Page 26 - CEREC Q1 | 2014

24 | CERECDOCTORS.COM | QUARTER 1 | 2014
implants are the hottest topic in
dentistry. You can’t open a dental journal
or visit an online dental community
that doesn’t talk about dental implants.
However, most implant educators,
authors and experts are missing a huge
piece of the puzzle: digital workflow.
We all agree that implants are the ideal
choice for replacing missing teeth and
that adding implants to our practice can
kick-start an otherwise stagnant prac-
tice. However, we are led to believe that
implant dentistry requires numerous
visits (oftentimes to multiple dental
offices) and requires expensive labora-
tory procedures. In this case study, I
would like to sharehowimplant dentistry
is being revolutionized and how CEREC
owners are poised to lead this revolution.
FIRST THINGS FIRST
(MY SOAP BOX)
Beforewe begin the case study, I’d like to
discuss something important: how our
profession is failing the dental implant
consumer in two important ways.
First, we have failed to properly
educate our patients about what a
dental implant is (and what it isn’t).
A dental implant is a titanium fixture
that is placed into bone — nothing
more, and nothing less. However, we
have allowed the public to believe that
a dental implant is a tooth. How many
times have you had a patient look at you,
dumbfounded, when you give them a
fee to restore a dental implant? “Doc, I
thought I already paid for
the implant at the surgeon’s
office.” My answer (said in
a joking manner) is always,
No-Compromise
Digital Implant Dentistry
Utilizing Proper WorkflowWith 3-D Technology
C A S E S T U D Y | | | B Y TA R U N A G A RWA L , D . D . S .
neither the patient nor I could justify the
cost difference to have a dental implant.
So I took things into my own hands and
startedprovidingno-compromise implant
treatment from start to finish by utilizing
3-D technologies. I haven’t looked back,
and we are now doing things that I never
dreamt possible. And, by the way, I would
say that 75 percent of the implants I
place don’t require any grafting or fancy
biologics!
Now, let’s get back to the task at hand:
No-compromise digital implant dentistry!
DIAGNOSIS AND PLACEMENT
Linda comes to our office, missing tooth
#19, which was removed about nine
months earlier after being non-restorable
due to an extensive fracture that verti-
cally extended down the root (Figs. 1-3).
At her re-care visit, my hygienist began
talking with Linda about her missing
tooth. She expressed an interest in dental
implant treatment. This triggered an
action in our 3-D implant workflow. It is
my preference to save the patient a visit
by going ahead and taking the neces-
sary records so I can properly diagnose,
educate and explain to the patient how
we go about implant treatment.
So, when I walk into the operatory, a
Galileos scan is up on the monitor, and
my hygienist has taken an Omnicam
digital impression (Fig. 4). After all, our
hygienists are typically waiting for us
anyway, so we might as well train them
to make the practice more efficient.
I am now able to integrate the CEREC
data with Galileos to allow the patient to
see what her tooth will look like, go over
exactly what an implant looks like and
“Yes, you did. Now it’s time to pay for the
tooth that goes onto the implant.”
What has happened is that term
“dental implant” has become synony-
mous with the overall procedure. Truth
be told, a dental implant is only one-
third of the picture; there’s still the abut-
ment and the crown. So, make it a point
— whether or not you place implants —
to properly inform your patients about
what a “dental implant” really is. You’ll
save yourself from having a difficult
conversation later.
Secondly, our profession is slowly
making dental implants too darn
expensive. These fancy bone grafts,
membranes, PRPs, BMPs, implants
with fancy coatings, costly custom abut-
ments and numerous office visits to
multiple providers … all just to replace a
single tooth. I am not talking about the
complex cases where this stuff is often
called for, but it seemed like every time
I referred a patient to the specialist for
the single implant, the patient always
needed all this fancy stuff.
It not only kept the patient from
doing the treatment, but also taints the
consumer about dental implants. How
many timeshave you talkedwithapatient
about dental implants and the patient
stops you and says, “Doc, I’ve heard that
dental implants require surgery, cost a lot
of money, and hurt.” Look, I’m not saying
this stuff isn’t needed, I’m just saying it
isn’t needed in every case.
Why did I just waste your time withmy
ranting and raving? Because these two
things are exactly why I was forced into
havingtoplacedental implants inmyprac-
tice. I simply refused to do a bridge, and