Dentist2Dentist

Minimally Invasive Implants for Superior Patient Outcomes

August 16, 2024 Dr. Micheal Miyasaki Season 2 Episode 8

Ever wondered how to transform your dental practice and stay ahead with the latest implant techniques? Discover the secrets of minimally invasive implantology that promise to elevate your skills and patient outcomes. This episode unpacks the revolutionary shift from traditional, invasive methods to the state-of-the-art Magic Core system. Learn how advancements like CBCTs and innovative implant designs, featuring wide rectangular threads and a machine-polished magic cuff, can reduce patient discomfort, shorten recovery times, and ensure superior long-term results. Witness how the Magic Core system's unique design promotes stable, healthy healing and tackles the challenges of micro-gaps and movement for more reliable results.

In the second part of our episode, we reveal the global success stories of minimally invasive implantology and its potential to boost your practice growth. Highlighting the necessity of continuous education and the right tools, we discuss effective strategies to market your new skills. This isn't just about meeting patient expectations—it's about driving your practice to new heights. Join the Omni group and embark on a transformative journey that promises to enhance both your professional capabilities and patient care. What are you waiting for? Take the leap and watch your practice thrive.

Speaker 0:

Hi, thank you for joining me. This is going to be a quick review about mastering minimally invasive implant techniques and it really is an introduction for a general dentist, and I hope you've had a chance to look at this, the printout, because I'm going to be following basically that, that outline. Are you ready to elevate your practice to new heights? If you're a general dentist and you don't place implants, I think you're missing a large segment of practice growth. Patients want to replace their missing teeth and they're tired of using bridges and removable appliances. They want implants because they look and feel like their natural teeth. I've been using the Magic Core system now exclusively in our practice for about four and a half years, ever since it was introduced to the United States. Ever since it was introduced to the United States, my patients have loved the way that these implants are placed and I love the way that they heal and the way that they're so easy to restore. So why did we do maximum invasive implants before? Well, obviously we had to lay a flap, which meant we had to create incisions, which meant there was probably going to be more discomfort for the patients. But we had to do this so we could see the bone, because we were replacing bone-level implants At the time. But we had to do this so we could see the bone. Because we were replacing bone level implants At the time, 20, 30 years ago we didn't have CBCTs in our office, so it was very hard to visualize this area. And if we were using an implant and the design of that implant required us to have a prosthetically driven placement, then many times we'd have to do guided tissue regeneration or guided bone regeneration to develop that foundation so that that implant could then heal to achieve the strength and the aesthetics needed. And if we were working in the maxillary posterior area, oftentimes we had to deal with the sinuses and so we would have to do a lateral window sinus graft, which is very invasive. And then when placing this bone level implant, I needed to see where the bone was so I could get that implant level with the bone.

Speaker 0:

Now let's go back. If we didn't have to use an implant like that, what would be the ideal implant system? Minimize the need for those incisions and laying it flat. One that had some sort of guide so I wasn't having to do it free-handed. One where I can minimize the use of other materials that just raise the cost for everybody, such as membranes and even graft material, one that did not require a second stage surgery to uncover the implant once it was placed, doesn't require working below the soft tissues when we are going to restore it, has no chance of micro-movement or micro-gapping, and is able to handle the occlusal stresses placed upon the fixture in the bone. And, ultimately, a system that could help us avoid what's one of the greatest challenges for us today, once an implant has healed successfully, is managing the problems of perimicositis and peri-implantitis by establishing a biologically healthy tissue attachment, like we have on natural teeth, around implant.

Speaker 0:

Well, now we can achieve all of these things with the minimally invasive implant system that we're going to talk about. So why do minimally invasive implants? Well, because patients are better informed. They're all Google doctors and they have higher expectations and they want procedures that are less invasive. It shortens their recovery time and can actually yield better long-term results. So if you can master these techniques, you're going to exceed their expectations and, with happy patients, they're going to refer and they're going to be loyal patients to your practice, and we want that today. So how do we get to this point? It really took a new implant design and with that new implant design, new protocols of placement with newly designed instruments, and that's all been done with the Magic Core system. So for more than a decade clinicians throughout the world have been using this minimally invasive implant placement approach.

Speaker 0:

So here are some of the features. In the upper left-hand corner you see that we've got what's called the magic fin threads at the very bottom. They're these very wide rectangular threads. The diameter of the actual osteotomy that we have to create is actually much smaller than most conventional implants, so we actually save more bone. But we have these wider fins, and these wider fins are rectangular, with a lot of interthread bone and because there's so much interthread bone that is better to distribute the occlusal forces. The wide fins actually connect as a scaffold for the blood. So sometimes we don't have to place graft material and even in areas of very, very thin bone, these wide threads give us great stability, allowing for us to have good healing. Above the threads we have what's called the magic cuff. That's a machine polished area that, once you place the implant, the connective tissue and junction epithelium can heal up around that area to form a nice biologic seal we were talking about, and we often see ungrowth, which means the soft tissue. As the bone heals up underneath, it will actually go upwards, not down.

Speaker 0:

It has this unique one-piece design. Basically that means the fixture and the abutment are all one piece. We don't have any screws, or one doesn't fit into the other, so we don't have any chance of a micro gap or any micro movement. And because that area is so strong, we can either be bone or prosthetically driven. In our treatment planning of this case we don't have to worry about any screws, fracturing and the prosthetic options that we can do on top of this platform are many. We can cement a restoration, we can screw a restoration and because it's all one piece, we can get away with very minimal occlusal clearance. So what we have to do is understand and then master these techniques.

Speaker 0:

One flapless surgery so we maintain the blood supply between the soft tissue and the bone. We can reduce post-op discomfort. We do place a pin in the bone. Take a CBCT just to verify that we like the position angulation of our guide pin. We then have a trefine drill that fits over that guide pin. So it is a guided surgery. We aren't just doing this free-handed, not knowing where we're going or the direction of our drill. We then tap the bone. Many times If I've got hard bone, instead of crushing the bone as I place the implant, we actually tap the bone or thread it, which means we create the threads in that hard bone for those large rectangular threads of our implant to follow and then we get that soft tissue on growth because we do not disturb the soft tissue. Once it heals up, the bone will rise up to level the connective tissue and then the junction of the thenum to protect that area will actually go up to recreate the sulcus. So the techniques may sound complex, may sound a little bit different, but with a little bit of practice and training you too will be able to successfully place these magic core implants in no time.

Speaker 0:

What are the benefits to the patients? We talked about it Less pain and less discomfort, faster recovery. And for our patients that are very busy today, they appreciate that Many times we can do a crestal approach with our sinus lifts if we have to do a sinus lift, and we can place implants in areas of very thin bone. All of this just means the patients can have less anxiety, knowing that the procedures that we're going to follow are minimally invasive. So these techniques overall will enhance the patient experience, making your practice the top choice for patients seeking dental implants and who's not doing that these days?

Speaker 0:

The benefits to your practice well, if we can place these implants with greater efficiency, it means we can do it faster, which means a happier patient, happier patient with higher patient satisfaction. They're going to be more loyal and, again, as we discussed, likely to refer patients to your practice. It will enhance your practice's reputation and yours. You're looked at as a cutting-edge clinician and ultimately, there's going to be financial growth. Implants are a larger margin procedure that we can do in our office, but our patients want this procedure, so they value it. If you can incorporate minimally invasive implant procedures into your practice, you're going to be viewed as a leader in dental innovation, offering better services, not commoditized types of services. So what's the step-to-step guide to get going? One invest in your education. The Academy of Minimally Invasive Implantology holds courses very often. There'll be lectures and there'll be live surgeries, and what we want you to do is work with your colleagues to be mentored until you feel comfortable placing these implants.

Speaker 0:

Get the right tools. The implant kit the MagiCore implant kit is very simple. There's one core kit where you can place implants from four millimeters to 6.5 millimeters in diameter, and then, more recently, there's been a narrow implant kit that's been introduced for your three and 3.5s. With these kits you can do everything you need for your sinus lifts, your ridge expansions and much more. So, unlike other implant kits, you don't have to have a lot of different kits. Most of the time 90% of the time I just open up the main kit and we're ready to go. Second, I'd recommend that you get a CBCT. You want to see what the bone looks like and what the anatomy and the sinuses and nerves looks like. Even if you lay a flap, you can't see that Just in any type of implant surgery. You will do more implant placements if you have a CBCT, whether it be minimally invasive or you're more traditional.

Speaker 0:

Third practice Practice, practice, practice. Start with simple cases and gradually take on more complex ones as you gain confidence, and don't hesitate to seek guidance from your colleagues or mentors that teach with the AMI group. The AMI program allows you to receive the amount of training you need to feel comfortable placing implants. Step four communicate with your patients. If you haven't placed implants before, they don't know that you placed implants. So educate your patients on the benefits of minimally invasive implant techniques. Use visual aids and simple explanations to help your patients understand the process and feel more comfortable with it.

Speaker 0:

Five after every procedure, just like everything else, we do take the time to evaluate your performance, what went well, what could be improved, because continuous learning and self-assessment are what is key to mastering the steps. Here are just a few photos of a case that we did in our practice. On the left-hand side you see the dentureless area. We then put guide pins into the ridge. We took a CBC to verify. We like the placement angulation of those guide pins. Use our trefine drills to go over the guide pins and place these implants. Now you can see these implants. They're one piece. They extend over the soft tissue. We don't bury them. Because of that, the soft tissue now heals up around that magic cuff and then we can place a cemented restoration. Here you see a five-unit bridge on three implants and on the far right-hand side you see the immediate placement photo. I'll get a better photo of that once the tissues have a chance to heal up around that area. But I will tell you our patient was very happy. They could eat, smile and talk again with confidence and he was just destroying his anterior teeth, teeth eight and nine, because those were the only teeth he had on the upper arch.

Speaker 0:

What are some of the common pitfalls? Just not having adequate training. Some people will take these kits and think I place implants for 20 years. I can take this kit and do it. It's a little bit different. So what I would ask you to do is just make sure that you feel properly trained. Give yourself a chance to get properly trained. Begin with those simple cases and as your confidence grows, you can do the sinus lifts and work on narrow ridges.

Speaker 0:

Pitfall number two is just poor communication with your patients. If you've got a tough case, tell your patient what those complexities are so they appreciate what it is that we're dealing with. Help them understand with this minimally invasive technique how you're gonna place the implants and they will literally be up and out of the chair, even if you've done a science lift. But they still have to take care of those implants. They can't overdo it. So we'll show you and explain to you how we communicate with the patients. And lack of acceptable restorative results Once we get that implant in it's healed up. If we don't have a lab that can then restore that implant properly, the patient's not going to be happy. So being aware of the possible pitfalls and taking proactive steps to help you avoid them will ensure that you have successful implementation of minimally invasive implant techniques into your practice. And once you've gotten good at placing minimally invasive implants, let the world know. Update your website with before and after photos, leverage social media, and if you've got those patient testimonials to put on your website and your social media, that's even better. Those positive reviews will make potential patients feel better about talking to you. Maybe offer some educational seminars, either live or like this, maybe online, and then network with colleagues. There's a lot of your colleagues that are trying to place dental implants but they do maximum invasive. Let them know you do minimally invasive. Maybe you'll be able to place those implants in their patients and they'll do the restorative aspect.

Speaker 0:

The future of implantology, and minimally invasive implantology especially, is exciting. We've got the trend going on with all NX. If you use these minimally invasive implants, you can place more implants because now we can work in those sinus areas, minimize the risk of what happens when we lose an implant and we have an all NX and patients can actually retain more of their bone. We don't have to level out the ridges, we can work with the bone that they have in most cases, then Magic Motion Magic Motion is a overdenture system that allows patients to comfortably eat and confidently speak, smile and laugh again, using just sometimes one or two implants and using an overdenture attachment system underneath their dentures. I've had patients with maxi dentures where you can take out the upper palate. They enjoy that. They're able to eat apples even. They have such good stability because with this overdenture system we have denture supported but implant retained prosthetics. It's truly affordable, life-changing dentistry. So, in conclusion, this is just a very quick introduction to what we can do with minimally invasive implants and the techniques.

Speaker 0:

I would encourage you, if you are a general dentist, to join those all over the world that are learning to use these techniques and having great success. Invest in your education, get into the right tools, effectively learn how to market your new skills and you will transform your practice. Provide exceptional implant care for your patients. Remember, the journey to mastering these techniques may seem daunting, but with a little dedication and practice with the Omni group, you too will become proficient in no time and your patients will thank you and your practice will thrive. So let me ask you. What are you waiting for? Dive into the world of minimally invasive implantology and watch your practice soar to new heights. I look forward to seeing you soon, thank you.

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