Editorial - ZZI 03/2017

Implantology in studies – is training up-to-date?

Implantology in studies – is training up-to-date?

Whereas implantology in the past was above all performed by specialists with focus on surgery, the increasing demand and the expanded indication spectrum has led to a wider establishment of dental implants in day-to-day work at a dentist’s office. Clinicians are increasingly endeavouring to offer their patients a holistic treatment at the same time taking all aspects into consideration, ranging from planning implant positioning, via surgery to restorative procedures. Implantology is thus currently not seen as an area of expertise which is assigned exclusively to specialists. Future dentists should therefore possess certain competences in implantology allowing them to identify relevant indications, to provide patients with correct information and to treat such patients within the scope of their competences or to refer them to other specialists.

Until 2009 implantology was taught primarily in comparatively short theoretical courses in the form of lectures. In the following, a continuing trend towards an improved implantological training was seen up to the point at which almost all training programs offered at least the scientific basis of implantological dentistry in their curricula. Despite this wide integration of implantology into studies a standardisation between the programs offered is still not in place; hopefully the new Order Regulating Licenses to Practice Dentistry [Approbationsordnung] will implement such a requirement.

At present three didactic components in the implantological training for dentists have been identified. The theoretical basic training is by far the most frequent. Preclinical exercises have a lower frequency and clinical training within the scope of supported or automated implant-related treatments is only offered in a limited scope. Thus, in practice, far from publication services of the respective institutions the impartment of skills required in implantology has not found its way into training at universities on a widespread basis. The know-how required for practical operation is thus mainly acquired in post-graduate curricula or master studies. The question thus arises as to whether the real pre-graduate training lags behind the requirements of modern dental medicine, or whether the respective professional associations should not after all engage more in the pre-graduate sector.

The installation of a defined preclinical and clinical training in implantology would require considerable investments in time and financial resources and possibly restrict other special disciplines at the same time. The specialised and to the largest possible extent realistic equipment for preclinical exercises required is costly and often unsuitable for repeated applications. Whereas conserving and prosthetic patient work can be currently produced without any problem in appropriate courses under the supervision of assistants and dental technicians, the direct adaptation of implantology is extremely difficult to enforce. Of course, it is possible to compensate such deficits by involving industry to a greater extent. However the question arises as to whether it can be the challenge of university training to solve the deficits with the appropriate product positioning to be expected.

Programs exclusively based on lectures and seminars offer graduates a fundamental background in implantology. The question should nevertheless be asked if that is sufficient as a preparation for day-to-day work in the clinical practice. As far my experience has shown additional (pre-)clinical practical
exercises and job shadowing is necessary to at least familiarise our junior dentists with the basics of implantology from a reliable training and learning environment.

Yours,

PD Dr. Dr. Peer W. Kämmerer, M.A., FEBOMFS

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