Laureen Langer: Thirty years of osseointegration in private practice - what have we learned

In this lecture, Dr Langer reviews implant dentistry over a 30 years time frame with almost 40.000 implants placed, and underlining with comprehensive literature support, with a focus on the treatment objectves predictability, beauty and longevity. The lecture discusses aspects of screw- and cement-retained restorations, implant surface design, immediate vs delayed placement, and their influence on potential complications, such as recessions, bone loss, peri-implantitis. Some thoughts and dogmas have changed over the last decades, some other still may need rethinking, and Dr Langer discusses the advantages and disadvantages of the evolving technologies and protocols over time. Moderately rough surfaces have shown to decrease early implant losses, and Dr Langer prefers those in combination with a smooth collar design. Immediate placement offers several advantages such as minimizing treatment time and number of interventions, capitalizing on the healing capabilities of a fresh extraction socket, with equal or even improved survival rates in comparison to delayed placement. In an ageing population remaining natural teeth at times tend to show more ageing than adjacent implants, such as tissue recession, caries and discoloration.