in midbuccal height and 1.18 mm in midlingual height when compared to extraction alone. This makes this type of treatment very effective for maintaining bone volume.ⁱⁱⁱ

By applying a xenograft or an allograft to the extraction site, you can expect superior bone height preservation.ⁱⁱⁱ Therefore ARP can make implant placement more straightforward, and improve treatment outcomes.

Choosing the best biomaterials for ideal outcomes

To create ideal conditions for dental implant placement by maximising the alveolar bone volume, material selection is important. Clinicians should select a high-quality xenograft, allograft, and/or membrane,ⁱⁱⁱ and use as necessary to create sufficient volume.

Straumann prioritises quality, and understands that each patient is unique and will require individualised materials for high standards of care. Straumann offers a wide-reaching portfolio of biomaterials, to make sure that you have the best solutions for a range of needs including periodontal regeneration, wound healing, bone regeneration, and soft tissue management. By providing innovative individual solutions, Straumann helps you to take on every challenge.

Maximise your patients’ potential for dental implant treatment by helping them to preserve as much alveolar bone volume as possible. Implant treatment is the ultimate replacement for missing teeth or failing and will help to restore your patients’ function and aesthetics. If you are able to retain large amounts of a patient’s bone volume through ARP, you will be able to save patients time and money, and make implant placement more straightforward.

For more information about biomaterials from Straumann please visit www.straumann-uk.co/biomaterials

[i] Saha S, Ray-Chaudhuri A. Mandibular implant-retained complete overdenture using retentive abutments: a case report. Dent Update. 2009 Apr;36(3):154-8. doi: 10.12968/denu.2009.36.3.154. PMID: 19480103. https://pubmed.ncbi.nlm.nih.gov/19480103/

[ii] D’Addazio, G.; Xhajanka, E.; Cerone, P.; Santilli, M.; Rexhepi, I.; Caputi, S.; Sinjari, B. Traditional Removable Partial Dentures versus Implant-Supported Removable Partial Dentures: A Retrospective, Observational Oral Health-Related Quality-Of-Life Study. Prosthesis 2021, 3, 361–369. https://doi.org/10.3390/ prosthesis3040032 file:///Users/officeone/Downloads/prosthesis-03-00032-v2.pdf

[iii] Avila-Ortiz G, Elangovan S, Kramer KW, Blanchette D, Dawson DV. Effect of alveolar ridge preservation after tooth extraction: a systematic review and meta-analysis. J Dent Res. 2014 Oct;93(10):950-8. doi: 10.1177/0022034514541127. Epub 2014 Jun 25. PMID: 24966231; PMCID: PMC4293706. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293706/

[iv] file:///Users/officeone/Downloads/Implant%20guidelines.pdf

[v] Oikarinen, Kyösti S., et al. “Augmentation of the narrow traumatized anterior alveolar ridge to facilitate dental implant placement.” Dental Traumatology 19.1 (2003): 19-29. https://d1wqtxts1xzle7.cloudfront.net/45844862/Augmentation_of_the_narrow_traumatized_a20160521-28564-1082bdg-libre.pdf?1463886615=&response-content-disposition=inline%3B+filename%3DAugmentation_of_the_narrow_traumatized_a.pdf&Expires=1671110292&Signature=DwmRJNsfEMiLCjSX7nIuhATwI4OnuXz0wepTd~Z4mxLQUtSpHg7Wrtv5-4CZASx5u3OP2yTQPCSGokF3gFCS2SncVBE7LOH32arwtlSAf4eKU6~VyNgN70ynA3wte4J89hN0VFUM7-pOcIa9CqSaCPUQDaQc3Fn85Qyat0KY90L9CBCd6x3heeaQNOuQcer4cEYJb9E2xU3Yhba-YrUu~S6XGS8y7JNpVu2QKv5CaxoJtpu1tPyklWlpZPiLqiqP4uRUtuAQ45mOrn8RMhq7wm-k1P58J1YbI8jzfSlH54I~EOKBY-rDgM58SNxGDhkNTvgT0mr3Sy8Fr3ti15yCPw__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA

Continuous training is mandated for all dental professionals, but there are still challenges to be overcome for many members of the team. These include access to quality education, relevance of programmes available and benefit of the new skills being learnt to support job applications. This is especially true for dental therapists, who still face difficulties when seeking postgraduate training and looking for new job positions.

Delegates who wish to share their own experiences and hear from those who have found successful training pathways for themselves shouldn’t miss the British Dental Conference & Dentistry Show (BDCDS) 2023. This May, we will bring together dental therapists and dental hygienists from across the nation for two days of world-class education and networking. A selection of renowned and highly experienced professionals will be taking to the stage to offer valuable insights and a wealth of information for delegates to benefit from.

Laura King will be among the speakers in the Hygienist & Therapist Symposium, supported by the British Association of Dental Therapists (BADT). Laura is a dental therapist who currently works within the UK Ministry of Defence and on a private basis. Passionate about on-going education and career progression, she will be advocating for postgraduate training for dental therapists. About her presentation, Laura says:

“My session will explore Postgraduate Foundation Training Schemes for dental therapists. I’ll consider how additional training can increase clinical confidence and benefit career prospects for many individuals. I will also discuss some of the barriers that dental therapists face whilst seeking jobs or new career opportunities and positions.

“This presentation is based on the findings of my Master of Research Degree and is not representative of the whole dental therapist population. It will, however, offer insight and a comparison into the experiences of dental therapists who have completed Postgraduate Foundation Training Schemes, and those who have not.

“Dentistry is evolving, especially with changes to the NHS contract. More Deaneries are now offering Postgraduate Foundation Training Schemes for dental therapists, yet many professionals seem unaware of their availability or the benefits of participation.

The Advancing Dental Care Report highlights training opportunities for the whole dental team and I will share some of the key findings with delegates.”

The Advancing Dental Care Report was published by Health Education England following a three-year review into the professional training infrastructure for the healthcare workforce. Its proposals included giving trainees diverse experience of managing complex care, better use of skill mix across dentistry and further options for all dental professionals to increase their knowledge and skills. It also highlighted the need for greater flexibility regarding routes of entry into training for wider access, apprenticeships, and digital/blended learning solutions.

During her session, Laura hopes to dispel some of the myths surrounding postgraduate education for dental therapists. She continues:

“There is a misconception that Postgraduate Foundation Training Schemes for dental therapists are for individuals who don’t feel confident at the point of qualification. This is not true. Postgraduate Foundation Training is mandatory for dentists who want an NHS Performer Number. It is a well-established and accepted training and career pathway for all dental professionals. The question now is whether this approach should be more widely adopted by dental therapy graduates, and if it could help dental therapists who continue to face challenges when seeking new job opportunities.

“It is my goal that delegates will leave my session with an enhanced understanding about the benefits of further training, skills consolidation, and increased clinical confidence. I also hope colleagues will be more aware of the common barriers that all dental therapists can encounter.”

The trade exhibition will complement the educational programme at BDCDS perfectly by hosting various training providers who delegates can liaise with directly. Whether you’re looking for a training course or seeking new ideas on how to diversify your career, this is the place to be!

Plus, BDCDS is a great opportunity to connect with the wider profession, to share experiences with like-minded colleagues and have some fun with friends. All members of the team will be in attendance, as well as representatives from an array of associations and professional bodies – including the BADT and the British Society of Dental Hygiene and Therapy (BSDHT).

Don’t miss out – register for your free delegate pass online today.

The British Dental Conference & Dentistry Show 2023 will be held on Friday 12 and Saturday 13 May, NEC Birmingham, co-located with DTS. 

For more information, visit the website or email dentistry@closerstillmedia.com

Register today

For many patients, visiting the dentist is a source of stress and worry. For some, this may be due to the fear of pain, uncertainty of what to expect, or maybe a lack of education about dental procedures or what they will be required to do during dental examinations. This uncertainty can make patients feel as if they are out of control – which is often a root cause of dental anxiety.[i] It can be challenging for clinicians to make patients comfortable during appointments, particularly if they are already worried about their upcoming examination or treatment. However, there are a number of ways to help make patients feel at ease, particularly if they are struggling to understand what their visit will entail.

Making patients feel comfortable

Add NewDental anxiety is estimated to affect 16% of the UK population. This is having a real impact on attendance with 2009 research suggesting that only 58% of people had attempted to make a dental appointment within the previous three years.[ii] It’s vital that dental teams do all they can to support anxious patients – especially as not attending dental check-ups and treatment is likely to result in poor oral health.

Patients with dental anxiety may experience: sweating, a racing heartbeat, fainting, and visible distress including crying and panicking. If patients show signs of dental anxiety, it’s important to take them seriously, and do all you can to make their appointment comfortable. Reassure them, and communicate clearly at each stage of their appointment to help reduce their fear and uncertainty.ⁱ If patients are happy with the treatment and standard of care they receive, they are more likely to return to your practice in the future. A big part of this is ensuring dental appointments are a positive experience.

Boosting understanding

By understanding why patients feel anxious in the run up to appointments, it becomes easier to help them. Clinicians might assume that dental anxiety is sparked purely by a fear of pain, however it is more likely to be caused by a combination of factors. Dental anxiety is likely to depend on how an individual perceives a situation, like treatment feeling uncontrollable, unpredictable, dangerous and disgusting – these strongly correlate with anxious patients.ⁱⁱ

Of those who are anxious or scared about visiting the dentist, 24% say that fear of dental equipment is the reason why.[iii] Things like needles, drills, or the dental practice environment in general can trigger patients’ anxiety.ⁱ Research suggests that using more advanced technology makes patients feel more confidentⁱⁱⁱ – it is important to what the equipment is for, and go through results in detail where possible – keeping patients informed every step of the way. Finding ways to inform patients about what to expect during their appointment may help them feel more in control and confident going into examinations and procedures. Whether that’s a conversation as you begin each appointment, information available to view in the waiting room, or communication prior to appointments (via email or phone) to help reduce the number of failed to attends (FTAs).ⁱⁱⁱ

Clarity to relieve anxiety

When using modern digital dental technology, be sure you are able to offer good explanations of what the equipment is for, and how it works in a way that nervous patients can easily understand. It is important that patients understand what is expected of them during examinations, so that they have a clear idea of the process as it begins. If you choose to invest in a high-quality imaging system, for example, ensure that all dental staff are able to assist patients with questions and concerns when necessary. Choose a system which prioritises patient comfort and makes workflows simple and repeatable, helping to minimise any stress during examinations.

The CS 9600 CBCT system from Carestream Dental is a versatile and scalable 5-in-1 imaging system which offers optimal patient comfort. It features a retractable seat which makes it clear exactly where the patient needs to be during their scan and helps to make the experience more comfortable for the patient. The CS 9600 also uses AI patient positioning allowing you to achieve precise images in every case – it is able to record each patient’s parameters, making follow-up imaging repeatable and consistent.

Making patient comfort a priority in your practice is vital for patient retention. If your patients have positive experiences when they visit your practice, they are less likely to develop dental anxiety, and will feel more confident to return for follow up appointments. Implementing digital dentistry into your practice is a great way to make dental appointments simpler for you and your patients. Digital equipment is a preference for patients, but is most effective when patients feel informed about the equipment that is being used. Implementing simple educational tools in your practice or conversations during appointments to ensure patients have a suitable understanding of processes will lead to increased patient satisfaction, and is likely to lower anxiety levels.

For more information on Carestream Dental visit www.carestreamdental.co.uk

For the latest news and updates, follow us on Facebook and Instagram @carestreamdental.uk

Author: Nimisha Nariapara is the Trade Marketing Manager at Carestream Dental covering the UK, Middle East, Nordics, South Africa, Russia and CIS regions. She has worked at Carestream Dental for the past 7 years, where she has developed her marketing skills and industry knowledge to bring the core values and philosophy of the company to the market. 

[i] Better Health. Dental anxiety and phobia. (Accessed: 08.11.22)  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dental-anxiety-and-phobia#

[ii] Calladine, Hannah, Charlotte C. Currie, and Chris Penlington. “A survey of patients’ concerns about visiting the dentist and how dentists can help.” Journal of Oral Rehabilitation 49.4 (2022): 414-421. https://onlinelibrary.wiley.com/doi/pdf/10.1111/joor.13305

[iii] Carestream Dental. The need for digital dentistry education – a global evaluation of patients’ awareness, attitudes and behaviours. (Accessed: 08.11.22)  https://www.carestreamdental.com/globalassets/microsites/ddd.org/assets/the-need-for-digital-dentistry-education.pdf

Dr Ramón Gómez Meda is a highly-esteemed international speaker in the field of periodontology, aesthetic dentistry and multidisciplinary treatment. He is an adjunct Assistant Professor for the Department of Prosthodontics at LSUHSC School of Dentistry in the USA and the founder of MEDA Training Centre in Spain.

Ramón will be among the speaker line-up for this year’s ADI Team Congress, which is being held on 4-6 May 2023 at the ICC in Birmingham. He will be discussing “A Paradigm Shift: Perio-Prostho Approach for Predictable FP-1 Rehabilitations”. He shares some of the difficulties associated with FP-1 restorations and aspects that clinicians must be aware of in order to fully maximise on the benefits available:

“FP-1 implant-supported restorations can be highly challenging for several reasons. In the short-term, because this kind of treatment option requires clinical knowledge in many different dental fields, including dental software, dental materials, periodontics, and prosthodontics, among others. In the long-term, bone resorption after tooth extraction may compromise the aesthetic result, making it almost impossible to use an FP-1 approach. Many therapeutic considerations have to be taken into account to avoid both short- and long-term complications.

“A thorough diagnosis allows the clinician to select the best treatment option for each patient, preventing future complications. Not every clinical case can be treated with an FP-1 rehabilitation, so contraindications must be carefully assessed. Aesthetic, functional and biological parameters should be explored before selecting the best treatment option.”

During his session, Ramón will talk about the digital workflow and how it can impact results of full arch dental implant treatment. Commenting on how digital solutions can improve the predictability of outcomes, he says:

“Digital workflows increase the predictability of this kind of full-mouth rehabilitation, because dental implants may be placed in a better position, improving the final shape and location of the emergence profile. Also, the printed or milled temporary restoration can be delivered faster while the surgeon reconstructs the hard and soft tissues.”

Delegates attending Ramón’s session can also expect to cover the prosthodontic steps necessary within a good diagnosis and treatment plan. In addition, the lecture will explore soft tissue augmentation techniques and how these can be utilised to ensure stable long-term results for a wide range of patients.

Ramón considers what else he hopes delegates will gain from his session and how it might benefit them in practice:

“I hope to be able to communicate how useful it is to incorporate new technologies, materials and software to increase the efficiency of our workflows as well as the predictability. In this way we can save time, reduce morbidities and lower costs to the patient, who is the leading beneficiary of an effective professional workflow.”

Other than Ramón’s lecture, the ADI Team Congress will explore a broad variety of topics relevant to the dental implant team. These will include biological construction of the peri-implant tissue, managing defects in the aesthetic zone, immediate and delayed dental implant protocols, the immune system behind osseointegration and management of aesthetic complications. These will be presented by globally renowned speakers, including Howie Gluckman, Tomas Albrektsson, Dirk Duddeck and several more.

This will be an event for learning, skill development and career progression, but it will also be an ideal platform from which to browse the latest products, materials and technologies. The major exhibition will host a selection of dental implant manufacturers, suppliers and training providers who will be more than happy to answer questions and provide any support delegates need. For further networking opportunities, there will also be various social events that will make it easy to meet new people and catch up with friends. For instance, Congress Drinks on Thursday 4 May will be held in the exhibition hall, followed by the Industry Party, “May The 4^th Be With You” at the iconic Birmingham Library. On Friday 5 May, the black-tie Congress Dinner “In a Galaxy Far Far Away” will be held at the ICC, providing another evening of food, dancing and fun with friends.

All of this encompasses what the ADI stands for – community, support, friendship, education and the advancement of the field. Looking ahead to the Congress, Ramón adds:

“I am excited to attend the event and to meet new colleagues sharing their experiences. I am looking forward to it. I want to thank the ADI for the kind invitation to be among so many talented clinicians.”

Register today to make sure you don’t miss out!

Dental Implants: Individual Excellence or Team Triumphs

Birmingham

4-6 May 2023

ADI members can access the event at a heavily discounted rate, join today

www.adi.org.uk