No abstract

The technology of the Strategic Implant® facilitates dental implant treatment almost regardless of the available bone. This explains its increasing use to resolve problems with the dentition of the middle-aged patient in a radical manner, simply by extracting the residual dentition and placing implants. While a radical change in the implant treatment paradigm has taken place in some countries, in other countries, dentists try hard to keep their work area free of implants or to deliver them only as a last resort. Liberating patients from the burdens of their own teeth are not advocated by dental universities, as their main field of teaching deals with the repair of teeth and conventional ways of replacing them. This case report shows a standard treatment with Strategic Implants®, discussing the topic from the point of view of practitioners, universities, and other parties involved in decision-making. The authors conclude that the interests of the patients are not respected in many cases because the parties involved have vested interests in other treatment modalities.

While materials for the restoration of teeth and new (digital) technologies develop fast, the choices of the treatment provider and the patients get wider. Choosing an adequate and long-lasting treatment is a question of “doing the right thing,” and only after that, the dentist has to think about the question how to do the work properly. This case report explains and illustrates a case, where an adequate treatment by means of conventional dentistry would not have been possible on one hand, and where treatment with the technology of the Strategic Implant® provided a perfect result within only a few days. Thanks to this technology, patients can be treated with fixed prostheses regardless of the amount of residual bone. Recently, published long-term observations on large amounts of implants have shown that the results are sustainable.

To date, the term peri-implantitis has been mostly associated with bacterial or foreign body reaction as primary factors of its development. Because of this, researchers’ and clinicians’ attention regarding treatment possibilities were directed into the solutions on the basis of surface modifications, debridement, and antibiotics. After years of clinical observations and poor results in treatment of peri-implantitis, a new proposal of this condition is presented, shifting our way of thinking regarding bone and implant interactions. In the second part of the paper presenting a new definition of peri-implantitis, we focused on a biological explanation of the bone behavior at the bone–implant interface. The main conclusion is that PI is not an “infectious disease”, but rather the result of natural changes of the bone’s morphology in response to implant such as a decrease in convexity of the outer surface of the bone and subsequently a decrease in concavity of the inner bone.