Yes, but the population of the Tohoku area, which was the worst affected, is less than 10% of the total population in Japan. The recovery from the earthquake and tsunami is progressing although the nuclear plant problem is not yet solved. The recovery of the dental business in Japan depends on the world economy rather than the recovery from this disaster.
It is difficult to understand our regulatory requirements. While I have heard that some drug metabolisms are genetically different, and the average jaw bone is larger in Europe than in Asia, I believe there is no big difference between Japanese and European patients. I strongly believe the response to titanium is the same. One reason for the unreasonable requests is that the PMDA (Pharmaceuticals and Medical Devices Agency) wants to demonstrate its authority. Another reason is that it has to take full responsibility if severe adverse effects occur, unlike regulatory agencies in Europe and the USA. PMDA officers were called to court when Japanese patients contracted hepatitis after treatment with a biomaterial prepared from human blood. Still, Japanese patients should have access to the latest treatments.
Yes. However, as in other countries, the final treatment decision depends largely on how much money and time is available.
CADCAM has changed my dental practice dramatically. Implant treatment planning is now simple, and guided surgery is more accurate and less stressful. Titanium or zirconia frames for implant prosthesis provide more esthetic and functional outcomes without much effort.
Social health insurance will cover implant treatment for edentulous patients and patients who need bone reconstruction because of tumors or congenital defects. Although the financial condition of the Japanese government is not good, this decision is very reasonable and welcome.
We have many patients who suffer from shamefully improper treatments. All clinicians get difficult cases. If they cannot handle a problem, they should refer the patient to an expert. Some unethical clinicians believe that implant treatment is simply a way to get money, and we do not have a good way of eliminating unscrupulous practitioners. Our university, two academic implant societies and some implant companies now provide educational courses for dentists. I strongly believe that educating patients and future patients is also very important. If ordinary people are well informed, these bad clinicians will be stopped.