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Is Not Flat Our World clinical articles • management advice • practice profiles • technology reviews June/July 2016 – Vol 9 No 3 OUR PROMOTING EXCELLENCE IN IMPLANTOLOGY IS NOT FLAT Case study: immediate WORLD implant placement and temporization Dr. Leon Pariente Changing paradigms in implant dentistry Dr. Ashok Sethi Case planning to IMPLANT PATIENTS OF YOUR ANATOMY THE IS NEITHER final restoration of a congenitally missing mandibular left second premolar Dr. Bart W. Silverman Company spotlight Luman Dental, LLC Practice profile Dr. Tigran Khachatryan TM OsseoSpeed Profile EV —It’s time to challenge conventional thinking PAYING SUBSCRIBERS EARN CONTINUING EDUCATION 24 CREDITS PER YEAR! www.dentsplyimplants.com BETTER. SIMPLER. STRONGER. Introducing the next generation of LOCATOR, the LOCATOR R-Tx™ Removable Attachment System– combining improved design, system simplicity, and DuraTec™ Coating toughness. DuraTec Titanium Carbon Nitride Industry standard Coating is aesthetic, harder and .050"/1.25mm* hex more wear resistant. drive mechanism. Dual retentive surfaces for 50% increase in engagement & narrower coronal pivoting capability to 60° geometry for easier seating between implants. of the overdenture. Enhanced geometry to resist Convenient all-in-one movement and anodized pink packaging. for improved aesthetics. Experience the next generation LOCATOR R-Tx Removable Attachment System today! Please visit ZESTANCHORS.COM/RTX, call us at 800.262.2310, or contact your implant manufacturer for more information. Available NOW for leading implant systems. *Excluding connections that utilize .048” hex drive mechanism. Please contact your implant company provider for more information. ©2016 ZEST Anchors LLC. All rights reserved. ZEST and LOCATOR are registered trademarks and DuraTec, LOCATOR R-Tx and R-Tx are trademarks of ZEST IP Holdings, LLC. INTRODUCTION Thinking beyond the conventional June/July 2016 - Volume 9 Number 3 to maximize solutions EDITORIAL ADVISORS Steve Barter, BDS, MSurgDent RCS Anthony Bendkowsk,i BDS, LDS RCS, MFGDP, nfortunately, ridge morphology does not always present with a DipDSed, DPDS, MsurgDent Uflat “platform” in which to place a “traditional, flat-top” implant, Philip Bennett, BDS, LDS RCS, FICOI regardless of implant brand. In my experience, I encounter a clinically Stephen Byfield, BDS, MFGDP, FICD significant ridge deficiency approximately 30% of the time. Historically, Sanjay Chopra, BDS in order to accommodate these “imperfect” sloped situations, the Andrew Dawood, BDS, MSc, MRD RCS implant must be placed where one aspect of the platform is seated Professor Nikolaos Donos, DDS, MS, PhD at the level of the bone while the other side is above the crest. This Abid Faqir, BDS, MFDS RCS, MSc (MedSci) commonly requires concomitant bone grafting in order to ensure Koray Feran, BDS, MSC, LDS RCS, FDS RCS that the implant is completely ensconced within the bony housing. Marc Bienstock, DDS, MD Philip Freiburger, BDS, MFGDP (UK) The other alternative is one in which one aspect of the implant is Jeffrey Ganeles, DMD, FACD positioned at the bone level while the other is buried deep to the crest requiring bone Mark Hamburger, BDS, BChD removal in order to develop the space needed for the restorative components. This results Mark Haswell, BDS, MSc in a longer clinical crown and increased difficulty with hygiene. In addition, there are many Gareth Jenkins, BDS, FDS RCS, MScD bony ridges that need bone augmentation prior to implant placement due to inadequate Stephen Jones, BDS, MSc, MGDS RCS, MRD RCS bone thickness, sometimes necessitating additional surgical sites and healing time to reach Gregori M. Kurtzman, DDS the final goal. Jonathan Lack, DDS, CertPerio, FCDS Now, in sites that have either sloped ridges or bony concavities that otherwise Samuel Lee, DDS would have required bone grafting in the past, we are able to plan for and utilize the David Little, DDS OsseoSpeed Profile EV implant (ASTRA TECH Implant System, Dentsply Sirona Implants) in Andrew Moore, BDS, Dip Imp Dent RCS combination with three-dimensional planning, which allows the surgeon and restorative team Ara Nazarian, DDS the opportunity to predict surgical site limitations and plan for success. In today’s environ- Ken Nicholson, BDS, MSc ment, the use of CBCT for implant treatment planning has become somewhat universal. By Michael R. Norton, BDS, FDS RCS(ed) continuing to leverage new advancements such as the OsseoSpeed Profile implant with its Rob Oretti, BDS, MGDS RCS sloped platform that can be oriented in any direction in order to match the direction and loca- Christopher Orr, BDS, BSc tion of the ridge’s slant, we now have an implant that naturally matches the sloping anatomy Fazeela Khan-Osborne, BDS, LDS RCS, BSc, MSc instead of having to match the anatomy to the implant. Due to this implant characteristic, I Jay B. Reznick, DMD, MD am able to streamline the implant process with less secondary bone grafting procedures, Nigel Saynor, BDS resulting in shortened treatment times and decreased costs for the patient. Malcolm Schaller, BDS I have been an avid user of the standard line of OsseoSpeed implants for the past 10 Ashok Sethi, BDS, DGDP, MGDS RCS, DUI years of my career as an Oral and Maxillofacial Surgeon in Santa Barbara, California. I have Harry Shiers, BDS, MSc, MGDS, MFDS had the opportunity to observe the consistent integration and bone support that this implant Harris Sidelsky, BDS, LDS RCS, MSc design offers my patients. As I have progressed to be an OsseoSpeed EV user, both my Paul Tipton, BDS, MSc, DGDP(UK) restorative dentists and I have appreciated the improvement in restorative simplicity. Restor- Clive Waterman, BDS, MDc, DGDP (UK) atively, the company also really added simplicity to the Profile implant line, whereby all the Peter Young, BDS, PhD indexed components are designed to match the slope and will seat in only one position in Brian T. Young, DDS, MS the implant. Taking the guesswork out of where to position the abutment helps set restorative dentists up for success. Consequently, referrals have increased, and patient acceptance of CE QUALITY ASSURANCE ADVISORY BOARD proposed care has skyrocketed. Dr. Alexandra Day, BDS, VT The standards and methods by which we have been providing implant treatment care Julian English, BA (Hons), editorial director FMC continue to evolve with the availability of new technologies and innovations. In order to provide Dr. Paul Langmaid, CBE, BDS, ex chief dental officer to our patients with the highest quality outcomes, we must often challenge ourselves to think the Government for Wales beyond convention to maximize the solutions available to us. Dr. Ellis Paul, BDS, LDS, FFGDP (UK), FICD, editor-in- chief Private Dentistry Marc Bienstock, DDS, MD, was born in Albuquerque, New Mexico, and raised in Waterford, Connecticut. He moved to Dr. Chris Potts, BDS, DGDP (UK), business advisor and Santa Barbara with his wife and two children in 2003 after completing his residency in Oral and Maxillofacial Surgery at ex-head of Boots Dental, BUPA Dentalcover, Virgin Mount Sinai Medical Center in NYC. Dr. Bienstock received his undergraduate B.S. from Union College, graduating with Dr. Harry Shiers, BDS, MSc (implant surgery), MGDS, honors in biology in 1993. He then received a Doctorate in Dental Surgery from Columbia University in 1997, followed MFDS, Harley St referral implant surgeon by a Doctorate in Medicine from the Mount Sinai School of Medicine in 2000. Dr. Bienstock is a Diplomate of the Board of Oral and Maxillofacial Surgeons and belongs to a number of organizations, including AAOMS, CALOMS, and the ADA. He has devoted his professional career to include all aspects of Oral and Maxillofacial Surgery, with specializations in © FMC 2016. All rights reserved. office-based oral surgery, anesthesia, facial trauma, maxillofacial reconstruction, dental implants, bone grafting, and bone FMC is part of the specialist publishing group Springer Science+ morphogenic protein (BMP). Due to the complex nature of dental rehabilitation utilizing dental implants, Dr. Bienstock Business Media. The publisher’s written consent must be obtained remains on the cutting edge of technology. He is involved in multiple implant study groups, where he lectures and is before any part of this publication may be reproducedvw in any form the surgical consultant in the treatment-planning process. Interdisciplinary communication is paramount for exceptional whatsoever, including photocopies and information retrieval systems. While every care has been taken in the preparation of this magazine, functional and esthetic results, and Dr. Bienstock values the input and expertise of everyone involved in the implant team. the publisher cannot be held responsible for the accuracy of the In addition, Dr. Bienstock continues to keep abreast of the latest developments in his specialty by continuously exceeding information printed herein, or in any consequence arising from it. The views expressed herein are those of the author(s) and not necessarily the the continuing education requirements of California. His hobbies include skiing, snowboarding, cycling, and hiking. opinion of either Implant Practice or the publisher. Volume 9 Number 3 Implant practice 1 TABLE OF CONTENTS Financial focus Being creative with 401k planning Tony Robbins addresses the question, “Is the 401k game still winnable for the average person?” ................12 Product profile Isolite® Systems Precision-designed, reliable, and efficient solutions for minimally invasive, easy-to-use
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