Newsletter
The latest Cochrane review on dental implants is a very impressive article. I would be interested in knowing the statistically well-documented long-term results referred to by the authors of the review. The findings may leave dentists wondering whether they should start using so-called easier and cheaper implant systems as promoted by some manufacturers.
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I hope that no dentists will interpret the findings this way. We have to keep in mind that this review was not based on all implant systems and that a limited number of the 1,300 systems currently in use were studied. The physiological properties of the healing process of the living tissue do not differ between the systems. Therefore, we should select a system based on scientific research results, pure surface properties without any contamination and the accuracy of the mechanism, applying the fail-safe concept.
I agree with the findings regarding turned implants. It is my impression that the establishment of osseointegration in turned implants was more difficult in some cases than in those with a medium roughness surface. It might be important to investigate the reason for this, however.
In the early days, the bone was prepared with a 3 mm twist drill up to the full length of the implant prior to the installation of turned parallel walled implants even in the maxillae. It was difficult to obtain initial stability in some cases. Once osseointegration has been established, in my 31 years of experience, inflammation in the surrounding tissue is rare and osseointegration remains stable for many years.
Dentists should adopt a longer-term perspective in selecting the implant system to use. The newness of the implant system is not a relevant criterion in the field of dental implants. We as dentists should place importance on the basic science and re-evaluate the original protocol proposed by Brånemark.
Dr. Yataro Komiyama