midwest implant institute

mii
midwestimplantinstitute.com
Dr. Duke Heller Director - 1980 - 31 years

Thank You for Attending

AAID/Iran Maxi Course

INTRODUCTION OF
CLASS PARTICIPANTS
ARE YOU PRESENTLY PLACING AND/OR
RESTORING IMPLANTS?
Why are you taking the AAID Maxi Course?

How to do the simple procedures

well !
Implant Placement
Implant Restoration

Assistants/Doctors
Utilizing/Using
Implant Dentistry in Your Practice

TODAYS SCHEDULE

TOMORROWS SCHEDULE

STAFF THAT
WILL BE
SERVING YOU
Dr. Alfred Duke Heller

GOALS OF COURSE
TO HELP YOU, THE DOCTOR AND
STAFF MEMBER, BETTER SERVE YOUR
PATIENTS WITH TREATMENT OPTIONS
THAT INCLUDE IMPLANT DENTISTRY

GOALS OF COURSE
TO HELP YOU, THE DOCTOR AND
STAFF MEMBER, BETTER SERVE YOUR
PATIENTS WITH TREATMENT OPTIONS
THAT INCLUDE IMPLANT DENTISTRY

GOALS OF COURSE

GOALS OF COURSE
ADD VALUE TO YOU

GOALS OF COURSE
ADD VALUE TO YOU
IN YOUR DENTAL LIFE

GOALS OF COURSE
ADD VALUE TO YOU
IN YOUR DENTAL LIFE
IN YOUR PERSONAL LIFE

GOALS OF COURSE
ADD VALUE TO YOU
IN YOUR DENTAL LIFE
IN YOUR PERSONAL LIFE
HUSBAND

GOALS OF COURSE
ADD VALUE TO YOU
IN YOUR DENTAL LIFE
IN YOUR PERSONAL LIFE
HUSBAND
WIFE

GOALS OF COURSE
ADD VALUE TO YOU
IN YOUR DENTAL LIFE
IN YOUR PERSONAL LIFE
HUSBAND
WIFE
CHILDREN

1999 in Heller Office - Both had hair

DUKES
STORY

Experience is NOT
the best teacher?

Evaluated Experience
is the best teacher

William Glasser - Michigan

This is how people learn:

20%
by
hearing
new
material

30%
by
seeing

50%
by
seeing
and
hearing
(You
will
only

10% by reading new material

remember 50% of this weekend)

William Glasser - Michigan

This is how people learn:

70% by discussing the material with othersimplants in models

80% by discussing and then personal experience

with the material - MII Externship Program

95% by teaching the material to someone else. Dr

to staff

(Glasser) Steps in the learning process:

Step 1 - We do it and you watch us - (Observation)

Step 2 - We do it and you are with us assisting and asking
questions

Step 3 - You do it and we are with you observing you and

your staff - answering questions

Step 4 - You do it - Until you are comfortable - for years

Step
5
You
do
it
and
someone
else
observing
you

(MII Externship Model)

WHY BECOME INVOLVED IN

IMPLANT DENTISTRY?

WHY BECOME INVOLVED IN

IMPLANT DENTISTRY?
LEARN TO DO THE SIMPLE IMPLANT
PLACEMENT THAT IS VERY
PREDICTABLE?

WHY BECOME INVOLVED IN

IMPLANT DENTISTRY?

WHY BECOME INVOLVED IN

IMPLANT DENTISTRY?
DEMOGRAPHICS WILL DIRECT
YOUR OFFICE TO DO SIMPLE IMPLANT
PLACEMENT

1990 to 2000
RETIREES

EMPTY
NESTERS
MUPPIES

YOUNG
ADULTS

65+AGE

32 - 35 MIL

+9%

45-64 AGE

46-61 MIL

+32%

35-44 AGE

38-44 MIL

+15.8%

18-34

70-66 MIL

-9.4%

POPULATION PROJECTIONS
1995-2010

POPULATION PROJECTIONS
1995-2010

AGE 45-54

POPULATION PROJECTIONS
1995-2010

36
MILLION
GROWS

AGE 45-54

TO 42 MILLION
PEOPLE

POPULATION PROJECTIONS
1995-2010

36
MILLION
GROWS

AGE 45-54

TO 42 MILLION
PEOPLE

INCREASE 36%

POPULATION PROJECTIONS
1995-2010

36
MILLION
GROWS

AGE 45-54

TO 42 MILLION
PEOPLE

INCREASE 36%

AGE 55-64

POPULATION PROJECTIONS
1995-2010

36
MILLION
GROWS

AGE 45-54

TO 42 MILLION
PEOPLE

INCREASE 36%

AGE 55-64
23 MILLION GROWS
TO 42 MILLION
PEOPLE

POPULATION PROJECTIONS
1995-2010
AGE 45-54

AGE 55-64
23 MILLION GROWS

TO 42 MILLION
PEOPLE

INCREASE 62%

36
MILLION
GROWS

INCREASE 36%

TO 42 MILLION
PEOPLE

YOU CAN NOT CHANGE

POPULATION TRENDS

YOU CAN NOT CHANGE

POPULATION TRENDS
SINCE JUNE 2007

50%

USA POPULATION
IS NOW OVER

50 YEARS OLD!!!!!

WHY BECOME INVOLVED IN

IMPLANT DENTISTRY?

WHY BECOME INVOLVED IN

IMPLANT DENTISTRY?
FINANCIAL CONSIDERATIONS
WILL DIRECT YOUR OFFICE TO DO
SIMPLE IMPLANT PLACEMENT

real life implant dentistry

midwestimplantinstitute

midwestimplantinstitute

Practice Production

$ 3,750
$ 7,500
$ 18,750
$ 37,500

Regular Implant Fee

Additional Production Per Month

Month

$40,000.00
$35,000.00
$30,000.00
$25,000.00
$20,000.00
$15,000.00
$10,000.00

$ 3,750

$5,000.00
$0

Implants Per Month

10

- Implant
- Abutment
- Crown

midwestimplantinstitute

Practice Production

$ 45,000
$ 90,000
$ 225,000
$ 450,000

Regular Implant Fee

Year

Additional Production Per Month

$500,000.00
$437,500.00
$375,000.00
$312,500.00
$250,000.00
$187,500.00
$125,000.00

$ 3,750

$62,500.00
$0

Implants Per Month

10

- Implant
- Abutment
- Crown

DUKE

AMY

WANDA

ROB

A
I
D
M
E
E
T

Get involved in the AAID

Become an MII Fellow

I
N
G

Learning to do the

SIMPLE SURGICAL
PROCEDURES that are very
PREDICTABLE!

Minds are like parachutes

THEY ONLY WORK WHEN
THEY ARE OPEN

PLEASE ASK QUESTIONS

AT ANY TIME DURING THE

PRESENTATION

Beware of False Knowledge--It is

more dangerious than

Ignorance
George Bernard Shaw

YOU ONLY SEE

WHAT YOUR BRAIN
TELLS YOU

Bringing a little history along!

1960s

Bringing a little history along!

Bringing a little history along!

1970s

BE
OBJECTIVE
Plan to learn today

SO WHAT IS
NORMAL?

LOWER
MOLAR

UPPER
MOLAR

NORMAL
ANATOMY

NORMAL
ANATOMY

Both of the patients want implants

WHY USE DENTAL

IMPLANTS??

Restore
Function

Improve
Esthetics

Increase
length
of
life

Restore
Self-esteem

Replace lost teeth

PATIENT SELECTION

Is there sufficient bone for

implant to support adequate
function?

Is the patient adequately

motivated to properly care
for the implant?

WHAT IS SUFFICIENT BONE?

Proggressive Bone Loss

MODERATE BONE LOSS

10-20 YEAR BONE LOSS--CAUSE--DENTURES

10-20 YEAR BONE LOSS--CAUSE DENTURES

SEVERE BONE LOSS--DENTAL CRIPPLE

DENTURES ARE A SUBSTITUTE FOR NO TEETH

DENTURES ARE NOT A SUBSTITUTE FOR TEETH

BITE
540 POUNDS
PER SQUARE
INCH

550
BITE
POUNDS
540
PER POUNDS
SQUARE
PER SQUARE
INCH
INCH

50
POUNDS
PER
SQUARE
INCH

37 TO 25
POUNDS
PER
SQUARE
INCH

PATIENT

ALWAYS

PATIENT

GETS

ALWAYS

PATIENT

GETS

ALWAYS

WORSE!

Missing Teeth of a PATIENT

Whose Problem is it???

Missing Teeth of a PATIENT

Whose Problem is it???

THE PATIENTS

Missing Teeth of a PATIENT

Whose Problem is it???

THE PATIENTS
PROBLEM

Patient responsibility?

Patient responsibility?

smoking

50,000 Americans Die each

year due to PASSIVE SMOKE
-DR. STANTON GLANTZ

UNIV. OF CALIF. AT SAN. FRANC.

SMOKING IS THE
#1
CAUSE OF HEART DISEASE
IN UNITED STATES

SMOKING IS THE SECOND LARGEST FACTOR IN

TOOTH LOSS BEHIND
TARTER/CALCULUS

PREVENTION IS A
DECISION WITHOUT
RISK

MOST PEOPLE TRY 3 TO 8 TIMES BEFORE

THEY CAN
QUIT SMOKING
8 OUT OF 10
SMOKERS
WANT TO QUIT

Smoking is a Factor in
Implant Failure
C.A. Bain and P.K. Moy
Intern. J. Oral & Max. Impalnts

2,194 BRANEMARK IMPLANTS

540 PATIENTS

FAILURES
SMOKING - 11.28%
NON-SMOKING - 4.76%

Smoking Protocol
STOP SMOKING
1 Month before surgery and 1 Month after surgery

IMPLANT DESIGN

IMPLANT DESIGN

SHEAR FORCE/DISUSE ATROPHY

IMPLANT DESIGN

SHEAR FORCE/DISUSE ATROPHY

COMPRESSIVE
LOADING

IMPLANT DESIGN

SHEAR FORCE/DISUSE ATROPHY

COMPRESSIVE
LOADING

IMPLANT DESIGN

SHEAR FORCE/DISUSE ATROPHY

COMPRESSIVE
LOADING

IMPLANT DESIGN

SHEAR FORCE/DISUSE ATROPHY

COMPRESSIVE
LOADING

IMPLANT MODALITIES

CYLINDER
TYPE
IMPLANTS

BLADE
IMPLANTS

SCREW TYPE IMPLANTS

BLADE IMPLANTS CAN WORK - 28 YEARS OF FUNCTION

IMPLANT MODALITIES

SCREW TYPE IMPLANTS

CYLINDER TYPE IMPLANTS
BLADE IMPLANTS
SUBPERIOSTEAL IMPLANTS

IMPLANT MODALITIES

SCREW TYPE IMPLANTS

CYLINDER TYPE IMPLANTS
BLADE IMPLANTS
SUBPERIOSTEAL IMPLANTS
RAMUS FRAME IMPLANTS

A Dentist who only uses

ONE TYPE OF DENTAL
IMPLANT
is like a physician who
uses only pencillin to treat all
INFECTIONS

PLACING MANDIBULAR
IMPLANTS

PLACING MANDIBULAR
IMPLANTS
Anatomical Considerations

PLACING MANDIBULAR
IMPLANTS
Anatomical Considerations

PLACING MANDIBULAR
IMPLANTS
Anatomical Considerations

Inferior Alveolar Nerve

PLACING MANDIBULAR
IMPLANTS
Anatomical Considerations

Inferior Alveolar Nerve

PLACING MANDIBULAR
IMPLANTS
Anatomical Considerations

Inferior Alveolar Nerve

Mylohyoid Undercut

MAXILLARY BONE
CONSIDERATIONS
POROSITY
MAXILLARY SINUS
BONE LOSS AFTER EXTRACTION
BUCCAL BONE 1mm.
LINGUAL BONE 2mm.
ANTERIOR TOOTH ANGULATIONS

MANDIBULAR
ANESTHESIA

MANDIBULAR
ANESTHESIA
ALWAYS, ALWAYS, ALWAYS

MANDIBULAR
ANESTHESIA
ALWAYS, ALWAYS, ALWAYS
ALWAYS, ALWAYS

MANDIBULAR
ANESTHESIA
ALWAYS, ALWAYS, ALWAYS
ALWAYS, ALWAYS

ALWAYS

InfiltrationInfiltration
Anesthesia
Anesthesia
Infiltration Anesthesia

Infiltration
Anesthesia
Infiltration Anesthesia

After 5 minutes 90 Degree Injection

Watch Tissue Bubble-up

INFERIOR ALVEOLAR NERVE

INFERIOR ALVEOLAR NERVE

MENTAL FOREMAN

INFERIOR ALVEOLAR NERVE

MENTAL FOREMAN

INFERIOR ALVEOLAR NERVE

MENTAL FOREMAN

Construction and use of

surgical template

SURGICAL TEMPLATE

SURGICAL TEMPLATE
Use Full Mouth Mounted Models

SURGICAL TEMPLATE
Use Full Mouth Mounted Models
Accurate Bite for Mounting Models Correctly

SURGICAL TEMPLATE
Use Full Mouth Mounted Models
Accurate Bite for Mounting Models Correctly
Posterior
USE
BICUSPID
SIZE
TEETH

SURGICAL TEMPLATE
Use Full Mouth Mounted Models
Accurate Bite for Mounting Models Correctly
Posterior
USE
BICUSPID
SIZE
TEETH

Anterior- DENTURE TEETH/WAX-UP

SURGICAL TEMPLATE
Use Full Mouth Mounted Models
Accurate Bite for Mounting Models Correctly
Posterior
USE
BICUSPID
SIZE
TEETH

Anterior- DENTURE TEETH/WAX-UP

Drill Verticle Hole- BRASSLER 219

SURGICAL TEMPLATE
Use Full Mouth Mounted Models
Accurate Bite for Mounting Models Correctly
Posterior
USE
BICUSPID
SIZE
TEETH

Anterior- DENTURE TEETH/WAX-UP

Drill Verticle Hole- BRASSLER 219
Use all remaining available teeth

SURGICAL TEMPLATE
Use Full Mouth Mounted Models
Accurate Bite for Mounting Models Correctly
Posterior
USE
BICUSPID
SIZE
TEETH

Anterior- DENTURE TEETH/WAX-UP

Drill Verticle Hole- BRASSLER 219
Use all remaining available teeth
Use Palate with Maxillary Unilateral situration

USE BICUSPID SIZE TEETH

USING SPACE THAT

IS AVAILABLE

Extern Surgical
Templates

Midwest Implant Institute

mii