I've had multiple dental implants fail, and I want to tell you something important about the dentist who placed them. I believe he is one of the most competent dentists in the world, I trust his skill completely, and I know he wanted those implants to succeed every bit as much as I did.
That's what made the experience so frustrating. If the dentistry was good, why did the implants fail?
I'm not a dentist, so I started asking questions. And the more I learned, the more interested I became in something patients rarely think about: the dentist can place the implant, but the patient's biology still has to integrate it.
PLACEMENT IS ONLY THE BEGINNING
To a patient, an implant can seem almost mechanical. Put the implant into the bone, allow it to heal, restore it and move on.
Biologically, there's a lot more happening.
After placement, the body begins a complex healing process. A blood clot forms, inflammatory and signaling processes begin, new blood vessels develop, bone-forming cells become active and new bone begins forming around the implant. That early bone then continues to remodel and mature.
In other words, osseointegration isn't a moment. It's a biological process. And not every part of that process is within the dentist's control.
YOU'RE NOT PLACING AN IMPLANT INTO AN INERT MATERIAL
You're placing it into a human being.
Bone quality can vary. Vascularity can vary. Healing capacity and inflammatory response can vary. The microbial environment, systemic health, medications and patient behaviors can all become part of the equation.
Clinical factors obviously matter too. Surgical technique, implant position, primary stability, loading and mechanical forces all play roles. The important point is that implant success isn't determined by one variable, and implant failure doesn't automatically mean somebody did something wrong.
Good dentistry still depends on the biology of the patient receiving it.
That distinction has changed the way I think about my own experience.
WHAT ELSE COULD WE HAVE KNOWN?
Instead of asking who was responsible when my implants failed, I became interested in a much more useful set of questions.
Could we have known more about my biological environment before treatment? Could we have identified risks earlier? Could we have supported healing differently? Could something have been monitored differently after placement?
Those questions lead into some fascinating areas of implant dentistry.
Dentists and researchers are looking at the oral microbiome, inflammation and biological markers that may provide additional information about the environment surrounding an implant. They're studying photobiomodulation and its potential effects on healing, as well as controlled mechanical stimulation and its relationship to bone biology and osseointegration.
Regenerative approaches such as platelet-rich fibrin continue to evolve, while exosomes are being investigated for their potential role in cellular communication and tissue regeneration.
Some of these approaches have stronger evidence than others, and important questions remain. That's precisely why I think the conversation is worth having.
WHAT MORE CAN WE DO TO HELP THE IMPLANT SUCCEED?
My experience with failed implants is what started me down this road. What interests me now isn't blame; it's what we may be able to learn from the biology surrounding the excellent dentistry that's already being done.
That's why I'm bringing together four clinicians and educators on Thursday, October 29, for a free live virtual Dental Summit called Biology in Dentistry.
If you place implants, restore them, maintain them or care for the patients who have them, I'd like you to join us. We'll explore the biology before, during and after implant placement—and what it may mean for healing, osseointegration and long-term implant health.
To your unstoppable success,
President
eLaunchers.Com