CBCT at Its Best: Get Involved

Dr. Kunal Shah is the Principal of a new practice in Hendon, London – LeoDental. With a state-of-the-art CBCT installed, the practice is receiving referrals for implant planning cases. Completing his series of articles looking at the use and benefits of CBCT in implant treatment, Kunal explores where dentists can start when getting involved with implantology, highlighting the importance of mentorship.

Unlike other areas of dentistry, there is no clear path to follow when looking to get involved in implantology. It is often down to the individual to seek the appropriate training through courses and postgraduate qualifications that satisfy the GDC’s requirement for implant dentists to be competent in the field.

When looking for an initial training course, I would recommend asking the following questions in order to overcome some of the hurdles I faced:

• What does the course entail? What do you gain at the end of it? – You need to establish whether you’re looking for a qualification or clinical experience, as this will determine what type of training you chose. The qualification courses tend to be the MScs and Diplomas, which are heavily theory-based, while others are more clinical and practical-based. I personally preferred the clinical element – as a dentist, you already have knowledge of the anatomy, so implantology is simply building on this. I also believe you need practical experience to develop your skills, learn from your mistakes and understand the different scenarios that can occur in practice.

• What implant system will you use? – It’s important to select a reputable system, with evidence and history behind it. I also think it’s helpful to use a system that other dentists are familiar with, so colleagues are likely to be able to answer any queries you might have and help you with any hurdles you may face.

• How much is the course? – It’s true that you get what you pay for, but be careful not to pay over the odds for training. Whether a course meets your objectives is most important, but compare a few courses making a decision.

• Does the course provide patients? – If the course provides patients, you need to know how many, but also how many implants (single or multiple) you will place in addition to the restorative element and which technicians you will use. If you need to find our own patients, make sure you have access to those who are interested in the treatment. Either way, the more implants you place while learning, the more confidence you’ll build in your own skills.

Before, during and after training, a clinical mentor is invaluable. They will be a great source of information and support when you come to start your first few implant cases. The implantologist I currently work with is highly experienced and it shows; he’s seen more pitfalls and complications and shares this information to help us avoid the same problems in our own surgeries. I have more experience with technologies and current techniques, which I am able to bring to our cases. We work well together and we help each other out – that’s what effective mentorship is.

From this, I have developed an appreciation for working with others and sharing information and experience. I am therefore very interested in and have begun working with other practitioners to help mentor them through cases. I do not charge for this, because I see the value in building professional relationships – dentists simply refer an implant case to me and we work through it together from planning to surgery and follow-up.

Regardless of your experience level in dental implantology, I believe a CBCT is a must. You simply cannot plan to the same level of detail without it. It also offers support from a medico-legal perspective, should a case ever be questioned – you’ll have the evidence you need to justify why you did what you did.

There is no reason for not utilizing CBCT scans in implant dentistry today. The machines are readily available and they are becoming more affordable for all practices. For those just starting out with implants or smaller practices, you can refer a patient for a CBCT scan for a minimal fee. This also means you can make the most of cutting-edge technologies, without financial investment. I use the CS 8100 3D from Carestream Dental, which delivers outstanding image clarity for superior diagnostics and planning procedures, helping to minimize surgery time and the risk of any complications. I simply cannot fault the technology.

If you are in a position to purchase your own CBCT, it’s necessary to think about whether a system is open or closed, what it provides, how easy it is to use, the radiation dosage and what technical support and training is available from the supplier.

However you decide to get started, dental implantology offers a world of opportunity. Just be sure to get the right training for you, seek the support and guidance of a more experienced professional and utilize the very best technology for safe and effective treatment of every time.