Development of Dental Implantology : towards dangerous decline in standards

The short-term forecasts for the growth of this market naturally makes some people in this sector’s eyes gleam. Right at the top of these is the world leader,  Nobel Biocare who, for over a decade, have developed a particularly aggressive marketing strategy both towards patients and practitioners.

 For actual and possible patients, there is the promise of an immediate, take-home smile, the assumption that inserting implants is an easy, routine procedure and the toning down of all these factors that indicate nevertheless that this is a major surgical procedure.
For example the product « Immediate Function™ is presented as a  ”unique concept [which] from now on enables patients to leave the dental surgery with new teeth, immediately after the implants are inserted-ready to eat, drink and smile. “ in

For dentists there is the promise of immediate and long-lasting profits  and the guarantee of rapid training with a spectacular return on investment. The reasoning has the merit of simplicity “ Join the  NobelSmile™ program and  acquire patients you never thought of. Just click on the links below to discover new opportunities  of increasing your practice income “ 

Beyond this aggressive marketing policy, there is also a new conception about
putting new products on the market, which is disturbing. As an example , Nobel Biocare proudly announced in a press release the marketing in 2005 of 560 new products. That is to say a trifle of two new products per working day  -almost as many as in the last 10 years !

This advertisement has caused  quite a stir among professionals ,particularly in France, more used to marketing a new range of implants, which are the result of long years of research and stringent testing. X. Assémat-Tessandier , chief editor of the journal « Implant », in his editorial of August 2005 has stated that “for a novice ,the performance is impressive ,for a well-informed practitioner it is disturbing”.

Le Groupement d’Etudes et d’Applications de l’Ostéo-Intégration (G.E.A.O)  (Osseointegration Group :trials and applications) whose Chairman P. Michelon reminds us , for his part, in his article that “ too many systems ,apparently  brilliant or innovative are or have been marketed with insufficient clinical long term effects studied and prove after a few years to be unreliable and sometimes even disastrous. Contrary to what the sales department, which sell us this at the end of the day, would like people to believe, dental, implantology is not easy or without danger. Although it is possible to redo a wrong prosthesis or redo the treatment of a tooth, it is impossible to refashion  a badly placed implantation cavity or repair a damaged nerve. “

In a general way, serious professionals (experts, dentists, researchers etc.) agree in thinking that good implantology practice, respecting patients and guaranteeing
best results is  a dental implantology  service which does not play around  with the health of patients and is based on clear principles:

  1. Use of components and reliable, tested techniques. « Our patients are not experimental subjects , we should treat them in a reliable, predictable way. » in
  2. Integrating dental implantology in a detailed treatment plan: insertion of implants is only one part of the treatment, which should lead to the well-balanced replacement of one or other of the missing teeth.
  3. Respect for "step by step" protocols is the only way of limiting the risk  of errors  is to standardize clinical procedures  and not to proceed to the next stage until after validating the present stage. Use of conventional dental knowledge : occlusion, aesthetics, phonetics  as well as the position and shape of prosthetic teeth have been studied for centuries ; integration  and  observance of these subjects  is indispensable  for a good final result.

In other words, a basic respect for the rules of good practice, such as one has the right to expect of any serious professional whatever the field might be but which is even more crucial when it comes to health.
Some companies in the pursuit of a profit goal do not adhere to best practice guidelines and alarm bells should be rung.

“In the last five years, the situation has rapidly deteriorated with the presentation of new products with no medium-term,scientific backing ,a simple animal study lasting six months or a one year prospective clinical study  bringing sufficient scientific gloss  to get the innovation through like a final, tested and checked body of knowledge.
It is difficult to sort through between a useless or even harmful gadget  and a promising development because of the growing number of new products. “
Xavier Assémat-Tessandier, Journal «  Implant », August Issue 05

Acquisition of solid knowledge, use of reliable components, observance of strict protocols, experience-all these basic principles have been flouted. The example of the practices of the world leader, Nobel Biocare, is a perfect illustration of this.