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
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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
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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
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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
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Undergraduate teaching situation
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(Public) undergraduate teaching institutions in Canada (n=10) ( 10) n
map
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Public undergraduate teaching institutions in the 5 Nordic countries (n=12)
8 May 2008
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Int J Prosthod 2002; 15: 145-53.
8 May 2008
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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
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R
Postgraduate teaching situation
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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
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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
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Public postgraduate teaching institutions in the 5 Nordic countries
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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
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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
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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
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Osfix
T Tenax Implants I l t
Simpler Implants (Pan Global Impl Corp.)
Biomet 3i
Innova Nobel Biocare Straumann
8 May 2008
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?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
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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
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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
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+ + ++ + -
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
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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
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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
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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
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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
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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
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