Q&A with Dr. Stephen Wheeler of the Academy of Osseointegration: The current and future trends in implant dentistry

I recently had the chance to sit down with Dr. Stephen Wheeler, the president of the Academy of Osseointegration (AO) about what he sees as the current and future trends in implant dentistry. In addition to his duties with the AO, Dr. Wheeler is an oral and maxillofacial surgeon who practices in Encinitas, Calif.

What trends do you see for dental implants in 2014?

I really see three trends. First, and the most encouraging, is the improvement in the technologies and techniques now available to dentists. Not long ago, broken abutments, broken screws, and a lack of integration were a problem. That isn’t the case today as implants have a 95% success rate. Look at where we are today with implants … they are more predictable, have better esthetics, and a shorter treatment time.

Second, over the last five or six years, marketing pressure has led to greater patient demand. More and more patients are seeing advertisements for solutions in an hour or in a day and that puts greater pressure on the dentist. When dentists get pushed outside their comfort zones, that’s when we see implant failures. It is so critical for practitioners to read between the layers of hype and know what works best for them and their dental practice.

Third, digital dentistry is here and making a difference. Today, an implant can be placed (if there is adequate bone volume) without laying a flap. There are better restorations available with custom abutments, which can be made without taking impressions or waxing up a case in the lab. We now have the ability to see things in 3D, which has changed my practice dramatically.

Two-dimensional x-rays only gave us an idea of what the anatomy was in an area without any accurate measurements to help us avoid critical anatomic structures when placing implants. I used to be very good at “winging it” and drilling down to see what I could find and where I should stop. There’s no need for that any more. The information I can now glean from a 3D scan tells me exactly where everything is and what I can do to best help my patients. I am a firm believer in 3D treatment planning.

What’s your advice to dentists about getting involved with implants?

My advice is simple: First, commit to education! Most of this education will come when you get out of school and will take much more than the 25 hours of CME required by the dental board each year. Implant dentistry is changing rapidly and, to provide excellence in care, we need to be fully informed. Better yet, look to venues that will give you unbiased information about implants in general, not just one system (such as the AO). Second: Don’t get pushed outside your comfort zone.

A patient may ask me to make a crown or do periodontal surgery for him or her, but these are not within my area of expertise. I could do it, but it has been a long time since I have made a crown and I only feel comfortable with minor flap revision. I sleep much better at night knowing I can refer out what is not comfortable for me. Remember, there is rarely such a thing as a “simple implant case.” Implant placement is at the top of the list when it comes to reasons for dental-related lawsuits. Don’t get pushed outside your comfort zone.

As president of the Academy of Osseointegration, what does your group offer in terms of education to help dentists and team members not go outside that comfort zone?

The Academy of Osseointegration has made a name for itself over the past 28 years by delivering cutting-edge information on the most recent advances in techniques and technology related to implant dentistry.

The AO is unique in its dedication to consensus conferences and literature research to provide evidence based treatment recommendations. It is also one of the only venues that allows dental specialists and general dentists to come together to share information within the team approach to implant reconstruction for the best possible patient outcomes. At our upcoming annual meeting (March 6-8 in Seattle), we will have more than 1,500 dentists listening to speakers from around the world and sharing time with 130 exhibitors.

We are going to tackle real problems and real solutions every dentist is faced with today by looking at what we know, what we have learned, and what we still need to know. We will then share expert advice from around the world and how to best treat our patients in the future. Everyone attending should be able to take home valuable information that will help them provide excellence in patient care in the future.