Implantology in 2020: There is now something new under the sun or rather ancient
I will paraphrase Giovanni Pascoli in saying how I foresee the future of implantology this year: I feel like I can say that much of what appears new is in fact a return to the past or turns out to be a false promise. I look around, listen, and attend conferences, not only as a speaker but also as a participant, in Italy and worldwide. What follows here is what I feel has emerged.
They were made of machined titanium. Their surfaces have undergone a thousand evolutions, offered as thaumaturgic, and now seen as the primary cause of failure and peri-implantitis, which is obviously a new problem that had never been so dramatic in the past and has brought the most authoritative schools (including the northern European one) to say that, except for very difficult bone conditions, the first choice should continue to be machined titanium implants.
Immediate loading and all-on-four
After great promotion of these concepts at every event, these options being offered as almost routine and within everyone’s reach, today they are certainly still considered but with more circumspection, particularly in light of the literature which demonstrates that it is not always true that the success rates equal those of traditional treatments (even if too often this is the way they are sold to the patient). Furthermore, the eventual failures can lead to sometimes dramatic consequences.
Again, this is a proposal that turns out to be the undisputed queen at every scientific event. Participants at these meetings are then convinced that everyone should do it, and if you do not you are a fool beyond hope. This solution, thanks to its (only apparent) operational simplicity, is sold as a way to compensate for lack of ability or experience. In reality, and in light of personal experience, it is still light years away from offering the declared safety and precision and is undoubtedly a complex tool to be entrusted to experts who know how to make good use of it. I have also discovered, thanks to my collaborators, that the same companies that push guided surgery as if it were an inescapable choice really do not want to invest too much money in educational ventures because the revenues are insignificant and market penetration too small.
All this leads me to conclude, and perhaps to some extent hope, that the implantology of the new year does not bring new products whose claim of what they offer does not have scientific support and is only based on the need of a company to stay competitive or of a speaker (so many new ones and their presentations often a little too improvised) to have his or her moment of glory!
It should probably lead us to review the therapeutic choices on the basis of the real needs of the patient, to decide according to science and conscience, and use what is really safe and validated, leaving to research groups the task of assessing any innovation not yet scientifically verified.
Dr Mauro Labanca, consultant professor of anatomy
Editorial note: This is a translation of an editorial, which was first published in the Italian Edition of implants―international magazine of oral implantology No.1, 2020.