PROSTHETIC RECONSTRUCTIONS AND REFERRING IMPLANT SURVIVAL IN A POSTGRADUATE PROGRAM : A RETROSPECTIVE STUDY
placed prosthodontic graduate training curricula . As mentioned in the introduction many articles show clear trends that implant dentistry becomes integrated worldwide in the undergraduate training of dental students . Implant dentistry knowledge , however , is mostly a basic theoretical overview on implants . It appears that if the undergraduate students get in touch with implant dentistry they are more likely to incorporate implant treatment in their practice 34 . A small survey restricted to a local area revealed that particularly male general practitioners felt the need to obtain training in implant dentistry 35 . Today young dentists will meet patients who will ask for implant treatment 7 and who have already all kind of information on implants . In this respect , it seems important that in-depth knowledge is provided and the graduate students must achieve a good level of skills in well structured implant programs . A recent survey conducted in the States revealed that today many postgraduate prosthodontic curricula allow students to perform implant surgery in their advanced education program 36 . The answers indicate that up to 50 % of students judged their implant-surgery skills on a level of good competence while others felt the need of more training to reach a better level of competence . One study showed that even a short but intense and closely supervised training of 4 sessions 3 days each may significantly improve surgical skills and as a result also implant survival 37 . Postgraduate implant programs in University settings often underscore the multidisciplinary aspect of implant dentistry , as there are oral or maxillofacial surgery , prosthodontics and periodontology . With regard to implants , the specialty training programs subsequently focused on their own , specific knowledge and skills , and several specialists perform the implant treatment . Therefore , the comprehensive character of implant dentistry does not become sufficiently visible . In general , the intent of oral surgery is the removal of a pathological process and treatment of dental or oral diseases . Although implant placement is a surgical procedure , as well , its result is not the pathology but the prosthetic rehabilitation after tooth loss . The implant itself is a tool used to enable , improve and perform prosthetic treatment . Thus , implant dentistry must be prosthetically centered and driven , with regard to analysis , planning and the final outcome . Already in the nineties some authors emphasized the importance of prosthodontics training with regard to implant therapy 1 , 2 . The chewing function , phonetics and esthetics are the crucial aspects oft implant treatment . The term „ backward planning “ was created and this should become the standard in any implant treatment , particularly for full mouth rehabilitation . Accordingly , a comprehensive prosthetic training including implant placement and implant restoration appears to be the most effective approach to a broad understanding of the potential and limitations in implant rehabilitation .
The data of the present study show that the students were involved in the whole broad , therapeutic spectrum of implant dentistry , including the surgical and prosthodontic part as well as maintenance care . Thus , they reached full competence level of grade A ( advanced ) for surgery and prosthetics , while level C ( complex ) can be practiced under close supervision , particularly with regard to the surgical techniques . At the end of the training curriculum it is expected that the students are able to properly judge their own knowledge and skills and to adhere to strict patient selection criteria . Furthermore , the use of CAD / CAM technology for implant supported fixed and removable reconstructions helped to standardize the fabrication workflow and minimize inaccuracies due to manual errors . As reported in another investigation , the specific analysis revealed a predictable outcome of the implant reconstructions with improvements for the digital workflow 38 . In the current competitive and fast developing market of implantology , which is often business driven , it becomes essential that high quality education and treatment is guaranteed . Therefore , theoretical knowledge and training of clinical skills must be an integral part of well-structured educational programs in comprehensive implant dentistry to reach the required competence and to maintain a high standard of care 39 . The majority of articles on implant curricula deal with undergraduate education while information on specialty training for young dentists and general practitioners is somehow confusing and less clear . If implant teaching in University curricula is described , a variety of terms are applied , such as : undergraduate , predoctoral , graduate , postgraduate or residency and specialty training , advanced education or master program . It appears that there is no consensus and common use of these terms - except with regard to undergraduate education , which would clearly address the degree of training and specify the level competence . Furthermore , two universities recently reported on a predoctoral implant program where selected students placed a series of implants themselves . While the students highly benefited from this experience by improving their understanding of the connection between surgical implant placement and definitive prosthodontics reconstruction , their interest for a postgraduate implant program to improve theoretical and clinical skills became more intense 40 . The placement of implants by undergraduate students as part of an implant program would require significant efforts in theoretical education , pre-clinical laboratory training and clinical treatment . However , it has been demonstrated that this approach may result in acceptable clinical outcomes , patient satisfaction and positive student perception 41 .
232 STOMA . EDUJ ( 2016 ) 3 ( 2 )