Gum Diseases

Bone grafting with soft tissue

05/04/2008 01:36PM

Question:

A month ago I had bone grafting done on two sides of my mouth to prepare for implant placement. The procedure was done by a Prosthodontist who is also an implantologist, who works as a team with my primary Prosthodontist. Since I am doing a full mouth reconstruction, I was told I would also need a bone grafting with soft tissue placement (due to gum recession) in the front. I am concerned if this should be done by a Periodontist. Are implantologist also trained in procedures such as soft tissue placement?

Answer:

I am so glad that you are questioning this as a patient. As far as specialities go in USA (and in most of the countries), there is no dental speciality called "implantologist" - meaning none of the universities can offer implantology certificate. They can offer one or two years training programs, but implantology is not accepted as a speciality by American Dental Association and by European schools (at least not yet). And unfortunately, most of the time, a shorter and not formal training can be obtained through implant companies.
Implant placement related surgeries are generally performed by an oral surgeon or a periodontist (especially for full mouth rehabilitation). Also, some of the "advanced general dentistry" programs may offer training for the surgical component. A prosthodontist is responsible for the fabrication of implant supported restorations (especially for full mouth rehabilitation).
I should also point out that it is not illegal for a general dentist or prosthodontist to perform oral surgeries including bone grafting etc. However, as you are questioning, a periodontist who spends three extra years in graduate school and concentrates his/her work only to save teeth and regenerate lost hard and soft tissue would have more experience to manage these types of problems.
A prosthodontist should be the best option to design implant supported restorations and fabricate them for the best treatment outcome. And fortunately, it generally works this way and we practice as a team.

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Response by:

Binnaz Leblebicioglu, DDS, MS, PhD
Assistant Professor
Section of Periodontology
College of Dentistry
The Ohio State University