Implantology in Ireland—A dental specialty with tradition

The Blackrock Clinic in Dublin, in association with Trinity College Dublin and Prof. Daniel van Steenberghe at KU Leuven in Belgium, became a centre for the provision of advanced courses given by Prof. Brånemark, with colleagues from over 40 countries attending. This collaboration continued over the years in the areas of research, teaching and the treatment of patients with large maxillofacial defects and at the European Osseointegration Training Center based in Leuven.

Today, oral rehabilitation by means of osseointegrated implants is widely available in both private clinics and academic institutions in the Republic of Ireland. Specialists, prosthodontists, periodontists, oral surgeons and maxillofacial surgeons are extensively involved in the provision of basic and advanced treatments. A small number of general dental practitioners carry out implant surgery and a larger number choose to provide restorations on implants placed by specialists. In the vast majority of cases, a team approach is encouraged and favoured, with only a small number of practitioners carrying out both aspects in more straightforward cases.

In Ireland, implant dentistry is not recognised as a specialty in its own right, nor is there any proposal to do so at the moment. It is appreciated that in some European countries such a specialty exists and, occasionally, some of these dentists from the European Union set up practice in Ireland. The Dental Council of Ireland, who is the competent authority for registration in Ireland, does not permit the registration or the use of the term “implant specialist”. A view has been taken in Ireland that the range of competencies required to provide the full spectrum of treatment, both prosthodontic and surgical, from straightforward selected single-implant cases to full mouth rehabilitation involving advanced surgical procedures, such as large autogenous bone grafts and zygomatic implants, is too wide to allow for this. The successful treatment of some patients will require all the skills and training of collaborating specialists to provide optimum patient care.

Training programmes in implant procedures are available from various sources in Ireland. Implantology is, however, considered a postgraduate subject. Comprehensive training in implant procedures is an important component of the specialty training programmes provided by universities.

Undergraduates have access to lectures and demonstrations. They are also assisted in the treatment of patients and many may have a supervised opportunity to carry out a restoration on an implant. The focus is to provide undergraduates with a thorough understanding of the role of implants in dental practice and the range of skills that may be required for successful diagnosis, treatment and maintenance. This allows them to understand what will be involved in continuing their training after graduation. The emphasis is always on the value of a team approach in providing the best care for patients.

Basic training courses for general practitioners are available as well. They are often sponsored by different companies and are provided by specialists. These events include short courses on restoration and extended courses on surgery. Some practitioners choose to travel abroad for training, whereas others prefer to avail of local training with specialists who usually provide a mentoring service or membership of a study group to help with diagnosis and determining the suitability of cases for treatment. This latter approach is particularly helpful to the novice surgeon or prosthodontist, as it allows for a gradual, ongoing transfer of knowledge as experience builds up.

Continuing professional development in implantology is well catered for with the provision of excellent lecture programmes at Trinity College Dublin, University College Cork and the Faculty of Dentistry at the Royal College of Surgeons in Ireland, often with the help of a prestigious international faculty. Additionally, implant dentistry features regularly in the scientific programmes promoted by the Irish Dental Association and the various specialist societies. Many specialists have completed their training abroad in USA, the UK and other regions in Europe. This has greatly enriched the knowledge pool for teaching and practice. Irish dentists are also enthusiastic attendees and contributors at the larger overseas implant meetings in both the USA and Europe, especially the EAO.

Over the years, implant companies have always been encouraged to support the organisations listed above rather than providing direct training courses themselves and this has worked to the advantage of all concerned. From time to time, companies will have open meetings with overseas speakers to promote a new product or technique.

Patients and dentists in Ireland have benefited from the early involvement in this exciting treatment modality, as well the generous and helpful collaboration with many of the implant pioneers over the years. Ireland was among the first countries to host an EAO meeting and the return of EAO to Dublin in 2013 is especially welcome. The training and regulatory structures outlined above have worked well for the small country. It has ensured a high standard of treatment and care for patients, as well as professional and excellent collaboration between the various dental professionals and laboratories involved.