Do I really need a membrane?

Membrane or Nah? A little while back one of my friends told me that membranes make no difference for bone grafting. He told me of a prominent oral surgeon who doesn’t use membranes either.  That got me wondering.  Am I wasting my time fidgeting with that little construction-paper-looking POS?  Is it really necessary for me to be spending all of that effort with fancy suturing or tacks (the darn tips

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Top Secret All on X Scan Protocol

I’ve been looking everywhere (to no avail) to find out how I can put my little intraoral scanner to use for All on X (All on 4) restorative cases. When I call and ask, most labs have no idea what the heck I’m trying to do. They just want me to send them the case and do it the conventional way. EVEN the labs that say they are utilizing this

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Bone Loss with Subcrestal Implants

Crestal vs Subcrestal: Should we be submerging our immediate implants? I got a great question about this topic in my previous post and wanted to look at this from a evidence based approach, rather than just give an anecdotal “This-works-for-me” type of response. On the one hand, if we place immediate implants crestally, we will risk showing exposed threads if there is any bone loss. On the other hand, if

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A little Trick for Immediate Placement

Sup guys! Lately I have been placing a lot of immediates (especially now since I’m also placing implants for Western Dental). I want to share a trick I picked up a little while back. I am getting better at extracting root tips. Especially now that I’ve gotten a few new tools for fishing those suckers out. (spade elevators & periotome + mallet) But every now and then I get a

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Dental Practice Start Up Tip – Do this First!

Yes, it’s true. I started my dental practice from scratch without taking any practice loans. I’m not talking about student loans, I have a boatload of those. Its actually because of my insane student debt that I decided I do not want to get further in debt by taking a business loan. I’d like to take some time and share with you exactly how I was able to do that.

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Implant Ninja 10 Point Story

I’m sort of in a sentimental mood, so I’d like to share with you a bit of my story. Here’s some trivia to know about my life: I left Peru with my parents when I was 2 years old because of terrorist attacks & Molotov cocktail explosions in front of my house (true story) On Saturdays, my parents and I would go to a warehouse and stack newspapers for 1

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NP Trouble & Tissue Biotypes

Hey! So I got a lot of questions about this topic I put up on IG a few days ago. The Nasopalatine Fossa has constantly been an annoyance for me in planning implants at the maxillary central incisor area. Sometimes the ridge will look super fat and then I take a CBCT and the NP Fossa takes up 50% of the area where I want to place my implant! Let’s

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How to get Started with Learning Dental Implants

I’ve gotten this question a lot recently from new grads. They say something like, “I had an implant course in school but I still don’t feel confident to actually place implants. There seem to be so many training courses but I feel a little overwhelmed because I don’t know where to start. Any tips?” I totally get it. I went through the same thing. I had an implant course in dental

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A Comparison of Survival Rates of Short Versus Long Dental Implants

Clinical Application Summary: I regularly use implants as short as 8mm in my practice without thinking twice about it. I would use 6mm implant in some cases but I like to keep things simple and stick to one implant system (I’m currently using Zimmer TSV) My caution to anyone placing short implants is to keep in mind the height of the crown you will build on top of that implant.

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Oh Snap! Perforated the Sinus during implant placement

Clinical Application Summary:  If a perforation has already happened inside of an implant preparation, I assess if I can still get a decent length implant placed and that this implant will NOT be any more than 3mm into the sinus. An implant 1-2mm into the sinus should heal uneventfully. If the sinus is perforated, I have my patients take Augmentin during the healing process. Be carefull with irrigating inside of

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Placed dental implant too close to the IA Nerve!

“Help! I placed a dental implant too close to the IA nerve!” This is not an uncommon thought for a dentist placing dental implants in the posterior mandible. Sometimes, it is not clear on the panoramic image exactly where the Inferior Alveolar nerve is. Other times the patient may jump up in the chair when you are only a couple of millimeters deep. It is a commonly accepted best practice

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All-on-4 Denture conversion

How to convert an All-on-4 Immediate Load Denture

Hey guys, As promised, here is the step-by-step walkthrough of converting an All-on-4 denture. In my upcoming ebook, The Implant Ninja All-on-4 Handbook, I will cover this process in more depth and will discuss different approaches & materials, and most importantly, complications. (It will become available in Spring 2017. Pre-order to reserve your copy! ) If you’re interested in learning my technique, we are also offering All-on-4 learning webinars. This is the

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All-on-Four Complications: Part 2

  This is a continuation of The All-on-Four Complications Part 1. Again, I’m not writing this to scare you off from this treatment. I am not saying that I don’t believe in this treatment. On the contrary, I think it is a fantastic solution. However, I would like to shed some light on some of these issues which are not regularly discussed in an open forum. By sharing these limitations, we

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All-on-4 Complications: Part 1

Full Arch implant bridges (All-on-4, permanent dentures, etc) are a wonderful thing. They quickly turn around a patient’s self-confidence and get them back on track with their diet and overall health. I have had a very positive experience providing my patients with this treatment. …but, if done the wrong way, they can lead to pretty disastrous outcomes. Although failure of osseointegration of dental implants does sometimes occur, is not the major

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The Importance of Lip Support – Part I

Someone asked me the other day, “What is the most overlooked aspect of All-on-Four Dentures?” By and large, I think the answer is lip support. Too often, after hearing a patient say they want “permanent dentures” the case is hastily planned as an All-on-Four case. The implants are placed, the case is restored, and Viola! But every so often, (especially if the case is not planned properly) a patient will

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