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ePaper created 2017-03-17, 11:21:45 | version 1.38.0
| feature interview “ Machines will never replace the human hand…” An interview with Dr Stavros Pelekanos, assistant professor at the School of Dentistry of the University of Athens, Greece, and faculty member of the Global Institute for Dental Education, Los Angeles, USA What is the role of aesthetics in dental implantology today? Dr Stavros Pelekanos: Implan- tology in the 1980s and 1990s was bone-driven. The Albrektsson criteria for a successful implan- tation back in 1986 did not even refer to aesthetics and were fol- lowed for many years to come. Nowadays, prosthodontists start the treatment and perform back- wards planning, always keeping in mind the correct positioning of the tooth or teeth to be replaced. Patients’ expectations regarding aesthetic results are growing with the emergence of new technologies and materials. However, have these innova- tions truly arrived in every dental office? Well, in continuation of my re- sponse to your first question, there are two major problems that the dental community has been fac- ing in recent years, incorrect implant positioning and peri-implantitis both being difficult to resolve. As patients become more aware of these compli- cations, they expect and demand more aesthetic and predictable results. New technologies such as high-resolution CBCT, CAD/CAM abutment man- ufacture, abutments produced using new zirconia technologies, and digital planning are already widely in use in everyday dentistry, minimising risks, as well as enhancing aesthetics and treatment workflow. Have digital solutions changed the way dental restorations and full-mouth rehabilitations in particular have been performed over the past several years? Digital planning, intraoral digital impressions and CAD/CAM technologies have really changed im- plantology today. First of all, preoperative planning is a helpful tool for ensuring correct implant place- ment, for both novice and experienced surgeons. Furthermore, more conservative (sometimes flap- less) surgical approaches result in much less post- operative swelling, facilitating greater patient ac- ceptance. The digital workflow in prosthodontics facilitates milled abutment constructions or even same-day teeth when immediate loading or provi- sionalisation is chosen in the treatment planning. CAD/CAM laboratory procedures reduce human error, providing more robust and accurate frame- works and final reconstructions. In your experience, what is the best way to achieve a natural-looking implant crown? Irrespective of the digital revolution, the hand skills of a talented dental technician are indispensable, especially in the case of a single implant crown next to natural teeth. Machines will never replace the human hand, as individual perception of every case, the knowledge of biology and anatomy are of the greatest importance. The factors that determine the success and natural appearance of an implant crown are accurate implant positioning, meticulous bone- and soft-tissue handling, and a skilled dental technician. The number of implants placed worldwide is ex- pected to double over the next five to six years. Dr Stavros Pelekanos 42 CAD/CAM 1 2017