Dental implants. Did you know that dentists can take a weekend course and be able to surgically place dental implants by Monday? It’s true! I say, “Good for them, but I am not a believer.” The amount of knowledge needed to properly place and restore an implant is far beyond this dalliance. In today’s world, in a sophisticated area like Stamford, Connecticut, I don’t see a reason for not utilizing the strengths of our dental community. Specialists abound that can do a far better job than any general dentist. For example, it has been decades since I have done a root canal. Yes, decades! I live in an area where the endodontists (root canal specialists) are not far from my office. Endodontists are well-informed about the latest techniques, enabling them to work in the very tiny and intricate area of the root canal system. Going to see an endodontist, as opposed to having a general dentist perform the root canal, can make the difference between success and failure. And failure means extraction of a tooth. I have seen far too many failures of root canals performed by general dentists. The majority of root canals in the United States (and the world) are done by general dentists. But when one lives in an area where there is an abundance of specialists available, it is hard to make the case for the general dentist doing this service.

So, dental implants. I apply the same reasoning to the placement of dental implants. Even more so. I have been working closely with two surgeons that do a magnificent job of collaboration with me. Truly incredible. Collaboration, placement of the implant(s), temporization, and subsequent restoration—a properly performed sequence that yields great results. I have been working closely with oral surgeons Dr. Naushad Edibam and Dr. Donald Case, as well as periodontist Dr. Robert Chung. I learn from these surgeons and they learn from me. Together, we take an integrated approach that ultimately provides the patient with a solid restoration, a solid bite, and a great smile. We leave no stone unturned. Whenever possible, Drs. Edibam, Case, Chung, and I do cases in which the implants are placed by them and then restored by me—all in the same day (unheard of just a few years ago!). Science and art merge as we are able to restore a smile almost immediately by placing these root-form implants that mimic the natural contour of the root of the extracted tooth. These implants are torqued to a level in which they can often be utilized (i.e. temporarily restored) immediately.

Dental technology has advanced the science from what would have once been looked upon as pure fiction. Cone Beam Computerized Tomography, also known as CBCT, is used by endodontists to see the root structure in three dimensions. The oral surgeon and periodontist use the CBCT to plan and execute for the placement of implants in 3D. If this technology is not being utilized, it is like doing dentistry with one eye closed. I have simplified the process. Endodontists, oral surgeons, and restorative dentists use this technology in many ways, and their areas of expertise overlap like Venn diagrams. That is to say, we all see the same things from different angles. And in that lies the beauty of it all. We all have something to say about the best way to treat a patient. And the patient wins by having a collaboration of minds set to providing the best outcome.

Can you imagine being in a room where the restorative dentist is talking to the surgeon about the angulation of single or multiple implants? The bone structure. The size of the implant. The placement of the implant. Do we use two implants? Do we use three? What will the smile line look like? Do we need a surgical stent to be precise about the position? The questions are many, and the amount of time spent planning cannot be overestimated. In the end, the patient benefits. And, yes, more than any weekend course could provide.

Thanks for visiting 🙂

—Dr. Edward Shukovsky