Teaching Implant Dentistry in the Predoctoral Curriculum: A Report from the ADEA Implant Workshop’s Survey of Deans

In 2004, a survey of the deans of U.S. and Canadian dental schools was conducted to determine the implant dentistry curriculum structure and the extent of incorporating implant dentistry clinical treatment into predoctoral programs. The questionnaire was mailed to the deans of the fifty-six dental schools in advance of the ADEA Implant Workshop conference held in Arizona in November 2004. Out of the fifty-six, thirty-nine responded, yielding a response rate of 70 percent. Thirty-eight schools (97 percent) reported that their students received didactic instruction in dental implants, while one school (3 percent) said that its students did not. Thirty schools (86 percent) reported that their students received clinical experience, while five schools (14 percent) reported that theirs did not. Four schools (10 percent) did not respond to this question. Fifty-one percent of the students actually receive the clinical experience in restoring implants, with the range of 5–100 percent. Of those schools that provide clinical experience in restoring implants, four schools (13 percent) reported that it is a requirement for them, while twenty-eight schools (88 percent) reported that it is not a requirement for them. Three schools (9 percent) did not respond. The fee for implants is 45 percent higher than a crown or a denture, with a range of 0–100 percent. Twenty-nine schools (85 percent) indicated that they did receive free components from implant companies, while five schools (15 percent) did not. The conclusions of this report are as follows: 1) most schools have advanced dental education programs; 2) single-tooth implant restorations are performed at the predoctoral level in most schools; 3) implant-retained overdenture prostheses are performed at the predoctoral level in most schools; 4) there is no predoctoral clinical competency requirement for surgical implant placement in all schools that responded to the survey; 5) there is no predoctoral clinical competency requirement for implant prosthodontics in most schools that responded to the survey; 6) prosthodontic specialty faculty are often responsible for teaching implant prosthodontics at the predoctoral level; 7) periodontics and oral and maxillofacial faculty are commonly responsible for teaching implant surgery at the predoctoral level; 8) support from implant companies is common for dental schools, with most providing for implant components at discounted costs; and 9) there is a lack of adequately trained faculty in implant dentistry, which is a significant challenge in providing predoctoral students with clinical experience with dental implants.

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The use of oral implants in the rehabilitation of partially dentate and completely edentulous jaws has been a well-established and accepted contemporary clinical method due to its success and predictability.¹ In 1988, a symposium was held in Toronto on the topic “Towards Optimized Treatment Outcomes for Dental Implants.” Following this symposium, a consensus report was developed delineating the criteria that should be used with clinical trials evaluating the efficacy of implant therapy. A careful assessment of these criteria will disclose that the discipline of implant dentistry has indeed matured tremendously in the past two decades.² Although postgraduate continuing education courses are increasingly available, the need to include additional courses in implant dentistry in the dental school curriculum remains. Most dental schools here and abroad now do offer a few lectures and/or a didactic course in implant dentistry.³ A survey conducted by Lim et al. in 2002 revealed that 84 percent of the responding U.S. dental schools required students to complete an implant dentistry course as part of their predoctoral training.³ Some allow predoctoral students to place implants.⁴

An informal meeting in the fall of 2003 took place at New York University School of Dentistry to discuss what could be done to increase the number of patients being treated with dental implants. All members agreed that, although there is a large number of patients who would benefit from implant therapy, particularly patients who are edentulous, few actually receive implants and implant prosthodontics.

Out of this preliminary meeting came the concept that increasing the hands-on implant dentistry knowledge imparted to dental students would increase the number of patients benefiting from dental implants. It was felt that if a student did not perform clinical implant care on a live patient, he or she was less likely to perform that care in practice. The dental literature indicates that there is a strong correlation for recent graduates between offering and restoring implants in their practice when an implant course was taken as part of their dental school curriculum.^5–8

Towards that end, those involved agreed to assemble an implant workshop involving all deans of U.S. and Canadian dental schools, as well as representatives of their surgical and prosthodontic faculty. At this workshop, action ideas for schools were to be generated across the various clinical disciplines and school boundaries to improve the care of fully and partially edentulous patients by increasing implant therapy. The results of this workshop will be published in a separate report.

Other goals of the ADEA Implant Workshop were to share instruction methods for predoctoral implant dentistry programs, including predoctoral curriculum information that would better facilitate additional training in implant prosthodontics while students are still in dental school. This report presents the results of an implant survey sent to the deans in advance of the workshop. The survey was intended to identify the then-current status of implant education and, particularly, the predoctoral students’ clinical experience with implant treatment.

Bradley J Engle, DMD MHS
5659 Naples Blvd
Naples, FL 34109

http://www.engleimplantdentistry.com
Tel: (239) 593-2178
Fax: (239) 593-2179
Email: info@engleimplantdentistry.com