8+ Best Implant Experts: Oral Surgeon vs. Periodontist


8+ Best Implant Experts: Oral Surgeon vs. Periodontist

Selecting between a periodontist and an oral surgeon for dental implant placement could be a complicated resolution. Each specialists have superior coaching, however their focuses differ barely. Periodontists specialize within the gums, supporting constructions of tooth, and ailments affecting them. They routinely carry out surgical procedures, together with implants. Oral surgeons, however, concentrate on a wider vary of surgical procedures for the mouth, jaw, and face, together with dental implant placement and knowledge tooth extraction.

Applicable specialist choice can considerably affect the long-term success and stability of implants. Components such because the affected person’s particular wants (bone grafting, sinus raise, complicated anatomical issues) and general oral well being play an important position in figuring out probably the most appropriate practitioner. Traditionally, each specialties have contributed considerably to the development of implant dentistry. As implant expertise has advanced, each periodontists and oral surgeons have adopted and refined strategies to make sure optimum affected person outcomes.

This dialogue will delve deeper into the precise coaching, experience, and typical procedures carried out by every specialist. Additional, it’s going to discover related elements sufferers ought to take into account when making this necessary healthcare resolution. Lastly, the article will spotlight the significance of consulting with each specialists to acquire complete evaluations and customized therapy plans.

1. Coaching

The coaching pathways for oral surgeons and periodontists, whereas overlapping in some surgical facets, diverge of their core focus. Oral surgeons bear 4 to 6 years of post-doctoral surgical coaching, encompassing a variety of procedures associated to the mouth, jaw, and face. This broad scope equips them to deal with complicated extractions, facial trauma, and reconstructive surgical procedure, along with dental implant placement. Periodontists, after dental faculty, full three years of specialised coaching centered on the prevention, prognosis, and therapy of periodontal illness and the position and upkeep of dental implants. This concentrated coaching emphasizes the intricate relationship between gum well being, bone construction, and implant success.

The differing coaching emphasis influences every specialist’s strategy to implant dentistry. An oral surgeon’s in depth surgical background gives a powerful basis for dealing with complicated implant circumstances, similar to these requiring important bone grafting or sinus lifts. For instance, a affected person with extreme bone atrophy within the higher jaw would possibly profit from an oral surgeon’s experience in sinus augmentation. A periodontist’s specialised coaching in gum well being and supporting constructions gives benefits in circumstances involving periodontal illness or gentle tissue administration. As an example, a affected person with energetic gum illness would profit from a periodontist’s experience in controlling the an infection earlier than and after implant placement.

Understanding these distinct coaching pathways gives beneficial perception into the strengths of every specialist. Whereas each are certified to put dental implants, their particular coaching influences their strategy and experience in managing totally different medical eventualities. This underscores the significance of complete consultations with each specialists to find out probably the most acceptable practitioner for particular person affected person wants and complexities.

2. Specialization

The specialization of oral surgeons and periodontists performs an important position in figuring out their suitability for particular implant circumstances. Whereas each possess the surgical abilities vital for implant placement, their centered areas of experience differentiate their approaches and the kinds of circumstances they usually deal with.

  • Advanced Surgical Procedures:

    Oral surgeons routinely carry out complicated surgical procedures involving the mouth, jaw, and face. This experience interprets to proficiency in managing difficult implant circumstances requiring bone grafting, sinus lifts, or nerve repositioning. As an example, sufferers with important bone loss within the jaw might require in depth bone grafting previous to implant placement, a process usually finest managed by an oral surgeon attributable to their in depth coaching in these strategies. This specialised ability set permits them to handle complicated anatomical challenges and guarantee a secure basis for the implants.

  • Tender Tissue Administration:

    Periodontists specialize within the prognosis, therapy, and prevention of gum illness and different situations affecting the gentle tissues supporting the tooth. This experience makes them notably well-suited for managing the gentle tissue facets of implant placement, guaranteeing optimum aesthetics and long-term gum well being across the implants. For instance, a affected person with skinny gums would possibly profit from a periodontist’s specialised information in gentle tissue grafting strategies to create a thicker, more healthy gum line across the implant.

  • Full Arch Rehabilitation:

    Each oral surgeons and periodontists can carry out full arch rehabilitation utilizing implant-supported dentures or bridges. Nonetheless, the selection of specialist might rely upon the complexity of the case. Instances requiring in depth bone grafting or different complicated surgical procedures is perhaps higher fitted to an oral surgeon, whereas circumstances centered on optimizing gum well being and aesthetics would possibly profit from a periodontist’s specialised information.

  • Administration of Peri-Implantitis:

    Peri-implantitis, an inflammatory situation affecting the tissues surrounding dental implants, requires specialised administration. Whereas each specialists can diagnose and deal with this situation, a periodontist’s centered coaching in gum well being and illness administration usually makes them the popular selection for complicated peri-implantitis circumstances. Their experience in non-surgical and surgical periodontal therapies gives a complete strategy to managing this situation and preserving the long-term well being of the implants.

Contemplating these specializations, the perfect selection between an oral surgeon and a periodontist relies upon closely on particular person affected person wants and the complexity of the case. Sufferers presenting with important bone loss, complicated anatomical challenges, or the necessity for in depth surgical procedures might profit from the experience of an oral surgeon. Sufferers with issues primarily associated to gum well being, aesthetics, or the administration of periodontal illness might discover a periodontist higher suited to their wants. Consulting with each specialists permits for a complete analysis and customized therapy planning, resulting in optimum outcomes and long-term implant success.

3. Surgical Experience

Surgical experience performs a pivotal position within the success of dental implant procedures. Each oral surgeons and periodontists possess superior surgical abilities, but their particular areas of experience affect their strategy to implant placement and the kinds of circumstances they’re finest outfitted to deal with. Evaluating surgical experience requires consideration of the complexity of the process, the necessity for ancillary procedures like bone grafting, and the administration of potential problems.

Oral surgeons, attributable to their in depth coaching in a variety of surgical procedures involving the mouth, jaw, and face, usually deal with complicated implant circumstances requiring superior surgical strategies. As an example, sufferers with important bone loss or complicated anatomical issues might profit from an oral surgeon’s expertise in procedures like sinus lifts, bone grafts, and nerve repositioning. These procedures require a excessive degree of surgical precision and experience to make sure the long-term stability and success of the implants. A case requiring a zygomatic implant, which anchors to the cheekbone, usually necessitates the specialised surgical skillset of an oral surgeon.

Periodontists possess specialised surgical experience within the space of gum well being and the supporting constructions of tooth. This specialised coaching makes them adept at managing the gentle tissue facets of implant placement, similar to creating ideally suited gum contours and guaranteeing correct therapeutic across the implant. They’re additionally expert in managing problems like peri-implantitis, an inflammatory situation affecting the tissues surrounding dental implants. A affected person requiring a gingival graft to extend gum thickness round an implant would profit from a periodontist’s experience on this space.

Finally, probably the most acceptable specialist relies on the person affected person’s wants and the precise complexities of the case. A radical analysis by each an oral surgeon and a periodontist gives sufferers with complete insights and permits for knowledgeable decision-making based mostly on their particular circumstances and desired outcomes.

4. Expertise with Implants

Expertise with implant placement is a vital issue when selecting between an oral surgeon and a periodontist. Whereas each specialists obtain surgical coaching, the quantity and kinds of implant procedures carried out can considerably affect outcomes. Excessive-volume practices usually correlate with refined surgical strategies, environment friendly workflows, and diminished complication charges. A practitioner who routinely locations quite a few implants develops a deeper understanding of varied implant programs, bone grafting supplies, and surgical approaches. For instance, an skilled implantologist will probably be more proficient at recognizing and managing potential problems similar to sinus perforations or nerve harm throughout surgical procedure.

Assessing a practitioners expertise includes inquiring in regards to the variety of implants positioned yearly, the kinds of implant circumstances dealt with (easy to complicated), and their familiarity with totally different implant programs. Moreover, understanding their strategy to persevering with training in implant dentistry displays a dedication to staying abreast of the newest developments and finest practices. A practitioner actively concerned in skilled growth and superior coaching demonstrates a dedication to refining their abilities and enhancing affected person outcomes. That is notably essential in a subject like implant dentistry, which is continually evolving with new applied sciences and strategies. As an example, expertise with guided implant surgical procedure, a computer-aided strategy to implant placement, can considerably enhance accuracy and scale back invasiveness.

Prioritizing expertise in implant placement contributes considerably to profitable outcomes. A practitioner’s observe document gives beneficial perception into their proficiency and talent to handle complicated circumstances. Whereas board certification in oral and maxillofacial surgical procedure or periodontics signifies a baseline degree of competency, in depth sensible expertise with implants in the end differentiates practitioners and strengthens their means to navigate difficult surgical eventualities and obtain optimum aesthetic and useful outcomes for sufferers.

5. Bone Grafting Proficiency

Bone grafting usually performs an important position in profitable dental implant placement, particularly in circumstances the place the jawbone lacks adequate density or quantity. The proficiency of a practitioner in varied bone grafting strategies turns into a major issue when selecting between an oral surgeon and a periodontist for implant placement. Understanding the nuances of various grafting supplies and procedures clarifies the strengths of every specialist.

  • Forms of Bone Grafts:

    Numerous bone grafting supplies exist, together with autografts (bone from the affected person’s personal physique), allografts (bone from a donor), xenografts (bone from an animal supply), and artificial bone substitutes. Every materials has particular properties associated to therapeutic time, integration with present bone, and potential problems. An skilled practitioner understands these nuances and selects probably the most acceptable materials based mostly on the person affected person’s wants and the precise traits of the defect being addressed. For instance, an autograft, whereas providing the very best potential for integration, requires a second surgical web site for harvesting the bone, including to the complexity of the process.

  • Methods for Bone Augmentation:

    Totally different strategies are employed for bone augmentation, together with socket preservation, sinus lifts, ridge augmentation, and block grafts. Every method addresses particular bone deficiencies and requires a specialised ability set. As an example, a sinus raise, which provides bone to the higher jaw within the space of the sinuses, is a fancy process usually carried out by oral surgeons attributable to their in depth surgical coaching within the facial space. Periodontists, whereas additionally able to performing sinus lifts, usually concentrate on much less invasive augmentation strategies like socket preservation, which helps preserve bone quantity after tooth extraction.

  • Development Components and Membranes:

    Using progress elements and membranes along side bone grafting can improve bone regeneration and enhance the success of implant integration. Development elements stimulate bone formation, whereas membranes act as obstacles to stop gentle tissue from encroaching on the grafting web site, selling optimum bone progress. Proficiency in using these adjunctive supplies requires specialised information and coaching of their software and potential interactions with varied grafting supplies.

  • Issues and Administration:

    Bone grafting, like all surgical process, carries potential dangers and problems. These can embody an infection, graft failure, nerve harm, and sinus problems within the case of sinus lifts. A practitioner’s expertise and proficiency in managing these problems is essential for guaranteeing affected person security and profitable outcomes. For instance, recognizing the early indicators of an infection and implementing acceptable therapy protocols can stop important morbidity and protect the integrity of the graft.

Proficiency in bone grafting strategies considerably impacts the success of dental implant procedures, particularly in sufferers with compromised bone high quality or amount. Whereas each oral surgeons and periodontists are educated in bone grafting procedures, their particular areas of experience and expertise affect the kinds of grafting strategies they generally carry out. Choosing the proper specialist includes rigorously evaluating their expertise with varied grafting supplies, strategies, and their means to handle potential problems. A radical session with each specialists permits sufferers to make knowledgeable choices based mostly on their particular person wants and the complexities of their case.

6. Tender Tissue Administration

Tender tissue administration performs an important position within the aesthetics and long-term success of dental implants. Wholesome gums present a significant basis for supporting the implants, guaranteeing correct perform and a natural-looking smile. The experience of a practitioner in gentle tissue grafting, administration of gum illness, and aesthetic issues considerably influences the selection between an oral surgeon and a periodontist for implant placement.

  • Gingival Grafting:

    Gingival grafting procedures increase the thickness and quantity of gum tissue round implants, enhancing aesthetics and defending the underlying bone. Skinny or receding gums can expose the implant floor, resulting in elevated threat of an infection and aesthetic issues. Periodontists usually have extra in depth expertise with varied gingival grafting strategies attributable to their specialization in gum well being. Whereas oral surgeons are able to performing these procedures, a periodontist’s centered coaching usually makes them the popular selection for complicated grafting circumstances.

  • Administration of Gum Illness:

    Pre-existing gum illness or the event of peri-implantitis (irritation across the implant) requires specialised administration to make sure implant success. Periodontists, as specialists in gum well being, are adept at diagnosing and treating these situations. Their experience in non-surgical and surgical periodontal therapies gives a complete strategy to controlling an infection and selling wholesome gum tissues across the implants. Whereas oral surgeons can tackle some facets of gum illness, a periodontist’s specialised information is usually vital for complicated circumstances or these requiring ongoing upkeep.

  • Aesthetic Concerns:

    Tender tissue administration considerably impacts the aesthetics of dental implants. Making a natural-looking gum line across the implant requires exact surgical abilities and an understanding of aesthetic rules. Periodontists usually prioritize aesthetics of their therapy planning, contemplating elements like gum symmetry, shade, and contour to attain optimum outcomes. Whereas oral surgeons additionally prioritize aesthetics, a periodontist’s specialised coaching in gum well being and aesthetics usually gives a bonus in reaching a harmonious and natural-looking smile.

  • Peri-Implant Tissue Well being:

    Sustaining wholesome peri-implant tissues (the gums surrounding the implant) is essential for long-term implant success. Common monitoring {and professional} cleanings are important to stop irritation and an infection. Periodontists concentrate on sustaining periodontal well being, making them well-suited for offering ongoing care and upkeep for dental implants. Their experience in detecting and managing early indicators of peri-implantitis can stop problems and make sure the longevity of the implants.

Tender tissue administration considerably influences each the aesthetic and useful outcomes of dental implant procedures. Whereas each oral surgeons and periodontists possess surgical abilities, a periodontist’s specialised coaching and expertise in gum well being and aesthetics usually make them the popular selection for circumstances requiring complicated gentle tissue administration or these the place aesthetics are a major concern. Nonetheless, the last word selection relies on particular person affected person wants and the precise complexities of the case. Consulting with each specialists gives a complete perspective and permits sufferers to make knowledgeable choices based mostly on their distinctive circumstances and desired outcomes.

7. Affected person Wants

Figuring out probably the most acceptable specialist for dental implant placement hinges considerably on particular person affected person wants. These wants embody a variety of things, from the complexity of the required process to the affected person’s general well being standing and aesthetic targets. Cautious consideration of those particular person wants guides the decision-making course of and ensures optimum therapy outcomes.

  • Medical Historical past and Present Well being:

    Sure medical situations, similar to uncontrolled diabetes or osteoporosis, can affect the therapeutic course of and affect the success of dental implants. Medicines, together with blood thinners and bisphosphonates, may have an effect on therapy planning and require cautious coordination with the affected person’s doctor. A radical medical historical past evaluation is essential for each oral surgeons and periodontists to evaluate potential dangers and tailor the therapy strategy accordingly. For instance, a affected person with a historical past of bleeding issues might require modifications to the surgical protocol to attenuate bleeding dangers.

  • Complexity of the Case:

    The complexity of the implant process itself performs a major position in specialist choice. Instances requiring in depth bone grafting, sinus lifts, or complicated anatomical issues usually profit from the experience of an oral surgeon attributable to their broader surgical coaching and expertise with complicated procedures. Much less complicated circumstances, similar to single implant placements in areas with satisfactory bone density, might be efficiently managed by both an oral surgeon or a periodontist. A affected person requiring a number of implants in an space with restricted bone quantity would possibly profit from an oral surgeon’s expertise in complicated bone grafting strategies.

  • Aesthetic Targets:

    Aesthetic issues, similar to the specified look of the ultimate restoration and the encircling gum tissues, affect specialist choice. Sufferers with excessive aesthetic calls for, notably within the seen entrance tooth space, might profit from a periodontist’s specialised information in gentle tissue administration and aesthetic gum contouring. Whereas oral surgeons additionally take into account aesthetics, a periodontist’s centered coaching in gum well being and aesthetics might be advantageous in reaching optimum beauty outcomes. A affected person involved about gum recession round present tooth would possibly favor a periodontist’s experience in gentle tissue grafting to make sure optimum aesthetics across the implant as properly.

  • Monetary Concerns and Entry to Care:

    Price and insurance coverage protection can affect a affected person’s selection of specialist. Charges for implant procedures can fluctuate relying on the specialist, the complexity of the case, and the geographic location. Insurance coverage protection for implant procedures additionally varies, and sufferers want to grasp their protection limitations and out-of-pocket bills. Moreover, accessibility to care, together with workplace location and appointment availability, can play a task within the decision-making course of. Sufferers would possibly have to weigh the experience of a specialist towards the comfort and affordability of care.

Understanding particular person affected person wants is paramount in figuring out probably the most acceptable specialist for dental implant placement. A radical evaluation of medical historical past, case complexity, aesthetic targets, and monetary issues permits for knowledgeable decision-making. Open communication between the affected person and each specialists ensures that the chosen therapy plan aligns with the affected person’s particular person circumstances and desired outcomes, in the end maximizing the probabilities of long-term implant success and affected person satisfaction.

8. Total Well being

Total well being performs a major position within the success of dental implant procedures and influences the decision-making course of when selecting between an oral surgeon and a periodontist. Sure medical situations can affect therapeutic, improve the danger of problems, and have an effect on the long-term stability of implants. A complete well being evaluation is crucial for figuring out the suitable specialist and tailoring the therapy plan to attenuate dangers and optimize outcomes.

Situations similar to uncontrolled diabetes, osteoporosis, autoimmune ailments, and bleeding issues can have an effect on bone therapeutic and improve the danger of an infection following implant surgical procedure. Sufferers with these situations might require specialised pre-operative administration and nearer post-operative monitoring. For instance, a affected person with poorly managed diabetes might expertise delayed therapeutic and an elevated threat of an infection. In such circumstances, optimizing blood sugar management earlier than surgical procedure is essential. Equally, sufferers with osteoporosis might require bone density assessments and probably extra bone grafting procedures to make sure satisfactory help for the implants. A affected person taking bisphosphonates for osteoporosis requires cautious consideration of the medicine’s potential results on bone therapeutic and the danger of medication-related osteonecrosis of the jaw. In these conditions, session with the affected person’s doctor is crucial to develop a coordinated therapy plan that minimizes dangers. Some sufferers would possibly profit from the collaborative strategy facilitated by a hospital setting, the place medical specialists can readily seek the advice of and coordinate care.

Total well being issues lengthen past particular medical situations. Smoking, for instance, considerably impairs blood circulate to the gums and bone, rising the danger of implant failure. Dietary deficiencies may have an effect on therapeutic and compromise implant stability. A radical well being evaluation permits the specialist to determine potential threat elements and implement methods to mitigate them. This will likely contain smoking cessation counseling, dietary steerage, or changes to medicine regimens. Finally, addressing general well being issues optimizes the situations for profitable implant integration and long-term perform. The collaborative nature of implant dentistry usually necessitates communication between the dental specialist, the affected person’s doctor, and different healthcare suppliers to make sure a holistic strategy to care and maximize the chance of profitable outcomes.

Steadily Requested Questions

This part addresses widespread inquiries relating to the number of an oral surgeon or periodontist for dental implant placement.

Query 1: Does one specialist have a better success charge for dental implants?

Success charges for dental implants are excessive for each oral surgeons and periodontists. Success relies upon extra on elements like affected person well being, bone high quality, and oral hygiene than the specialist performing the process. Choosing the proper specialist relies on particular person wants and case complexity.

Query 2: Is one specialist costlier than the opposite?

Charges can fluctuate based mostly on the specialist, geographic location, complexity of the process, and supplies used. It is important to acquire detailed value estimates from each specialists earlier than making a choice.

Query 3: If bone grafting is important, which specialist is most popular?

Each specialists carry out bone grafts. Nonetheless, the complexity of the graft would possibly affect the selection. Intensive grafts or complicated anatomical conditions would possibly favor an oral surgeon’s broader surgical background. Much less complicated grafts might be successfully managed by both specialist.

Query 4: How necessary is expertise in inserting dental implants?

Expertise is essential. An skilled practitioner may have encountered a wider vary of medical eventualities and developed refined surgical strategies, resulting in probably higher outcomes and fewer problems.

Query 5: What if a complication arises after implant placement?

Each oral surgeons and periodontists are educated to handle implant problems. Nonetheless, particular problems associated to gum well being or peri-implantitis would possibly profit from a periodontist’s specialised information. Open communication and follow-up care are important for addressing any problems successfully.

Query 6: How does one select the best specialist for his or her particular person wants?

Consultations with each an oral surgeon and a periodontist are extremely really useful. Complete evaluations, discussions of therapy choices, and consideration of particular person wants enable sufferers to make knowledgeable choices based mostly on their particular circumstances.

Cautious consideration of those continuously requested questions assists in navigating the decision-making course of. Thorough consultations with each specialists in the end present probably the most customized and efficient strategy to dental implant therapy.

The next part will supply concluding ideas and summarize key takeaways relating to specialist choice for optimum implant outcomes.

Ideas for Selecting an Implant Specialist

Choosing the suitable specialist for dental implant placement requires cautious analysis of particular person circumstances and session with certified professionals. The next ideas supply steerage in navigating this decision-making course of.

Tip 1: Schedule Consultations with Each an Oral Surgeon and a Periodontist

Acquiring a number of views gives a complete understanding of obtainable therapy choices and permits for customized suggestions tailor-made to particular wants. This comparative strategy facilitates knowledgeable decision-making.

Tip 2: Totally Assessment Credentials and Expertise

Inquire about board certification, the variety of implants positioned yearly, and expertise with complicated circumstances. Search practitioners who prioritize persevering with training and keep abreast of the newest developments in implant dentistry. Verifying credentials and expertise ensures a baseline degree of competency and experience.

Tip 3: Assess Consolation Stage and Communication Type

Efficient communication and a powerful patient-doctor relationship contribute considerably to a constructive therapy expertise. Select a specialist who actively listens, addresses issues comprehensively, and fosters a way of belief and confidence.

Tip 4: Contemplate the Complexity of the Case

Instances requiring in depth bone grafting, sinus lifts, or different complicated procedures usually profit from an oral surgeon’s broader surgical experience. Much less complicated circumstances might be successfully managed by both specialist. Matching case complexity with acceptable experience optimizes outcomes.

Tip 5: Consider Tender Tissue Concerns

Sufferers with issues relating to gum well being, aesthetics, or the necessity for gentle tissue grafting would possibly profit from a periodontist’s specialised information in these areas. Prioritizing gentle tissue administration ensures optimum aesthetics and long-term implant well being.

Tip 6: Consider Total Well being and Medical Historical past

Sure medical situations or medicines require cautious consideration and should affect specialist choice. Brazenly discussing medical historical past with each specialists permits for acceptable therapy planning and threat mitigation.

Tip 7: Inquire About Submit-Operative Care and Upkeep Protocols

Understanding post-operative directions, follow-up appointments, and long-term upkeep protocols ensures correct therapeutic and maximizes implant longevity.

Following the following tips empowers people to make knowledgeable choices relating to their implant therapy. Selecting the suitable specialist, based mostly on particular person wants and case complexity, contributes considerably to profitable outcomes and long-term satisfaction.

The next conclusion will synthesize the important thing info introduced and supply ultimate suggestions for navigating this vital decision-making course of.

Conclusion

Figuring out probably the most acceptable specialist for dental implant placementoral surgeon or periodontistrequires cautious consideration of particular person affected person wants and the precise complexities of every case. Each specialists possess the required surgical abilities and coaching for implant placement, however their areas of experience differ. Oral surgeons, with their in depth coaching in complicated surgical procedures involving the mouth, jaw, and face, are sometimes well-suited for circumstances requiring important bone grafting, sinus lifts, or complicated anatomical issues. Periodontists, specializing in gum well being and the supporting constructions of tooth, excel in managing the gentle tissue facets of implant placement, together with gingival grafting, managing gum illness, and reaching optimum aesthetics. Finally, the perfect selection relies on a complete analysis of the affected person’s medical historical past, the complexity of the deliberate process, aesthetic targets, and particular person preferences.

Profitable implant outcomes depend on a collaborative strategy between the affected person and the chosen specialist. Open communication, thorough evaluations, and a shared understanding of therapy targets are important for reaching long-term implant stability, perform, and aesthetics. Consulting with each an oral surgeon and a periodontist permits sufferers to achieve complete views, weigh some great benefits of every specialist’s experience, and make knowledgeable choices based mostly on their distinctive circumstances. This knowledgeable decision-making course of empowers sufferers to embark on their implant journey with confidence, realizing they’ve chosen probably the most acceptable specialist to satisfy their particular person wants and obtain optimum outcomes. Prioritizing complete consultations and cautious consideration of particular person elements ensures the very best likelihood of long-term implant success and affected person satisfaction.