SRR 'Spotlight on JOMI': Recent issue of JOMI paves the way for future dental implant thinking

Dec. 3, 2014
In a new Surgical-Restorative Resource series called “Spotlight on JOMI,” we’re working with the Academy of Osseointegration’s (AO) Young Clinicians Committee (YCC) to get a peek inside the International Journal of Oral and Maxillofacial Implants (JOMI), the official journal of the AO, published by Quintessence Publishing. YCC Chair Dr. Lauren Brownfield kicks off this new series and explains why she reads JOMI — and why you should too.
After reviewing the September/October issue of International Journal of Oral and Maxillofacial Implants (JOMI), I could not help but think back to Dr. Dennis Tarnow’s closing remarks at the Academy of Osseointegration’s (AO) 2014 meeting in Seattle. In an age of successful and predictable dental implant therapy, we will have to rethink the way we look at dental implants in order to allow progress to continue. While as a clinician I love that dental implants have become such a great tooth replacement option, they are not without their problems. This was the topic of discussion at our annual meeting, where we focused on how to diagnose, treat, and prevent these implant problems in order to take better care of our patients now and in the future.ADDITIONAL READING |Standards of care for implant dentistry: an interview with Dr. Joseph Gian-Grasso, president of the Academy of Osseointegration

The current dental implant microstructure, utilizing a rough surface, has led to this predictability. Now we can focus on customization of the implant macrostructure and implant-abutment interface (IAI) for improvements, as well as new diagnostic parameters for candidate selection and long-term evaluation. A current trend within the dental implant community is shorter implants. Some implants have been launched into the market with a shorter design, while others have modified their existing implant. In the most recent issue of JOMI, Lee et al. completed a review of previously published studies comparing shorter vs. longer implants. They did an excellent job in reviewing their study parameters. And their data, although limited, was positive for shorter implants when multiples were placed in the posterior and splinted together. It is apparent that while there is a clear need in the market, there is still a lot left to learn.

ADDITIONAL READING | A periodontist's protocols to avoid dental implant complications: Part 1

ADDITIONAL READING | A periodontist's protocols to avoid dental implant complications: Part 2 -- establishing an implant maintenance protocol

Platform switching is a well-known concept in dental therapy. The concept is now incorporated into several implant designs, with the intent to reduce crestal bone loss associated with the microgap with dental implant therapy. Caram et al. looked at several IAI options with one company’s implant, evaluating with or without the “microgap,” and changing the abutment design to be concave in order to reposition the microgap. While performance overall was good, the trend of bone loss associated with a microgap was confirmed. However, I was surprised to see the concave abutment design that repositioned the microgap further from the crestal bone did not perform the best. I do think they are asking the right questions and are headed in the right direction.

CBCT scans provide clinicians with a plethora of information to plan dental implant therapy, but are just as pivotal in dental implant research. In this issue, Koutouzis et al. evaluate the buccal and lingual plate following implant placement. For decades, we have evaluated interproximal bone at an implant site, which does not paint the full picture of the alveolus and allows the buccal plate to go undocumented. I have used this method in research studies, and have found the buccal plate to be the most variable. They utilized the Ankylos implant, and found a variability of remodeling at the crest in regard to where the implant was initially placed. Overall the implant appeared to retain the crestal bone following placement, but what I thought was the most interesting was the bone’s remodeling behavior relative to crestal placement, something to keep in mind when placing implants.

So, why do I read JOMI? I read it because a peer-reviewed journal such as JOMI is an excellent resource for learning about the new techniques and equipment that your peers are using. I use this information to continue improving my clinical skills and to determine what technology to implement in my practice. JOMI specifically helps me provide the highest quality of care to my patients in regard to dental implant therapy. One of the many benefits of being an AO member is that I automatically receive a JOMI (bimonthly) subscription for free.

Lauren Brownfield, DDS, MS, completed her undergraduate training at the University of Texas at Austin, and her Doctor of Dental Surgery, and periodontal and dental implant residency at the University of Texas Health Science Center at Houston School of Dentistry. She is a diplomate of the American Board of Periodontology, one of the founding members and chair of the Young Clinicians Committee, and a member of the Research Submission Committee for the Academy of Osseointegration. She takes pleasure in clinical research with experience in studies evaluating ridge preservation, bone healing, and implants. Dr. Brownfield maintains a full-time private practice in the heart of Houston, Texas, where she and her husband spend their time outside of work chasing around their 1-year-old twin boys.