Implant safety Continued »
still have all of the implants in their cupboard, or perhaps are being economical with the truth. We should not be tempted in hard economic times to switch to unproven implants without a valid evidence base, just because of the lower price and the sales pitch. They may be fine, but they may also eventually prove to end up like the PIP breast implants. Those of us who are familiar
with the implant literature will be aware of Implamed implants showing a failure rate of up to 63 per cent in smokers (Jones et al ı999); Calcitek HA Coated implants having an overall 6ı per cent failure rate after six years and even higher failure rates in the maxilla (Watson et al ı998). Malmqvist and Senerby (ı990) at University of Oregon reported success rates of between 9.3 per cent and 37.2 per cent for 47 consecutively placed Core-Vent implants depending on the success criteria used. All of these were systems
that met acceptable criteria as devices to be used in the human jaws. Many other examples could be cited. Even credible premier companies such as Nobel have had significant problems when new implants were introduced with less than their usual pre-launch research (Albrektsson et al 2007). We have all been exposed
REFERENCES
Jones JD, Lupori J, Van Sickels JE, et al. A five-year comparison of hydroxyapatite-coated titanium plasma-sprayed and titanium plasma- sprayed cylinder dental implants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999 87: 649–652.
Watson C.J. Ogden A.R. Tinsley D.A Three to six-year study of over- dentures supported by hydroxyapatite-coated endosseous dental implants. Int J Pros 6 ;610-619 1999
Albrektsson T, Gottlow J, Meirelles L, Östman P-O, Rocci A, Sennerby L. Survival of NobelDirect Implants: An Analysis of 550 Consecutively Placed Implants at 18 Different Clinical Centers. Clin Impl Dent and Rel Res, 9, 65-70, 2007
Malmqvist JP, Sennerby LClinical report on the success of 47 consecu- tively placed Core-Vent implants followed from three months to four years. Int J Oral Maxillofac Implants. 1990 Spring; 5(1):53-60.
Rose H and Radnor A – Would you like some filler with your filling? Times Magazine 21-1-12
Scottish Dental magazine 35
“I am reminded of the advice of Harold Gelb, a ‘guru’ of TMJ treatment: ‘Never buy a cheap parachute, or shop around for a neurosurgeon’”
Crawford Bain
to lectures on how to assess the evidence base of various dental materials and devices. We should be influenced by evidence, not price and testi- monial, when deciding what implant to use. A decision on which implant system to use should also be based on what you would have placed in your own or a family member’s mouth (not the mother-in-law!). Only if two systems are equally well proven over time should cost become a factor. It is interesting to also see
the media turn its focus on to dermal fillers and Botox. For those of us who are not only dental professionals but also plastic and dermatology amateurs, it might be wise to proceed with caution, or perhaps retreat? Are we really trained to differentiate the ı60 injectable fillers available in the UK (only six are approved for use in the US according to The Times – Would you like some filler with your filling?). But that’s another story.
Decisions in healthcare should not only be aimed at restoring or maintaining health, but also at showing that we truly care for our patient. The PIP situation should remind us of two things; that Harley Street is an address, not a qualifica- tion, and that some of our medical colleagues are more focused on treatment than care. The dental profession has an opportunity to learn from the problems with breast implants and show that we are
not prepared to use minimally tested devices on our patients because of price. I am reminded of the advice
of Harold Gelb, a ‘guru’of TMJ treatment: “Never buy a cheap parachute, or shop around for a neurosurgeon.”
® Dr Crawford Bain accepts referrals for periodontics and all aspects of implant dentistry at 14 Somerset Place, Glasgow G3 7JT (0141 353 3991) and at Edinburgh Dental Specialists (0131 225 2666).
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