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Piracy reaches the implant segment


Piracy reaches the implant segment

Unlike many people thinking, Implantology did not begin in 1950, but for thousands of years ago. Egyptians and Mayans tried to replace teeth for gold and shells. In 1950, research on rabbits for other purposes accidentally demonstrated the osteo integration possibility. "It was from there that systematic research on casting techniques and biological studies were initiated in order to enable a prosthesis by means of a biocompatible material, associated with the advent of antibiotics, allowed its implementation with less chance of postoperative infections being a success, thus stimulating the dental profession to play the most diverse techniques of implantology", explains the expert dentist in dental implants, Norberto Ruben Gonsales Junior*.

Historic data indicate that in 1965, Dr. PI Brånemark developed and installed, for the first time, an osteointegrated implants´ system, with prosthesis´ fixation with screws. Four implants were installed in his first patient, who had congenital deformities in the jaw and chin, and misaligned teeth. After six months, this patient was, then, rehabilitated. This is the best documented case so far, with monitoring for a period of 40 years.

However, according to the dentist Norberto, until the early 1980s, the techniques used materials such as surgical steel, and did not intend to promote osseointegration. The implants were installed under the mucosa, but based on mechanical retention indicated by the technique. So, over the years and the use of implants in chewing, inflammation naturally arose, and some implants were lost. "It was only after the Toronto Protocol, in the early 1980s, that we had knowledge about the dental implants´ installation as we know them today: they are made in commercially pure titanium and installed by trained professionals, achieving a success rate above 90 %."

Until today, these papers are named protocol. The prostheses can be delivered in a few days and the success rate reaches almost 100 %. It was these results that boosted the success of Modern Implantology.

The Implant in Brazil
In Brazil, the technique began to be used in the mid- 1980s, with the first dental implants´ surgeries.

The first Brazilians moved to Sweden and to the USA to learn the implant´s techniques, which already showed a reliable alternative to what was done before.

These pioneers, back to Brazil, started training their colleagues, as well as the technical prosthesis.

Norberto remembers that at this time, few professionals dominated the Implant System and few imported brands were available at the Brazilian market, cost quite taken, causing gentrification in this specialty. "Some pioneers began to develop an implants and components´ industry in our country, at first, with low quality and technology. With the international patents fallen and economic stability that we had in the last two decades, there was a significant ability gain at the Brazilian industry to incorporate and develop technology and production methods. Today, our implants are international reference, exported to many first world countries, "celebrates.

In 2014 were carried out in Brazil, 2 million 200 thousand implants, fewer only to the United States. This success story can be directed to the enrichment technique in the segment.

Today we can say, emphatically, that Implant System is an indispensable tool for the population life quality.

Norberto, who is also an honorary member from the Bolivia Oral Implant College, explains that this rise of specialty is due to the fact that the practice has achieved considerable part of the Brazilian population. "A therapy that in its early days was only available to the elite today is available for large population, with the growth of a wide range of good quality products and professionals able to run it.”

Question of originality
According to the Brazilian Association of the Industry Products and Medical Equipment, Dental, Hospital and Laboratory ( ABIMO ) , three in 10 dental implants made in Brazil are pirated . The statement has worried every dental professional from the country, considering that implant area is one of the areas that grow fastest.

Norberto says that, majority; the professionals are concerned with the products sales´ growth at the market. "Serious professionals with sufficient knowledge to assess the implications know that the implants´ success is directly related to the material used quality, and supporting initiatives to curb dubious origin materials sale and use. On the other hand, if sales grow, this is due to conduct of unscrupulous or misinformed professionals who are unaware of or ignore the consequences of the use of implants and especially pirates’ components", says the expert.

The category awaits a bill approval at the São Paulo State, which will force the dental products´ sale with proper identification. Example to be followed at the federal level.
As such law, indispensable for the perfect performance of the specialty, do not comes into force, it is for skilled professionals , the function of evaluating the material used originality.

"Even among dentists, it is difficult to know whether the problem at the patient´s prosthesis is caused by pirated component. The use of counterfeit components leads to complications in the prosthesis and only from that moment is possible to realize the counterfeiting at the legalized industry. For each implant, there must be a component. But now a day, out of 10 implants sold, only seven components are marketed. So it's important to check the product provider, the ANVISA registration number, and always confirm the information accuracy on the agency's site," says Norberto.

Another very important observation to try to reverse this situation is the good relationship with the prosthetic, which is normally responsible for the components´ purchase.
Norberto emphasizes that the link dentist / prosthetic must be based on trust, but the dentist should not assign your function to another professional, except for lack of scientific or technical knowledge.

"I mean that when a treatment is superficial, without planning criteria, and its misguided implementation, prostheses´ technician ' fix ' in the prosthetic what the implant diverges in the mouth. Not always the prosthesis technician maintains a prosthetic components usage criterion from the same implant manufacturer used by the dentist, and calls for the ' generic '. We know there are companies specialized in manufacturing interchangeable products with various implant trademarks, and are even certified, however, there is rather the need to recommend the use of implant / component of the same origin. "

The around calibration, raw material origin, quality control and product warranty can make a difference in the event of a prosthesis presenting problem and needs analysis. In addition, the dentist who provides your own component is convinced of the type of implant you want to accomplish, which is, trust in your planning.

"A product for implant quality is very advanced. Scientific research that choked the production chain of implants, prosthetic components, molding transferees, healing abutments, retaining bolts, and even the mills and installation of keys, is designed to ensure a standard of quality certification subject to the regulatory bodies, and can be absorbed international technology export route", elucidates the dentist.

The ABIMO in February 2015 , warned that 30% of the procedures performed in 2014 relied on the use of prosthetic components without proper certification, which tests the quality of the products before allowing marketing.
It should be emphasized that the implant / prosthetic component pirate can be purchased up to the Internet, without targeting sites in the dental products , but sets up illegal imports , as well as not meeting the requirements of ANVISA , creates unfair competition by underpricing the product. Thus, crime against public health and against the IRS .

The dentist explains again that the compatibility of products between implant manufacturers and independent prosthetic components is not guaranteed. " Ill-fitting dentures can cause local damage , causing deterioration and loss of implant - prosthesis complex / bone. This site provides a situation exacerbated and timely bacterial development , which of course, enhances the problem itself ; and that can indeed through the blood , spread into the body , putting out istêmicas diseases such as bacterial endocarditis famous , often associated with periodontal problem. "

Clinical data show that the loss of the implant , such as tooth loss , can generate local occlusion disorders develop into TMJ disorders and overload gnatológico complex. " And it is in this line that we can enumerate poor mastication , swallowing atypical , unbalanced phonetics, oral and cervical- cranial muscle disorders and also gastric disorders bad chewing, middle ear disorders - for involvement of the temporomandibular complex - among other disease " , highlights the expert in dental implants . It adds , clearly and objectively , that " this ' economy ' in dental supplies, puts into disrepute the specialty and the reputation of the dentist determines the decrease in quality of life of our patients and frustrates the public as our ability and professional competence " .

United against piracy
Before this disgusting scene, authorities and dental class must unite to together fight against the practice of piracy, not only in implantology but in all segments of dentistry .

Norberto believes that to change this situation , vocational training should be the first point to be considered . " The Regional Council of Dentistry of São Paulo ( CROSP ), for example , advocates the completion of a proficiency examination, as with lawyers , filtering the entry of ill-prepared professionals in the market ." "In Brazil we have 20 % of dentists in the world , 230,000 are professionals. I believe that most of these , ill-prepared , dispute a saturated and low-income market, " he adds.

Also according to the dentist , another point that should not be overlooked is the intensification of actions of sanitary surveillance bodies in offices and laboratories , verifying the origin of the inputs used . " A well-prepared professional with knowledge of the implications of the use of inappropriate materials , will make the selection of what to use , always based on technical- scientific and ethical criteria."

Implantology and oral and overall health tool of the Brazilian population
Teething is critical to maintaining the overall condition of individuals. In the physical aspect, it is possible to say that the way to survive is food , which must be properly processed in the mouth to move through the gastrointestinal route. The teeth promoting a first digestion. "Thinking this way , edentulism came to an end marked by implantology , and as a result , the competition for good eating habits," exposes the professional oral health .

Norberto argues that the psychological aspect is important, after all, return teething brings new life to the patient. This social reintegration can be seen to the labor aspect , since it arouses the condition retraining .
"Brazilian elderly have poor oral health, and the dentures on implants have been reported , according to the literature , as possible promoters of significant improvement in quality of life , with the increasing percentage of elderly in the population , which should be viewed carefully by the Government, in order to establish a policy that addresses this population , "argues the expert.

Recently, the Smiling Brazil program , the Federal Government authorized the rehabilitation funding through implants osseointegrated by the Unified Health System ( SUS) , in their specialized dental clinics ( CEOs) . "It's still a shy initiative due to the costs involved and the limited availability of skilled professionals on its staff . Few CEOs currently offer the service, but it is expected growth in supply , due to the positive results achieved in openness and the population's quality of life gain, especially in the elderly , "says Norberto , who believes that our Dentistry is a example to the world . " We have the best Globe professionals, these professionals offer that few countries have , availability of technology and cutting edge products and perhaps the huge competition , accessible values most people ," he concludes .

Source: Odontomagazine, escrita por Vanessa Navarro
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