Science, Innovation and Education as Pillars of High-Quality Implant Dentistry: Overcoming Challenges through Innovation Dictates Trends

The evolution of implant dentistry since the discovery of the osseointegration concept has been remarkable [...]

Hypodontia [11], or using zygomatic anchored implants as a successful alternative option for graftless restoration of the severely resorbed maxilla, including immediate loading protocols [12]. Moreover, innovation might be the response to overcome challenges that demand a skillful solution as registered in a retrospective study, where the use of a low-resorption collagen membrane coverage produced comparable results to suturing when attempting to seal ruptured Schneiderian membranes [13].
Innovation in implant dentistry includes methods, comprising both surgical [14] and prosthetic preparation techniques [15,16], post-operative interventions to increase implant stability [17], or new methods of measuring peri-implant bone [18], aiming to increase the probability of success in the long term. Innovation in implant dentistry also includes new materials and surface treatments. One such material is Polyetheretherketone (PEEK), considered a prime candidate to replace metallic implants and prostheses in orthopedic, spine and cranio-maxillofacial surgeries [19]. Additionally, substantial research efforts are undertaken in the development of bioactive implant surfaces, combining antimicrobial activity with osteogenic capacity to achieve correct osseointegration and long-term stability [20,21]. Innovation in implant dentistry is paramount, but only when the benefits are incremental or exponential when compared to the state-of-the-art. This makes it mandatory to perform comparisons between techniques in order to validate new methods, to otherwise account for reproducibility of current methods if no incremental gain is registered [22,23], or to evaluate the impact of previous methods in the long-term [24]. In any of the three scenarios, science emerges victorious.
The connection of a final implant-supported fixed prosthesis allowing high satisfaction of both patient and clinician stands as a landmark for success. However, it does not guarantee the maintenance of success in the long term. Peri-implant pathology (otherwise known as peri-implantitis, including all the anecdotal connections to imply a disease process similar to periodontitis-which is not!) [25,26] is regarded as the primary process for late implant failure. Therefore, it is important to develop tools that provide risk assessment based on science and data (rather than opinions), to enable both clinicians and patients to produce the necessary changes that increase the probability of success. The risk assessment tool for peri-implant pathology published in this Special Issue is the first in implant dentistry to be validated, registering an excellent discriminating capacity for indicating which patients were at greater risk during a five-year post-surgery follow-up period [27]. Moreover, this risk assessment tool was made open access through the Foundation for Oral Rehabilitation (https://www.for.org/en/treat/peri-implant-pathology-risk-assessment/take). Even when delivering high quality restorations and attempting to control potential risk factors, peri-implant pathology can occur. This poses a significant challenge for the recovery of the peri-implant complex, due to both the doubts concerning current treatments [28] and the early stage of the development of new treatments [29]. The first prognostic model for implants with peri-implant disease to be derived and validated in implant dentistry was published in this Special Issue, being useful to understand the prognosis of the implant(s) in question and shed light on the possible (favorable or unfavorable) outcomes [30].
Finally, there is education, whose absence would render translational science impossible or meaningless. A narrative review published in this Special Issue discusses the evolution of training and education in implant dentistry. The authors forecast a rapid evolution over the next decade, as technologies already being used in other industries (displayed and discussed in the manuscript) are incorporated into new and innovative learning models [31]. Furthermore, the merging of technological innovations is suggested to culminate in "Digital Dentistry", which in turn will render "Digital Education of Digital Dentistry" inevitable.
It can be interpreted from the present Editorial (written as a summary of the 28 published manuscripts) that the present Special Issue provides an insightful reading to contemporary and future implant dentistry. The complete collection is provided open access for the reader to explore. For this to be possible, we must acknowledge the effort of all authors and reviewers that contributed for this Special Issue, whose commitment is deeply appreciated. Happy reading!

Conflicts of Interest:
The author declares no conflicts of interest.