Training a general dentist in implantology requires a comprehensive, multifaceted approach, and successful training is not something that can be achieved overnight. To succeed, the dentist in training needs to be fully committed and dedicated to learning a new skill.
Implant training begins with didactic coursework, and it is imperative that the dentist possess a strong understanding of anatomy, physiology, and pharmacology, along with a basic skill set in oral surgery. Once a dentist completes didactic coursework, the next step is hands-on training with objects that mimic real patients, such as mannequins and pig jaws. Finally, the dentist moves on to implant training on “live” patients.
Most dentists get into implant-specific training a few years into their careers, after they’ve spent time in general practice and decide to continue broadening their skill sets. However, more and more dentists are coming out of dental school looking to pursue implantology immediately. While dental schools prepare a doctor to restore an implant, they often do not prepare doctors to perform the more technique-sensitive surgical placement.
Regardless of career stage, a dentist can pursue various areas of implant-specific training through residencies or fellowships. A few examples of in-depth training include:
- Treatment planning and case selection: At the beginning of this journey, it is wise to select easier cases with lower risk and higher chances of success. Our experience suggests doctors do better over the long term, if they stay within the anterior mandible for their first dozen or so cases.
- Training with CBCT: This technology produces 3-D images of teeth, soft tissues, and bone in a single scan. These X-ray images allow for more precise treatment planning and increased patient safety when regular 2-D dental X-rays are not sufficient. Dentists who complete CBCT training will have a better understanding of the basic principles and anatomical needs for sound implant placement and recognize situations where a CBCT scan is needed.
- Armamentarium options: Armamentarium in implantology can be overwhelming to the uninitiated. Providers need to learn what works in their individual hands and understand the basic instrumentation specifically required for effective and safe implant surgery.
- Soft-tissue management: Managing the soft issue well is paramount to implant success. Doctors need to learn the principles of good flap design and how to maintain attached gingiva around the healing abutment/restorations to achieve long-term success.
- Bone grafting and sinus lift procedures: Often, the patient does not have adequate bone to place a successful implant. More advanced doctors performing more difficult cases need to learn to how to correct for years of bone loss. This is particularly frequent in the posterior maxilla. At times, to make room for the bone graft, the sinus membrane has to be “lifted” when there is not enough bone height for a dental implant to be placed. Through additional training in this area, dentists will learn how to master this technique-sensitive procedure.
Other areas of implantology training include medical evaluation and clearance, pre- and post-op care, pharmaceutical regiments, suturing techniques, prosthodontic/restorative considerations, and much more. Advances in technology have truly helped with surgical success rates and are making the implant procedure more predictable for dentists and safer for patients. Through these types of additional training, dentists can gain the necessary confidence and expertise to perform implant procedures with high success rates.
Once a dentist has an established role in implantology, there are several organizations and associations available for continuing education including the International Congress of Oral Implantologists, the American Academy of Implant Dentistry, and the American Board of Oral Implantology. These associations host annual meetings and events, allowing dentists to come together for additional education and training.
Any dentist looking to become skilled in implantology needs to be aware that the training and preparation can be lengthy. To be a successful implant dentist, the individual must embrace surgery and learning with determination and commitment.
If I could give some advice to any dentist hoping to get into this field, it would be to maintain a lifelong pursuit of learning because our industry and its technology are constantly changing. As G. V. Black, the father of modern dentistry, once said, “The professional person has no right to be other than a continuous student.” Finally, stay persistent and, when possible, seek out hands-on “live” training to get the most realistic experience possible. Implantology is a compelling field within dentistry, and one that will continue to grow at an exciting pace.
Dr. Zasso is the chief clinical officer of Affordable Dentures & Implants. He earned his DDS degree at Northwestern University Dental School. Based on many years of valuable dental experience, he and his staff are proud to offer professional, compassionate care to patients who visit this practice. He can be reached at (719) 286-9796.