After reading Zero Bone Loss Concepts I was bought in but these are great points that I hadn't considered. You guys have the best and most applicable implant content out there. I don't know of very many other that add so much free value. Can't wait to make it out to NC for some of your courses.
Hey Doc, Thanks for the kind words and I am glad the content is helping. We would love to have you attend our fall class. More details are available on stanleyinstitute.com when you are ready.
First of all , we are not talking about natural tooth , we’re talking about dental implants in ZBLC we need to consider many factors like type of the implant conical connections ,gingival thickness,depth of placement, abutments gingival hights , polish zr , etc..
The IMS method suggests the starting point to be beneath the FGM of the desired tooth by at least 3 mm. This usual results in the majority of the implant platform below the “level of bone”. If this is the case we proceed and let the individuals body determine it’s own “biologic width” which is near 3mm for most everyone. This results in a solution that has long last function and beautiful form. I have never once measured soft tissue thickness to determine my course of treatment options. It is not clinically relevant. I hope this makes sense?
Sir what about edentoulous ridges, where there is no tooth to support ur papilla which we create after implant placement. Then phenotype matters, or placing implant deeper cope that thing, pls answer
Both Kois and Tarnow published fundamental research the showed 100% papilla fill if the interproximal contact point is 4mm or less from the interproximal crest of bone. NEITHER of these two papers controlled for gingival phenotypes! In other words, thick and thin gingival phenotypes both had papillary fill (no black triangles) if the above mentioned criteria are meet. I NEVER measure the mid crestal gingival thickness and subsequently use that data to alter my treatment plans. The IMS method we teach empowers clinicians with real evidence based guidelines to crush anterior esthetics as well as immediate implant placements with out this proposed “concept”.
Thank you. Using your own words, most of your arguments are centered around ... marketing... ok? Marketing. And I'm not sure if it's coming from a dental supply company or it's coming from an individual who has agendas to meet. But even if some of your ideas including ideas from other videos you put out, are reasonably well thought out, they are still very, very debatable. I don't want to bust your kettlebells too much, whatever works for you, but my concern is that a lot of dentists, especially ones starting their implant journey really seem to look up to you and you have a responsibility to uphold as an educator. A reasonable and experienced doctor might listen to your opinions, take whatever makes sense home and be glad. But let's be frank, most of your audience is not that. Even though you elaborate on your opinions, your videos usually leave an "impression" so to speak, like a clickbaity thumbnail of a video does. And that impression usually is that something doesn't matter, gingiva thickness doesn't matter because biohorizons are so good, all free hand drills bounce, stay too long in the osteotomy and then and only then they can overheat bone unless you use our guide, torque value doesn't matter and Implant-abutment interface joint stability doesn't matter. But Snoopies and ETs do... Yes, I Agree, implant positioning in the grand scheme of masticatory system in a particular patient does play a really large role, maybe the largest but that doesn't change that your content justifies a viewpoint that if it's in the mouth it's successful even if that is not what you are trying to do. Your factual message goes directly against what a certain well known Dr. , who literally put Biohorizons on the map, said, especially about the reason why some people can be called Dr. and some Mr. So thank you for your content. I admire your passion for work. Honestly. Your perspectives from a mechanical and engineering standpoints are valuable but that is not enough for implant dentistry. Unless your main goal is not elevating the standard of care. It's not trendy but accountability for your words exist. I encourage you to take notice on that.
Thank you for your thoughtful and detailed feedback. I genuinely appreciate your insights and the time you took to share them. You are correct that a significant portion of my content revolves around marketing concepts and colloquial beliefs in dentistry. My objective is to present a rational, scientific analysis and perspective that often challenges these conventional views. By doing so, I aim to equip clinicians with the knowledge they need to critically evaluate, accept, or build upon these beliefs. None of the contrarian views I present are driven by corporate bias. Instead, they offer a critical approach to the body of knowledge surrounding implantology, which can be invaluable to both new and experienced clinicians. Experienced clinicians often find these insights particularly clarifying, as they help prioritize and quantify various aspects of implantology. New dentists may see the information as beneficial but may lack the historical context to have those "aha" moments. It's understandable that you feel the content on UA-cam might seem incomplete. That's because it is! The full body of knowledge I share takes seven days to cover comprehensively. The videos are just snippets meant to spark curiosity and deeper understanding. On a lighter note, they say everyone has a price. I would consider offers starting at $15 million to buy my character. Until then, I will continue to provide independent, unbiased, evidence-based solutions to help our industry achieve better outcomes with fewer risks to our patients. If you're looking to deepen your understanding and become a master of "Implants Made Simple™," I encourage you to sign up for classes at the Stanley Institute. Together, we can elevate the standard of care in implant dentistry. P.S. I'm always open to constructive feedback and discussions. Feel free to reach out anytime!
I believe you are mistaken about the ZBL concept. You make 2 assumptions which are wrong: 1) You can only control for implant position OR vertical tissue thickness as if they are mutually exclusive. 2) You are claiming that in the ZBL study he had more implants placed in the wrong position in the < 3 mm vertical tissue height group. If his sample size is big enough in the study, than there should be an equal distribution of malpositioned implants. You state very logical reasons to dismiss a study but I'm not sure if you have enough evidence to make the claims you are making to dismiss his study. And just to be clear, I'm not sold on the ZBL concept yet. I'm a new perio starting to practice and I'll judge for myself.
Thank you for your comment. I hope this provides some clarity. My approach focuses on identifying consistent "rules" or "guidelines" that can be applied across different cases. Managing a separate treatment plan for each individual site is not practical, so I concentrate on principles that are broadly applicable, allowing us to direct our energy where it's most needed. For example, 98% of my implants are placed in fresh extraction sites. In these cases, there's no tissue height to measure at the center of the tooth, as the tissue isn't present. Therefore, adjusting implant placement based on a factor relevant to only 2% of cases doesn't warrant my focus. ZBL concepts have a great brand following but if followed will lead you astray from reducing risk and improving patient outcomes.
@@Stanleyinstitute Thank you for clarifying. That makes complete sense that his concept doesnt apply to you in immediate cases. The only exception is if there is a way to predict how much more apical to place the implant based on existing tissue thickness or bone height, which he would have to run the study for. The bigger question I have is, If it turns out to be true that vertical tissue height is an important factor in preventing bone loss down the road, would that be enough evidence to say immediates should be avoided for the posterior at least so you can plan out cases based on soft tissue height?
After reading Zero Bone Loss Concepts I was bought in but these are great points that I hadn't considered. You guys have the best and most applicable implant content out there. I don't know of very many other that add so much free value. Can't wait to make it out to NC for some of your courses.
I used to think Zero Bone Loss made sense too before I started watching this channel 😬
I’m literally reading zero bone loss concepts and have the exact same feeling!
@@oldmachinesicecreams7609 Ive read it too and I combine what Ive learned from both teachers.
Hey Doc, Thanks for the kind words and I am glad the content is helping. We would love to have you attend our fall class. More details are available on stanleyinstitute.com when you are ready.
"concepts" tend to sound good until one reads the original art and realizes there are questions that need to be answered. Thanks for watching.
First of all , we are not talking about natural tooth , we’re talking about dental implants in ZBLC we need to consider many factors like type of the implant conical connections ,gingival thickness,depth of placement, abutments gingival hights , polish zr , etc..
Most of those “concepts” are not supported by the literature. Stay tuned for more on that.
interesting... would you say you place all bone level implants at crestal height except for maybe an immediate implant?
The IMS method suggests the starting point to be beneath the FGM of the desired tooth by at least 3 mm. This usual results in the majority of the implant platform below the “level of bone”. If this is the case we proceed and let the individuals body determine it’s own “biologic width” which is near 3mm for most everyone. This results in a solution that has long last function and beautiful form. I have never once measured soft tissue thickness to determine my course of treatment options. It is not clinically relevant. I hope this makes sense?
Sir what about edentoulous ridges, where there is no tooth to support ur papilla which we create after implant placement. Then phenotype matters, or placing implant deeper cope that thing, pls answer
Both Kois and Tarnow published fundamental research the showed 100% papilla fill if the interproximal contact point is 4mm or less from the interproximal crest of bone. NEITHER of these two papers controlled for gingival phenotypes! In other words, thick and thin gingival phenotypes both had papillary fill (no black triangles) if the above mentioned criteria are meet. I NEVER measure the mid crestal gingival thickness and subsequently use that data to alter my treatment plans. The IMS method we teach empowers clinicians with real evidence based guidelines to crush anterior esthetics as well as immediate implant placements with out this proposed “concept”.
Thank you. Using your own words, most of your arguments are centered around ... marketing... ok? Marketing. And I'm not sure if it's coming from a dental supply company or it's coming from an individual who has agendas to meet. But even if some of your ideas including ideas from other videos you put out, are reasonably well thought out, they are still very, very debatable. I don't want to bust your kettlebells too much, whatever works for you, but my concern is that a lot of dentists, especially ones starting their implant journey really seem to look up to you and you have a responsibility to uphold as an educator. A reasonable and experienced doctor might listen to your opinions, take whatever makes sense home and be glad. But let's be frank, most of your audience is not that. Even though you elaborate on your opinions, your videos usually leave an "impression" so to speak, like a clickbaity thumbnail of a video does. And that impression usually is that something doesn't matter, gingiva thickness doesn't matter because biohorizons are so good, all free hand drills bounce, stay too long in the osteotomy and then and only then they can overheat bone unless you use our guide, torque value doesn't matter and Implant-abutment interface joint stability doesn't matter. But Snoopies and ETs do... Yes, I Agree, implant positioning in the grand scheme of masticatory system in a particular patient does play a really large role, maybe the largest but that doesn't change that your content justifies a viewpoint that if it's in the mouth it's successful even if that is not what you are trying to do. Your factual message goes directly against what a certain well known Dr. , who literally put Biohorizons on the map, said, especially about the reason why some people can be called Dr. and some Mr. So thank you for your content. I admire your passion for work. Honestly. Your perspectives from a mechanical and engineering standpoints are valuable but that is not enough for implant dentistry. Unless your main goal is not elevating the standard of care. It's not trendy but accountability for your words exist. I encourage you to take notice on that.
Thank you for your thoughtful and detailed feedback. I genuinely appreciate your insights and the time you took to share them.
You are correct that a significant portion of my content revolves around marketing concepts and colloquial beliefs in dentistry. My objective is to present a rational, scientific analysis and perspective that often challenges these conventional views. By doing so, I aim to equip clinicians with the knowledge they need to critically evaluate, accept, or build upon these beliefs.
None of the contrarian views I present are driven by corporate bias. Instead, they offer a critical approach to the body of knowledge surrounding implantology, which can be invaluable to both new and experienced clinicians. Experienced clinicians often find these insights particularly clarifying, as they help prioritize and quantify various aspects of implantology. New dentists may see the information as beneficial but may lack the historical context to have those "aha" moments.
It's understandable that you feel the content on UA-cam might seem incomplete. That's because it is! The full body of knowledge I share takes seven days to cover comprehensively. The videos are just snippets meant to spark curiosity and deeper understanding.
On a lighter note, they say everyone has a price. I would consider offers starting at $15 million to buy my character. Until then, I will continue to provide independent, unbiased, evidence-based solutions to help our industry achieve better outcomes with fewer risks to our patients.
If you're looking to deepen your understanding and become a master of "Implants Made Simple™," I encourage you to sign up for classes at the Stanley Institute. Together, we can elevate the standard of care in implant dentistry.
P.S. I'm always open to constructive feedback and discussions. Feel free to reach out anytime!
I believe you are mistaken about the ZBL concept. You make 2 assumptions which are wrong: 1) You can only control for implant position OR vertical tissue thickness as if they are mutually exclusive. 2) You are claiming that in the ZBL study he had more implants placed in the wrong position in the < 3 mm vertical tissue height group.
If his sample size is big enough in the study, than there should be an equal distribution of malpositioned implants.
You state very logical reasons to dismiss a study but I'm not sure if you have enough evidence to make the claims you are making to dismiss his study. And just to be clear, I'm not sold on the ZBL concept yet. I'm a new perio starting to practice and I'll judge for myself.
Thank you for your comment. I hope this provides some clarity. My approach focuses on identifying consistent "rules" or "guidelines" that can be applied across different cases. Managing a separate treatment plan for each individual site is not practical, so I concentrate on principles that are broadly applicable, allowing us to direct our energy where it's most needed.
For example, 98% of my implants are placed in fresh extraction sites. In these cases, there's no tissue height to measure at the center of the tooth, as the tissue isn't present. Therefore, adjusting implant placement based on a factor relevant to only 2% of cases doesn't warrant my focus.
ZBL concepts have a great brand following but if followed will lead you astray from reducing risk and improving patient outcomes.
@@Stanleyinstitute Thank you for clarifying. That makes complete sense that his concept doesnt apply to you in immediate cases.
The only exception is if there is a way to predict how much more apical to place the implant based on existing tissue thickness or bone height, which he would have to run the study for.
The bigger question I have is, If it turns out to be true that vertical tissue height is an important factor in preventing bone loss down the road, would that be enough evidence to say immediates should be avoided for the posterior at least so you can plan out cases based on soft tissue height?
You are taking the zero bone loss concept out of context.
I would suggest you subscribe and continue to watch the videos. I am certain with a little time you will see the truth.