by Dr Alex Fibishenko
I was honored to present back-to-back at NYU Linhart College of Dentistry, New York, followed by the 4th Evidence Based Symposium on Oral Rehabilitation, Beijing.
My presentation was about simplifying the workflow of complex surgical cases, assessment and management of the terminal dentition, Zygoma ‘Plus’ and quality standards in advanced oral implantology.
I showed cases with terminal dentitions ranging in age from 20’s to 70′ with decay, gum disease and total deterioration. The most important question before offering these patients any kind of treatment is how did they get to that point in the first place?
There are many causative factors for tooth loss leading to a terminal state, but perhaps the critical ones are neglect due to poor hygiene, sugar consumption and/or poor compliance. These in turn can be the result of a poor dental IQ (“…I had no idea I had to floss or avoid energy drinks) or due to fear and distrust because of a poor past dental experience.
As dentists we can also be guilty of judging those patients and offering them only patch-up treatments, or things they can’t bear to wear …like dentures. The cycle of patch-up treatments inevitably leads to failure (at least according to the patient) which only reinforces their distrust, and which leads to a lack of motivation, followed by a lack of compliance to reach a point of despair.
The factors that lead to the ultimate failure of the patient’s natural dentitions can also cause issues with implants. The natural question is whether we will be risking the failure of our own work if we offer those patients implants? If we don’t break the cycle of distrust and poor compliance, then perhaps! Tough we can break that cycle by giving the patient a “Solution”, not just treatment after treatment, a definitive and more reliable solution to their ongoing cycle of breakdown and dissatisfaction.
In my presentation I demonstrated how patients can be re-engaged and become participants in their own success and long term enjoyment of their implants/teeth when we fulfil their desires with a positive experience. To attain a successful result we individualise treatments for our patients and often have to combine procedures such as bone grafting to improve the volume of lost or deficient bone in our implant procedures.
It was great to meet some of my past residency graduates and to hear about their successes.
A very special thank you to my hosts Prof. Lin Ye, Peking University, Arrail Dental, China-Japan Collaboration Hospital and Geistlich Biomaterials, for the warm welcome and all your generous hospitality.
