Endo + Implants?
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This program at LOMA LINDA is sweet! Here's a link: http://www.llu.edu/dentistry/endo/graduateprogram.page?#curriculum36 - Thank you very much Mr24! Anyone know of any programs in the north east by chance?
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Amazingly EFFICENT this new field with be! I'm very interested! Thank you so much, if anyone knows anymore please keep them coming!
Has anyone done an endo residency and then just taken some CE courses to place implants as well?
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This combo has never really made sense to me. I understand perio and os placing implants. General dentists and pros - sure. I even understand ortho getting on board (TADs and such). But endo??? Nothing is further from the goals of that specialty than the extraction of a tooth and replacement with an implant. Endo guys are supposed to SAVE the teeth. If it's cracked or perfed and can't be saved they can take it out, but how do implants fit into the scope of their specialty?
Well I just figured that when all else fails and one can no longer save the tooth, they might as well replace it that's all.
My general dentist went to several (don't recall #) CE courses for implants.
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This point of view has never made sense to me. What is the goal of periodontics? Up until the last 10 years it was to SAVE teeth through periodontal procedures. Now for some reason ($) the goal has become prophylactic extract viable teeth to "conserve bone" and placement of implants. This could not be further from the original goal of periodontics. So applying your argument periodontists should not be placing implants. However, implants pay more than periodontal maintenance. With more and more dentists placing implants the pendulum will swing back to a more balance approach.
When implants first started it was just OS guys who placed. They said we should be the only group. Then perio guys said why just them we should also place. The fought for the right and began placing and then said well now only os and periodontists should place and no one else. Then GP's said well why just them and not us, and then the prosth guys etc. etc. etc. The fact is anyone with the surgical training and ability to manage complications can place it is not one specialties right over anothers.
All dentists should be first looking to save teeth but not at all costs. If the tooth is cracked or decay goes below the height of the crestal bone and crown lengthening would compromise adjacent teeth then the endodontics should not be done. It is perfectly within the scope of the endodontist to ext, bone graft, implant placement IF the referring dentist wishes. This is also in the best interest of the patient because if an endodontist also places implants the patient will get a completely unbiased evaluation of their tooth and patients dont want to be bounced around from office to office.
Endodontists are in the sinus and on top of the IAN all the time for apicos. They are placing "bone graft" material and managing infections etc etc. Many are former general dentists with implant experience in GPR's and private practice. They are more then qualified to place implants if they so choose. I would however advocate for formal training in the area and not a weekend course even though weekend courses is how all old school OS and Perio guys got started. Today many Endo programs have integrated implant curriculum.
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Weird, I can't see an endodontist making a practice of placing implants.
Maybe if a rural GP didn't have a periodontist or OS to do it, but other than that, who is going to refer their implants to the endodontist? Are you going to advertise directly to patients and do comprehensive care? You can't, it's not in your scope of practice as an endodontist. You'd piss off all the GPs that are referring your endo.
Maybe if a rural GP didn't have a periodontist or OS to do it, but other than that, who is going to refer their implants to the endodontist? Are you going to advertise directly to patients and do comprehensive care? You can't, it's not in your scope of practice as an endodontist. You'd piss off all the GPs that are referring your endo.
Interesting perspective. But why not persuade certain root canal referrals to get an implants instead when need be?
Anyone know of any programs in the N. East?
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Actually this combo makes sense in the view that endodontists realize that saving a tooth is slowly decreasing in importance with the advent of implants and therefore an attempt to preserve their speciality by getting their hands on the implant pie, which everyone and their brother seems to want a slice of. While there will always be people who want to save a natural tooth, as well as preventing the time-consuming procedure of getting an implant, there are many patients for whom saving the tooth does not present a favorable prognosis (due to poor hygiene, etc.). Cost-wise, a RCT/Bu/PFM is only marginally less than a dental implant, so there is that factor as well. To me, therefore, this endo/implant program is just a tacit admission that endo is changing in the dental landscape and an attempt to transform itself in response to the climate.
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Shunwei, thanks for that beautiful post and thanks for not getting mad by my curiosity's. I'm just gonna be honest with you folks! My mother went to get a root canal a few months ago and had been in pain from it ever since. She recently saw a GP, who now told her she would need to get the tooth extracted. I think there has to be situations in which a GP would refer a patient to get a root canal, when in reality the patient really needs an implant. I think the Endodontist's could go a step further and use their best judgment to decide what is really needed once the patient Arrives to their office. Therefore, I do think there is some practicality for this new and upcoming field.
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Implants in endo is not about preserving a specialty. Its about providing a service to the patient. Contrary to what those in dental school believe... in the real world of private practice people still want to save their teeth and endo if done correctly by a skilled provider is highly successful.
I do not see many endodontists doing large implant cases. Endodontists will most often be providing single or 2 or 3 implants. The cases done will most likely be when a tooth is deemed non-restorable due to root fracture. If a patient is sitting there flapped, with fracture visualized then it is in the patients best interest to extract preserve the socket. No patient I know wants to be closed, sent back to GP to then send to another provider to re-anesthetize and extract. It does not make sense.
Of course this is all done with communication with and consent from the patients primary provider. Endodontists are not out to take over the implant world and are not a threat to any other providers. Endodontists should be part of the decision making tree from which other specialties have been cutting them out with disregard to the literature. To many teeth are being extracted with the belief that implants are fool proof when that is anything but true.
Case in point. Family friend had ext and bone graft because provider rec implant. She went back for placement and provider found that graft had failed. Now the provider wanted to graft a second time. In the end she had a no implant two failed grafts and thus $3000 extraction. Needless to say she was not that happy.
If everyone reads the literature, looks out for patient interests not bottom $, correct decisions will be made with plenty of implants, rct, crowns, bridges, etc etc to go around. Endo is not dying but implant placement is a service that they should offer to patients if proper education is obtained.
I do not see many endodontists doing large implant cases. Endodontists will most often be providing single or 2 or 3 implants. The cases done will most likely be when a tooth is deemed non-restorable due to root fracture. If a patient is sitting there flapped, with fracture visualized then it is in the patients best interest to extract preserve the socket. No patient I know wants to be closed, sent back to GP to then send to another provider to re-anesthetize and extract. It does not make sense.
Of course this is all done with communication with and consent from the patients primary provider. Endodontists are not out to take over the implant world and are not a threat to any other providers. Endodontists should be part of the decision making tree from which other specialties have been cutting them out with disregard to the literature. To many teeth are being extracted with the belief that implants are fool proof when that is anything but true.
Case in point. Family friend had ext and bone graft because provider rec implant. She went back for placement and provider found that graft had failed. Now the provider wanted to graft a second time. In the end she had a no implant two failed grafts and thus $3000 extraction. Needless to say she was not that happy.
If everyone reads the literature, looks out for patient interests not bottom $, correct decisions will be made with plenty of implants, rct, crowns, bridges, etc etc to go around. Endo is not dying but implant placement is a service that they should offer to patients if proper education is obtained.
