Implant training in OS

[flat4]

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Just wondering how much training one gets in DENTAL implants in an OS program. I reckon it varies but on average, but what are we looking at in terms of # of implants and amount of emphasis compared to other procedures. Also, are there any schools in particular that have a stronger emphasis on implants (and please don't say Perio b/c besides bone grafts and implants, I'm just not that interested in that field). Thanks guys.

 

[ewsmith]

It depends! Each program is very different.

Really, I have a buddy at another OMFS program who did about 40 implants per month while at the VA and while I was at our VA I only did 2 in the most recent 3 weeks I was covering the clinic.

Why, b/c that was all that was set up for me by the previous resident. While I was there (3 weeks) I set up 12 for our 1st year resident coming the next month behind me. How many 1st years do you know get set up to do 12 implants in one day?

The great thing is the VA pays 100% for veterans who are eligible (many, many are) so they do not pay a dime. You could seriously do 100+/month if you really wanted to. Implants do not excite me a ton, so I am less ambitous about setting them up then say my friend who did 40 last month. There is absolutely no other residency program that has the ability to place more implants than OMFS b/c we work at the VAs. With that said, not all OMFS programs are in an area assoc with a VA, so you must check/ask when interviewing if they work at the VA. Also, you may find some perio programs have limited faculty at VAs in the same clinics, but the implants are typically reserved for the OMFS resident; at least this my understanding in speaking with friends at 4 diff programs across the nation.

So then, in my buddies 1st 2 years he has actually placed over 500 implants during his VA rotation of 9 months, but not all programs spend that long at the VA. For instance, I will only spend a max of 6 months or so there.

It basically comes down to money and there really is no way for a dental school perio program to have that many implants to let their residents place. I only mention perio b/c they are the other residency that primarily deals with implants. Sure, restorative, GPR, proths, and others may place a few, but the bulk is done by us and perio.

Hope this helps.

 

[PrincetonRocks]

Lets leave the dental implants to a Periodontist, sleep apnea to an ENT, and reconstructive surgery to a plastic surgeon 😱


OMS can just stick to the third molar extractions 😀

 

[flat4]

It depends! Each program is very different.

Really, I have a buddy at another OMFS program who did about 40 implants per month while at the VA and while I was at our VA I only did 2 in the most recent 3 weeks I was covering the clinic.

Why, b/c that was all that was set up for me by the previous resident. While I was there (3 weeks) I set up 12 for our 1st year resident coming the next month behind me. How many 1st years do you know get set up to do 12 implants in one day?

The great thing is the VA pays 100% for veterans who are eligible (many, many are) so they do not pay a dime. You could seriously do 100+/month if you really wanted to. Implants do not excite me a ton, so I am less ambitous about setting them up then say my friend who did 40 last month. There is absolutely no other residency program that has the ability to place more implants than OMFS b/c we work at the VAs. With that said, not all OMFS programs are in an area assoc with a VA, so you must check/ask when interviewing if they work at the VA. Also, you may find some perio programs have limited faculty at VAs in the same clinics, but the implants are typically reserved for the OMFS resident; at least this my understanding in speaking with friends at 4 diff programs across the nation.

So then, in my buddies 1st 2 years he has actually placed over 500 implants during his VA rotation of 9 months, but not all programs spend that long at the VA. For instance, I will only spend a max of 6 months or so there.

It basically comes down to money and there really is no way for a dental school perio program to have that many implants to let their residents place. I only mention perio b/c they are the other residency that primarily deals with implants. Sure, restorative, GPR, proths, and others may place a few, but the bulk is done by us and perio.

Hope this helps.

Thanks for the reply. I had no idea they did so many (at least that one program). I never thought about the money issue but it makes sense. If you had the money for implants, you'd probably just go to a real OS, Periodontist, dentist, etc. Most of the patients I have who have ideal bone for implants shy away from them as soon as I tell them the price ($800 mind you). The grad perio directors always looking for implant cases via our patients. Some Perio programs I saw ranged from 40-80 total in the 3 years so I guess if you choose the right OS program, you can easily surpass those numbers. Interesting....

 

[ajmacgregor]

Thanks for the reply. I had no idea they did so many (at least that one program). I never thought about the money issue but it makes sense. If you had the money for implants, you'd probably just go to a real OS, Periodontist, dentist, etc. Most of the patients I have who have ideal bone for implants shy away from them as soon as I tell them the price ($800 mind you). The grad perio directors always looking for implant cases via our patients. Some Perio programs I saw ranged from 40-80 total in the 3 years so I guess if you choose the right OS program, you can easily surpass those numbers. Interesting....

Don't forget implant reconstructions following traumatic injuries. The OMFS residents at our hospital get at least 20/year (each) based on trauma. This is certainly one place where the OMFS guys have the upper hand, as I don't know of any perios that cover dental trauma in the ER.

 

[toofache32]

Lets leave the dental implants to a Periodontist, sleep apnea to an ENT, and reconstructive surgery to a plastic surgeon

...and trolling to the trolls.

 

[ewsmith]

Hey Pinceton,

FYI...You obviously are very limited in your knowledge of various procedures and who does what, so let me help you out.

ENT typically does UPPP for sleep apnea with an overall 30% efficacy; not a cure, just improvement as seen in the RDI being decreased by at least 50%. They also do some genio advancement and hyoid resuspension procedures as we used to; not shown to have great efficacy.

OMFS has the only procedure shown to be a CURE for sleep apnea...the double jaw advancement. If the advancement is made all at once, only about a max of 15mm is able to be seen due to soft tissue structures. However, if distraction osteogenesis is used then we have advanced up to 25mm over months a my program. The only issue with DO is that a trach has to be done at time of surgery, so some pts do not want this.

So you know..ENT does not perform double jaw advancements, the only procedure shown in prospective trials to CURE sleep apnea. Only, let me repeat, only OMFS do them....did you know some hospitals insurance carriers will only allow OMFS to operate on mandibles???

As well, around the nation you we find what are called "sleep teams" which consist of neurology, sleep medicine, OMFS, and ENT...these teams see the patients after the PSMG is completed and determine the appropriate treatment. I do not expect you to understand all that goes into this, as you have probable not been exposed to it.

As another FYI....the double jaw was not always covered under medical insurance in the past, but since the data regarding its success in the hands of only OMFS has shown the best result to date, many insurance companies have started to pay in full. Why, b/c data shows SA pts have increased car accidents, increased cardiomyopathy with right heart failure, secondary polycythemia, increased all-cause mortality, impotence, and early loss of mentation to name a few comorbities arising from the disease; wow saving lives sure is cool.

As well, zygomatic implants are not placed by anyone except OMFS due to the OR privilages and training required to place them.

 

[tx oms]

You know, I don't worry about the shear number of implants I put in. Anyone can put a scew into a bone. Only a periodontist makes it into a huge deal equivalent to a CABG. The only thing that really matters is learning how to do advanced dentoalveolar surgery, like more complex flaps and grafts.

 

[ewsmith]

You said it Tx-OMS!

Like a CABG man; my gut is hurting! They must love dental school and all the analness that goes along with it...it ain't rocket science, but for some reason that thought is being placed in the dental students minds.

Don't forget to get that last hemidesmosome on the root surface...do you like greens?

 

[J2AZ]

Whats up with this program at LLU? Has anybody heard anything about "implant dentistry" breaking off and becoming a specialty all its own?
I would hate to see that happen.

http://www.llu.edu/llu/dentistry/programs.html#implant

 

[Jawfixer]

Just more indication that other specialty services are drying up as the general dentist expands their scope.

 

[flat4]

You know, I don't worry about the shear number of implants I put in. Anyone can put a scew into a bone. Only a periodontist makes it into a huge deal equivalent to a CABG. The only thing that really matters is learning how to do advanced dentoalveolar surgery, like more complex flaps and grafts.

I agree with you 100%. I realize how easy it is to place implants and that tissue management is 90% of the battle. Sorry if it sounded like a dumb question but I really had no idea how much implants were emphasized. I've really only seen the Perio side of things up to now so I was just curious how much training you guys actually had in that department since you have such a wide scope of training in OS. So basically, it sounds like you get enough training to be able to handle the entire scope of placing implants straight out of residency, plus on top of that, you will be able to handle any complications.Sounds like a good deal.

 

[J2AZ]

Just more indication that other specialty services are drying up as the general dentist expands their scope.

Yeah but its a 3 year program. No general dentist in his right mind is going to go through a three year residency just to learn to place implants when there a guys doing it after a few CE courses.

 

[Jawfixer]

Yeah but its a 3 year program. No general dentist in his right mind is going to go through a three year residency just to learn to place implants when there a guys doing it after a few CE courses.

Mr Obvious, that is the point. Why would someone spend 2-3 (not all 3 years unless applicant is foreign trained w/o DDS/DMD) learning to place implants and polish teeth when they can take a few hands-on clinical courses? Obviously, the general dentist is the best one (if trained) to place implants since they will restore them. That's right, not perio, prosth, or my group (OMFS).

 

[GatorDMD]

Mr Obvious, that is the point. Why would someone spend 2-3 (not all 3 years unless applicant is foreign trained w/o DDS/DMD) learning to place implants and polish teeth when they can take a few hands-on clinical courses? Obviously, the general dentist is the best one (if trained) to place implants since they will restore them. That's right, not perio, prosth, or my group (OMFS).

where are you a resident at friend?

 

[J2AZ]

Mr Obvious, that is the point. Why would someone spend 2-3 (not all 3 years unless applicant is foreign trained w/o DDS/DMD) learning to place implants and polish teeth when they can take a few hands-on clinical courses? Obviously, the general dentist is the best one (if trained) to place implants since they will restore them. That's right, not perio, prosth, or my group (OMFS).

WTF! OK whatever, you still have not clarified your statement that LLU program is an example of specialties drying up and general dentists expanding their scope. Since prosth, OMS, GPR, and perio programs are all placing implants why is there a need for a three year implant specific program at LLU. This actually indicates a future shrinkage of GP's scope of practice b/c those who attend the 3 year program become "implant specialists"(no longer GP) Since no GP would ever attend this program why does LLU feel the need to create a new specialty.

 

[OMFSCardsFan]

Since no GP would ever attend this program why does LLU feel the need to create a new specialty.

What about the three guys each year that try and can't get into a perio or a pros program? Hard to believe that this could happen, but let's not cast them aside! They have feelings, too. They need a home. LLU will now give them an opportunity to feel a part of something--to feel what it's like to be a specialist. It's so nice to know that there are people out there still willing to stand up for the underdog...

(This is, of course, extremely sarcastic. I agree with you, J2AZ. Why would anyone do that?)

 

[Jawfixer]

No you freaking ****, the comment wasn't in reference to GDs wanting to do the 3 year program. It was basically to point out that others are jumping on the band wagon. I agree, the program is more or less for those with GPA lower than the perio residents, if this is possible, to have a place to call home.

Actually, most GDs do not want to take the time to place implants b/c it eats into their schedule, they have to set up their operatories specifically for it, and it doesn't flow yet with the way most practices are laid out. Will this change...more than likely a little as a new breed of GDs wanting to do more graduate and the old-time gold foil packers close up shop.

It probably is not even a money thing with GDs who are placing implants; more ego. Or perhaps, there is no specialist near them in their community. I do the taxes for a single practitioner GD working 4days/wk whos' gross revenues are 1.3mil/yr with 30+% practice profitability and this person does no implants....you figure take home.

 

[chadDMD]

No you freaking ****, the comment wasn't in reference to GDs wanting to do the 3 year program. It was basically to point out that others are jumping on the band wagon. I agree, the program is more or less for those with GPA lower than the perio residents, if this is possible, to have a place to call home.

Actually, most GDs do not want to take the time to place implants b/c it eats into their schedule, they have to set up their operatories specifically for it, and it doesn't flow yet with the way most practices are laid out. Will this change...more than likely a little as a new breed of GDs wanting to do more graduate and the old-time gold foil packers close up shop.

It probably is not even a money thing with GDs who are placing implants; more ego. Or perhaps, there is no specialist near them in their community. I do the taxes for a single practitioner GD working 4days/wk whos' gross revenues are 1.3mil/yr with 30+% practice profitability and this person does no implants....you figure take home.

Set up the office for implants? With what, an implant drill and burrs? It's nothing. An implant takes all of 10 minutes to place....why wouldn't GDs start doing more implants when the fin return is so obvious?

 

[Drtrigeminal]

I would love to see the quality of implants you place in 10min!

Set up the office for implants? With what, an implant drill and burrs? It's nothing. An implant takes all of 10 minutes to place....why wouldn't GDs start doing more implants when the fin return is so obvious?

 

[ItsGavinC]

They must love dental school and all the analness that goes along with it...it ain't rocket science, but for some reason that thought is being placed in the dental students minds.

Well put. Now go preach that in the Dental forum to those that insist failing biochemistry will make you a crappy clinician.

 

[ip]

This thread is funny.

LLU implant program is 30 years old, the founder was one of the first in the US to place implants, the director and other faculty are world-reknowned researchers & clinicians, it has graduated numerous other top implant guys and the program gets ~30 applicants for 2-3 spots/year.

It is considered the best training program for implants. Too funny.

 

[Jediwendell]

This thread is funny.

LLU implant program is 30 years old, the founder was one of the first in the US to place implants, the director and other faculty are world-reknowned researchers & clinicians, it has graduated numerous other top implant guys and the program gets ~30 applicants for 2-3 spots/year.

It is considered the best training program for implants. Too funny.

The "Implantologists" have been clamoring to get specialty status. I think that is what is the real issue. And also whether GPs are good enough to place implants.