Implant safety
The recent issues with PIP breast implants should be a salutary lesson for all dentists, warns Crawford Bain, BDS, DDS, MSc MBA
Should dentists be using cheap implants?
T
he recent publicity about high compli- cation rates with PIP silicone breast implants has led
to both public and political scrutiny of the EU standard of assessment before these implants were made freely available for use in Europe. The CE mark used for “quality
assurance” in breast implants is the same one used in dental implants (and children’s toys). Because both types of implants are classified as devices, they do not have to meet the same stringent assessment that is the case with prescription drugs. Several dental implant manufacturers have spon-
sored extensive prospective multi-centred research of their products over a prolonged period, followed by the scrutiny of internationally renowned refereed journals before launching their prod- ucts on the market. Others, however, seem to
rely on an approach not far removed from the TV advert “it sounds just like a Golf” and “it looks just like a Golf”. In the past ı8 months, I have
been approached by repre- sentatives of three relatively new implant companies, each boasting CE marks and offering significantly lower prices than the more established compa- nies with a published strong
evidence base. While sales approaches have varied, they are usually made up of a second-hand testimonial: “So and so are using more of these implants than any other with great success,” and a thick bundle of glossy brochures. When read in detail, the “scientific documentation”, while displaying impressive graphs and tables and boasting success rates close to ı00 per cent, is sadly lacking in refer- ences to credible refereed journals for the specific implants being offered. Recently, another newish
company, presenting at a sponsored forum in an inter- national implant meeting,
presented very high success rates, basing failure figures on the percentage of failed implants returned to them as a ratio of the number sold. Using this basis, the 70 or so implants I have placed but not yet exposed, as well as the ı20 or so implants in my cupboard, are all successes! Oh, that it were so. All implant surgeons will
have integration failures, regardless of the system they are using. On top of this, we have aesthetic failures, phonetic failures and oral hygiene failures. Those who boast ı00 per cent success
Continued »
Fig 1
Massive bone loss around implants placed less than three years ago in South Africa
Fig 2
The implant bridge was very mobile and everything was removed by hand. Treatment costing less than $1,000 was not such a bargain.
Scottish Dental magazine 33
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