According to the wisdom, experience, and advice of senior practitioners who have graduated from the college of personal, professional, and clinical complications, and who willingly make this presentation, drawn from the wisdom of the ages, as a contribution to all those who follow in the noble practice of implant dentistry.
These are troubled times for the world. Each of us has deep concerns for the future of our country and for mankind. We hope for peace, and we pray for the health of our friends and family. We seek to improve our skills and to deliver services of value that will offer benefits and well being to our patients. In an effort to codify some exemplary goals, these Implant Commandments (and their sources) might serve as a guide to many practitioners.
Thou shalt not make incisions away from the ridge crest. (Moses Maimonides. On the cutting edge of gums. The Hebrew Journal of Stomatology; December, 1204–1210.)
Thou shalt not attempt to resuture wounds that have become dehiscent but instead, treat such defects with protective dressings. (Saint Luke. Let them heal by secondary intention. Leperology; 6:551–558.)
Thou shalt not inundate thy patients with prophylactic antibiotics. Thou shalt prescribe narcotics in dosages sufficient to relieve pain (Saint Appolonia. Allow the body defenses to serve as therapy. Egyptian Journal of Analgesics; 5[June]:245–249.)
Thou shalt practice assiduous tamponade to stem the flow of hemorrhage and have a broad spectrum of remedies on hand to assist in the processes of coagulation (Imhotep: Hold It, Squeeze It, and Press It Until the Fluxe Ceases. The Heliopolis Clotting Review; Harvest Moon [2629 BC]: Tablets 4–16.)
Thou shalt use continuous horizontal mattress suturing whenever possible. (Galen. Sew It but Don't Blow It. Pergamon Journal of Oral Stitching; 13[199 AD]:CXL–CCL.)
Thou shalt utilize synthetic, resorbable sutures despite their expense. (Andreas Vesalius. You Can't Take It With You. De Humani E Corporis Fabrica, Vol III. Louvain, France; 1547: XXV.)
Thou shalt remove mobile implants immediately without seeking time-consuming, painful and ill-advised attempts at salvage. (Hippocrates. Leave ‘Em In and They'll Come Back to Bite You: Ethics in Implanting the Artificial Toothe. Santorini Journal of Disease Prevention; 11[406 BC]:XX–XXV.)
Thou shalt not overload by depending on too few implantes nor should thee place an overabundance of fixtures. (Plutarch. Take the Middle Road. Paper presented at: Annual Meeting of the Roman Dental Association; June 17, 99 AD; Delphi, Greece.)
Thou shalt keep accurate and unaltered medical records and radiographs. (Pasteur, Louis. Les Fauts Dans Les Documents: Officielle Changé Par Vois. Journal D'Microbiologie. 1849;12:237–244.)
Thou shalt remove implants immediately when postoperative symptoms of dysaesthesia are noted; nor should they be replaced at a shallower depth on that same day; the 90-day window must be respected as gospel and appropriate remedies taken within that time-frame. (Koch, Robert. Restrain Your Nervous Energy: A Lecture to the Veterans of the Franco-Prussian War. Presented March 3, 1873.)
A. Norman Cranin, DDS, DEng, is Editor-in-Chief of the Journal of Oral Implantology