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XXXXX B2 Publisher & Chairman Torsten Oemus t.oemus@dental-tribune.com President/Chief Operating Officer Eric Seid e.seid@dental-tribune.com Editor in Chief Dr. Sebastian Saba feedback@dental-tribune.com Group Editor Kristine Colker k.colker@dental-tribune.com Managing Editor Implant Tribune Canada Robert Selleck, r.selleck@dental-tribune.com Managing Editor Implant Tribune U.S. Sierra Rendon s.rendon@dental-tribune.com Managing Editor Fred Michmershuizen f.michmershuizen@dental-tribune.com Product/Account Manager Will Kenyon w.kenyon@dental-tribune.com Product/Account Manager Humberto Estrada h.estrada@dental-tribune.com Product/Account Manager Maria Kaiser m.kaiser@dental-tribune.com BUSINESS DEVELOPMENT MANAGER Travis Gittens t.gittens@dental-tribune.com Education DIRECTOR Christiane Ferret c.ferret@dtstudyclub.com Accounting Department Coordinator Nirmala Singh n.singh@dental-tribune.com Tribune America, LLC Phone (212) 244-7181 Fax (212) 244-7185 Published by Tribune America © 2016 Tribune America, LLC All rights reserved. Tribune America strives to maintain the utmost ac- curacy in its news and clinical reports. If you find a factual error or content that requires clarification, please contact Managing Editor Robert Selleck at r.selleck@dental-tribune.com. Tribune America cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume respon- sibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Tribune America. Editorial Board Dr. Pankaj Singh Dr. Bernard Touati Dr. Jack T. Krauser Dr. Andre Saadoun Dr. Gary Henkel Dr. Doug Deporter Dr. Michael Norton Dr. Ken Serota Dr. Axel Zoellner Dr. Glen Liddelow Dr. Marius Steigmann IMPLANT TRIBUNE Tell us what you think! Do you have general comments or criticism you would like to share? Is there a particular topic you would like to see articles about in Implant Tribune? Let us know by emailing feedback@dental-tribune. com. If you would like to make any change to your subscription (name, address or to opt out) please send us an e-mail at database@dental-tribune.com and be sure to include which publication you are referring to. Corrections Implant Tribune strives to maintain the utmost accuracy in its news and clinical reports. If you find a factual error or content that requires clarification, report the details to managing editor Robert Selleck, r.selleck@dental-tribune.com. Implant Tribune Canada Edition | April 2016 FROM THE EDITOR IN CHIEF typically surrounds teeth. Instead, it appeared to be an immobile form of a softer, elastic tissue similar to that lining the floor of the mouth and cheeks. Not withstanding this variation, the new tissue created protection for the dental implants from distortion that is frequently caused by the pull of facial muscles. The author concluded that the graft was effective in providing the intended support for the existing dental implants. “This work may provide a quicker way for implant dentists to provide the ne- cessary protective soft tissue for atrophic edentulous sites with fewer morbidities,” said Dr. Dennis Flanagan, author of the article. “However, as with previous and concurrent work, the resulting type and amount of keratinized tissue is not predictable.” Full text of the article, “Stented Porcine Collagen Matrix to Treat Inadequate Facial Attached Tissue of Dental Implant Sup- ported Fixed Partial Dentures,” Journal of Oral Implantology, Vol. 42, No. 2, 2016, is available at: http://www.joionline.org/doi/ full/10.1563/aaid-joi-D-15-00050. “ GRAFT, Page B2 10 rules of order in implantology By Sebastian Saba DDS, Cert. Pros., FADI, FICD, Editor in Chief 1. Choose one well-documented, scien- tifically supported implant system. Any dental implant system demonstrating ongoing research and design will achieve high success rates and be adequately equipped to deal with most clinical chal- lenges. Surprisingly most successful implant systems are similarly designed, making the thought of owning different implant systems in the office redundant. Implant macro- and micro-topography may vary, but similar success rates are seen. Prosthetic connections and abut- ment designs appear very similar. 2. Not all dental implant companies are created equal; warranties, customer ser- vice, availability of representatives and technical support may be highly variable. Companies that tend to merge may have a transition stage where customer sup- port may vary. 3. If you pursue both the surgical and prosthetic phases of treatment, be ready to assume twice the responsibility for diagnoses and clinical execution. As a prosthodontic specialist, keeping up with the prosthodontic and laboratory literature alone is complicated enough. I rely on my surgical team to provide the most up-to-date surgical information to guide my prosthetic objective. 4. If you fiddle with any implant, re- stored or not, you just bought it. On a larger scale, this involves the topic of informed consent. It’s common to see patients with prosthetic complications relating to implant dentistry. Make sure you have a full disclaimer regarding any proposed intervention; otherwise, you may be held responsible for a pre- existing condition. 5. All screws loosen with time; its not if, but when. Properly supported prosthetic designs and proper torque execution will minimize such complications. Re- member one screw loose per week is too many. 6. Most insurance companies don’t rec- ognize implant prosthetics. Properly in- form your patients of this reality. 7. Even good implant systems can have complications and failures. Poor surgical execution, patient selection or manage- ment and/or poor pros- thetic design can all cre- ate problems with the best of systems. 8. Some single-implant cases are quite difficult, and some multiple- implant cases are quite simple. Not all single- implant cases are pre- dictable (i.e., matching a central incisor); while multiple, implant-supported, pos- terior bridges can be quite predictable. 9. Implant prosthodontics is not simple. In general, any prosthodontics case is not simple, regardless of what a salesperson might tell you. Prosthetic components can be technique sensitive, and they can be difficult to select. Step-by-step instructions can oversimplify and mis- represent the clinical challenges. 10. The likelihood that an implant is malpositioned is directly related to the surgeon’s resistance to a surgical guide. Sebastian Saba, DDS, Cert. Pros., FADI, FICD, is a graduate of the Goldman School of Dental Medicine, Boston University. He has published extensively on the topics of prosthetic and implant dentistry and has a private practice in Montreal limited to prosthetic and implant dentistry. Photos/Dr. Sebastian Saba Common sense to live by if you practice implant dentistry Table: Patients treated with porcine collagen graft with an acryl stent at various postoperative measurements; measurements were taken from the crest of the gingival margin to the junction of the immobile mucosa or perceived attached gingiva and the flaccid mucosa.