Barry Levin talks about achieving primary stability with dental implants
Many topical subjects will be covered at the ADI Team Congress 2019, where world-renowned speakers will share their insights and experience. Within the plenary programme, delegates can hear internationally recognised lecturer Barry Levin present about achieving primary stability with dental implants.
Barry is a Clinical Associate Professor in Graduate Periodontology and Implant Surgery at the University of Pennsylvania, where he has received several teaching awards. He is also a Diplomate of the American Board of Periodontology and Implant Surgery, plus he runs his own specialty practice in suburban Philadelphia, Pennsylvania, USA.
Barry explains why he feels the topic of primary stability is so important in implantology today: “There has been a rapid shift in dental implant therapy towards immediate and early loading. Empirically, surgeons attempted to achieve ‘high’ primary stability.
“This often translates to insertion torque values (ITV), so the higher the ITV, the more confidence clinicians have about successful immediate provisionalisation and/or loading. This may be unfounded and possibly deleterious to the long-term outcome. The biologic ramifications of deliberately under-sizing osteotomies and compressing cortical and trabecular bone may lead to necrosis and bone loss.
“Other methods of determining stability, such as resonance frequency analysis (RFA), assess the axial stability of the dental implant and can be repeated many times – not just at placement – which may or may not be correlated with ITV. With a greater understanding of dental implant stability, more patients may be considered for immediate temporisation and not limited to dental implants with ‘high’ ITVs.”
Barry continues: “Several challenges can often occur in clinical practice. First, placing dental implants into immediate extraction sockets differs considerably from working in healed/grafted sites. In these situations, a significant portion of the dental implant is not in direct contact with bone, so the majority of stability is coming from the apical and/or palatal bone.
“These dental implants frequently require lower ITVs compared to non-immediate placements and the way a clinician addresses this varies. Some prefer under-sizing osteotomies while others may place wider or longer dental implants than those selected for healed sites. Oral surgeons will often opt not to immediately temporise because the ITV is not considered high enough to provide the level of comfort they are accustomed to in healed situations.
“Is this cautious approach justified? If dental implants are placed in modified osteotomies, omitting final drills to increase ITV, are the risks of biologic complications increased? These are just some of the challenges that must be addressed during implant treatment planning.”
Truly an honour
Barry will be presenting: “Primary Stability: What Do We Know and What is ‘Truly’ Important for Success?” on Friday 3 May as part of the plenary programme. This will be the first time Barry has spoken in, or even visited the UK.
“What can delegates take away from my talk? If I had to choose just one thing, it would be that when working with biologic tissues such as trabecular and cortical bone the response to surgical trauma such as osteotomy preparation can have long-lasting positive and negative ramifications.
“Only with proper diagnosis and treatment planning, combined with training and experience, can clinicians anticipate predictable outcomes. I hope that after my presentation, delegates will think more biologically rather than mechanically when it comes to dental implant surgery.”
He concludes: “Having not visited Edinburgh before, I am excited to visit this historic land, eat the food and sip the whiskey with colleagues and friends. I have presented at many congresses in the US, Europe and South America, however, I do not believe I have ever looked forward to a meeting this much, to which so many fantastic clinicians, researchers and colleagues will attend.
“It is truly an honour to be invited to speak at the ADI Team Congress 2019. So many thought leaders in dental implantology will assemble in one place over three days and it is amazing to think about the high level of information exchange that will occur – the ADI should be commended.
“As a student of the literature, it seems like a rare delicacy to be able to hear so many key opinion leaders not only present their ground-breaking material, but also then to discuss ideas with each other after each session. This will certainly be a career highlight and I am very grateful for the opportunity – it is a meeting not to be missed!”
ADI Team Congress 2019
Shaping the Future of Dental Implantology: Techniques - Technology - Teamwork
2 - 4 May 2019, EICC, Edinburgh