The EAO Consensus Conference is a pivotal event that brings together leading experts in dental implantology to discuss the latest advancements and best practices. In a recent session, Dr. Hannes Wachtel and Dr. Niklaus P. Lang explored the ongoing debate between retaining natural teeth versus opting for implants. Here, we delve into their insights and the key takeaways from their discussion.
Balancing Decisions in Dental Practice The decision to retain a natural tooth or replace it with an implant is complex and influenced by numerous factors. Dr. Lang emphasized that there is no absolute right or wrong answer, as each case must be evaluated on its unique circumstances. Factors such as the patient’s quality of life, aesthetic desires, financial considerations, and the overall health of the remaining teeth all play critical roles in this decision-making process.
Dr. Wachtel highlighted that time is an important consideration for patients. While a longer treatment period might yield better long-term results, patients often prefer quicker solutions. He advised that while dentists should prioritize comprehensive treatment plans, they must also consider the patient's perspective and preferences.
The Importance of Maintenance Both experts underscored the necessity of ongoing maintenance for both natural teeth and implants. Regardless of the chosen treatment, patients must commit to rigorous oral hygiene and regular dental check-ups to ensure the longevity of their dental work. Dr. Lang noted that effective maintenance is essential to preventing complications such as peri-implantitis, a condition that can significantly affect implant success.
Dr. Wachtel shared practical advice on maintenance routines. Initially, removing the superstructure of an implant-supported bridge three times a year was common practice. However, now they evaluate the need based on signs of inflammation, such as bleeding detected through flossing. Radiographs are also taken every two to three years to monitor the health of the implants.
Addressing Complications Complications can arise in both tooth retention and implant cases. Dr. Wachtel explained that primary stability is crucial for implant success. If an implant fails to achieve the desired stability, an additional implant may be placed as a precaution. This proactive approach ensures that the treatment can proceed without significant delays.
Long-term complications are often technical, such as fractures of the prosthetic components. Dr. Wachtel emphasized the importance of meticulous occlusal adjustments and the use of durable materials to minimize such issues. Peri-implantitis, while relatively rare, is another concern that requires vigilant monitoring and timely intervention.
Patient-Centric Approach A recurring theme in the discussion was the importance of a patient-centric approach. Dr. Lang and Dr. Wachtel both advocated for involving patients in the decision-making process. Providing patients with comprehensive information about their treatment options, including the benefits and potential risks, enables them to make informed choices that align with their preferences and expectations.
Guiding Principles for Treatment When considering whether to preserve a natural tooth or proceed with an implant, Dr. Lang suggested a cautious approach. If a tooth has adequate structure and can be treated effectively with less invasive methods, it is often preferable to retain it. Endodontic treatments and periodontal therapies can be highly effective in preserving natural teeth, thus delaying or avoiding the need for implants.
However, Dr. Wachtel noted that advanced periodontal treatments and surgeries should only be pursued if they offer a good prognosis. The goal is to provide sustainable, long-term solutions without incurring unnecessary costs or compromising the patient's dental health.
Conclusion The debate between tooth retention and implants is multifaceted and must be tailored to each patient's unique needs and circumstances. The insights from Dr. Wachtel and Dr. Lang at the EAO Consensus Conference highlight the importance of comprehensive evaluation, patient involvement, and rigorous maintenance in achieving optimal outcomes. As dental professionals continue to refine their approaches, the emphasis remains on balancing evidence-based practices with patient preferences to deliver the best possible care.
For more detailed insights and to stay updated on the latest advancements in dental implantology, practitioners are encouraged to visit the EAO website and explore the publications from the consensus conference.