Couple of decades ago there was the osseointegration revolution. Then there was the bone grafting one. The last decade has been all about two topics: Soft tissue management in the esthetic zone and Guided implant placement. Guides are pretty common place today but not ubiquitous, although they should be. Of course implants can be and are placed without guides. But if given a chance everyone would like to have a guide for ease of placement and greater accuracy. Then why don’t they? Mainly due to the additional cost and the complexity of working up the case using software. Well instead of having simplant or other CAD/CAM type guides made. Here is a guided case done with a local lab. The guide was made to the size of the final drill (nobel 4.5mm in this case). The telescoping pieces slide in and out to make the drill hole 2mm and 3.5mm in diameters for the intermediate drills. The precision placement allowed me to place this implant and immediately load it with a screw retained temporary crown for ideal soft tissue contours. The cost of the guide – $100. The two telescoping pieces are autoclavable and reusable for multiple cases. No need for the guided kits from nobel or straumann, etc. You can just use your normal surgical kit.
There are 318 implant manufacturers in existence today! That means tons of different connections, grooves, threads, tapers, collars, and surfaces. How to keep track of it all? Specially if you get a patient who has moved from another area of the country or the world for that matter. Or someone who had work done and can’t find their records and now you have to tighten a loose abutment or restore the over denture. Well I have come across two excellent resources and they are absolutely free! 
The powertome on the other hand creates too much noise for my liking. The luxators have very fine but yet durable tips that fit right into the PDL space. I take it all around the tooth going deeper each time until the tooth is loose. It is the quickest and easiest way to get that tooth out! (Atraumatically that is…) I even use it for wisdom teeth. Eventhough they are not elevators, and the manufacturer makes sure you are aware of that… it is hard to resist. This has led to multiple orders of the instruments as the tips will fracture or shred. So remember just apical forces and minimal torquing forces. Buy the plastic handled ones over the metal version and a pack of three maybe just as good to start. The real set comes as a pack of seven and has a greater variety of tips and angles. I find that I end up using three to four anyway most of the time. If you have picked up a drill to remove maxiallary teeth in the past five years then this bud is for you! 
Yes, this is the beginning of a whole new decade. TIME magazine wrote that the last decade would be remembered for 9/11, two wars, and two economic meltdowns. But I like to look on the positive side of things. To me the last decade was all about the iPod, iPhone and the iCAT. I use the iCAT for every implant case I do. It is unimaginable to me that this technology was just not available a few years back. I think it ranks right up there with the discovery of anesthesia and x-rays. This month a new textbook was released. It is comprehensive in scope and detailed in content and comes highly recommended based on previous editions. 
The company’s flagship product, which is in the final stages of development, is an Implant Location System (ILS) that uses a disposable micro-robot for carrying out dental implant procedures. The company promises that when this product hits the market, the process of getting dental implants will be less painful and less expensive.
Where will today’s implant companies be tomorrow?
This may not be absolutely critical to torquing down your implant practice today… but maybe tomorrow!! While we look for the right surface, taper, strength, and alloy research is producing some very interesting results. I always thought that stem cell application would start by creating a graft site and then seating the cells within, then guiding the tooth to occlusion orthodontically. It appears that at least some research has taken a different approach. Dr. Jeremy Mao of Columbia University has developed a tooth shaped scaffold which can be impregnated with stem cells resulting in a completely formed tooth in nine months. It’s in alpha testing now but makes me think of where the implant companies of today will be tomorrow? Read the full story here…