Dr. Shatkin graduated from the University of the Pacific Dental School in 1989 and has been in private practice with his father Samuel Shatkin, DDS, MD and his brother Samuel Shatkin, Jr. MD, both Board Certified in Plastic surgery. Their practice of plastic surgery and cosmetic dentistry is located in Amherst, NY, a suburb of Buffalo. He has placed and restored over five thousand IMTEC mini-dental implants in the last six years. About half of these were for denture retention and the other half for single and multiple tooth replacement with F.I.R.S.T. tm Restorations. Dr. Shatkin has been lecturing for IMTEC Corporation for the past several years teaching seminars and mini residency programs. He can be reached at firstname.lastname@example.org or at www.minidentalimplant.com.
OsseoNews: Dr. Shatkin, do you have a formula or system for deciding how many mini-implants to place? For example, in a square maxillary arch how many mini-implants would you place to replace #7-8-9-10? One mini-implant per tooth? To replace #3-4-5? Would you use a mini-implant to replace #6 if it were free standing?
Dr. Shatkin: At our clinic, we use one IMTEC MDI per anterior tooth and two MDI’s for molar teeth. We routinely replace #6 and 11 with an IMTEC MAX thread 2.3mm MDI.
OsseoNews: What is the proper or ideal alignment of the mini-implant? Long axis of the tooth replaced? What would be the alignment planned for a mini-implant to replace #8, through the long axis of the cingulum of the prior natural tooth? (This question is important since many of our online subscribers are lab owners.)
Dr. Shatkin: We place the MDI central on the available bone bissecting the buccal and lingual plates. Occasionally we use a custom abutment to angle the implant lingually.
OsseoNews: What kind of abutment interface do you have for cementing a crown or fixed partial denture? The most commonly displayed mini-implant has a ball at the coronal end and a square neck directly subjacent.
Dr. Shatkin: We cement the crown directly to the ball and square on the implant. The crown is like a pontic with a cylindrical hole under it. We use a resin cement.
OsseoNews: As you know, a real hot topic is maxillary overdentures.
In your Amherst practice, do you use the MDI mini-implants to support a bar or would you use free-standing? Also, how many for each?
Dr. Shatkin: We customarily use 6-8 MDI’s with o-balls to support a full upper denture with o-rings. These procedures are great because they require no flap, no sutures, little post-op discomfort and immediate results the same day as placement. I have personally placed over 5,000 MDI’s in the past six years and have had 95% success.
OsseoNews: It appears to me that you’re on the cutting edge with your F.I.R.S.T. technique. I believe that immediate placement and immediate temporarization or permanent restoration is the key. With your system it appears the dental lab does most of the work. I really like your approach.
Dr. Shatkin: We assist dentists in treatment planning, selecting the appropriate implant for placement, occlusion analysis, etc. A dentist who’s been trained in an IMTEC MDI seminar sends us the polyvinyl impressions, a bite registration and a panoramic x-ray, along with details as to shade etc., and we do the rest. The F.I.R.S.T. technique and service to the industry is really taking off. With a minimum amount of promotion, we now have about 750 dentists regularly using our services and we are growing every day. There is a huge need for immediate implant and crown services from the dental profession. There has been a huge swing in favor of placing MDI’s in the anterior mandible to support an overdenture, and I’ve enjoyed immense success with that service. However, I think that use of these devices in other treatment situations may represent the next stage in the evolution of the approach to implants. I encourage all dentists to begin providing
these simple, cost-effective methods of tooth replacement.
OsseoNews: You had a F.I.R.S.T. two-day seminar in Las Vegas last fall that from all reports was successful. Tell me about it and when another one’s planned.
Dr. Shatkin: We had over 75 doctors enroll in the course and the evaluations were extremely favorable. Most of those enrollees are now routinely accepting single tooth and crown/bridge cases utilizing the F.I.R.S.T. technique. We’re going to have another one in Baltimore on August 19/20. It will be a two-day symposium on the MDI for use with denture stabilization as well as for use with single and multiple crowns and for full arch reconstruction. The course is August 19 and 20th and will be held at the Baltimore Marriott Waterfront. The enrollment fee is $1,295 and includes 14 hours AGD CE. Any interested dentist can contact F.I.R.S.T. Laboratories, LLC at 716-839-2959.
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