There
are well over 40 million partially and completely edentulous patients
in the United States who at one time or other require surgical treatment.
When teeth are extracted, particularly due to infection of the gums (periodontal
disease), there often are irregularities of the alveolar bone structure
of the jaws. These irregularities are often painful and produce so-called
"denture sores" beneath their dentures. At times small fragments of bone
may pierce through these ulcerations of gum tissue. This can happen several
months after extraction. The procedure to smooth out or trim the bone
is called an alveoloplasty or alveolectomy, and is an office procedure.
If the dentist happens to leave a small root tip behind because of its
presence near the lower jaw nerve or 
fusion to the sinus wall of
the upper jaw, this is not bad practice. Simply trying to excise these
fragments might produce more serious surgical morbidity and side effects.
If the wound is contaminated and reveals large amounts of infected tissue,
then this abnormal tissue should be cleaned out and debrided. Radiographs(x-rays)
are necessary to determine the character and quality of bone, pathological
lesions present and the anatomy of the teeth that are to be removed.
For many years dental implants of varied sizes have been used in Dentistry to augment or replace hard and soft tissue components of the jaws. Implants have been shown to be "compatible" with the hard tissues and associated with responses that mimic the periodontal membrane attachment . This attachment is an element present around the normal tooth root structure. The dental profession has followed acceptable methods of biocompatibility testing and the products currently marked as dental implants do not cause serious harm to the patient.
Cooperation between the oral surgeon and prosthodontist or restorative dentist is also essential to ensure that the optimal number of locations of implants is agreed upon. This in turn will ensure optimal functional stress distribution, access for oral hygiene maintenance, and aesthetic considerations. It is clearly impossible to separate the quality of the implant anchorage from its subsequent loaded assignment. Therefore, it is presumed that the surgical skill that ensured a biomechanical anchorage is matched by the prosthodontic skill that maintains it.
The field of dental implantology is becoming more complex and requires an educational level and expertise far beyond a weekend course in Palm Springs. For those who are interested in getting involved with dental implants it behooves them to take not only didactic lectures but to participate in as many live mini-residency programs and hands -on workshops as possible. Once again, do question one's background and training ,as well as, qualifications in this area.
