Dr Alex Fibishenko, founder of All-on-4 Clinic, was an invited speaker at the 2015 IIDC on All-On-4 Plus and Zygomatic Implants.
“Thank you Alex. We expected a presentation, not a performance. This deserves a standing ovation.“- Moderator Prof. Dr. R. Gunaseelan, Oral and Maxillofacial Surgeon MBBS, BDS, FDSRCS (England), President of Association of Oral and Maxillofacial Surgeons of India.
The India International Dental Conference (IIDC) was held in Mumbai this year and was themed “Holistic Restorations With and Without implants”. Dr Alex Fibishenko was invited to present on solutions with Dental Implants, and specifically on the ‘All-On-4 Plus’ and ‘Zygoma Plus’ concepts that he spearheaded, and the treatment of highly atrophic jaws. Prof. Dr. Gunaseelan Rajan from Tamilnadu was appropriately appointed to moderate the session, having held some of the highest positions in the country including Presdient of Dental Council of India, President of Indian Dental Association, and a university Vice-Chancellor. He closed with a take home message for the 600 IIDC attendees saying, “Dr Fibishenko really summed up restoring the patient as a whole and not just the “teeth”. Some very nice points about the surgical design, and very importantly the contingency plans. Last but not least he showed what he can achieve with speed. A wonderful performance.”
It was an interesting choice for the organising committee to include Dr Fibishenko under the “Hollistic” banner. His philosophy, concepts and the systems that Dr Fibishenko adheres to in oral rehabilitation and dento-facial surgery do not on the surface appear as being “holistic” or conservative. But his presentation proved quite the opposite as time and time again Dr Fibishenko emphasises that “we need to provide our patients with a definitive plan …because implants are not reversible. They are difficult to undo and often impossible re-do. So as clinicians, especially in an era of pressures from the expectation of instant gratification, we must do what is necessary to ensure predictable aesthetics, long term function, simplified hygiene, and contingency options. We treat persons who have needs, desires, hobbies, skills, talents and social lives. We treat individual people, not just “teeth” or “jaws”, and we must recognise that what we do, especially with dental implants, could potentially impact their lives in a positive way, or quite the opposite. What we do not want to do is to replace one problem with deteriorated teeth or dentures, yet with another problem with implants. We need to provide a solution, not merely a treatment concept.”
Patient don’t want ‘Implants’! A Synopsis by Dr Alex Fibishenko
The edentulous, or those soon to be edentulous, are oral invalids who can be rehabilitated with dental implants. The trend has been to use less and less implants in total rehabilitation, and immediately load them. In doing so the question is: are we pushing the limits, or simply providing the product of evolution in this field?
Osseointegration is the single most researched topic in dentistry today. In 2004 the American Dental Association has reported that “the average survival rates of multiple implant designs placed in various clinical situations are more than 90%”. They also reported findings that implants may provide a “more predictable outcome” than alternative therapies [Stanford C, Rubenstein J. Dental endosseous implants-an update. ADA Council on Scientific Affairs. Journal of the Americal Dental Association 2004; 135:92-95]. Review of some of the current literature suggests survival rates in the vicinity of 97% to 98.5%. These figures are more favourable than almost any other day-to-day procedure we perform.
However, we have long passed the development phase of implant therapy where restoring function and ensuring implant ‘survival’ were central. In todays society, these criteria alone are no longer acceptable on their own. Function, aesthetics and long-term oral health parameters must all go hand in hand as implant ‘Survival’ is not necessarily synonymous with Implant ‘Success’, just as a cosmetic procedure is not necessarily an aesthetic one. We know the implants will survive, we now need to make them ‘successful’.
Whilst dextrous accuracy and following surgical and prosthetic protocols are paramount in implant therapy, these will always be secondary to sound treatment planning. As clinicians in the era of ‘aesthetics and high expectations’, we must think beyond the square, beyond the ‘teeth’. We must recognise that at the tip of the scalpel is a person, – people with personalities, talents, hobbies, and social lives, and whose lives can be altered one way or the other with the treatment we provide.
Patients who need dental rehabilitation prefer a quick ‘makeover’ …a concept certain dental professionals traditionally resisted due to a perceived potential compromise to quality and longevity as well as complex co-ordination and set-up requirements. But what if a quick makeover was in fact the treatment that offered the better aesthetics, quality and longevity as well as facilitating oral hygiene, such as the case with All-On-4 Plus®? Then the only obstacle may lay in our ability to deliver!
We must recognise that patients don’t want ‘Implants’, they come to us because they want a beautiful smile, to be able to enjoy all foods and desiring uncomplicated options in the event of the unforeseen.
The modern challenge of total rehabilitation lies in providing a functional and aesthetic rehabilitation which at the same facilitates long term oral health and improves the longevity of our supra-structures. All-On-4 Plus® addresses this challenge through indication-specific treatment planning incorporating Dr Fibishenko’s internationally acclaimed innovative techniques that have a built-in contingency and facilitate the delivery of an immediate FINAL restoration in the most streamlined process.
The quality of our treatment planning is in the end judged through our ability to differentiate or synchronise what is possible and what is practical and predictable; as well as our ability to draw on what we know, recognise and learn what we still don’t know, and be mindful of those things we don’t know that we don’t know.
“Its the things that appear ‘simple’ that require the highest degree of sophistication” – Dr. Alex Fibishenko
The lecture by Dr Alex Fibishenko was dedicated as a tribute to and in memory of Professor P I Branemark who recently passed away.
This post was written by All-On-4 Clinic HQ