Implant dentistry has advanced significantly since the 1980s, but this increase in popularity has led to more complications as many dentists now offer implants without proper training. Dr. James Vito, an expert in implant dentistry, sees many patients who require repairs after poorly performed implants by inexperienced dentists. He warns that implants are unforgiving and require artistry to position correctly. Dr. Vito advises patients to thoroughly research a dentist's credentials and experience in implants before undergoing the expensive and permanent procedure.

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2. he world has changed quite a bit
since the 1980s, when James A. Vito,
D.M.D., began building his reputation
as one of the Main Line’s premier
practitioners of implant dentistry.
Back then, implant dentistry—the art and
science of extracting a failing tooth and then
restoring it with an implant-supported re-
placement that is virtually undistinguishable
from a natural tooth—was akin to “some
form of witchcraft,” he says. While he’s thrilled
with how far implant dentistry has come in
terms of both its predictability and its accept-
ance, such change has not come without its
drawbacks.
Dr. Vito is widely known as someone who
can get optimal results from even the most
compromised cases, as well as someone who
is called upon to repair the work of less skilled
professionals. As such, he has noticed an
increaseinthenumberofcomplicationscaused
byfailingimplants,mostlybecausemoredental
professionalsthanevernowofferdentalimplants
as part of their menu of services, even though
many lack the necessary skill and training
needed to ensure predictable results.
“People have to understand and appreciate
that a dentist is not a dentist is not a dentist,”
says Dr. Vito, whose practice is based in Wayne.
“Dental implants are in vogue right now, and
you have a lot of dentists who go to a weekend
lecture or a one-day course and feel they are
proficientatdeliveringthelevelofcarenecessary
for implant dentistry. There’s a lot more art
and science and thought that goes into doing a
dental implant than just the mechanics of
drilling a hole and putting in a screw.
“Unlike teeth, implants are unforgiving,”
hecontinues.“Ifteethareinthewrongposition,
you have a lot of things you can do to put them
in the right position. If you put a dental implant
in the wrong spot, there is a lot of creativity
that is then needed to make a poorly positioned
dental implant look and feel like it is in the
right position.”
Most patients in need of dental implants
arenotwhatDr.Vitocalls“idealcases,”meaning
they lack the bone width or depth to accom-
modate a dental implant or otherwise have a
situation that requires advanced care. In the
hands of a dentist without the proper training,
Dr. Vito believes such cases often push the
dentist outside of his or her comfort zone,
thereby increasing the likelihood of an aesthetic
or functional compromise.
“Sometimes a lesser experienced implant
dentist will find themselves in a hole but keep
digging, hoping for the best,” he says. “That’s
when the patient will come to me, after the
fact,andI’llhavetocorrecttheproblemscreated
from the implant not being done correctly the
first time. … If it had been done right initially,
there would be less of a chance of potential
T
Choose
Wisely
Whenitcomestoenhancingsmilesthroughimplantdentistry,
dual-board-certified JamesA.Vito,D.M.D.,offersguidelines
forevaluatingtheskillandexpertiseofdentalprofessionals
by Bill Donahue
photography by Jody Robinson
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3. problems and, in all likelihood, it would have cost significantly less.”
A typical dental implant, when done properly, might cost as much
as $6,000, according to Dr. Vito’s estimate. When the implant is done
improperly, assuming the implant body is in a quasi-correct position,
creating a new abutment and crown might run another $3,000. If the
implant body fails because it was positioned incorrectly, repairing the
bone and placing a new implant, abutment and crown could cost an
additional $7,200.
This is why Dr. Vito believes it is critical for patients to research a
dental professional to make sure he or she has the experience needed to
deliver a positive result. He suggests patients take to the Internet to
research each provider’s expertise, and then follow up by asking the
tough, even potentially awkward questions that could help prevent an
avoidable problem. These questions include:
• “What is the source and scope of your training in implant dentistry?”
• “Are you affiliated with organizations such as the Academy of Os-
seointegration, the American Academy of Implant Dentistry (AAID) or
the International Congress of Oral Implantologists (ICOI)? Are you
board certified in implant dentistry by the AAID or the ICOI?”
• “Do you have in-office technology such as 3-D imaging to assist in
planning and placing the dental implant?”
• “Do you have the knowledge to guide the dental laboratory in
designing the implant to provide ideal aesthetic and functional results?”
• “Are you experienced enough to teach implant dentistry to other
dental professionals?”
• “Can I speak with a few patients to see how their experience was?”
“Dental implantology is an expensive form of dentistry; we’re
basically giving you a third dentition,” Dr. Vito says. “And because it’s
expensive, you should look into who is going to be doing the work.
When you buy a car, you don’t just go to one dealership and take the
first deal you’re offered without doing your homework. It’s easy
enough to check up on somebody and research their credentials, and
it’s better to do that once than it is to have to do it later when you’re in
a compromised situation.”
Fixing Problems
Earlyintohiscareer,Dr.Vitowasdrawntothesubspecialtyofperiodontal
prosthesis, which requires rigorous training in reconstructive dentistry,
periodontics and dental implants. He, like the other men and women
who chose this path, were often seen as “hero dentists,” the ones to call
when nobody else could figure out the problem.
“We were like the Special Forces of dentistry,” he recalls. “We were
all that was standing between patients and dentures. A lot of people used
to think dentures were the answer to all their tooth problems, but there
are some real health consequences and quality-of-life issues that come
with having dentures. When you think of all the health advancements
that have been made through the years, to say ‘I’ll settle for dentures’ is a
decision made out of ignorance as to what is available today.
“Research has shown that people with dentures live 15 to 20 years
less than people with intact dentition,” he continues. “Dental implants
arenotonlythewaveofthefuture,butthey’realsoalife-savingalternative
to dentures.”
Dr. Vito, who is a prosthodontist and a periodontist, is among the few
dentists in the nation to have two board certifications in the surgical
placement and restoration of dental implants. He trained at the University
of Pennsylvania School of Dental Medicine and is a graduate of the
school’s prestigious Periodontal-Prosthesis Program. He also completed
a general practice residency at Albert Einstein Medical Center, during
which time he received the Dr. Benjamin Lebby award for “Outstanding
Performance as a Dental Resident.”
Aside from running a busy practice, Dr. Vito serves as a clinical
associate professor of periodontics and implant dentistry at Temple Uni-
versity’s Kornberg School of Dentistry, as well as a faculty member at the
Misch International Implant Institute. In fact, the three years he spent
studying under Carl E. Misch, D.D.S., the world-renowned implant
specialist and founder of the Misch International Implant Institute, helped
shape the way he treats patients in his own practice.
“One of the things [Dr. Misch] taught me is that we, as dentists,
should be putting patients on a pedestal and look at not what is faster,
easier or simpler but what is right,” Dr. Vito says. “If more health care
practitioners followed that motto, there would probably be fewer issues.
… Another saying of his is, ‘If you can’t afford to do it right the first time,
can you afford to do it over?’ As a patient, you have one shot to have [an
implant] done right, so my advice is to choose your dentist wisely.” n
Dr. Vito, pictured here with Justine, Nicole and Barbara, is among the few dentists in
the nation to have two board certifications in the surgical placement and restoration of
dental implants.
Dr. Vito suggests researching a dental professional to make sure he or she has the
experience needed to deliver a positive result. Researching each provider’s expertise
through the Internet is a good start, he says.
D JAMES A. VITO, D.M.D.
523 E. Lancaster Ave. | Wayne, PA 19087
610-971-2590 | www.jamesvito.com
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