Colin Burns reflects on how his involvement with the International Team for Implantology has provided crucial support throughout his implant career

The International Team for Implantology (ITI) unites professionals around the world from every field of implant dentistry and related tissue regeneration. As an academic association, it promotes networking and exchange among its more than 16,000 members.

The ITI has built a reputation for scientific rigour combined with a concern for patient welfare. The organisation supports the development of well-documented treatment guidelines backed by extensive clinical testing and long-term results. It funds research as well as scholarships, organises congresses and continuing education events, runs more than 600 study clubs worldwide and publishes reference books, such as the ITI Treatment Guide series.

Growing interest

1990 saw me graduate from Glasgow and head straight to hospital work in Bristol, Blackpool, Preston, and Lancaster; I loved surgery. Implants were there, but being able to place them was a dream for another day.

I first became a member of the ITI in 2006, inspired from attending a surgical skills course with my friend and colleague, Colin Campbell.

Colin and I both come from Gourock in Scotland, a small town on the banks of the River Clyde. Five years his senior, we both went to the same school. I had heard of Colin’s progress in our profession over the years and quickly realised I shared his passions for implant dentistry and patient care, and embraced the principles and teachings of the ITI. Our paths stayed close together; I completed a masters degree in implant dentistry and Colin developed the amazing Campbell Clinic and Academy in Nottingham.

Several years down the line I am now a fellow of the ITI; active in ITI speaking and mentoring and teaching on the foundation course to colleagues beginning their journey in implant dentistry. I also relish the honour of being part of the teaching faculty of The Campbell Academy, working on the year-long and live skills courses.

The focus of my working life, however, is the care of implant patients, primarily at Mydentist in Crow Road, Glasgow.

One common link to the ITI, The Campbell Academy, and practise at Mydentist is the SAC classification. It comprises the proceedings of a consensus conference organised by the ITI in 2007, with the aim of providing normative guidelines for various types of restorative and surgical cases, based on a system referred to as the SAC (straightforward, advanced and complex) classification system.

Classifying cases

Over the last 30 years, the developments of new technologies and advances in clinical procedures have led to a steady integration of implant dentistry into daily practice. Dental professionals have had to broaden their range of skills in order to provide patients with the highest standard of care.

Education, however, has placed little emphasis on the identification of the degree of complexity and risk involved in individual procedures. This presents clinicians with a significant obstacle in their undertaking to provide patients with optimal treatment.

In response to this situation, the ITI has formalised a system of classification for dental implant procedures to support clinicians at every level of expertise and experience. This publication is based on the debate and findings of an ITI Consensus Conference attended by a multidisciplinary group of 28 clinicians that was held in Mallorca in March 2007.

It provides guidelines to a broad variety of implant situations for both restorative and surgical cases, which are classified according to three categories: straightforward (S), advanced (A) and complex (C).

The SAC classification allows clinicians to assess care in terms of complexity, in surgical and prosthodontics procedures. Based on a series of factors – for example, visibility of the implant site when smiling, available bone, medical risk factors – we can assess the suitability of the case for treatment by a clinician, based upon their experience and skillset.

Furthermore, the tool allows the patient to be educated in the risk factors applicable to their treatment, not just in terms of failure, but also in terms of the likelihood of a sub-optimal outcome being the result. The SAC assessment tool does not exactly mirror the recent FGDP guidance, Training standards in implant dentistry, but it does highlight specific risk factors that may render a case beyond the scope of practice for a particular clinician.

In my mentoring practice we aim to complete cases in the ‘S’ category of SAC. This reflects the philosophy of the ITI Foundation Course. For aspiring implant clinicians, beginning the exciting journey into implant dentistry, I would encourage you to look at the SAC classification.

The ITI Online Academy (iti.org) allows access to training and education on SAC, and access to an online assessment tool.

The more things change…

The ITI continues to inspire me in daily practice. I am director of the Glasgow study club, and the section coordinator of ITI study clubs in the UK and Ireland. Forty-nine study clubs throughout the UK and Ireland offer – free of charge to members – over 150 events around the country. These events are suitable for colleagues at every level of experience.

As I reflect on my implant journey, it is clear that the ITI has provided me with training and education that has allowed me to develop an implant practice with a large referral base.

Things change, and continue to change. We stand at the doorway of the digital world and the way ahead is both exhilarating and challenging.

Some things, however, still remain true – risk, and the need to respect biology. On this basis, therefore, I firmly believe that an awareness and respect of the factors and modifiers of the SAC are as important as ever.