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Last month, I was with Dr. Gordon Christensen at the CR Foundation headquarters in Provo, Utah, for some meetings. Before those started, Gordon had an older female patient to see. After he asked her permission for me to observe the procedure (she was a little hard of hearing and didn’t really hear what he said, so we took that as a yes), he invited me into the operatory.

Gordon had made her a denture a year or so ago and told her she wasn’t going to like it due to the impending ridge resorption. She was stubborn enough to try it for a year before she decided to come back and have Gordon do what he wanted to do in the first place: Place two implants so that she could have a denture with enough functional strength to bite someone’s finger off if she had to.

Knowing Gordon well enough to not mind annoying him, I told him we should probably reschedule the case. When he asked, “Why?” I said, “The lab forgot to send the surgical guide.” I tried to deadpan my expression, but I started laughing when I saw the incredulous look on his face.

Gordon studied the cone-beam image on the big screen, gave two mandibular blocks and got to work, placing both implants freehand in about eight minutes. He told me he believed that 80 percent of dentists in the U.S. could do the same thing. While I agree that 80 percent of dentists possess the hand-eye coordination to place implants, I just don’t think that’s what’s holding them back.

I was afraid to place implants for the first 23 years of my career until the lab walked me through digital treatment planning and handed me a surgical placement guide. Equipped with that, I now had the confidence to place that first implant. (We filmed that case, and you can watch it here, under the intentionally Playskool-esque title “My First Implant”.)

When you look at surveys of how GPs practice in the U.S., it’s clear we aren’t big fans of doing surgery. But this is the one surgery where a metal tube guides you to the correct position, and the only surgery where we get to put a crown on top when it’s done. Is guided surgery the key to getting GPs to start placing their own implants?

Yours in quality dentistry,

Dr. Michael C. DiTolla
Editor-in-Chief, Clinical Editor

Chairside Magazine: Volume 9, Issue 2

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