I have already written several articles on dental implantology, carried out either with traditional methods or with the so-called modern, or rather osteointegrated, techniques. However, traditional methods, despite the objections which they have, strangely enough, always aroused, are those which have so far offered superior guarantees, because, having been in use for over thirty years, it has been possible to establish their reliability and durability. The newer, “osteointegrated”, method is also valid, but in order to be applied it demands the availability of a very abundant osseous tissue, and if this tissue is unavailable or insufficient, it is necessary to resort to graft operations that are rather invasive and traumatising. With traditional implants, such transplants of osseous tissue from other parts of the skeleton, aimed at broadening the site in which the implant will be inserted, are generally not required. In fact, they have been investigated with the purpose of inserting also minimum amounts of tissue. They therefore offer great advantages, which of course should not be undervalued! With regards to osteointegration, that is (to put it baldly) when the implant perfectly integrates within the tissue in which it is placed, traditional implants also display a similar propriety: indeed if they were not to osteointegrate they would become mobile and fall out, which has in fact never happened over the very long period of time they have been in use. Unfortunately, however, there has always been great suspicion of such implants, because of the deep-rooted and erroneous conviction that only the “osteointegrated” ones are valid and safe. This diatribe may seem a small thing, but in fact it is a very serious one. Indeed it has often happened that expert witnesses appointed by the court in legal cases which had aroused between patient and dental surgeon in charge, have deemed the latter guilty because in implantology works he had not applied these so-called osteointegrated last-generation implants. And for the sake of truth, I wish to mention here a few cases, among the numerous ones I have witnessed, in which the “osteointegrated method” proved unsuccessful. Indeed the implants placed displayed a perimplantitis, that is an infection all around the implant itself, and they therefore had to be removed. However, in the cases in which it was necessary to remedy the damage caused by this methodology and therefore reconstruct the dental arch by means of the often criticised traditional methods... Most surgeons are still insufficiently informed with respect to this procedure and do not have a knowledge of the equipment to be employed, even though it has proved to be significantly effective, also in the cases in which it is used to remedy the failures of more technologically advanced apparatuses.

(traduzione Interpres sas Giussano)

Massimiliano Apolloni

Specialista in implantologia