There is no disputing the fact that in the U.S., nearly 12 million people remain edentulous in at least one arch. As such, it continues to be an understatement to claim that the dental profession has its work cut out for it if this crippling problem is to be adequately addressed. Expert All-on-X dental implant training continues to play a part in the solution.

From a clinical training perspective, BioHorizons is often considered the most forward-thinking dental implant company on this subject. And the Oral Reconstruction Foundation (ORF) International Symposium 2022, sponsored by BioHorizons, did not disappoint on the subject of All-on-X. The event made a concerted effort to educate and train more dentists on All-on-X dental implant procedures.

Dr. Michael Pikos on treatment for atrophic maxilla with zygomatic implants

Few world-renowned implant surgeons can command the undivided attention of so many experienced clinicians like Dr. Michael Pikos. Over the course of an hour and a half, symposium attendees in the large general assembly benefited from a wealth of experience shared on zygomatic dental implant approaches.

Dr. Pikos demonstrated multiple full-arch principles at the ORF International Symposium. He suggested these hard and soft tissue principles are foundational and should be followed during the treatment planning phase as well as in the execution of the zygoma implant treatment therapy.

Consistent with Dr. Pikos’ training method, several literary references where shared in support of his treatment protocols. Multiple zygoma implant cases were demonstrated as he walked doctors through this beneficial service to patients in need.

Drs. Andrew Ferrier & Arshiya Sharafi hosted TeethXpress All-on-X lecture

Dr. Andrew Ferrier, prosthodontist, and Dr. Arshiya Sharafi, oral surgeon, hosted an informative All-on-X breakout session at the Symposium. Attendance to this sold-out, four-hour event required preregistration.

Dr. Ferrier began the session by discussing best practices in All-on-X restorations. One point of emphasis included designing immediate load provisional prostheses for strength and functionality. Dr. Ferrier suggested that reducing the likelihood of a prosthetic fracture – during the three-to-five-month implant integration period – is tantamount to the success of the case.

“For both esthetics and durability, my immediate-load provisional prosthetics are designed as FP3s using monolithic PMMA materials,” said Dr. Ferrier. He went on to discuss treatment planning for All-on-X smile design, occlusion and leveraging internal marketing resources for improved full-arch case acceptance.

Presenting second in this duo line-up session, Dr. Sharafi’s lecture emphasized best practices in All-on-X implant surgery. Extraction techniques that save time as well as root-banking to preserve a thin buccal plate were discussed. Dr. Sharafi emphasized the importance of achieving adequate interarch occlusal spacing while demonstrating various ridge reduction techniques that allows him to be super efficient in this process.

If you missed this advanced full-arch lecture, two more opportunities to learn from them are available in 2022. The first is a comprehensive two-day, TeethXpress course in San Diego, California, June 17-18, 2022.

Drs. Ferrier and Sharafi will also offer the same two-day TeethXpress course in Providence, Rhode Island, Sept. 30–Oct. 1, 2022. Both TeethXpress course dates will include a live All-on-X surgery and immediate-load prosthetic delivery. Visit TeethXpressCourses.com to register while seats remain available.

Panel discussion on varying full-arch treatment protocols among Symposium’s most anticipated sessions

Most frequently, when key-opinion-leaders take the stage, there are no contrasting views represented in the same forum. The Full-Arch Implant Therapy: Pros and Cons of Specific Treatment Protocols breakout session was very different in this sense.

Three well-respected clinicians, Dr. Matthew Fien, periodontist, Dr. Arshiya Sharafi, oral surgeon, and Dr. Curry Leavitt, periodontist, participated in this panel discussion, presenting three different approaches and protocols to full-arch, implant therapy. This panel discussion was well-moderated by Dr. Bart Silverman, a renowned oral surgeon and noted lecturer in his own right.

Each of the three panelists were charged with making a case that supports their respective All-on-X treatment protocols. Dr. Fien presented first on the use of narrow diameter implants in full-arch implant dentistry.

Dr. Matthew Fien
Dr. Matthew Fien discussed his appreciation for the sturdy purchase that the MDL narrow diameter, self-tapping implants offer. To achieve this solid foundation, he frequently uses the pilot drill only, often creating osteotomies that are approximately half as deep as the length of the implant. From this point, the self-cutting design of the MDL system allows Dr. Fien to place the implant to depth and achieve the primary stability required for predictable, immediate-load conditions. Dr. Fien presented multiple arches that included both MDL and Tapered Pro regular diameter implants.

Dr. Arshiya Sharafi
Dr. Arshiya Sharafi was the second presenter. His focus was about performing All-on-X procedures using a freehand, non-digital approach. Dr. Sharafi represents perhaps the largest swath of clinicians who believes that the freehand protocol offers the best opportunity to gain a tactile feel for the bone density and otherwise. This increased ability to survey the bone and each implant site allows for flexible and real-time implant placement decisions. He suggested that these decisions can influence optimal osteotomy site development and positioning of the implants.

Dr. Curry Leavitt
The third and final panelist to present was Dr. Curry Leavitt. Dr. Leavitt made a case for CBCT-based, stackable guides for his All-on-X surgeries. He demonstrated a great appreciation for a digital-based protocol that allows him to first perform such treatment, virtually. In his experience, a fully guided approach – using the nSequence fully guided system – allows for the most precise execution of the pre-planned surgery and prosthetic delivery.

Following each of the three presentations, Dr. Silverman was masterful in moderating a panel discussion that allowed the presenters to simultaneously share the stage for a Q&A session.

While there were distinct differences in panelists preferred approaches to full-arch immediate load, there was plenty agreement for foundational approaches to achieving a predictable and favorable treatment outcome. Some common approaches included the use of Tapered Pro implants (by BioHorizons), torque value requirements, proper A-P spread, lip-line considerations, and much more.

A schedule of 2022 courses offered by Dr. Matthew Fien are outlined at fienodontics.com. A schedule of remaining 2022 freehand/analog and fully guided TeethXpress All-on-X courses led by Drs. Andrew Ferrier, Arshiya Sharafi, Curry Leavitt, and Bart Silverman can be found at teethxpresscourses.com.