Faces, smiles and teeth.

Faces, smiles and teeth, a message that has been reinforced recently with 2 lectures that  I attended recently.

In fact I have seen both of them speak before and they have spoken about the holistic approach to dentistry, whereby diagnosis and planning begins not with the mouth, but with the face.

Proffessor Piet Haers, a maxillo-facial surgeon with an interest in orthognathic surgery   (surgery where the bones of the face are moved and aligned to create a more harmonious  appearance and improve function) discussed his concept where he creates a face, and in the face a smile, and in that smile the ability to  bite and chew. He starts his journey on  the bones of the patients, and working with his patients to move bones and then alter the muscular relationships to leave his patients in Neuromuscular balance.

Christian Coachman, founded of Digital Smile Design, a concept which allows dentists and their teams to design smiles around the whole face, communicate these plans to the patients, perform the treatment with the whole team having a common goal, and then review their performance on delivering the treatment plan in order to improve. All using modern digital dentistry.

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These 2 recent talks have reinforced our philosophy at Ten Dental:

We design patients smiles to work in harmony with their faces.
We use natural tooth shapes and designs to work in harmony with your face.
We are an interdisciplinary specialist team that works together to deliver the best result possible.
We allow you to see a treatment simulation as to what your teeth may look like before we start treatment.
We invest in the latest technology to deliver the best treatment we can.
We deliver healthy confident smiles and faces.
We also still carry out routine Check-ups and hygiene visits, but we can now offer much, much more…

It was a pleasure to take some of our team to the Digital Smile Design day and for them to see the founder of DSD speak and explain  his philosophy.

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With this in mid it seems like the best time ever to change our name to reflect what we have become

Welcome Ten Dental&Facial. Opening June 2018. 154 Clapham High Street

 

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Meeting Dr Palo Malo, a true pioneer

From March 2016. Re published

 

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I was privileged to see Dr Palo Malo, the man who designed the protocol for “all-on-4” and same day teeth that we use in our practice, speak at the recent BAAD conference and this is the second time I have heard him speak and both times it has been inspiring.

His mission of making implant treatment more accessible to the public and quicker cheaper and less complex with same day teeth solutions has changed implant dentistry.

He has gone from being considered a heretic for using only 4 implants (as opposed to 6 or 8 as we used to) to support a full arch of teeth, as well as giving patients teeth on the same day (immediate loading) to his protocol being mainstream and used all over the world successfully.

At Ten Dental we have been offering same day teeth solutions for 10 years, and have achieved  very high success rates.

We look forward to other innovations in implant dentistry when they appear and offering the right ones (which are backed by research and protocols) to offer even more solutions to our patients.

 

Martin Wanendeya

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Lake Como-The Calm after the Storm

 

If Pete Sanders www.dentalconfidence.com  and Dermott Mcnulty   www.bathspadentistry.com who are the program directors from the FGDP diploma in implant dentistry (for more information click  here)  meant to give us contrast in the inaugural program in Italy then their aims have been well and truly met.

After the day before where we witnessed the  firebrand southern preacher pushing the limits of biomechanics and surgery with the fixed on 2  concept (Dr Cannizzaro) came the calm measured reason of Professor Tiziano Testori at the Lake Como Institute (see website here ) who showed us sinus augmentation lsurgery live focused on predictability and a touch of class.

By the shore of Lake Como, in a truly phenomenal dedicated teaching facility, reason and science replaced emotion and intuition.

The day started with a clear explanation of the micro and macro anatomy of the maxillary sinus, followed by a description of the live cases we would be seeing, after which the live  surgery began.

We watched one of the cleanest and tidiest (if not the cleanest and tidiest) surgeons  I have seen show us the best way (in his view) to carry out sinus augmentation. I have sat through a lot of sinus augmentation surgery, if I put all of it together, probably 7 days in total, but this was up there with the best.

Every part of the process that he was doing came with a clear and calm explanation the surgery was methodical, with every process came with a hint and tip on how to improve, and there was something for everyone, beginners and experienced implant dentists all left knowing more about how to improve their practice.

My mother uses a phrase that comes to mind- “experience is the best teacher, the problem is the fees are too high”

This was a chance  for us to learn from someone who has paid more than their fair share of the fees in gaining their experience, without having to pay and “fees” ourselves.

Many thanks to Proffesoor Testori and his team, for the warm welcome and the excellent food and hospitality, and this was at least on a par as the day before.

 

What will I take away?

Everyone has complications, to quote Nigel Jones (the lead tutor on the FGDP program, website here)  “complications can occur during complex treatments”, but more experienced operators are able to manage their complications.

As you get better at performing certain treatments you should get higher success rates, but you will still get failures.

More meticulous technique leads to less less infection.

Base what you do on science and methodology that someone else has worked out.

There is still so much more to learn.

As always It was also a pleasure to learn from, bounce ideas off  and spend time with the other FGDP tutors:- Will Murpy, Harmit Kalsi and David Gonzalez .

If carlsberg ran an implant course… The FGDP diploma would be heavily involved.

Goodbye Italy, it’s been enlightening, challenging, fun and tasty.

Fixed on 2.-All on 4 gone mad?

When does something experimental become acceptable to the scientific community?
When does one persons exceptional skill and determination become a technique?
What’s the process by which one mans inspiration and passion which is outside the accepted norm become something that we all accept?
How much data is enough?

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I had the privilege to watch Dr Canizarro working in a way that  breaks all the rules and he appears to be getting away with it.

At the #FGDPItaly course Dr Canizarro showed us his fixed on 2 technique. Fixed on 2 involves placing 2 implants flapless and loading them with  fixed full arch 10-12 unit bridge on the same day.

I remember seeing the controversy that started and in some circles still exits about all on 4, and I can’t imagine what people will make of this new variation.
Dr Canizarro reminds me of a southern baptist preacher when lecturing. The lectures are delivered with passion, with fire and amusing anecdotes, with references to football (he supports AC Milan) art and a personal philosophy that calls for us to think and question the scientific rationale that we believe.

Frequent calls that will stick with me are

Why do you do that ? Why ?

Think! Think you have to think!

In addition to breaking all the biomechanical rules about implant prosthesis he is breaking the all the surgical rules- carrying out his surgery flapless , using a “one drill one implant” protocol, with short implants that have a smooth surface.

He is also using the implant motor in ways that the manufacturers of both the motor and the implant have not dreamed could be done, implants are placed at 900rpm and with 80 Ncm of torque.

One the unconventional (and incredibly fast) surgery is complete, the 2 implants are  loaded on the same day !

It has to be seen to be believed. If you blink you miss the surgery.

Dr Canizarro was training to be an eye surgeon and, as is common in Italy, was carrying out some dentistry in the evenings to help pay his bills. His father died during his training and his family needed the money, so he never completed his eye surgery and so began his working life as an a Implantologist.

The lighting speed with which the surgery is performed is sharply contrasted by the slow methodical, attentive, deliberate and artistic technical team headed by Marco, his technician.

In the middle of this grand 4 floor , 10 surgery practice, the last person you would expect to be here is a man of science, of studies of controls, but right next to this implant maverick with a volcanic personality (his description of Dr Canizarro) is Marco Esposito (for those of you who have not met him, pronounce ex-posssss-ito)

Marco is slowing him down and at the same time looking at how one dentists technique can be turned into something that we may all one day use. The is data coming out of the studies, some of the early data is positive, but more time, data  and studies are needed.

The MAY be a technique for the future, but not one I would use now.

 

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Why is he doing this? Why is he putting his patients through this?

The reason is people, patients in his practice may not have the money for more complex and expensive techniques and chose this option because of price.More traditional and expensive techniques are out of their price range, and for many this is the only price point at which the can afford implants. They may not know that they are part of an experiment, but will be happy to have the fixed teeth for as long as they last. He is not short of patients, and the size and quality of the facility tends to suggest that he is doing well.

As part of his personal philosophy he wants all  dentists to sometimes look at how lucky we are to be dentists and to be happy that we can provide a living for us and our families.

Remember when all on 4 was first discussed? Palo Malo was thought of in the same  way, and now his technique has become part of the accepted landscape in implant dentistry. Pretty much all the implant companies  have an all on 4 protocol, and the components for dentists to use this technique.

I saw him recently at BAAD (http://www.baad.org.uk) showing his twenty year results with all on 4.

He is at the forefront of experimentation and has the patients, prosthetic and scientific team around him to test if fixed on 2 will work as a technique. He also has an implant company, Sweden and Martina, who will make components as he designs and needs them when some of the bio-mechanical complications occur. And he is passionate, (very passionate ) and determined to succeed.

He also has a belief that he can change Implantology, that he will help patients and he will use his position and skills for more than his own gain, and that is a potent cocktail that may lead to success.

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In summary don’t write off fixed on 2 just yet, but don’t try this at home!

If you are a patient, ask about the more about what your dentist is doing, how long they has been doing it and what problems they have had before you accept it.

Tomorrow we go to another part of Italy  to see a very different approach with Proffessor Tiziano Testori

 

 

 

 

 

 

 

 

 

 

 

 

 

At Ten Dental , we place implants using tried and tested techniques with sound scientific research in our implant practice in Clapham, and implant practice in Balham.

At Ten Dental we use the All-on-4/same day teeth/teeth in a day  techniques and have been using this for many years with excellent success rates.

#implants clapham, #implants balham, #implants wandsworth, #all on 4 london #implant london.

Building a team

Its all about the people…

Its about the people who work with you the people who support you at home and at work to allow you to help people, and sometimes…. the people are the hardest bit to get right.

And after our recent  highly commended award for best team in London I am over the moon and immensely proud of “our people”

I feel that I sometimes get the glory and the recognition when in the background there are so many people who work tirelessly to endure that everything works, I very grateful to them for the hard work that they put into making the practice a success.

Managing expectations, managing results, managing fear, managing ambition, managing anger, frustration, happiness, overconfidence are all part and parcel of an Manager/implantologists role.

I am still learning and always will be learning more, but I am, despite the more difficult days, always grateful to the people around me, and need to express it more.

The Team are the  Reception, nursing and clerical support Staff ( including our fantastic cleaners who I rarely see, but always do a great job), our ( now award winning) specialist dentists, our associates, our referring dentists, our lab technicians ( who make me look good), our maintenance team ( who keep the equipment running) and also my family who keep me balanced.

So here it it!- Probably too small and hidden away on the internet somewhere, but here to stay…

Thank you to the Ten Dental team for a great year in 2015, onwards and upwards for 2016

Martin Wanendeya

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SODOTO otherwise know as See one, do one teach one..

At Ten Dental, we have been teaching dentists about restoring implants for 10 years and work with a number of dentists where we place the implants and they restore the implants.

The course we run is practical, theoretical and involves mentoring the dentists we teach.

I learnt about implantology from some excellent surgeons and prosthodontists based all over the world and I enjoy passing that information on as it was passed to me..

This Friday Nik Sisodia and I spent a very enjoyable day  at the British Academy of Cosmetic Dentistry teaching dentists from all over the UK about implant restoration, and had some excellent feedback from the delegates.

SODOTO !

 

 

Making a difference

Making a difference

At the start of the year I looked forward to another busy year of practice and thought about what and our team approach to the year would be.

I thought through the people that the team and I had worked with to get dentally healthy and also those patients whose lives we have had the privilege of changing with dental implant treatment. Some of whom had been who had been in a very bad way dentally.

I decided that this year I wanted to make a difference to people’s lives. I think it’s a privilege that we have as an implant team and I have as an implant dentist to make a profound impact on people’s lives.

People who can’t smile, can’t chew, in some cases can’t leave the house have all at some time turned up in the last year either waving the white flag to say that they give up with the failing loose mobile teeth and denture, or have decided preemptively to start the journey to optimal oral health and function.

Helping them has been an enriching experience. I have met some wonderful people who have educated me about subjects and topics that were never on my radar, this weeks new learning has been Tuscan truffles and classical music classifications.

What I really enjoy is hearing what they have so say about where they were and how they felt about their teeth at the start of the process and comparing it to the end.

Seeing these changes in people makes implant dentistry this more than a job for me it makes it all the effort, learning, training and endeavor worthwhile.

If you are a patient considering implant treatment, make the leap, its worth it in the end. If you are a Dentist talking to your patients, tell them about the study attached that shows that “90% of patients were completely satisfied with implant therapy both from an functional and aesthetic point of view” and also “the costs associated with implant therapy were considered to be justified”

At the tenimplantcentre we have a very high success rate for our implant treatment ( despite the fact we get refereed the very difficult cases from other dentists) and we hope that our patients fall into the 90% category described of “completely satisfied” if we asked them to fill out a survey.

I enjoy making a difference and look forward to the next person whose life I can make a difference to.

Long may it continue!

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