Why are we all in such a hurry??
I am often perplexed by the need so many of us feel to progress from full-arch beginner to full-arch expert…somehow, miraculously, overnight.
This week, I wanted to provide a bit of perspective surrounding this somewhat controversial, and ego sensitive topic.
I was recently in a meeting with a group of oral surgeons interested in learning more about full-arch surgery. All of the surgeons attending were actively performing full-arch cases.
There was a comment made at a “breakout” by another participating surgeon, who is both a colleague and friend of mine – and someone whom I look up to in the world of AOX surgery.
The value in this comment was likely overlooked by most attending, and may have very well offended some.
However, this comment struck me as an incredible pearl of wisdom.
Let me preface by saying that this particular surgeon is literally one of the most experienced full-arch surgeons in the world and has completed ~5,000 arches to date. He is one of the surgeons I go to when I have a question.
During the breakout, he and I were discussing with the group various AOX tips and techniques in response to proposed clinical questions.
As part of the breakout, a graph of the participating surgeons’ experience was shown. Most surgeons attending had completed between 100-250 arches. A strong number by most accounts.
However, in seeing this, my colleague immediately stopped with almost a perplexed look on his face and made the following profound comments,
This instantly struck me.
While an often unpopular opinion, I have long felt this way – and this is why I wrote the article Arch Goals.
The fact that one of the most experienced surgeons in the world, also independently shared these values, was a confirming moment for me in full-arch education.
I don’t know if it’s social media or simply competition with colleagues, but I see an immense pressure amongst new full-arch surgeons to tackle “the difficult cases”, to be “fast”, to learn zygomatic and pterygoid implants “as soon as possible”…
Why? Why the rush?
There is incredible value in slowing down.
Learn and perfect full-arch fundamentals. Learn at a speed that builds confidence. Learn and refine each step of the surgery so that as your arch numbers build you are truly becoming a master of this procedure – not just a volume producer.
Wanting to learn is admirable. Don’t lose that desire.
But my humble advice is to resist the urge to keep up with social media.
Operate on your terms. Operate on your timeline. Let your driving goal always be to be the BEST full-arch surgeon you can be. A master of the fundamentals, confident and adaptable because you’ve learned each and every step.
This takes time. And that’s OKAY.
Here’s to slowing down and enjoying the full-arch ride.
Matthew Krieger DMD
“Slow is Smooth, Smooth Is Fast.“
Q & A with Dr. K
“Do you bone graft extraction sockets during full-arch surgery?” |
No. This is not something that I routinely do.
One of the benefits of full-arch surgery is that it is usually a graftless procedure.
I find that grafting increases post-op edema and discomfort and therefore I avoid it unless absolutely necessary. It’s also an added foreign body material that is simply one more thing that can cause a post-op infection.
I do not hesitate, however, to graft implant sites that have defects around the implant threads. I try to use autogenous bone as much as possible by saving bone debris during reduction.
Even this is not notably common though, as I will simply move to a different implant site if there is a substantial defect to work around.
And – while not common, for those that are curious, here are The 6 Scenarios in Which I Do Prefer to Bone Graft During AOX Surgery.