Dear all,
With all above discussion, main question is still not answered anywhere.
Does any one recommend Rutger's AAID Maxi-course, DC AAID Maxi-course, Columbia university implant, MISCH Implant or Charlotte, NC one? You may still need to practice after learning, but advice at least for 1st level from increase knowledge and skills. Please share your experience if you have attended.
I am looking for DC AAID Maxi-course to begin, but these are all very expensive courses and better to get other GP's advice (specialist have different vision and like to get advice from GP)
Thank you
I think it all depends if you need a lot of guidance with implant placement or a basic primer course. If all you need is a system to start with and a basic primer course, look for a weekend implant course. Placing an implant is just like placing a screw in particle board. Except you gotta avoid vital structures, avoid perforation, avoid overheating, and look at it from a biological perspective (medical hx, habits, occlusion, etc...). When it fails, back it out or trephine, regraft and start again. I think this is where most people struggle... what to do when things fail. Once I started placing implants, I realize that most cases are a cakewalk (3-5 unit implant bridges, single tooth implants and mini's). CT with tooth borne surgical guides make implants a lot easier. Non-full arch restorations are even easier. Do easy cases, punt difficult cases. If you really want to do more difficult cases, then you should definitely go to more intensive courses such as the ones offered in south america, tijuana, or carribean. I've heard good things about the programs outside the country
Edit:
You are held to the standard of care of specialists, as the standard of care of specialists is the standard of care for GP's. There is no difference. However, standard of care for implants does have some subjectivity (i.e survival v. success). An implant can survive, but if you have the implant fixture showing on the anteriors, it's a failure (even in the absence of pathology, inflammation, etc...). In the posteriors, the patient may be more accepting of it as a success. Or if there's inadequate keratinized tissue but the perimplant tissue is not inflammed and appears healthy. From a clinical persepctive, you may say that it's not a success due to lack of keratinized tissue, but from the patient perspective, it looks good and functions well.
If you really want to get started without going through these long courses, do easy cases first. If you want to make it nearly idiot proof, screen the "easy cases" (first molars, non-smoker, non-diabetic, good OH, a lot of width and height), get a CT + digital impression or PVS, hire a treatment planning company to plan the treatment for you and fabricate the surgical guide, and do the surgery flapless. I think it's a good way to get your feet wet.
Easy tips for starting out implants:
- Preop abx 1 hour po before procedure + CHX rinse
- Sharp drills and drill quickly (but not forcefully) to reduce heat generation. If you have to force it, your drill is probably dull or you're about to perforate. If it suddenly slips, good chance of perf especially if your planned implant is close to sinus or lingual/buccal plate. Ball tip probe is a great way to detect perforations.
- Refrigerated irrigation (I keep mine at 40 degrees F)
- Most implants fail by week 3. Do a 3 week post-op (besides other post-ops)
