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Australia has a chance to become a world leader in dental implant tracking and analysis thanks to an innovative new registry. By Cameron Cooper
Dr Steve Soukoulis has seen the stories suggesting it is easier to track car parts than dental implants.
He is on a mission to help change that perception through the Dental Implant Registry, an initiative that has no apparent equivalent around the world. “Unfortunately, more people know what’s in their airbags than what’s in their mouth. That’s crazy,” says Dr Soukoulis, founder of the registry and a specialist periodontist at Greenhill Periodontics & Implants in Adelaide.
Officially launched in March 2018, the registry is a central hub of information and data that acts as a national database of implants. Patient information is retained and accessible outside of dental practice records. The registry helps dentists identify implant components that they did not install themselves. If an implant fails or there is a product recall, for example, it can catalogue those problems and inform patients, their dental professionals, manufacturers and regulators.
Dr Soukoulis says the ultimate aim is that “transparent, accurate and rapid access to dental implant information will result in superior patient outcomes”. He wants to bring together dental professionals, patients and dental implant manufacturers to minimise potential complications such as infections, fractures or loosening of implant crowns or bridges.
Broadly, the registry seeks to make a difference in three key areas:
- Improving communication between patients and treating dental professionals;
- Providing dental professionals and implant manufacturers with feedback to identify trends in the industry; and
- Helping to identify the best surgical practice and prosthetic patient health outcomes.
With 4500 patients already signed up, the goal is to keep growing that number and bring on board more dental practitioners. “We’ve grown slowly, but the main thing is that we’re growing and trying to get the word out,” Dr Soukoulis says
The Dental Implant Registry represents a 20-year passion for Dr Soukoulis. After completing his general dental degree and then going on to study clinical dentistry before entering a periodontal specialty program, one big question kept niggling at him. How can periodontists and other dental professionals track the history of implants?
At the time, senior colleagues simply suggested ringing dentists and trying to piece together records. Dr Soukoulis thought there had to be a better way. “So, the issue has been brewing in the back of my mind for a long time,” he says.
Fast-track to about 2014 and two pivotal discussions convinced Dr Soukoulis to set up the registry. First, a medical colleague bemoaned the lack of an app to record his optometry details when he lost glasses. Another colleague working in palliative care shared a story about a patient who suffered serious infections from an illegal breast implant product that surgeons could not initially identify.
“For me, I was seeing similar issues in the dental implant industry and thought we needed to do something,” Dr Soukoulis says. Initial investigations pointed to the presence of registries for devices such as hip and other joint replacements, but they were all paper-based and excluded dentistry.
Likewise, checks into dental implant registries around the world largely revealed a blank. “Surprisingly, very little was happening,” Dr Soukoulis says. The only global example he could pinpoint was a government-backed program in Sweden that contained data on dental healthcare.
Closer to home, he benefited from discussions with key personnel at the Australian Orthopaedic Association National Joint Replacement Registry, a South Australian entity that seeks to improve the quality of care for people receiving joint replacement surgery. It is regarded as a world leader in registry science.
Three years on, the Dental Implant Registry is getting positive feedback from all sides. “It really facilitates the communication process, from the dentist to the patient, from dentist to dentist, and from the dentist to the manufacturer,” Dr Soukoulis says.
Patients certainly get a voice, with an advocacy group meeting regularly to discuss implant issues. Based on their insights and data drawn from the registry, manufacturers have changed some products, while clinicians have altered some procedures.
Dr Soukoulis is convinced that the registry can help dentists and patients. He notes that research reveals that after five years, about 8-10 per cent of implant patients experience biological complications (such as infections that cause bleeding and bone loss), while about 20-30 per cent have technical complications (such as fractures).
“But what’s really concerning is that some of the literature at 10 years indicates that only about 9-10 per cent of patients don’t have problems.”
Although some of those issues are likely to be minor, “that’s not a great selling point”, Dr Soukoulis concedes. “So, what the registry is trying to do is help the supply chain achieve better health outcomes for patients.”
With the registry having bedded down over the past few years, Dr Soukoulis and his peers are focusing on growing member numbers and expanding the service.
Marketing and education programs will be ramped up to alert more people to the platform, negotiations will be held with manufacturers to better understand supply chains, and system upgrades offer the prospect of the registry collating ever stronger and more valuable implant data. “We also want to develop a strong scientific team to help analyse the data and put out research papers,” Dr Soukoulis says.
He adds that it is important for the registry to attract a new cohort of young dental industry leaders who will carry the flame for the industry in the years to come.
“At the end of the day, dental implants are medical devices that go inside the body and can be life-changing for many patients but also can in rare instances lead to patients experiencing significant oral health complications. So, implants have to be done right—from a surgical perspective, using high-quality parts when restoring them, and maintaining them properly over their lifetime. This registry will help do that.”
The Dental Implant Registry promises to deliver benefits for patients and dental professionals.
For the former, those advantages can include:
- enabling quick and efficient treatment as dentists get access to patient information around the clock;
- ensuring implant components comply with Therapeutic Goods Administration rules; and
- knowing exactly what components and materials are being used.
For the latter, the gains can include:
- quickly identifying implant and restorative components to treat patients efficiently and effectively;
- showing patients that dentist care about their dental implant outcomes; and
- providing transparency for a dental practice and patients by identifying what implant components have been used.