Implant dentistry: the bigger picture
by Rowan Thomas
Irish Dentistry talks to Sinead McEnhill about her approach to multidisciplinary planning in implant dentistry.
Name: Dr Sinead McEnhill
Qualifications: BDS MSc (Imp Dent) FCGDent MFGDP Adv Dip Imp Dent RCS(Eng) FICD
Practice: Belmore Dental Implant & Aesthetics Clinic in Enniskillen
Job role: Director and practice principal
Can you tell us a little about yourself and your practice?
I’m practice principal of Belmore Dental Implant & Aesthetics Clinic in Enniskillen. My work is centred on multidisciplinary treatment planning, based on the premise that most patients need a comprehensive assessment of their oral health.
My practice follows this same ethos, where the clinicians share their thoughts and often plan cases together, with the aim that nothing is missed, and to hopefully achieve the best possible outcome for the patient.
What made you want to focus on implants and digital dentistry?
I was lucky to be in dentistry when the digital age was being born. It has enabled so much more than ever before in terms of patients visualising their own outcomes, often with smile planning harmoniously integrated within their own facial scans and videos of their own facial movements.
In this way they can now be involved in every decision regarding how they smile, how they laugh and how they speak.
We have so many tools at our disposal now to enable us to plan and share information in a much more comprehensive fashion.
Implants are only one part of a case. We can no longer place an implant just because the space happens to be there, without first taking into consideration the other aspects of the patient’s dentition. We need to design the ultimate look – which might include orthodontics, stabilising their periodontal condition or doing something to rehabilitate their occlusion – prior to implants going into an ideal, planned position.
You’ve written a textbook on your approach to dentistry that’s about to be published. Can you tell us about it?
The book is aimed at clinicians who want to broaden their approach to implant treatment planning. It’s a multidisciplinary treatment planning book that involves assessment and diagnosis options for each individual case, including periodontal, aesthetic and functional risk assessments as well as the surgical component, which cannot be underestimated.
It provides a pathway through complex treatments, breaking them down into individual learning points, where the patient is central to the decision-making process.
What constitutes a good implant system in your opinion?
Every implant has its own individual design aspects such as a certain type of surface or a particular connection. The design of the implant is important because this will also dictate the position and emergence of the implant, how it is restored and how well it is going to support the soft tissue.
My choice of implant or implant system is dependent upon the case at hand, and will be swayed by many factors including the type of surface, the connection, and its length, particularly in more difficult anatomical areas.
What about the restorative side of implants? Which materials do you use in your daily practice?
I use many of GC’s materials. There’s such a broad portfolio of incredible products there. I favour using GC’s bonding agents with its composite materials and I often put my patients into long-term provisionals using G-aenial Universal Injectable flowable composite.
I use the Initial Lisi block made from fully crystallised lithium disilicate to complete many of my restorations in rehabilitation cases involving implants. With Lisi blocks, I can also digitally mill my own crowns and veneers in-house, which is another massive bonus from a patient perspective.
With your comprehensive approach in mind, is it important to be able to access both implants and restorative materials from the same manufacturer?
For me, it’s about trust. I have used GC’s materials for years as they have always given me predictability and good clinical outcomes. With such a track record, it makes sense to try any new materials or equipment GC puts its name to. Its Aadva implant range is one such recent example, which has become another treatment plan option, particularly in areas where a shorter implant is required, such as the posterior mandible or maxilla.
GC is very customer-centric; its product specialists have always been extremely approachable to answer any questions and provide product information and I’ve had nothing but help in every aspect.
I believe the company cares about its dentists rather than just see us as a number, and that type of relationship is extremely important in today’s dentistry.
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