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Thursday, Aug. 30, 2012

Dentists take proactive course to correct large number of poor implants

Kyodo

While dental implant surgery may be deemed by many as a groundbreaking option for restoring missing teeth, there is after all no tooth fairy and the surgery can involve risks, just as in any other surgical operation, experts warn.

Over a five-year period from fiscal 2006, the National Consumer Affairs Center of Japan received 343 reports related to postoperative problems such as lingering swelling and pain. Some patients even suffered from neurolysis, a destruction of nerve tissue.

Various associations formed by dentists and oral surgeons have set out to investigate the situation and are devising ways to improve treatment standards as well as raise public awareness.

The steps include compiling treatment guidelines for surgeons and creating a notebook for patients to keep records of their treatment.

Developed in Europe, dental implant surgery gained popularity in Japan in the 1970s and 1980s, with the average cost to implant one tooth running ¥300,000 to ¥400,000.

The problem lies in the way such surgery has spread in Japan, experts say. The method was disseminated through direct promotion by medical device makers to dentists running private clinics, rather than through standardized training procedures at medical universities and institutions.

As a result, there may be gaps in the quality of treatment provided, officials at the consumer affairs center said.

According to the Japanese Academy of Maxillofacial Implants, formed mainly by oral surgeons at university hospitals, doctors at 74 medical facilities accredited by the group had to treat 421 patients for serious postsurgery problems between 2009 and 2011.

Among them, about 38 percent involved paralysis caused by nerve injury during surgery, followed by the intrusion of the implant into sinus passages. The majority of the problem cases were caused at private dental clinics, the doctors said.

In light of the findings, the group has created a prototype notebook for patients, with the implant's exact location, size, manufacturer and other crucial information to be filled in by the dentist conducting the surgery.

The notebook includes a column for the patient's medication records as a precaution against complications, such as for those taking medicine for osteoporosis.

The notebook is designed to help patients seek second opinions and receive treatment from university hospitals and other established facilities at an early stage if they experience problems.

Getting treatment early is a huge boost to the chances of recovery, the academy said.

Experts say patients must understand that implant treatment is a surgical operation that involves fusing the titanium implant into the jawbone. It comes with a risk, especially in the case of the lower jawbone, where nerves and blood vessels are located.

"People shouldn't just think of it as they do with dentures," said Kanichi Seto, president of the Japanese Academy of Maxillofacial Implants and director of the oral cancer treatment center at Minami Tohoku Hospital.



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