Where can I learn how to
place dental implants?
Perspectives from Scandinavia
and Canada
Canada.
Asbjørn
jø Jokstad
Professor and Head, Prosthodontics
Faculty of Dentistry, University of Toronto
Location of 5 Nordic
countries + Grenland &
Spitsbergen
8 May 2008
ACFD / CDA Teaching conference
Demographics*
Population
(x1.000.000)
Canada
Denmark
Finland
Iceland
Norway
Sweden
33.11
33
(38)
55.5
5
(111)
55.2
2
(113)
00.3
3
(177)
44.6
6
(118)
99.0
0
(87)
323
(68)
+61 (125)
4450
0
(56)
23.6
Area
A
(1000 km2)
9984
99
4
(2)
43
(135)
+2166 (14)
338
33
(65)
103
(108)
1267 + 2227
* Source: The CIA Factbook. https://www.cia.gov/cia/publications/factbook/
8 May 2008
ACFD / CDA Teaching conference
Demographics
Population
(x1.000.000)
Canada
Denmark
Finland
Iceland
Norway
Sweden
33.1
(38)
5.5
(111)
5.2
(113)
0.3
(177)
4.6
(118)
9.0
(87)
323
(68)
+61 (125)
450
(56)
19
66
15
38
17
66
18
41
23.6
Area
(1000 km2)
9984
(2)
43
(135)
+2166 (14)
338
(65)
103
(108)
1267 + 2227
0-14 y
yrs.
15-64 yrs.
>65 yrs.
Median age
18
69
13
39
19
66
15
40
17
67
16
41
22
66
12
34
100 %
80 %
60 %
40 %
20 %
0%
8 May 2008
ACFD / CDA Teaching conference
Canada
Denmark
Finland
Iceland
Norway
Sweden
Demographics*
Canada
Denmark
Finland
Iceland
Norway
Sweden
Population
(x1.000.000)
33 1
33.1
55
5.5
52
5.2
03
0.3
46
4.6
90
9.0
Area(x1000 km2)
9984
43 +2166
338
103
323+61
450
>65 yrs.
Median age
13
39
15
40
16
41
12
34
15
38
18
41
Age expectancy
80.2
(12)
77.8
(48)
78.5
(38)
80.3
(11)
79.5
(20)
80.5
(7)
Growth Rate (%)
.88
.33
.14
.87
.38
.16
* Source: The CIA Factbook. https://www.cia.gov/cia/publications/factbook/
8 May 2008
ACFD / CDA Teaching conference
Demographics*
Canada
Denmark
Finland
Iceland
Norway
Sweden
Population
(x1.000.000)
33 1
33.1
55
5.5
52
5.2
03
0.3
46
4.6
90
9.0
Area
(1000 km2)
9984
43 +2166
338
103
323+61
450
>65 yrs.
Median age
13
39
15
40
16
41
12
34
15
38
18
41
Age expectancy
80
78
79
80
80
81
Growth Rate (%)
.88
.33
.14
.87
.38
.16
GDP / capita
(x1000)
$38
(21)
$37
(24)
$36
(27)
$39
(16)
$55
(5)
$37
(26)
* Source: The CIA Factbook. https://www.cia.gov/cia/publications/factbook/
8 May 2008
ACFD / CDA Teaching conference
Undergraduate teaching
situation
8 May 2008
ACFD / CDA Teaching conference
(Public) undergraduate teaching
institutions in Canada (n=10)
( 10)
n
map
8 May 2008
ACFD / CDA Teaching conference
Public undergraduate teaching
institutions in the 5 Nordic countries
(n=12)
8 May 2008
ACFD / CDA Teaching conference
Int J Prosthod
2002; 15: 145-53.
8 May 2008
ACFD / CDA Teaching conference
Implant Dentistry - teaching
1
Lectures
Hands-on
5
4
Bergen, No
4
Gøteborg, Sw
...............................................................................................
Helsinki, Fi
5
København, Dk
4
3
2
R
Malmø, Sw
5
Oslo, No
O l Fi
Oulo,
...............................................................................................
Reykjavik, Ic
...............................................................................................
Stockholm Sw ...............................................................................................
Stockholm,
Tromsø, No
...............................................................................................
5
Umeå Sw
Umeå,
7
Aarhus, Dk
8 May 2008
ACFD / CDA Teaching conference
R
Postgraduate teaching
situation
8 May 2008
ACFD / CDA Teaching conference
Dental Demographics*
Canada Denmark
Finland
Iceland
Norway
Sweden
Population (Mill.)
33.1
5.5
5.2
0.3
4.6
9.0
Area (x1000 km2)
9984
43 +2166
338
103
323+61
450
>65
6 yrs.
Median age
13
39
115
40
16
41
12
34
115
38
118
41
Age expectancy
80
78
78
80
80
80
G
Growth
th Rate
R t (%)
.88
88
.33
33
.14
14
.87
87
.38
38
.16
16
GDP/capita x1000
$38
$37
$36
$39
$55
$37
Dentists: total
Patients/dentist
Graduates/yr
Dentists/new
graduates
d t
18340
1805
520
4900
1100
125
4590
1132
50
272
1068
6
4300
1070
140
7500
1250
150
35
30
92
45
31
50
Specialities
OMSurg OMSurg
Perio
-Pros
OMSurg OMSurg OMSurg OMSurg
Clin Dent
Clin.Dent
Perio
Perio
Perio
Pros
Pros
Pros
.
* Source: FDI World Dental Federation: http://www.fdiworldental.org/resources/3_0facts.html
8 May 2008
ACFD / CDA Teaching conference
Dental Demographics – Dentists to
Specialists Ratios
Canada
D ti t
Dentists
Oral Maxillofacial
Surgeons (OMS)
Denmark
Finland
18340 4900 4587
Iceland Norway Sweden
272
4300 7500
44
250
(18)
339
60
84
3
Dentist : OMS
54
82
55
91
99
30
Periodontists
296
62
0
--
(268)
|
8
34
90
48
200
38
171
107
0
--
|
|
6
45
55
78
200
38
346
13
5
54
0
--
0
--
Dentist : Periodontists
P
Prosthodontists
h d i
Dentist:Prosthodontists
Denturists
2225 460
8
11
Dentist
8 May 2008: Denturists
ACFD / CDA Teaching conference
(Public) postgraduate teaching
institutions in Canada
*Source: CDA: http://www.cda-adc.ca/en/cda/cdac
8 May 2008
ACFD / CDA Teaching conference
Public postgraduate teaching
institutions in the 5 Nordic countries
8 May 2008
ACFD / CDA Teaching conference
CONTINUING DENTAL
EDUCATION PROVIDERS
1.
2.
3
3.
4.
5.
8 May 2008
University - affiliated
Manufacturers
Manufacturers & distributors
Interest associations
Private enterprises
ACFD / CDA Teaching conference
CE programs: quality ?
The providers
Academy of
General Dentistry:
PACE
8 May 2008
ACFD / CDA Teaching conference
American Dental
Association: CERP
CE programs: quality appraisal
ADMINISTRATION
ADMISSIONS
COMMERCIAL OR PROMOTIONAL CONFLICT
OF INTEREST
EDUCATIONAL METHODS
EVALUATION
FACILITIES
FISCAL RESPONSIBILITY
INSTRUCTORS
MISSION/GOALS
NEEDS ASSESSMENT
OBJECTIVES
PATIENT PROTECTION
PUBLICITY
8 May 2008
ACFD / CDA Teaching conference
RECORD KEEPING
9
12
5
1
6
14
6
4
8
10
7
1
7
12
8
2
10
3
2
4
3
13
11
14
5
9
11
13
CONTINUING DENTAL
EDUCATION PROVIDERS
1.
2.
3
3.
4.
5.
8 May 2008
University - affiliated
Manufacturers
Manufacturers & distributors
Interest associations
Private enterprises
ACFD / CDA Teaching conference
CDE teaching institutions in Canada
( 10 + 1)
(n=10
n
map
8 May 2008
ACFD / CDA Teaching conference
CONTINUING DENTAL
EDUCATION PROVIDERS
1.
2.
3
3.
4.
5.
8 May 2008
University - affiliated
Manufacturers
Manufacturers & distributors
Interest associations
Private enterprises
ACFD / CDA Teaching conference
Manufacturers production facilities
Dentatus
Astra Tech
Nobel Biocare
Ospol
8 May 2008
ACFD / CDA Teaching conference
Osfix
T
Tenax
Implants
I l t
Simpler Implants (Pan
Global Impl Corp.)
Biomet 3i
Innova
Nobel Biocare
Straumann
8 May 2008
ACFD / CDA Teaching conference
?Bi H Corp.
?BioHex
C
CONTINUING DENTAL
EDUCATION PROVIDERS
1.
2.
3
3.
4.
5.
8 May 2008
University - affiliated
Manufacturers
Manufacturers & distributors
Interest associations
Private enterprises
ACFD / CDA Teaching conference
Approved Implant systems &
manufacturer courses
per 2.2008:
148 manufacturers
>500 systems
8 May 2008
ACFD / CDA Teaching conference
Germany:
32
USA:
31
Italy:
15
Korea:
10
Spain:
10
Brazil:
9
France:
7
Japan
6
Switzerland :
6
Canada:
4
Sweden:
4
Israel:
3
United Kingdom:
3
Other countries:
9
Approved implants – Nordic countries
= approved
d ffor sale
l
in Europe
Finnish Implant
Register 1994 – 2004
8 May 2008
ACFD / CDA Teaching conference
CONTINUING DENTAL
EDUCATION PROVIDERS
1.
2.
3
3.
4.
5.
8 May 2008
University - affiliated
Manufacturers
Manufacturers & distributors
Interest associations
Private enterprises
ACFD / CDA Teaching conference
Interest associations
Canada
Canadian Society of Oral Implantology
Canadian Academy of Restorative Dentistry
and Prosthodontics
Denmark
Danish Society of Oral Implantology
Norway
Norwegian Dental Association
Norwegian Society of Oral Implantology
Sweden
Swedish Dental Association
Swedish Society of Oral Implantology
8 May 2008
ACFD / CDA Teaching conference
+
+
++
+
-
CONTINUING DENTAL
EDUCATION PROVIDERS
1.
2.
3
3.
4.
5.
8 May 2008
University - affiliated
Manufacturers
Manufacturers & distributors
Interest associations
Private enterprises
ACFD / CDA Teaching conference
CONTINUING DENTAL
EDUCATION PROVIDERS
1.
2.
3
3.
4.
5.
8 May 2008
University - affiliated
Manufacturers
Manufacturers & distributors
Interest associations
Private enterprises
ACFD / CDA Teaching conference
In Canada:
69 CERP and/or
PACE Providers
16 providers give
course on implant
dentistry
4 manufacturers
11 private
Implant Resource Center, Vancouver
8 May 2008
ACFD / CDA Teaching conference
1 has both CERP
and PACE
1. Canadian Implant Institute, Quebec
2. I.D.E.A.S. Institute for Dental
Education & Advanced Surgeries Inc
Inc,
Richmond
3. Kennedy Professional Educational
S i
Seminars,
Wi i
Winnipeg
8 May 2008
ACFD / CDA Teaching conference
1.
2.
3.
4
4.
Arlin Seminars, Toronto
Implant Smile Center, Vancouver
Seminar Marketing Services Toronto
(T
(Toronto
t IImplant
l t IInstitute
tit t St
Study
d Cl
Club
b
Toronto (ICOI))
5 Toronto Implant Study Club
5.
Club, Toronto
6. Toronto Institute for Dental Excellence,
Toronto
7. Veisman Institute of Periodontics,
Toronto
8 May 2008
ACFD / CDA Teaching conference
A curriculum for
implant dentistry ?
8 May 2008
ACFD / CDA Teaching conference
A curriculum for
implant dentistry ?
1. The differences between the
countries approach to dental
education and care suggests
that it is questionable if one
model will fit all.
2. If to proceed, apply the Ronald
M Harden three-circle
three circle model
for competency assessment.
8 May 2008
ACFD / CDA Teaching conference
Health personnel education:
three-circle model
1. ”Practical skills”:
1. What the dentist
is able to do
• Clinical
Cli i l information
i f
ti
gathering
((”technical
technical intelligencies
intelligencies”))
• Treatment planning
• Treatment
T t
t procedures
d
*RM Harden, 1999
8 May 2008
ACFD / CDA Teaching conference
Health personnel education:
three-circle model
2. How the
Clinical
dentist approaches
information
their practice
gathering
What
the Treatment
1. What1.the
dentist
planning
dentist
is
able
to
is able to do do
(”technical
intelligencies”) procedures
reatment
((”technical
technical intelligencies
intelligencies”))TTreatment
((”intellectual,
intellectual, emotional,
analytical & creative
intelligencies”)
8 May 2008
ACFD / CDA Teaching conference
2. ”What they bring to the
treatment of each patient”
•Application of basic
clinical sciences
•Clinical reasoning and
judgment
•Communication
•Health
Health promotion
•Attitudes, ethical stance
and legal responsibilities
•Information handling
*RM Harden, 1999
Health personnel education:
three-circle model
3.The dentist as
2. How the
2
dentist approaches
1. What
1
Wh t the
th
dentist is able
to do
”technical
intelligencies”
their practice
”intellectual, emotional,
analytical & creative
intelligencies”
a professional
”personal intelligencies”
8 May 2008
ACFD / CDA Teaching conference
Clinical
information
gathering
g
g
Application of
basic clinical
sciences
Treatment
planning
Clinical
reasoning
and judgment
Treatment
procedures
Personal
development
The role of
the dentist
within the
health service
Health
promotion
Information
handling
Attitudes,
A
i d
ethical stance
and legal
reponsibilities
Communication
*RM Harden, 1999
Thank you for your
kind attention
8 May 2008
ACFD / CDA Teaching conference