In a recent session at the EAO Congress in Lisbon, Dr. Homayoun Zadeh from the United States and Dr. Markus Hürzeler from Germany engaged in a thought-provoking discussion on whether implants should be avoided in the aesthetic zone. The session was moderated by Stefan Fickl, a professor at the University of Würzburg and a private practitioner in Nuremberg.
The Debate The core of the debate centered on the challenges and potential complications of placing implants in the aesthetic zone, particularly in younger patients. Dr. Hürzeler emphasized the long-term complications associated with implants, such as infra-occlusion due to continuous craniofacial growth, which he argued could happen at any age. He stressed that clinicians should not rush to place implants as the first option when a tooth is deemed hopeless. Instead, they should consider alternatives and thoroughly assess the risks and benefits.
Dr. Zadeh, while acknowledging the complications highlighted by Dr. Hürzeler, argued that implants could still be a viable option when appropriately assessed and planned. He highlighted the importance of involving patients in the decision-making process and tailoring treatment plans to individual needs. Dr. Zadeh emphasized that every treatment, whether it involves implants or alternatives, comes with its challenges and should be chosen based on the patient's unique situation.
Key Points Complications of Implants: Both speakers acknowledged the potential complications of implants in the aesthetic zone, particularly infra-occlusion, where implants do not grow with the rest of the craniofacial structure. This issue can lead to aesthetic and functional problems over time.
Risk Assessment: Dr. Zadeh highlighted the necessity of comprehensive risk assessment and patient involvement in decision-making. He stressed that clinicians must discuss all possible complications and treatment options with patients to ensure informed decisions.
Alternatives to Implants: Dr. Hürzeler presented several alternatives to implants, such as orthodontic solutions, resin-bonded bridges, and other conservative approaches. He argued that these alternatives should be considered, especially in younger patients, to avoid long-term complications.
Patient-Centric Approach: Both speakers agreed on the importance of a patient-centric approach, where the clinician's experience and the patient's needs and preferences are balanced to achieve the best outcome. Dr. Zadeh pointed out that involving patients in the treatment planning process helps in managing their expectations and ensuring satisfaction.
Technical Challenges: The discussion also touched on the technical challenges associated with both implants and their alternatives. Dr. Zadeh emphasized that all procedures in the aesthetic zone are complex and require a high level of skill and experience.
Conclusion The session concluded with a consensus that while implants can be a viable option in the aesthetic zone, they are not always the best choice. Clinicians must consider all alternatives and conduct thorough risk assessments to make informed decisions. The discussion underscored the importance of a multidisciplinary approach and the need for ongoing research and evidence to guide clinical practice.
The debate highlighted that dentistry in the aesthetic zone is highly complex and that every treatment option has its pros and cons. By involving patients in the decision-making process and considering all possible alternatives, clinicians can provide better care and achieve more predictable outcomes.