1. Struggles and Successes

When too many people agree on the same subject, it is high time to call it into question. Few other areas of medicine are better characterized by this statement than dental implantology. Why? Because both academic “researchers” and practitioners focus their efforts solely on crestal implants. In other words, they completely ignore any designs or concepts other than screws and cylinders, which guide the masticatory forces, into bone areas that mainly consist of cancellous tissue. If the available vertical bone supply is insufficient, measures are taken to rebuild the morphology of the bone tissue – whether by transplantation, by augmentation or by induced growth. Unless aesthetic considerations play a major role, these modifications of the bone situation are performed solely to facilitate the use of crestal implants, which would be impossible to insert otherwise. In many cases, these adjuvant measures are considerably more time-consuming and more expensive than the patient can afford. Meanwhile, no implant treatment is performed whatsoever, and the patient is left without an adequate fixed restoration. At the same time, the focus of dental implant treatment tends to shift away from the dental offices as these adjuvant measures gain respectability, towards the specialists capable of performing them. Due to the additional cost of these adjuvant measures, many patients are unable to afford adequate implant treatment. The consequence is that their masticatory function cannot be restored in a truly comprehensive manner.