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The beloved Midline Implant.   A favorite of many a practitioner and part of the 5 Implant Configuration used frequently in All-On-X surgery.  As someone who almost never…ever…places a midline implant, I have struggled to grasp the value in this technique. Furthermore, I think the midline implant can actually be a disadvantage to your AOX […]

All-On-X surgery draws on many different aspects of oral & maxillofacial surgery. This is one reason the procedure is so challenging, yet fun and rewarding at the same time.  Because this procedure involves many different surgical skillsets and techniques, it is tempting to use countless different surgical instruments.  There is obvious, inherent value in having

The piriform rim is a thin, cortical layer of bone that outlines the nasal aperture.  In laymen’s terms, it’s a rim of dense bone around the nose.  The maxilla, often having more cancellous bone than the mandible, will typically present with less bone density than its counterpart. The piriform rim has become increasingly popular as

There are many things that make a great All-On-X surgeon.  That being said, the one most likely to make you restorative friends, keep your referrals flowing, and make you enjoyable to work with is the often underrated ability to actually put your abutments in an ideal or close to ideal restorative position.  I get it.

The acclaimed movie Rounders, tells the story of a professional poker player (Matt Damon) grinding it out to make a living, ultimately trying to make it big at the World Series of Poker in Las Vegas.  During his journey, he finds himself at an intense, high stakes table. Caught up in the moment, he foolishly

Most practitioners who routinely perform All-On-X surgery have some preference toward a certain implant size. Sure, depending on the case, we adjust as necessary. But there tends to be a certain implant we prefer most of the time.  In discussing this topic with experienced providers, who cumulatively have done thousands and thousands of arches, the

I extract all teeth in the arch before I make my surgical incision.  Cue the “Gasp”?! I realize that I am in a very small minority, if not a loner when it comes to this technique.  I did not always perform surgery this way. I used to be like many of you…an incision first surgeon. 

While often overlooked, I feel that closure is one of the single most important aspects of All-On-X surgery.  I believe that the quality of surgical closure directly impacts both soft and hard tissue healing.  My closure is also the most easily visible reflection of my work and attention to detail that my referring restorative providers

Inadequate alveolar reduction is one of the worst, but most avoidable, All-On-X complications.  Insufficient reduction of the alveolar ridge can lead to a thin prosthesis prone to fracture, having to unnecessarily open VDO, lip incompetence, and the dreaded visible transition line of the prosthesis.  The first step in preventing the above complications is that the

There are three primary ways to place anterior maxillary implants (#7/#10) in an All-On-X configuration. 1. Vertical Orientation   2. “M” or “M-4″ Configuration    3. “Inverted V” or “V-4” Configuration All of these options are clinically sound. I know great surgeons that fall into all three of these categories.  And, as shown by my