Talk:Dental implant/Archive

Mini Implant Methods and Difference
From various articles I've read, it appears that the "small diameter" mini implants are significantly different enough that they really should have either a dedicated section, or even better, their own article. The sources I read indicate that there are differences in patient eligibility, bone density requirements at the site of the implant, and recovery/healing times. — Preceding unsigned comment added by LaEremita (talk • contribs) 06:56, 7 January 2015 (UTC)

Comment
This article is much better than Osseointegration, it might might be more helpful if the other one was replaced with a redirect to this one.

I changed the definition of dental implants from a "part of restorative dentistry" to "part of prosthetic dentistry" to be more consistent with its true intent. "Restorative dentistry" more properly deals with the structural re-building of a damaged tooth, whereas prosthetic dentistry most commonly involves replacement of missing teeth or other maxillofacial structures. See the definition of Dental restoration -- Mark Bornfeld DDS dentaltwins.com Brooklyn, NY 16:55, 27 October 2005 (UTC)
 * Dental implants are items and osseointegration is a biological process -- the articles should remain separate and distinct.  DRosenbach  ( Talk 13:56, 23 February 2010 (UTC)

The article should include price ranges. As it stands it is simular to marketing for implant sites. Tom Fallon tomsails40@yahoo.com  — Preceding unsigned comment added by 67.184.67.242 (talk) 14:10, 13 June 2011 (UTC) Implants can be Crestal or Basal by bone placement.By functions can be also bi cortical screw,compression screw,Boi or combination type.Basal implantation has totally different outlook than Crestal. They are orthopedic implants used in dentistry without complications which are common in Crestal implantation.Basal implants has success rate in risk groups like low jaw bone,smokers,periodontal or peri mplantitis complications.What article is this if there are no information on basal implantation. — Preceding unsigned comment added by 121.44.217.75 (talk) 18:16, 21 December 2014 (UTC)

Success Rate
I removed the phrase "Dental implant treatment is regarded as having a very high success rate", since the next sentence quantifies the success rate. This renders the relative and judgemental phrase "very high" redundant.--Mark Bornfeld DDS 15:04, 3 January 2006 (UTC)

Introducing a timing factor into the article

The current success rate of osseointegration is 98.5% success osseointergration within 12 weeks * Pjetursson et al 2008, 2009. The reported 5 and 10 year survival rates for single implant reconstructions are 5 Year 94.5% and 10 Year 89~90%.

Additionaly should this be survival as opposed to success?. There is a difference between survival and success, survival is dictated and a binary system, if it is in the mouth then it has survived. Success however is the absence of problems. There were proposed success criteria put out after Albrektsson et al. IJOMI 1986, 1:11

1 An individual, unattached implant is immobile when tested clinicaly

2 Radiographic examination does not reveal any peri-implant radiolucency

3 After the first year in function, radiographic bone loss is less then 0.2mm per annum

4 The individual implant performance is characterised by an abcence of signs or symptoms such as pain, infections, neuropathies, paraesthesia, or violation of the IAN —Preceding unsigned comment added by Lint.n (talk • contribs) 02:36, 10 November 2010 (UTC)

pictures needed
anyone whos got pictures, put em up --Aspensti I agree - this article definately needs some color diagrams. I have put up a link where there are some nice ones but I don't think we are allowed to copy them. I will email the site and see if they will allow it or not.

You can contact us via socialmedia@straumann.com if you wish to get pictures (and more informational material) for this wiki entry (they will of course be "neutral" ones without Straumann branding).

Deleted Submission Question
Bbowenjr 12:46, 5 September 2006 (UTC)I am new to Wikipedia and would like to understand why a link I submitted (http://www.studysphere.com/Site/Sphere_13920.html) to the "External Links" section was deleted? This directory has over 3,000 human selected articles and dental implant resources in it. Thank you for any assistance.Bbowenjr 12:46, 5 September 2006 (UTC)
 * Hmm; dunno. There is a reluctance on WP to add external links - see WP:EL for guidance. However, this article is already pretty heavy with links and this does seem a useful one. I have therefore added it back. If someone wants to remove it again then they will be expected to discuss their reasoning here. BlueValour 03:19, 5 November 2006 (UTC)


 * Here's a hint: studysphere.com links have been campaign-spammed to Wikipedia; see 29 November 2006 discussion at WT:WPSPAM. Bbowenjr added them to a wide range of articles from Dental implants to Military robots. There's been a misconception among some spamdexers that if they get a link deleted they can question the deletion on the talk page and still get the page rank benefit; this is wrong since all Wikipedia talk and user page links are automatically coded with the html tag rel="nofollow"; search engine bots don't follow these links. --A. B. 23:23, 2 December 2006 (UTC)

Added The Dental Implant Blog
It's the official blog of the ICOI's Auxiliary component. It's non-sponsored. I've submitted it before and it was deleted - not sure why. Please contact me at user name TeresaDuncan or through my blog if you have any questions about it. Thank you.

Teresaduncan (talk) 04:49, 5 January 2008 (UTC)Teresa Duncan, M.S.
 * I took a look at the website, and I found that the content was not focused on dental implants. Thus, the link was removed from the external links section. - Dozenist talk  13:12, 5 January 2008 (UTC)

Strange content
Why is this sentence included:

“In Israel, single implants begin around 5000 NIS, comparable to Turkey and Egypt where they begin around 700-800$,while in Iraq single implants begin around 250-350$.”

I can’t imagine that many implant procedures are performed in Iraq right now. . . Is this subtle vandalism? --S.dedalus (talk) 05:42, 16 May 2008 (UTC)

rejected implants?
any evidence of rejected implants or side effects to other parts of the body suggesting rejection?24.116.238.101 (talk) 17:03, 13 September 2008 (UTC)
 * Titanium is completely biocompatible. There is thus no aberrant host response that could lead to a true rejection, per se.  There can, however, be infection that can easily lead to early or late dental implant failure.  Other than infection (termed peri-implantitis, the other reason for implant failure is mechanical overload.  DRosenbach  ( Talk 13:05, 23 February 2010 (UTC)

types of implants
I think this article should include a very important section on various types of dental implant system available now and cons and pors of each. —Preceding unsigned comment added by 195.146.47.210 (talk) 05:44, 24 October 2008 (UTC)

'properly trained'
an anonymous user has altered the order of which 'specialists; should/can be placing implants. now that it's in the spectrum of many general dentists what does everyone think about removing which dentists' place implants. The sentence could read 'a dentist with training in dental implants' - i'm not sure what the standards are around the world.Ian Furst (talk) 00:19, 23 March 2009 (UTC)

Titanium 6/4
In the section on composition, this article states that implants are usually made of Ti6AlV4 - This is written to look like a chemical compound, it should be written Ti-6Al-4V signifying the Titanium alloy containing 6% Aluminium and 4% Vanadium. There is a page on it here: http://en.wikipedia.org/wiki/Titanium_6AL-4V

Also higher tensile strength does not necessarily lead to higher resistance to fracture, thus, the word 'thus' should be removed. J33los (talk) 23:37, 25 April 2009 (UTC)
 * Hardly -- titanium alloy is certainly not as widespread as this makes it seem they are. Commercially pure titanium is still the primary implant material.  DRosenbach  ( Talk 13:15, 23 February 2010 (UTC)

Define Terms First
This article starts right off with "osseointegrated implant and the fibrointegrated implant", and then goes on to use those terms right away. They mean absolutely nothing to the average person and must be defined before use. Varkstuff (talk) 21:55, 4 June 2009 (UTC)

Surgical Timing and Immediate Placement
The "Surgical Timing" and "Immediate Placement" sections imply that dental implants occur ONLY after extraction when in reality it seems to not be the only scenario (tooth agenesis, for instance). —Preceding unsigned comment added by CH3374H (talk • contribs) 20:51, 9 July 2009 (UTC)

Patients' perspectives
Having just undergone major oral reconstruction including nine implants, four bridges, and crowns on every tooth over 18 months I would like to suggest that a section in the article dealing with patients perspectives may be useful. While the scientific and technical descriptions here have certainly been useful for me, the article does not provide me as a patient with the opportunity to make some non-scientific contributions. I suggest that the majority of people reading the information on this page will not be dentists but people contemplating undertaking implants.

Placing this in context I decided to have my work done in Thailand, primarily because of the prohibitive costs that the significant treatment was going to incur in Australia where I live. This decision was done with a great deal of concern that the treatment and results would be of the highest quality. As things have turned out to me, the results have been excellent, and the treatment that I received as a patient was  outstanding.

Some areas that could be included are:


 * Choosing a prospective dentists, doing your research
 * Decisions relating to cost
 * Dental tourism
 * The "experience" -- what it feels like to  undertake major dental reconstruction
 * Things that dentists can do and say, and explain, to better help the patient understand what is going on, what are the consequences, and to help the patient's peace of mind

If there is another place where I might add these suggestions, and where others could contribute, you might let me know here. —Preceding unsigned comment added by Greg Shaw (talk • contribs) 04:49, 29 January 2010 (UTC)
 * While your comments are certainly welcome and you brought up some wonderful points, many of your specific recommendations are really out of bounds for this article for the following reasons:
 * Choosing a dentist has nothing to do with implants per se -- such a section, if deemed encyclopedic (which I doubt) would belong in the dentist article.
 * While cost certainly plays a part in accepting a treatment plan, any mention more than the need to integrate cost into one's overall treatment cost-benefit analysis is really excessive.
 * Dental tourism has nothing to do with implants per se, other than tourism being a solution for high costs and implants being relatively expensive.
 * Experience is highly subjective.
 * Things dentists say or do are highly subjective and certainly unencyclopedic.
 * Perhaps this article needs a complete overhaul, and your points can be built into this process, but high-level focus on these items as you suggest would not be ideal.  DRosenbach  ( Talk 13:30, 23 February 2010 (UTC)

Merger proposal
New article Implantology was added. I started to wikify it when finding it very similar in scope to this article. It may have additional and valuable information. Could some experts please see what's worth incorporating here? Thanks. noisy  jinx  huh? 18:18, 7 February 2010 (UTC)
 * Agreed -- although implantology is the field of study relating to dental implants, and I don't suggest merging the zoology and animal articles, I don't think having both of these articles contributes to either the comprehensiveness of Wikipedia or any benefit to the lay or professional reader. I think I'll set my sights on merging these two articles and getting them up to speed.  DRosenbach  ( Talk 13:50, 23 February 2010 (UTC)


 * disagree -- the pages are getting large enough to split into two. Implants (implants themselves) and implantology (the science of the surgery/techniques, etc..).  Right now, both are a mishmash of both. Ian Furst (talk) 14:14, 23 February 2010 (UTC)
 * The articles may be large quantitatively, but the implantology article is far from large qualitatively. The text is either more closely related to dental implants themselves, is poor in scope and content or not really useful because it's, as you say, a mishmash of words and sentences without real direction or objective.  Perhaps I'll just work on dental implants and try to trim this article of the weak content it possesses.  DRosenbach  ( Talk 14:18, 23 February 2010 (UTC)
 * sounds good - if you're looking for some help with the content I'm happy to help -- let me know a section you'd like edited...pics...whatever. Ian Furst (talk) 15:46, 23 February 2010 (UTC)

As this is not generating much discussion at all, I'm removing the merger tab from the article. Secondary to that, I'll be moving the bulk of the surgical technique information to the implantology article, as that's where it belongs.  DRosenbach  ( Talk 16:45, 5 March 2010 (UTC)

History of dental implants
There's certainly a place for information related to ancient use of gold, bone and chips of plaster and pottery implanted into the jaw bones -- but it should not be in this article as it adds clutter and shifts the focus of what most people are looking for when they get to this page. As in almost every dental text book dealing with implants, a short summary of such information is provided, but the focus quickly shifts to modern medicine. I think a similar thing should be done here, with the bulk of ancient Mayan and Chinese dentistry placed into an article entitled History of dental implants, which can be linked to as a "Main Article" link at the heading of the subsequently summarized section.  DRosenbach  ( Talk 05:47, 5 March 2010 (UTC)


 * agree with the above - it's one thing to talk about modern dental implants but older versions are not particularly relavent in the article. —Preceding unsigned comment added by Ian Furst (talk • contribs) 19:11, 5 March 2010 (UTC)


 * I disagree. The history of implants should be included in an encyclopedia reference to dental implants. It should not include every little modification over the years but at least the mayan and chinese historical stuff should be included and maybe a couple of key turning points eg discovery of osseointegration. I don't think what one person percieves is "what most people are looking for" should determine the content of the page especially if it is relevant to the topic. To illustrate my point, what might be considered "what most people are looking for" may not even be appropriate for this page. e.g. testimonials and specific implant brands.Bouncingmolar (talk) 08:10, 11 January 2014 (UTC)

moved from article
''lade implants usually fibrointegrated. The most widely accepted and successful implant today is the osseointegrated implant, based on the discovery by Swedish Professor Per-Ingvar Brånemark that titanium can be successfully fused into bone when osteoblasts grow on and into the rough surface of the implanted titanium. This forms a structural and functional connection between the living bone and the implant.''

need for dental colleges/dental assoc post to net & update
I searched and all I came up with was forum of individuals which is not helpful when assessing this procedure. Please have dental colleges, National Ass of Dentists keep updated page with info regarding historical timeline of implant patients. How else can we really know how implants are successful unless dental collages post their history of implants to the web on a current basis? The ADA should be a leader in this current posting instead of letting the consumer wander among private postings!Katesisco (talk) 15:35, 8 May 2010 (UTC)

"A dental implant is considered to be a failure if it [shows peri-implant] bone loss of greater than 1.0 mm in the first year and greater than 0.2mm a year after." Can 1.0 mm possibly be correct?
Given the scale of the implant itself, a 1 mm loss of bone (in which direction?) seems large enough to significantly loosen it. Though tempted to "correct" it to 0.1 mm, instead I raise the question for anyone more informed. (See also the discussion on success rates, which does not quantitatively address bone loss in the first year but confirms the quantity and thus the scale for subsequent years.)

Should the 1.0 mm figure be correct, does it require any further comment with respect to the discrepancy of scale or direction of loss? Michael (talk) 19:17, 15 February 2011 (UTC)
 * After attachment to a transmucosal healing/temporary restorative abutment, implants will generally lose some bone because of the establishment of biologic width. As such, some bone loss was classically accepted as a given.  Albrektsson gave some figures for that, and it's generally accepted that bone will move apically to the first thread, which is 1.5-2mm from the platform.  Even an 8mm implant (shown, by randomized controlled trial to be the longest implant at which shortened length is shown to be significant) that loses 5mm of supporting bone may not exhibit mobility, because dental implants osseointegrate and are thus comparable to ankylosed teeth which are connected directly to the bone.  The prognosis will be unfavorable, and the restored implant might very well be a prosthetic nightmare, but that would fall under a failure of success rather than survival, seeing how the implant is still functionally fused and able to tolerate occlusal stresses.  Make sure you mind that difference between success and survival, as it's a little trick that authors can employ.   DRosenbach  ( Talk 14:49, 18 September 2011 (UTC)

Implanturi dentare
Implanturi dentare sau radacini artificiale, din titan sau zirconiu, ce inlocuiesc radacinile naturale ale dintilor si au ca scop crearea suportului pentru realizarea de coroane sau punti dentare, atunci cand pe arcada nu mai sunt prezenti dinti sau cand cei prezenti nu se califica pentru un tratament dentar de succes.

Practic, implanturile dentare se prezinta sub forma de "surub", cu un relief divers, in functie de categoria din care fac parte si de producator. Astazi, cele mai de succes si cele mai des folosite in lumea medicala dentara sunt reprezentate de implanturi dentare din titan, osteotintegrat endo-osos (cu alte cuvinte, implantri care se insereaza complet in osul maxilar sau mandubular si in jurul caruia se formeaza substanta osoasa, os).

Pasii pentru un implant dentar:


 * Primul pas este reprezentat de consultatie.
 * In cea de a doua sedinta - medicul implantolog va analiza examenele complementare cerute, va prezenta pacientului eventualele particularitati observate in urma realizarii acestora si in cele din urma va da sau nu acceptul pentru interventia de inserare a implantului dentar.
 * Inserarea implantului dentar - pentru a se introduce implantul dentar este necesar in prealabil crearea unei cavitati la nivel osos, maxilar sau mandibular, cavitate realizata cu ajutorul unei aparaturi specifice, freze speciale, utilizand tehnici si viteze adecvate fiecarui caz particular. Dupa realizarea cavitatii, implantul dentar se infileteaza (autofilentant) in cavitatea creata, avand in vedere si urmarind aplicarea unor forte de infiletare extreme de precise.

In functie de implantul folosit protezarea poate fi aplicata pe loc sau in termen de maxim 6 luni de la interventie, timp in care vindecarea va fi completa iar zambetul dumneavoastra va fi gata sa straluceasca !

Implanturi dentare

Souljahdgw (talk) 14:55, 2 February 2012 (UTC)

Market: 'wordly recognized'
Notwithstanding US spelling in a UK influenced section, what does 'wordly recognized' mean? Is it a corruption of 'widely recognised'? Or is it alluding to the idea of global recognition, a form of 'worldly recognised'? — Preceding unsigned comment added by 2.125.64.152 (talk) 23:10, 30 April 2012 (UTC)

Patient Perspectives
It would be helpful-from a patient perspective-to discuss the advantages & purported longevity of crowns vs. implants, based on the assumptions that an implant is otherwise possible without serious risk or complications. Also to include any true or perceived benefit of trying to "save" a natural tooth (even when there is little to nothing left above the gum line), especially within the context of longevity of a crown vs. implant. Djwhite077 (talk) 15:24, 17 October 2012 (UTC)
 * With respect, wikipedia is not here to provide information to patients. Your point could be rephrased as a suggestion for how to improve the article, and I agree if a suitable secondary source could be found then this would be useful to include. Lesion  ( talk ) 18:57, 5 March 2013 (UTC)

Sapphire implants
I have heard that sapphire is a safer and more bio-compatible material than titanium.

It would be helpful to include this sub-topic.

74.108.171.185 (talk) 00:09, 29 October 2012 (UTC)jeffreygratton@gmail.com

Dental Implants
I did not see any info on how effective the anesthesia is or post-op pain involved. Any comments for Implantees? LB, Plano Texas 71.42.140.52 (talk) 15:22, 29 March 2013 (UTC)
 * WP:NOTAFORUM, Lesion  ( talk ) 15:38, 29 March 2013 (UTC)

I just had one done. The procedure took about 20 minutes. Didn't feel a thing, except for soreness of having to open very wide. Was prescribed Tylenol 3 for post-op pain. Took a few for the next day or so, none required after. Obviously this will vary and may depend on the dental surgeon. Mine has been doing implants since 1989 and claims a failure rate of about 2% (I didn't realize how good that was until I read this page). kovesp (talk) 18:25, 13 April 2013 (UTC)
 * Did you read the above link? Here it is again for your convenience: WP:NOTAFORUM. Lesion  ( talk ) 18:45, 13 April 2013 (UTC)

Composition alloys a little confusing - typo?
In the 4th sentence of Composition, Titanium 6AL-4V is introduced as a 5th grade of titanium. In the next 2 sentences we see a new reference to Ti- 6Al-4V which is unexplained. One wonders whether these are one and the same thing or not? Capitalization should be preserved in each instance if so, or the newer reference should have some brief explanation as the first reference did. Jintian (talk) 10:06, 9 May 2013 (UTC)
 * Maybe I'm late here, but they are one and the same.  DRosenbach  ( Talk 04:04, 10 December 2013 (UTC)
 * they are the same; Titanium alloy containing 6% Aluminium and 4% Vanadium alloy although that portion of the article has been changed. It was difficult to find any good reference but I contacted the lead scientist from Nobel to get more information on the use of the alloy in the industry. Ian Furst (talk) 02:17, 13 December 2013 (UTC)

Proposed merge with Mini dental implant
It's a type of dental implant. No need for a different page Lesion  ( talk ) 11:40, 28 May 2013 (UTC)

While a mini implant is, generally speaking, a type of a dental implant, it deserves to have a page of its own. Mini is significantly different from a traditional implant.


 * Yes, but "minimplants" was a separate page before...which did indeed suggest that mini implants can mean non dental implants as well... but that page got deleted, Articles for deletion/Minimplants. We are talking about mini dental implant here, which as the title implies is definitely a type of dental implant and not other kind of implant... Lesion  ( talk ) 18:52, 19 June 2013 (UTC)
 * Non dental mini implants should be discussed in an article without "dental" in the title... e.g. Implant (medicine) or such like. Lesion  ( talk ) 19:00, 19 June 2013 (UTC)

Merely being on a separate page does not suggest that mini implants are other than dental implants. Based on your point of view, it's feasible to lump ALL of the implants together, i.e. breast implants, dental implants, and so on. Mini dental implants deserve a separate page. This simplifies the research done by a general public, while listing all of the dental implants will further confuse them. — Preceding unsigned comment added by 66.61.123.248 (talk) 19:05, 19 June 2013 (UTC)
 * I disagree. We have a page that already lumps together all types of implants: Implant (medicine). This is the parent page for the whole topic. Then we have dental implant, breast implant, etc etc. I haven't checked, but I doubt that there are individual sub pages for the different types of breast implant. Merge does not imply any loss of content. All can be moved potentially to a subsection of main dental implant page. I'm a fan of presenting topics together, it saves repetition on separate pages, and presents easily a sub topic in the setting of the main topic. P.s. you are going to make the rest of this talk page purple if you don't close that font code =D Lesion  ( talk ) 19:42, 19 June 2013 (UTC)

Seeing the articles were merged recently (which I approve, by the way) I've cleaned up some links from other articles to point to the Dental implant article or its MDI section instead of to Mini dental implant and Mini dental implants. I'm not sure I did the formatting correctly (for instance, URLs for section links look pretty ugly pointing to Dental_implant but when I tried to truncate them, links didn't seem to find the anchor any more) so I'd be grateful if someone would take a few minutes to review my September 9 edits. Thank you.--Egmonster (talk) 07:36, 9 September 2013 (UTC)

unsuitable sources
I removed some recent links to private practices, which had a very strong sense of advertising. Medical content on Wikipedia follows WP:MEDRS sources. Lesion ( talk ) 10:18, 28 June 2013 (UTC)

How this article should be

 * Find sources for unreferenced content.
 * Change wording from the slight how to manual tone we have in places
 * Rm unencyclopedic language such as "patient", wikipedia readers are not assumed to be medical professionals nor patients, but a general audience, per WP:MEDMOS
 * Remove all primary sources, per WP:MEDRS, e.g. Grant BT, Amenedo C, Freeman K, Kraut RA (February 2008). "Outcomes of placing dental implants in patients taking oral bisphosphonates: a review of 115 cases". Journal of Oral and Maxillofacial Surgery 66 (2): 223–30. doi:10.1016/j.joms.2007.09.019..
 * Reduce emphasis on "training" & "markets". This reads like periodontists and maxillofacial surgeons sniping at each other, saying they are better qualified to place implants. Article should be primarily about the medical device and the surgical procedures, not a platform for consumers to window shop, which is not encyclopedic.


 * Remove emphasis on individuals, e.g. "Dr. Leonard Linkow placed his first dental implant in 1952, four months after he graduated from dental school. By 1992, Dr. Linkow had placed over 19,000 dental implants and stopped counting. He retired from private practice in 2002 leaving a body of work that included 12 major books and 36 patents. Many implant dentists refer to Dr. Linkow as the father of modern implant dentistry." unreferenced, subjective opinion.

I would completely rework this article myself, but I find the topic incredibly boring. For now I will try to remove the EL section entirely, maybe if it is not there then people will be less inclined to linkspam constantly. Lesion ( talk ) 22:30, 6 August 2013 (UTC)

How can you say to "remove emphasis on individuals" and yet leave two paragraphs on Per-Ingvar Branemark? Dr. Leonard Linkow, at 88 years young, was a pioneer of implant dentistry. NYU created an endowed chair in implant dentistry in his name. The major dental implant books he wrote and patents he obtained are facts and are not an unreferenced, subjective opinion. In 2014 he published his 20 book. http://www.dentalaegis.com/id/2012/04/pioneers-of-dental-implantology http://www.nyu.edu/dental/nexus/issues/winter2011/523 http://aaipusa.com/uploads/Dilema__of_Ignorance.pdf http://www.aaid.com/uploads/cms/documents/2004_1_jan_aaidnews.pdf - page 9 former President, American Academy of Implant Dentistry http://www.amazon.com/s/ref=sr_pg_1?rh=i%3Aaps%2Ck%3Aleonard+linkow&keywords=leonard+linkow&ie=UTF8&qid=1412383551 - some Linkow textbooks are still available on Amazon DentalSchoolProfessor (talk) 00:48, 4 October 2014 (UTC)DentalSchoolProfessor

Images and other improvments


It looks like both the above persons have recently expressed interest in uploading more images for this article. This would be great, and if any other improvements in the article occurred at the same time too... Many thanks, Lesion  ( talk ) 19:31, 2 November 2013 (UTC)

Major Update
It's time for this article to have a major revamp. has given a fantastic summary of what's required in how this article should be. I enjoy the topic, so I'm going to start on the rework. My intent is to follow the structural flow of Hip Replacement, deemphasize markets, training and history and refocus the information on what a layperson would find useful/relevant. If anyone would like to help with the work, please leave me a message (here is best) and we can coordinate the work to be done. Ian Furst (talk) 19:46, 2 November 2013 (UTC)

Major Update, Update
Summary: I know a lot of work has gone into this article over the years, but it does not read well for a layperson. There are a lot of industry undertones (about who invented the implant, the best type, how important CT scan guided is) that appear to drive the article flow. I'm going to embrace the WP:BOLD philosophy and start the process. It will take at least a month so please be patient. For infrequent editors, this page has been watched by the Dentistry Project for some time, and labeled as being in need of major changes. If something gets removed, that you believe should be included, please add a note to the Talk Page (e.g. here) so we can all discuss it. The aim is not to drive a particular agenda, but to make the page useful for the general public.

Here's the plan:

1. Rework the intro to make it much more general 2. Reorganize to: -Uses (single teeth, multiple teeth, retain dentures, other uses (anchor for orthodontics) ADD LOTS OF PICS FOR THIS -Modern Process (overview, surgical, prosthetic, long term maintenance) -Risks (failure(short and long-term), infection, bleeding, periimplantitis, structural implant failure, prosthetic failure) -Types (general composition, root form, zygomatic, small diameter) -History 3. Rebuild references (98% of all references in this article are either primary or non-specific (e.g. no page number), this is a major issue). Unless a claim is backed-up by a secondary reference, or it's so vital to the article that the page can't stand without it, I'll remove the fact. 4. Shorten and depersonalize history (review the progression from preprosthetic surgery to subperiosteal implants to osseointegrated implants then modernization of them).  Regarding, who invented the implant see point #3 - please add secondary references otherwise there will be a very quick blurb about Branemark and that's it. I'm not an expert on implant history, so I'm happy to learn but we have to get better references.

Regarding MDI's: MDI is a trade name (the generic being small-diameter implants which several suppliers have) and there are no secondary references attached to it. The technique is not unique enough in my mind, nor are there sufficient secondary references, to warrant it's own section. Other than a small section on small-diameter implants in types the sections will be removed

Regarding training: this entire topic has degenerated into a sniping section between GPs, Perio and OMFS. Wikipedia can't be a bully pulpit for the profession. Given that this area is fraught with debate, my vote is we either remove the discussion entirely or include a small blurb (with a secondary reference) that experience correlates to success rates. Dentistry Project group, I'm not sure what your take on the topic is - please add comments.

Please add any thoughts - I'll start the process soon.

Ian Furst (talk) 12:02, 3 November 2013 (UTC) also note - the article implantology, my view (now) is that it should be merged with this one. it's a watered down version of the existing article. Ian Furst (talk) 15:28, 3 November 2013 (UTC)
 * Sounds good. Agree to remove or reword the training section. It looks bad and is not encyclopedic.
 * Re implantology article, don't forget you can use a wp:SUMMARY STYLE, with more focused nested articles linked from the parent article. Such nested articles could be History of implantology, etc. Lesion  ( talk ) 15:33, 3 November 2013 (UTC)

Under Construction
I've added in a new section called uses, currently unreferenced but will be in the coming week or two (once I pull textbooks - I'd like to get away from the primary references). Please be patient. All major changes are made, now the article will be slowly reworked for readability and references. Please add any comments hear as we move thru the page. Thx. Ian Furst (talk) 00:38, 4 November 2013 (UTC)


 * update Nov 9 2013; work on the page is coming along. For anyone that is watching it, the plan is to continuing stripping out highly technical, useless or poorly substantiated claims and build a framework that's of more use to the layperson and adding pictures.  I'll then be adding back in secondary resources (mostly books and Cochrane reviews (thank you Wiley for access)) and more granularity.  Please add comments if you think the page should be taking different directions (or make changes and we can talk after).  Thank you for the patience.  Ian Furst (talk) 18:19, 9 November 2013 (UTC)
 * I'm having trouble with the prosthetic section of the article; I've written enough for a layperson but would appreciate someone with prosthetic expertise to help me develop it. If any of the wiki editors are interested, please let me know.  If you know someone that might be interested (but isn't a wiki editor), I can develop it with them thru email.  Have them contact me thru my office.  https://www.coronationdentalspecialty.ca  Thx.  Ian. Ian Furst (talk) 12:44, 10 November 2013 (UTC)
 * Suggest try to contact some of the users who occasionally edit Crown (dentistry)? Some are IP editors, so I don't know if they will get any message however.
 * Also, a helpful admin has moved the page I just merged on your suggestion to sinus lift. Lesion  ( talk ) 13:19, 10 November 2013 (UTC)
 * Good idea - thx. Once I get thru risks here, i'll launch into sinus lift. Ian Furst (talk) 14:01, 10 November 2013 (UTC)

I'd like to add a section on 'anatomic' implants. This does not fit readily into the existing article, since it's unlike any conventional implant: it's not a screw, it's immediate, and there's no surgery involved. There are less secondary than primary sources, but it's important enough to warrant its own section. Perhaps I can add a new section after 'Risks', section 4: 'Anatomic implants: a new type of implant'? Shall I put it up with pictures and references, or should there be some discussion first? Amir Ansari (talk) 18:58, 11 November 2013 (UTC)

Also, some comments about the current article: in section 4 'Common types of implants', the first item is 'root form implants'. This is misleading: it probably refers to a tapered screw, which is anything but 'root form'. (A real tooth can have multiple roots - how can a regular screw claim to be 'root form'?) I think this should be changed to 'screw-type implants'. Is it also worth adding 'subperiosteal' and 'blade' implant types? Amir Ansari (talk) 19:13, 11 November 2013 (UTC)
 * Amir and I have been discussing this on my talk page briefly, but from an editorial perspective my opinion is that subperiosteal and blade implants are of limited historical significance. They might find a place in a pre-prosthetic surgery article (again, historical) or in this article in history.  The root form implant, to the best of my knowledge, is made by Amir's company and has several case reports published on it but no large scale trials, no 5 year results, ??any FDA/Health Canada or EC approval as an implant??.  He's been very upfront about the conflict of interest so I have no issues with that; I don't think we'd hear of the implant otherwise.  My concern is maintaining the integrity of this article against experimental therapies.  That was one of it's major downfalls previously. I haven't been able to find verifiable references for this implant therapy outside of the limited case reports so I don't think it qualifies to be included.  Other opinions?


 * Yes, to be clear, I would like no mention of the company whatsoever. It's the concept and the (radically different) non-surgical nature of the treatment that's potentially of interest to readers, and (I think) deserves a wider audience, and discussion. The 5 year results are being held up by dental journals, under 'review'. There's very little we can do about this. There are 8 year results too, now... We're in the process of applying for FDA approval, and I believe we have EC approval (I'll have to check). While there have been no large-scale trials, the procedure is certainly out of the experimental stage. Amir Ansari (talk) 21:15, 11 November 2013 (UTC)

Construction Nov 13, 2013 update
I've now created the intended sections of the article and am slowly building them up with more text and pictures. Please take a look if you're following the page and let me know if you think any critical issues have been overlooked. Regarding references; until now I've used {almost) exclusively textbooks and Cochrane reviews but I still have some well-established areas that need to be covered. You will see a limited amount of primary research which will all be either large-scale trails, long-term results or meta-analysis.  More pics to be added.  Ian Furst (talk) 17:44, 13 November 2013 (UTC)
 * My understanding is that systematic reviews + meta analyses are secondary sources and they are ideal sources for wikipedia... Use of individual randomized control trials generally discouraged in most cases, especially if there are systematic reviews available. Lesion  ( talk ) 19:41, 13 November 2013 (UTC)
 * editing process is nearing the end, please take a peak and if you see any typos please fix or leave me a note. I still need to review several sections to word-smith them but the structure, references and media are basically set.  All references are metaanalysis/books/systematic reviews/Cochrane with very few exceptions (and those are VERY large scale, long-term or sentinel papers e.g. tarnow).  Thx.  Ian. Ian Furst (talk) 03:59, 16 November 2013 (UTC)

No one's addressed the use of the term 'root form', which covers the majority of implant types. It's a misappropriation: screws are clearly not root formed. Implants have a history far beyond Brånemark; root-formed implants (made out of shell) were discovered in archaeological sites in Honduras (I'll add this last fact to the 'History' section of the article). But I think it's important to establish that screws and 'root form' are quite different shapes, and to conflate the two will surely confuse the audience. Amir Ansari (talk) 13:09, 21 November 2013 (UTC)
 * I don't know enough about the topic to comment on this, sorry. We should follow the most common terminology in the sources, whatever this is. Lesion  ( talk ) 23:04, 24 November 2013 (UTC)

Ian: you mention that your 'concern is maintaining the integrity of this article against experimental therapies.' Is there any reason not to have a section entitled 'Experimental therapies'...? Amir Ansari (talk) 13:09, 21 November 2013 (UTC)
 * The article previously had archeological findings but I couldn't find an adequate reference to use to keep it in. Under history, we could cover a many aspects of previously preprosthetic surgery but it's just too broad to put in this article in my mind. Same thing with experimental therapies, if something has secondary sources there's no reason it shouldn't be included. See WP:CITE Prior to the clean-up one of the major problems was a reliance on primary sources. Ian Furst (talk) 01:45, 22 November 2013 (UTC)
 * Amir - regarding the last edit, I appreciate you bringing the information forward but, in my opinion, you should not be posting it due to the conflict-of-interest. Also, describing the implant as "the most significant advance in the last 50 years...." is a bit OTT and does not appear to be from a neutral point of view.  I'd volunteered to clean-up the dental implant article by the Dental Project and one of the biggest issues was the volume of primary research that existed on the page.  I am not opposed to a section called Novel Techniques, so long as its has a neutral point of view and references that Wikipedia considers sound.  Also, part of Wikipedia is building consensus.  As passionate as you seem to be about what defines a root-form implant and how innovative you believe the implant your company developed to be, I haven't seen a consensus of editors agreeing the information should be included.  For these reasons, I reversed the edit. Ian Furst (talk) 22:33, 24 November 2013 (UTC)
 * Ah, I didn't realise - I just put it back, thinking there was an error! Amir Ansari (talk) 22:49, 24 November 2013 (UTC)
 * Are you intending to take it back down?Ian Furst (talk) 22:56, 24 November 2013 (UTC)
 * Yes, I'll remove it now. Just dealing with conflicts in this page when I try to post my reply! Amir Ansari (talk) 23:10, 24 November 2013 (UTC)

Hi Fractallyte. To expand on the points raised by Ian above Re conflict of interest, if you have some link with this product, it is a good sign that you admitted this. Many editors do not admit a COI. As long as you edit in accordance with Wikipedia's policies like neutral point of view, then there is no issue with you writing about a topic that you are linked with, however often persons are generally advised not to write encyclopedia articles on topics they are very close to, e.g. their own biography page or company's page. See also Conflicts of interest for more info. The kind of sources that are preferred for Wikipedia's medical content are described by this guideline: WP:MEDRS. I understand that your content in this reverted section was based upon primary sources. Ideally need secondary and tertiary sources. We also need to make sure that due weight is given to the parts of this article. Therefore, we should have a Novel techniques section, but it should be in the context of the whole article. We should not go into great detail for techniques that have not yet caught on. Might be an idea to present a draft of your section on this talk page for further discussion? Lesion ( talk ) 23:04, 24 November 2013 (UTC)
 * Yes, I am linked with the product, but I'm not the originator of the research or concept. It's the latter that I feel is a valuable contribution to this article. Please note that I have not mentioned anywhere the proprietary name of the product. I made sure to use secondary and tertiary sources, with a single exception. Amir Ansari (talk) 23:24, 24 November 2013 (UTC)

Regarding the term 'root form': "Root form implants are a category of endosteal implants designed to use a vertical column of bone, similar to the root of a natural tooth. Although many names have been applied, the 1988 National Institutes of Health consensus statement on dental implants and the American Academy of Implant Dentistry recognised the term 'root form'." (Contemporary Implant Dentistry, by Carl E. Misch, page 28). Strictly speaking, the term is still inaccurate, but at least now there is an origin for it. Amir Ansari (talk) 23:24, 24 November 2013 (UTC)
 * The term endosteal was to differentiate modern implants from those that were subperiosteal and the term root-form was to differentiate both the modern screw-form and cylindrical non-screw-form (push fit, whether sintered or coated surface) from previously designed blade-form. In order to immediately put an investigatory report (i.e. a research paper), a textbook chapter or a live/recorded presentation into context, the opening sentence or two will often make reference to "endosteal root-form" implants.  Even though an implant does not appear similar to any particular tooth, such as a three-rooted maxillary first molar, a tapered titanium fixture that screws into an osteotomy does bear resemblance to a tooth root.  The term was never meant to convey the notion of an actual replication of anatomical roots.  DRosenbach  ( Talk 04:00, 10 December 2013 (UTC)

Proposed "novel treatments" section
Here is a draft of the section 'Novel treatments' (with Ian's suggestions taken into account): Amir Ansari (talk) 23:32, 24 November 2013 (UTC)

A notable advance has been the invention of so-called 'anatomic' zirconia implants. An anatomic dental implant replicates the shape of the patient's natural tooth.

Each implant is individually customized for the patient's anatomy, in a process made possible by the use of modern CAD/CAM technology, and zirconia (a very hard, highly biocompatible white ceramic). This kind of implant typically has a more complex form that includes single and multiple roots, and thus is a genuine 'root form' or 'root analog' implant.

The implant procedure is simple. The bad tooth is carefully extracted, so as not to cause damage to the surrounding bone or gums. Then the anatomic implant is inserted immediately into the empty tooth socket and gently tapped into place. The fit is exact, so there is no need for drilling or surgery. Precisely placed protrusions secure the implant in the softer spongiform bone of the jaw. The implant procedure typically takes less than a minute. Because there is no injury, healing and osseointegration are relatively rapid. The only requirement is that the patient should have relatively healthy bone and gums.


 * Comment-- is there any other types of implant or technique that should be briefly discussed in this section? It might be undue weight to discuss only this technique in the section? Lesion  ( talk ) 23:54, 24 November 2013 (UTC)
 * agree. I would argue that mini-implants, short implants and all ceramic implants should be considered under novel approaches. I must admit, this seems to be the most novel but I agree an entire section to it is undue weight.  I remain concerned that there are no longitudinal/multi-patient studies published in peer-review on this technology and/or technique.  Also, there are several neutrality issues in the above text (although these could be corrected).  While unique, I do not believe the concept is ready, yet, for Wikipedia. My opinion is that it should be left out until a greater amount of data is published.  Interested to hear what other dental/medical editors think to try and develop consensus.Ian Furst (talk) 01:52, 25 November 2013 (UTC)
 * I'm rather concerned there isn't more information about zirconia implants. Why shouldn't they be considered a mainstream treatment? They're widely used in Europe, and several are FDA-approved. The rationale for having a 'Novel Treatments' section is precisely to include discussion of potentially groundbreaking treatments. By definition, these may be unproven or not widely published; there should be comments to this effect. The absence of secondary or tertiary sources will limit the entries in this section. We should remember that the purpose of the article is inform a lay audience about the current state of implantology. Amir Ansari (talk) 08:30, 26 November 2013 (UTC)
 * Good point re zirconia, although you'll notice in addition to titanium "and some ceramics" is used throughout. Will look some more and add into materials if I can find references.  However, Wikipedia is intended to be a an encyclopedia for general readers not to inform on the current state or list potentially groundbreaking work.  See medmos and medmosIan Furst (talk) 13:14, 29 November 2013 (UTC)

Cochrane study results
FYI: I've used a series of Cochrane meta-analyses in the article and wanted to be able to give a general initial failure rate and effect of antibiotics. I had some difficulty in interpreting the data so I contacted the statistician for the project (dr. Helen worthington). according to her the data showed a) risk reduction with antibiotics is 67% from 6% to 2% failure rates and b) overall initial failure rate is estimated at 5%. This information will be included with the citation being the 2 Cochrane studies. Ian Furst (talk) 14:29, 29 November 2013 (UTC)

GA and Peer Reviews
the page has now had 3 reviews and a common thread is the use of primary references; they have to be removed. Apparently this is a hard standard in MEDMOS. I will be working over the next couple of weeks to rid the article of any primary references. Ian Furst (talk) 02:21, 13 December 2013 (UTC)

Dental Prosthesis is not synonymous with Dental implant
I disagree that Dental Prosthesis redirects to the dental implant page. Following this logic I also disagree that the dental implant + abutment/crown = 'dental prosthesis' (mentioned in the intro). A prosthesis refers to any artificially created device to simulate the appearance and function or enhance a human body part or contour. Therefore a Denture, crown, bridge, fixed or removable bridge/denture, onlay inlay and even a filling/restoration(although maybe going a bit far) with or without an implant can be referred to as a dental prosthesis. Therefore the Dental prosthesis page should refer to a disambiguation page which discusses all of the aforementioned prostheses. Regarding the inclusion into the introduction. Perhaps a dental implant is a prosthesis in itself, but I think it would be more correct to say that the dental implant is a fixture which may enable the connection of a dental prosthesis such as.... Bouncingmolar (talk) 08:03, 11 January 2014 (UTC)
 * agree with the redirect sentiment. But it's tough to talk about dental implant, for the layperson, without talking about the prosthetics that attach to it. Technically it's tough too, since many of the complications to the fixture vary with the prosthetic that's attached.  If you're proposing the obliteration (or moving of all that is prosthetic in the article) to the individual pages; I don't agree. When rewriting the article, I struggled with this exact dilemma.  I like the reword in the intro - thx. Re the sentence, "Pre-prosthetic procedures sometimes are required to recreate ideal bone and gingiva to enable implant placement (particularly after atrophy from previous tooth removal)." but would add back in a small explanation of pre-prosthetic, again, for the layperson I think it gets too technical too quickly. Ian Furst (talk) 12:24, 11 January 2014 (UTC)
 * Dental prosthesis equally applies to denture, orthodontic appliance, bridge, etc. Agree disambig best. Lesion  ( talk ) 13:48, 11 January 2014 (UTC)
 * I've never made a disambiguation page - will leave it to more experienced wikipedians. sorry. Ian Furst (talk) 14:51, 11 January 2014 (UTC)
 * hmm guess I used the wrong terminology. disambiguation pages are for when there are more than one definition of a page eg: crown disambiguation includes dental crown, currency crown, royal crown, so really dental prosthesis is a page of its own not a disambiguation page. Sorry about that, I see you've already created it. Bouncingmolar (talk) 12:56, 13 January 2014 (UTC)

main articles > see also
I think the main articles (at least in the uses section) are not really the main articles for that section. Perhaps a See also section at the end of the article. Also I think blade implants should be included somewhere. I have a book on them somewhere, not that I like to do referencing. I'll leave that up to u guys :) Bouncingmolar (talk) 06:19, 14 January 2014 (UTC)
 * I don't have a lot of textbooks at home, probably best if you find the source before adding the item (although I have a TAD book at work, will find one for the ortho claims). Strongly disagree on the blade implant. There were 100's of implant iterations before the concept of osseointegration (there are still many) - the article would become unreadable or unintelligible to the layperson reader trying to sort the historic stuff from what has become the modern dental implant.  My thought was that either a) we create an article on preprosthetic surgery which could include this b) add an area to the history section for implants that existed in 19th and early 20th century dentistry c) create a separate article for blades although, I don't think they played any greater roll in dentistry than any other bit of preprosthetic surgery (and imo, less).  Along the same lines, I don't think the TAD belongs here either for similar reasons, but there's nowhere else to put it.  For a while, "mini-implant" (which turns out to be a trade name) had their own page but we merged it, normalized the terms (e.g. took out the trademarks, etc...) and incorporated. Ian Furst (talk) 12:00, 14 January 2014 (UTC)

Dental torque wrench
hi, i am pretty sure that the reference to it handles manual mechanical torque-limiting devices as mentioned in dental torque wrench and not the motor version, but it was a good point to bring up, i had to update the article for it. About the name change to "torque controlled drill" the twisted drill itself is just a material that relays forced brought upon it, the term would be "torque controlled surgical motor", see the update on the article. As the motor is a multi purpose tool it is more prone to deviations in torque than the manual mechanical torque-limiting devices, saying that the latter is more proper to mention as a correct fixation tool than a surgical motor, waiting for a free image :).Mion, on a second thought, maybe mention both (talk) 00:47, 23 June 2014 (UTC)

, even though the wrench may be more controlled, during the surgical phase it's usually impractical to use ("back in the day", we used to use it on occasion and there's a lot of sideways torque created on the implant which can physically damage thin buccal plates). The drill is technically easier. Many use the wrench for abutment screw torquing however. I'll take a couple of pictures today. Ian Furst (talk) 13:07, 24 June 2014 (UTC)

A Little More on Recent History, Please
I tried to find out when implant dentistry became common, but this article did not tell me. OK, the first experiment with titanium implants was in 1965, but that doesn't really answer my question. By "common", I mean that, if a tooth broke to the point that a crown was no longer feasible, my dentist would list an implant as one of my options. I lost a tooth in the mid 1980's, and my dentist told me to chew around it or on the other side of my mouth, but he did not mention the implant option. So I have the vague impression that implant dentistry really took off in the early 1990's?? And so, to someone my age, it is a new field??Scribe2u (talk) 06:12, 21 March 2015 (UTC)

add information to a section in the dental implant article
to the "planning" section of the article i would like to add the subsection of "Facial Esthetics and Aging"

Changes in the bones and soft tissues of the face are a normal dynamic phenomenon that continues throughout life. Thus implant placement today should attempt to compensate for future changes. Whereas some changes are similar for both genders, others are not. Three-dimensional changes in the position of teeth and associated hard and soft tissue relative to the static position of implants can introduce compromises. Age-related changes in the maxilla and mandible can create important alterations, the exact extent, vectors and magnitude differ between genders. The vertical and horizontal changes are more pronounced in patients with short or long faces. The challenge for treatment planning is to anticipate potential changes over time. The clinical decisions that must be made prior to treatment are described. The difficulties of implant placement in adult patients have not been addressed adequately. However, with proper planning, the esthetic and functional impact of tissue changes on implant reconstructions can be diminished. The professional challenge of treatment is to develop a time dependent individual protocol that will adapt to the aging face.

Reference for this is: Lifelong Craniofacial Growth and the Implications for Osseointegrated Implants by: Fereidoun Daftary, DDS, MSD/Ramin Mahallati, DDS/Oded Bahat, BDS, MSD, FACD/Richard M. Sullivan, DDS International Journal of Oral and Maxillofacial Implants Volume 28, Issue 1 January/February 2013 DOI: 10.11607/jomi.2827 http://www.quintpub.com/journals/omi/abstract.php?article_id=12894#.VT1e2aa22UM

More information will be available from these authors (and, I believe, Dr. Peter Wöhrle) in a book about surgical grafting techniques that is currently in pre-publication. The title of that article is "The 4th Dimension of 3-D Surgical Reconstruction: Bone & Soft Tissue Grafting to Compensate for Dynamic Craniofacial Changes Associated with Aging in Partially Edentulous Patients Influencing Placement Consideration for Osseointegrated Implants"

I am told that knowing Dr. Bahat is a conflict of interest. However, this issue of the skull continuing to grow as we age is an important and especially relevant when the topic is dental implants because they're static. Please help me get this information included. I believe that it is overlooked in the implant community. After a panel in March at the A/O Academy of Osseointegration the speakers were swarmed by attendees -- it was clear to me that this topic should get elevated to the level of general knowledge.

thank you.Vector4 intl (talk) 21:55, 26 April 2015 (UTC)
 * actually what you told me is that he is your friend, not just somebody you know, and whom you clearly know professionally since you were at that meeting. Please have a look at WP:MEDMOS with regard to tone - some of the stuff in your edit is "speaking to the wrong audience" described there.   Jytdog (talk) 23:31, 26 April 2015 (UTC)

-ok i see some issues, like the word patient, and have redrafted. if you continue to believe it's speaking to the wrong audience, could you be more specific, please? fyi: i read and re-read the dental implant article before submitting this change. personally i think the information under 'general considerations' talks about conditions that a doctor should consider NOT what a general reader who may be researching dental implants should consider. my point being is that opinions differ, and i'd appreciate specific suggestions to help publish this update -- which i believe is in the best interest of the public. again, i do know dr bahat. he is a friend. that's not why i'm here. i've seen people react to this topic and that's why i'm here. any way, here is my suggested revision. PLEASE advise.

subtitle: Facial esthetics and aging (to be included under the planning title)

Changes in the bones and soft tissues of the face are normal dynamic phenomenon that continues throughout life. Thus implant placement should attempt to compensate for future changes. Three-dimensional changes in the position of teeth and associated hard and soft tissue relative to the static position of implants can introduce compromises, or aberrations. Age-related changes in the upper and lower jaws can create important alterations, the exact extent, vectors and magnitude differ between men and women. The vertical and horizontal changes are more pronounced in people with short or long faces. The challenge for treatment planning is to anticipate potential changes over time. The clinical decisions that must be made prior to treatment can be identified and discussed with people considering implants. With proper planning, the esthetic and functional impact of tissue changes on implant reconstructions can be diminished. One challenge of treatment is to develop a time dependent individual protocol that will adapt to the aging face.

Lifelong Craniofacial Growth and the Implications for Osseointegrated Implants by: Fereidoun Daftary, DDS, MSD/Ramin Mahallati, DDS/Oded Bahat, BDS, MSD, FACD/Richard M. Sullivan, DDS International Journal of Oral and Maxillofacial Implants Volume 28, Issue 1 January/February 2013

PMID: 23377062 DOI: 10.11607/jomi.2827

More information will be available from these authors (and, I believe, Dr. Peter Wöhrle) in a book about surgical grafting techniques that is currently in pre-publication. The title of that article is "The 4th Dimension of 3-D Surgical Reconstruction: Bone & Soft Tissue Grafting to Compensate for Dynamic Craniofacial Changes Associated with Aging in Partially Edentulous Patients Influencing Placement Consideration for Osseointegrated Implants" Vector4 intl (talk) 00:03, 27 April 2015 (UTC)
 * I'm trying to clear some of the edit request backlog. Should this revised request should be added to the article? —S MALL  JIM   10:00, 7 February 2016 (UTC)
 * 2 issues with this (three really). Wikipedia aims to communicate "accepted knowledge" to the public, and in order to do that, we are careful about the sources we select in order to generate content.  This content is about health, and for health, WP:MEDRS guides our selection of sources - it tells us to use secondary sources from the biomedical literature, or statements by major medical/scientific bodies.  The source offered here is a primary source - an observational study, is how it is classified by Pubmed.  So we don't use it to generate content.  (The subsidiary reason here, is that it appears that the main reason this source is being selected, is to promote the author of the source)   The second reason is that the content is essentially advice on how to plan the procedure but Wikipedia is not a manual.   I've declined the request. Jytdog (talk) 15:26, 7 February 2016 (UTC)

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Root analogue dental implants
I've added a link in the History section to a separate article on root analogue dental implants. Custom implants are the latest in implant technology, so this seems like an appropriate section to write about them. Root analogue implants should be mentioned (or linked to) somewhere in the main 'Dental implant' article. — Preceding unsigned comment added by Logicwhatelse (talk • contribs) 16:48, 4 July 2018 (UTC)

Corrected the section title 'Custom made' to 'Root analogue dental implants', and added a link to the main article. As explained before, incorporating this article into the main Dental Implants article is detrimental to the subject matter - clearly demonstrated by the way the article has been cut by various editors. Please don't edit the linked article unless you have knowledge, skills and experience in root analogue dental implants, and start a proper discussion first.Logicwhatelse (talk) 18:41, 26 January 2019 (UTC)

File:Spinning root analogue dental implant.gif A robot has removed the GIF. Is the robot right or wrong? I don't know. I include the GIF here for future follow-up purpose. Tony85poon (talk) 02:51, 1 February 2019 (UTC)

In the Bulgarian version, I inserted a link to the Peri-implantitis. However, it got reverted. Would a real Bulgarian please help? One of the argument why conventional implant is worse than RAI is that screws cause inflammation. If there is a Bulgarian version of the Peri-implantitis article, of course I would link to the Bulgarian version. But since the Peri-implantitis article is only available in 5 languages (English French German Italian Korean), the next best thing to do is to link to the English version. Without that link, the neutrality of the Bulgarian version is harmed. If we don't give a shit, the Bulgarian readers (who can't read other languages) are less informed about the major side-effect of conventional implant. God bless. Tony85poon (talk) 23:10, 3 February 2019 (UTC)

Seriously, there was only 1 citation for the Bulgarian version. It links to http://stomcenter.bg/implantology with marketing information ( e.g. (02 85 48 016) and (0879 209-691) phone numbers). I am not saying that the citation must be removed. I am saying that there ought to be a diversity of knowledge, and the Bulgarian readers shouldn't be blind-folded. Tony85poon (talk) 23:16, 3 February 2019 (UTC)

The Turkish version got reverted too. The Mongolian version is still good. Tony85poon (talk) 15:40, 6 February 2019 (UTC)

Merger discussion
Tony85poon (talk) 02:02, 23 January 2019 (UTC)
 * I propose to merge the contents from the article Root analogue dental implant. There is no need for a separate article for each type of implant.Gsingh (talk) 00:23, 15 August 2018 (UTC)
 * I totally agree. Root analogue dental implant was created in September 2016. If it is worth having a separate page, the French German Italian Spanish wikipedians should have written the different-language-counterpages already. 26 months is a really long time (taking into consideration the high activity of French German Italian Spanish wikipedias). By the way, I have saved the latest version of the article at User:Tony85poon/sandbox so people can retrieve it no matter what happens. Tony85poon (talk) 05:19, 14 January 2019 (UTC)
 * I have a stupid idea, probably going to fail, but those who are in favour of having a seperate article might want to try. Translate the RAI article from English to Japanese. Go to jp.wikipedia.org and create a NEW article. You cannot even come up with a nice article-name that the Japanese can understand straight-away, can you?
 * Dental translates to "デンタル (Dentaru in Romaji)"
 * Implant translates to "インプラント (Inpuranto in Romaji)"
 * ja:デンタルインプラント - and your problem with it is...? Do you think Japanese are sutupido? As for translating, we in English wikipedia go with our rules and have our own articles. So yes, the idea is stupid in a sense it has no relevance for English wikipedia. Staszek Lem (talk) 02:28, 23 January 2019 (UTC)
 * My real suggestion is that, to save time, Japanese should expand ja:デンタルインプラント by mentioning RAI. When it comes to eye surgery, de:Laser-in-situ-Keratomileusis and de:Photorefraktive Keratektomie do overlap. The former technique was invented by English-speakers whereas the latter technique was invented by Germans. The two articles have their own "other-language-counterpages" meaning a merge would be extremely difficult. Better leave them separate. Tony85poon (talk) 03:43, 23 January 2019 (UTC)

 * :~WikiProject:Dentistry~ has been notified to help generate additional attention to the above request(s). Thanks, Gsingh (talk) 00:32, 15 August 2018 (UTC)  Root analogue implants have nothing in common with screw, cylinder or plate implants, and unfortunately, the dental implant article is focused exclusively on these technologies. Merging the two articles would require substantial reorganization of the dental implant article, and I'm sure there would be resistance to this. I think a better idea would be to add a new section with a brief description of root analogue implants, with a link (https://en.wikipedia.org/wiki/Template:Main) to the main article on Root Analogue Dental Implants.Logicwhatelse (talk) 16:18, 20 August 2018 (UTC) I am optimistic with the reorganization of content. That's the beauty of free encyclopedia. Tony85poon (talk) 04:43, 14 January 2019 (UTC)

The root analogue implant page describes more than an implant: it describes a method by which an implant can be created that matches the hopeless tooth in form and color. This implant cannot be placed if the root is not present anymore, in contrast to screw type implants. There is no common ground with cylinder and screw type implants because each RAI is custom-made to fit only one patient. The method of placement is also different as there is no surgery required. The only thing in common between cylinder, screw and root analogue implants is that in the end both act as a dental implant. Everything else is completely different. And so they have nothing to do with each other. Therefore, this method merits its own entry, and should not be mixed up with screw type implants. Even the history is completely different and would lead to confusion of the reader. To summarize, with an analogy: it doesn't make sense to merge an article on apples with one on oranges. They're completely different fruits. Logicwhatelse (talk) 16:00, 16 January 2019 (UTC)

"There is archeological evidence that humans have attempted to replace missing teeth with root form implants for thousands of years. Remains from ancient China (dating 4000 years ago) have carved bamboo pegs, tapped into the bone, to replace lost teeth, and 2000-year-old remains from ancient Egypt have similarly shaped pegs made of precious metals. Some Egyptian mummies were found to have transplanted human teeth, and in other instances, teeth made of ivory.[8](p26)[35][36]"
 * They would be completely different fruits if they were, for example, hair implants and tooth implants. But we are still talking about dental implants here.  I see that Tony85poon  has started a deletion discussion on Root analogue dental implant, which may be premature, since it looks like the subject really is notable and is a real term being used in this area.  A merge seems more practical, since both articles are about the basic subject of replacing human teeth with manmade alternatives, yes?  And given that they are, from the perspective of our readers, more or less the same fruit, I see no reason not to merge them into the one article on dental implants.  I don't think any other outcome is either likely or desirable.  A loose noose (talk) 04:49, 17 January 2019 (UTC)
 * Yes, I agree with you. The history section looks nice now, what do you guys think? Tony85poon (talk) 06:18, 21 January 2019 (UTC)

"Tooth loss is as old as humanity. Examples from history show that it has always made sense to replace a tooth with an implant that is shaped like a tooth. Wilson Popenoe and his wife in 1931, at a site in Honduras dating back to 600 AD, found the lower mandible of a young Mayan woman, with three missing incisors replaced by pieces of sea shells, shaped to resemble teeth.[37] Bone growth around two of the implants, and the formation of calculus, indicates that they were functional as well as esthetic. The fragment is currently part of the Osteological Collection of the Peabody Museum of Archaeology and Ethnology at Harvard University.[8][35]"

"In modern times, a tooth replica implant was reported as early as 1969, but the polymethacrylate tooth analogue was encapsulated by soft tissue rather than osseointegrated.[38]"

There were previous attempts to add material on root analogue implants. Check the Talk history: Talk:Dental_implant, Talk:Dental_implant and Talk:Dental_implant. It is an entirely different paradigm; merging into the already sizable Dental Implants article would be confusing for readers. Here's a suggested alternative: look at the layout of the article on Engineering. There is a short summary of each branch, and then a link to the relevant article. This keeps the main article lean and readable, and leads the reader into relevant subsections. I propose a similar layout for the Dental Implants article. It would require some reorganization and rewriting, but I think clarity should be the main aim. Logicwhatelse (talk) 19:44, 21 January 2019 (UTC)


 * When it comes to engineering, that layout is suitable because chemical, civil, electrical, mechanical engineers have very different job natures. Tony85poon (talk) 07:55, 23 January 2019 (UTC)

Note I undid your merge because it it gave WP:UNDUE prominence to the Root analogue dental implant technique, and was also done during both an ongoing merge discussion and an AfD. I suggesting waiting until both disucssions are closed before attempting any merge actions.--Pontificalibus 13:56, 22 January 2019 (UTC)
 * We can't turn the clock back 3 or 5 years ago. https://www.grandviewresearch.com/industry-analysis/dental-implants-market says that in 2016, Titanium had 92.45% share. Zirconium was anticipated to be the fastest growing product. https://globenewswire.com/news-release/2019/01/22/1703455/0/en/Global-Osseointegration-Implants-Market-to-Surpass-US-10-2-Billion-by-2026.html says that "growing disposable income in countries such as India, China, and Australia, rising adoption of minimally invasive procedures, and advancement in healthcare facilities has supported overall growth of the osseointegration implants market." https://www.benzinga.com/pressreleases/19/01/r13002112/national-dental-now-offers-leading-full-arch-dental-implant-solution-t


 * The discussion started in August 2018, FIVE MONTHS ALREADY. Time and tide waits for no man. In determining proper weight, we consider a viewpoint's prevalence in reliable sources, not its prevalence among Wikipedia editors or the general public. Isn't it more efficient to read the 2 techniques one after the other? Why must readers click once more? Wikipedia is designed for readers with AVERAGE medical knowledge, not researchers or medical practitioners. Tony85poon (talk) 18:13, 22 January 2019 (UTC)

Oppose merge. COmpletely different topic. This is not just a yet another type of implant: this is a considerably different class of implants: the one not based on screws, and the article is large. We do not merge large articles; just the opposite: we split them. Staszek Lem (talk) 20:58, 22 January 2019 (UTC)
 * Support - changed opinion after recent developments. Staszek Lem (talk) 19:38, 25 January 2019 (UTC)


 * I agree that Copper and Hormonal IUDs are different, but disagree that (from the eyes of layman) titanium (atomic number 22) is different from zircon (atomic number 40). Heck, they actually are close in the periodic table. The loading speed of 92,258 bytes is tolerable. Feel free to throw in to make this article smaller. "Overlap: There are two or more pages on related subjects that have a large overlap." It is NOT rocket science. The question goes like this: After I instruct the dentist to remove my tooth, should I immediately replace it with RAI while the tooth socket is still fresh, or should I just let the tooth socket heal itself? I feel fine with you asking an administrator to protect the article (that ordinary editors cannot edit the article). The latest development at Articles_for_deletion/Root_analogue_dental_implant is that "A loose noose", "Gsingh", "Pontificalibus" are in favor of merging. Oh yes! Someone should remove the referenced RAI content. Tony85poon (talk) 03:21, 23 January 2019 (UTC)


 * Please place your signature AFTER ALL your text. This is second time I am moppin after you. Staszek Lem (talk) 02:58, 23 January 2019 (UTC)
 * Before you waste your time with other nice tables and languages, please read and understand MERGEREASON. Staszek Lem (talk) 02:58, 23 January 2019 (UTC)
 * is Dental implant not in favor of your merging. Staszek Lem (talk) 20:41, 23 January 2019 (UTC)


 * comment Root analogue dental implant why should it not have its own article?...(should indicate I rarely do 'dental articles')--Ozzie10aaaa (talk) 11:39, 24 January 2019 (UTC) It is because of WP:OVERLAP. Tony85poon (talk) 07:41, 25 January 2019 (UTC)
 * Sure merge In fact it was already merged. Needs references though. Doc James (talk · contribs · email) 18:07, 25 January 2019 (UTC)
 * The merge was reverted per WP:UNDUE, because this promising but still fringe technique occupied half an article. In the current state it can be definitely merged, with more trimming, to eliminate undue promotion.
 * Will you please give your reasons? In wikipedia, we do not vote, we !vote, and the closing admin must judge arguments, not head count. Staszek Lem (talk) 18:22, 25 January 2019 (UTC)
 * Once all the promotion is trimmed will probably leave a couple of paragraphs left. Than it will not be undue weight.
 * Currently there is not really anything in the Root analogue dental implant that is not already in the dental implant article. Doc James  (talk · contribs · email) 18:25, 25 January 2019 (UTC)

Should Dental Implant and Root Analogue Dental Implant be merged altogether? Tony85poon (talk) 00:13, 27 January 2019 (UTC) I have made three improvements and summarize here so everyone can pickup: A Message to the Koreans: kindly review ko:덴탈임플란트 after expanding with RAI content. Would a Russian offer to help please? The Russian counter-page was reverted. Tony85poon (talk) 01:19, 3 February 2019 (UTC)
 * 1) Expanded the Portuguese pt:Implantodontia and Dutch nl:Tandimplantaat counter-pages, will try expanding Russian soon;
 * 2) Created a page at Wikimedia Commons sister project. In any event, you can easily find all the RAI images (except the GIF) and videos;
 * 3) Moved pre-1981 history to History of dental treatments. Tony85poon (talk) 04:24, 30 January 2019 (UTC)


 * I support the already-done merge. Without the promotional text, the resulting paragraphs do not seem to be causing undue weight in the >70,000 byte long article. ~ ToBeFree (talk) 16:57, 9 February 2019 (UTC)

Medical slang question
What exactly is pre-operational CT/DVT scan? I know CT means CAT scan, but DVT usually means deep vein thrombosis which should not have relevance with dentistry, or is there? Tony85poon (talk) 07:39, 22 January 2019 (UTC)
 * DVT scan removed. Staszek Lem (talk) 20:44, 23 January 2019 (UTC)