Welcome to the EAO Congress 2018 in Vienna, where the dental community converged to discuss groundbreaking topics. One of the highlights was the session "Battle of the Concepts: Tooth vs Implant," featuring esteemed experts Niklaus P. Lang and Hannes Wachtel. This session delved into the critical decision-making process between preserving natural teeth and opting for dental implants, providing valuable insights for dental professionals worldwide.
Introduction: The Scene at EAO Congress
The EAO Congress is renowned for its high scientific level, bringing together dental professionals to share the latest advancements and innovations. The session began with Kenneth Hagin introducing the topic and highlighting the importance of this discussion for both onsite and online participants.
Expert Insights: Niklaus P. Lang
Niklaus P. Lang emphasized the importance of maintaining natural teeth whenever possible. He presented a compelling case of a patient treated in 1977, illustrating the long-term success of tooth preservation. Despite severe periodontal issues, Lang’s approach focused on meticulous periodontal treatment and prosthetic reconstruction, demonstrating that even compromised teeth could serve as reliable abutments for over three decades.
Lang argued that the decision to extract should not be taken lightly, highlighting that modern periodontal treatments could significantly improve the prognosis of natural teeth. He criticized the over-reliance on dental implants, advocating for a balanced approach where teeth are only extracted when absolutely necessary.
Expert Insights: Hannes Wachtel
Hannes Wachtel provided a contrasting perspective, showcasing cases where dental implants were the optimal solution. He discussed the advancements in implant technology and techniques that allow for immediate loading and restoration, significantly reducing treatment time and improving patient satisfaction. Wachtel emphasized the importance of considering the patient’s quality of life, especially in cases where severe periodontal disease or structural damage made tooth preservation impractical.
One notable case involved a young patient with aggressive periodontitis. Despite comprehensive periodontal treatment, the teeth were deemed unsalvageable. Wachtel’s approach involved immediate implant placement and restoration, transforming the patient’s oral health and quality of life within a significantly shorter timeframe compared to traditional methods.
The Debate: Factors Influencing Decision Making
The debate between Lang and Wachtel underscored the complexity of the decision-making process. Key factors included:
Patient’s Overall Health and Oral Hygiene: Lang and Wachtel agreed on the critical role of patient compliance and oral hygiene in determining the success of both tooth preservation and implant therapy. A patient’s ability to maintain oral hygiene significantly impacts the long-term prognosis of either treatment.
Bone Quality and Quantity: Wachtel highlighted the importance of bone quality and quantity in determining the feasibility of dental implants. Advanced imaging techniques and guided surgery have improved the predictability of implant outcomes, making implants a viable option even in challenging cases.
Aesthetic Considerations: Both experts stressed the importance of aesthetics in treatment planning. High smile lines, for instance, necessitate meticulous planning to ensure that restorations blend seamlessly with natural dentition.
Patient’s Preference and Quality of Life: Wachtel’s approach emphasized patient-centered care, considering the patient’s preferences, lifestyle, and the psychological impact of their oral condition. Immediate implant restoration often provided a significant improvement in the patient’s quality of life.
Conclusion: A Balanced Approach
The session concluded with a consensus that the decision between tooth preservation and implants should be personalized, considering each patient's unique circumstances. Both experts agreed that a thorough diagnostic process and a multidisciplinary approach are essential in making informed decisions that prioritize the patient’s long-term oral health and overall well-being.
The "Battle of the Concepts" at the EAO Congress 2018 provided invaluable insights, encouraging dental professionals to adopt a balanced and patient-centered approach in their practice. Whether preserving natural teeth or opting for implants, the ultimate goal remains the same: to enhance the patient’s quality of life through evidence-based, compassionate care.