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J Indian Soc PeriodontolJ Indian Soc PeriodontolJISPJournal of Indian Society of Periodontology0972-124X0975-1580Medknow Publications & Media Pvt Ltd India JISP-22-28810.4103/jisp.jisp_420_18Secretary's MessageJudicious efforts required in preserving the natural teeth Kolte Abhay Secretary, Indian Society of Periodontology, Professor and Head, Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Digdoh Hills, Hingna Road, Nagpur, Maharashtra, India. E-mail: drabhaypkolte@gmail.comJul-Aug 2018 22 4 288 289 Copyright: © 2018 Journal of Indian Society of Periodontology2018This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
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Dear Friends,

We live in a fast and competitive world where everybody is eager to succeed under all the circumstances. If we consider our profession many a clinician has been swayed by the so-called success rates of dental implants mentioned in the literature and in our practices. This has led to clinicians opting for dental implant therapeutics more often than ever and above all the manufacturing and marketing companies with their aggressive strategies have led to a widespread utilization of this modality. It is but natural that in such a scenario some of the clinicians are attracted in to an indiscriminate use of this therapeutic modality in many situations which otherwise could have been avoided with preservation of the natural dentition.

Periodontal diseases or other conditions which lead to a structural breakdown of the natural teeth are the commonest situations where the clinicians when with the slightest doubt about the prognosis would insist on replacement of the teeth with an implant. This is as if the artificial substitute would not be vulnerable for disease ingress thereby affecting the health and longevity of implant. It is really a matter of concern if such extractions are justified without the exhaustion of other treatment modalities for salvaging the natural teeth. Dental implants a few years ago were considered as a treatment option for partially or completely edentulous patients thus propagating the necessity, importance and usefulness of the natural teeth. But many of us do not realize when we over enthusiastically and conveniently leave aside the ethics and the basic principles of other treatment modalities. This could also be coupled with increased patient demands accrued through inadequate knowledge, media information and other promotional activities.

Even the literature inundates evidence regarding the long-term success of periodontally affected teeth or those conserved through restorative attempts. It must be emphasized that a natural tooth inherits superiority due to the presence of a functional proprioceptive periodontal ligament which under no circumstances can be replicated by an implant. In good oral health, the annual bone loss around implants is considerably higher than those of teeth. It has also been suggested by many authors that optimum periodontal care is a key feature in arresting progressive bone loss in periodontally compromised situations thus enhancing the life of the tooth which eventually can be replaced by an implant.

At the same time, it has to be noted that many of the failures in dental implant therapeutics have not been reported and majority of the patients do not turn up for regular follow up. Currently and especially in our country many clinicians are not aware about the biomechanical failures in implant therapy and are in deep slumber regarding the maintenance of implant hygiene and problems of peri implant diseases. As we move on, the complications in implant therapy would be more visible and will be required to be taken care of on a regular basis.

It is an apt time to educate our professional colleagues about the need to salvage the natural dentition as far as possible so that we do not overstep in our quest to satisfy the unrealistic needs and expectations of our patients. Dental implants are an excellent therapeutic modality but an indiscriminate use will definitely cause a great amount of disrepute to the modality. It is our collective responsibility to lead the charge in creating awareness in judicious utilization of therapeutic procedures and in offering the best suitable treatment to our patients.

A small and positive initiative and effort in this direction will ensure an overall good health of the society in times to come.

ISPecially Yours