www.osseo.org

Dr. Stephen Wheeler elected AO President,heads slate of newly-elected officers

A quarterly publication of the Academy of OsseointegrationVolume 24, Number 2 • 2013

In This Issue

President’s Message:Fulfilling our vision to be world’s premier dental implant organization . . . . . . . .2

Membership in the Academy and AO Fellowship . . . . . . . . .3

Do generic implants dream of off shore labs? By Bruce Barr, DDS . . . . . . . . .6

First AO Symposium featured August 30 at FDI Annual Congress . . . . . . . .7

Tampa Annual Meetingattendance approaches3,100/photo report . . . . . . . .8-9

AO Membership Committeehosts successful New MemberBreakfast . . . . . . . . . . . . . . . . . .9

Osseointegration Foundationannounces new officers . . . . .11

OF Charitable Grant may offersolution for patient with limitedfinancial resources . . . . . . . . .11

Young Clinicians Corner:2013 AO Annual Meetingfeatures exciting presenters,latest technology . . . . . . . . . .12

Editor’s Editorial:Past, present, future . . . . . . . .14

Academy NewsAcademy of Osseointegration85 W. Algonquin Road, Suite 550Arlington Heights, IL 60005847/439-1919

EditorKevin T. McNally, DDS

Editorial ConsultantsEdward M. Amet, DDS, BS, MSDBruce K. Barr, DDSDaniel R. Cullum, DDSBarry R. Franzen, DDSLouis R. Guenin, BDS, LDS, RCSPaige Warren Miller, DDS

© The Academy of Osseointegration. All rights reserved.

Stephen L. Wheeler, DDS, a Board certi-fied oral and maxillofacial surgeon fromEncinitas, CA, was elected President of theAcademy of Osseointegration (AO) duringthe organization’s annual Business Meetingin Tampa, FL. He succeeds formerAcademy President David L. Cochran,DDS, PhD, San Antonio, TX, a Board certified periodontist.

Newly elected members of the AO Boardof Directors with Dr. Wheeler are:

• Joseph E. Gian-Grasso, DMD, peri-odontist from Philadelphia, PA,President-Elect;

• Russell D. Nishimura, DDS, prostho-dontist from Westlake Village, CA, VicePresident;

• Michael R. Norton, BDS,FDS, RCS(Ed), oral surgeon from London,England, Secretary;

• Alan S. Pollack, DDS, periodontistfrom New York, NY, continues asTreasurer;

• Lyndon F. Cooper, DDS, PhD,prosthodontist from Chapel Hill, NC,Director; and

• Amerian D. Sones, DMD, MS,prosthodontist from Dallas, TX,Director.

AO President: Dr. Stephen WheelerDr. Wheeler’s private practice is based inEncinitas, CA, where he provides a full

scope of oral, maxillofacial and dentalimplant surgery. One of the first doctors inthe U.S. to begin titanium dental implantplacement in the mid-1980s, he went on toestablish the Rancho Santa Fe DentalImplant Dentistry Club as a forum forimplant dentistry training and education.

He has been an AO director since 2004,previously serving as the Program Chairfor our 2002 Annual Meeting in Dallas,Co-Chair for the 2003 InternationalCongress of Reconstructive andPreprosthetic Surgery, and Chair of AO’sClinical Innovations Committee.

…continued on page 13The purpose of the Academy of Osseointegration is to advance the science and application of tissue replacement in oral and facial care.

Call for AO InternationalAmbassadors“Following the success of the Academy’sfirst Charter Chapter meeting in Londonlast year, we are now looking for leadersamong the membership who would liketo become AO Ambassadors to establisha local Charter Chapter in their owncountry,” announced AO Secretary Dr.Michael R. Norton, London, England. Members interested in this exciting newarea of the AO are invited to contact Dr. Norton by email at drnorton@nortonimplants.com.The Charter Chapter program is a majorinitiative of AO’s Committee on GlobalProgram Development.

…continued on page 5

As I view the daunting task of the Presidency of the Academyof Osseointegration, I am extremely pleased to look back onthe progress we continue to make. While maintaining our keyfocus on the Annual Meeting, which has become the premierdental implant conference in the world, we continue to expandour influence and brand both at home and abroad. For thefirst time, after years of discussion, weare establishing programs I believe willplay a key role in fulfilling our visionto be “the world’s premier organizationfor implant dentistry.”

Our first Charter Chapter meeting inEngland, orchestrated by Dr. MichaelNorton, was a great success. Both heand I have written articles for theAcademy News as a start in promotinginterest for future Charter Chaptersaround the world. Dr. Norton will betaking over my position as Chair of theGlobal Program DevelopmentCommittee to pursue this, along witheducational outreach, initially to Indiawith help from Dr. GeorgiosRomanos. Dr. James Taylor will coordinate our first FDIinvolvement, sponsoring three speakers on a symposium panelat the world meeting in Istanbul this August (see article onpage 7).

Our Annual Meeting Evaluation Task Force has concluded itswork. We have received strong support from all fronts on theNew Technology Forum and International Symposium to beintegrated into our Annual Meetings during the next twoyears. We started this year in Tampa with a “New ProductShowcase” to allow our exhibitors the opportunity to highlightrecent developments in techniques and technology, both fortheir benefit and that of our meeting attendees.

Next year, we will continue the New Product Showcase andintroduce our first International Symposium, to be held Fridaymorning during the Seattle meeting, dedicated specifically toour colleagues from Japan. It is assumed that all of the lectureswill be in Japanese with English interpretation. This will allowkey leaders in the implant field from Japan to present here inthe United States in their native tongue. English to Japaneseinterpretation will then be provided from the main podiumthrough the rest of the meeting in hopes of encouraging moreinternational attendance.

We hope to provide the same forum for others of our interna-tional colleagues in future meetings. It is interesting to note

that 25% of our membership and Annual Meeting attendanceis already from countries outside of the United States.

Nationally, we are working to promote the AO in both mem-bership and meeting attendance through regional meetings fordental schools and residency programs, sponsored symposia atother key dental meetings, expanding the JOMI to include

even more cutting edge articles andresearch on implant dentistry and, ofcourse, providing the best in continu-ing education through our AnnualMeeting and online CE courses.

We have updated the requirements forFellowship status in the AO and will bepromoting this both nationally andinternationally. We were able to honorour two most recent recipients of thisaccomplishment on the main podium atour last Annual Meeting in Tampa.

Based on the work by the task forceheaded by Dr. Joseph Gian-Grasso wenow have a “Rapid Response” team formedia concerns. This should help the

AO in dispelling misinformation regarding implant dentistry,as well as help position the AO as the leader in this area.

The AO continues to organize consensus conferences approxi-mately every three to four years to evaluate treatment tech-niques and technology through an exhaustive review of theliterature, so we can provide the best in care to our patientsbased on all the evidence available. Dr. Clark Stanford isChair of the Maxillary Arch Consensus Conference, scheduledfor August 2014. This will bring together leaders in our fieldfrom around the world to evaluate treatment options inrestoring the edentulous maxilla.

Our immediate challenges ahead lie in continuing to focus andfine tune our international outreach, while being cautious tonot dilute our concentration on the Annual Meeting and thebenefits to our existing members. I am in the process of set-ting up a task force, approved in October, to evaluate how tobetter integrate GPs into the AO as active members and com-mittee participants, while maintaining our focus on the teamapproach to treatment. We are working to develop and inte-grate a plan for public relations, including media connections,website enhancement, social media, and public awareness.

We need to continue to foster communication with our cor-porate sponsors while maintaining control of our programs,

President’s Message

Fulfilling our vision to be world’s premier dental implant organizationBy Stephen L. Wheeler, DDS

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…continued on page 3

Incoming President Dr. Stephen Wheeler (right) presents an honorary gavel to outgoing President Dr. David Cochran.

The Academy of Osseointegration isrecognized as the premier association forprofessionals interested in implant den-tistry. It has always been at the forefrontof scientific advances in dental implantand tissue replacement therapy. Becauseits membership is international withmembers from more than 70 countries,AO offers the unique advantage of shar-ing information on a worldwide basis.

The organization fosters the dissemina-tion of knowledge to all disciplines and promotes developments in tissuereplacement therapies in oral and facialcare. The multidisciplinary make-up of the membership encourages dentalprofessionals from the various special-ties, as well as general practitioners,research scientists, academicians, laboratory technicians and other ancillary personnel to come together in a learning experience that provides a refreshing opportunity for an interdis-ciplinary approach.

The Academy ofOsseointegration is struc-tured so that profession-als with different interestsand backgrounds canenjoy the many and var-ied benefits of member-ship. These benefits aredesigned to provide thehighest quality continu-ing education programsand other resources thatwill enhance and aid in thedevelopment of dental implant relatedcareers and practices.

While the term "fellowship" is used by avariety of different programs, generallyfellowships:• are short-term opportunities lasting

from a few months to several years;• focus on the professional develop-

ment of the fellow;• are sponsored by a specific association

or organization seeking to expandleadership in their field.

Fellowship programs can be designed tosupport a range of activities including:

• graduate study in a specific field;

• research to advance work on a partic-ular issue;

• developing a new community-basedorganization or initiative;

• training and reflection to support thefellow's growth;

• opportunities to further explore aparticular field of work.

Fellowships have traditionally beenawarded to graduate and post-graduatestudents, but there are an increasingnumber of fellowships available to recentcollege graduates in public policy, thearts, education, and other professionalnonprofit groups such as the Academy.

AO FellowWhat steps are involved to becomea Fellow? The first step in becoming a Fellow inthe Academy of Osseointegration is tojoin the Academy as an Active member.

Individuals may not enterthe Academy as a Fellow.If you are already amember of the Academy,you may be ready toapply for Fellowship. Ifyou believe that youqualify for theFellowship, please com-plete the enclosedApplication forFellowship. Oncereceived, the Executiveoffice will verify yourdata and forward your

application to the MembershipCommittee for evaluation.

The following prerequisites are requiredof applicants:• Applicant must be a qualified

DMD/DDS/PhD or equivalent, witha minimum of ten (10) years, activelyinvolved in dentistry, in either a clini-cal or research setting or working inan implant-related academic positionfor a minimum of three (3) days aweek. (Excluding post-graduate training/research)

• Applicant must be a member of theAcademy of Osseointegration (AO)for five (5) consecutive years.

• Applicant must have attended a mini-mum of three (3) Academy ofOsseointegration Annual Meetingswithin the last seven (7) years.

• Applicant is required to provide sup-porting testimonials from two (2)current Fellows of the Academy ofOsseointegration.

Categories of membership are not permanent classifications. As experienceis gained or education completed, anindividual can apply or transfer onemembership category to another. Forspecific information about applying fora change in categories, please contactthe Academy's Executive Office at 847-439-1919 or e-mail them at membership@osseo.org.

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Membership in the Academy and AO FellowshipBy EDward M. Amet DDS BS MSD FACP, Academy News Editorial Consultant

so that they will always be driven byresearch and experience, not by mar-keting. As we continue to promotesummits and white papers, I feel theAO will establish itself even morefirmly as the leader in this field. It isalso exciting to see the response ofour members, who wish to becomemore involved in the inner workingsof the AO by volunteering to partici-pate in regional meetings and ourcommittees. We presently have over100 members volunteering their timeand efforts to help keep the AO mov-ing forward.

It has been enlightening to me to preview the video that looks back 27years with interviews of our “foundingfathers.” A task force led by Drs. AlanPollack, Michael Norton, andRussell Nishimura has been develop-ing this video over the past two years,and the editing is ongoing. I hope towork with the AO Board and ourstrong committee structure to buildon the shoulders of those who haveworked so diligently in the past tocontinue the vision of making the AO the premier organization inimplant dentistry.

President’s Message…continued from page 2

New Academy Fellows Drs. AmerianSones and Robert Miller receive their Fellow certificates in Tampa.

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Dr. Stephen Wheeler heads slate of newly-elected officers …continued from page 1

In addition, Dr. Wheeler chaired theAcademy’s International Relations andGlobal Program Development commit-tees, the Council on Expanding ImplantUtilization, the Ad Hoc Committee onWebsite and Electronic Services, and theProfessional Relations and PublicAwareness subcommittees.

A Fellow of the Academy,Dr. Wheeler served the AOas Secretary, Vice President,and President-Elect beforehis election to President.

Dr. Wheeler graduatedfrom the University ofSouthern California Schoolof Dentistry, after earninghis undergraduate degreefrom Stanford University.After dental school, hecompleted a three-year oral and maxillofacial resi-dency program at the L.A. County/USC Medical Center.

AO President-Elect: Dr. Joseph Gian-GrassoA Diplomate of the American Board ofPeriodontology, Dr. Gian-Grasso spe-cializes in the areas of periodontics anddental implantology in a Philadelphiagroup practice. He served as ClinicalAssistant Professor of Post-GraduatePeriodontics at the University ofPennsylvania’s School of DentalMedicine, Clinical Associate Professorof Periodontology at Temple UniversitySchool of Dentistry, and Director of theImplantology Center at the MedicalCollege of Pennsylvania.

Dr. Gian-Grasso is chair of theAcademy’s Public Relations Task Force.He was elected to the AO Board in2004 and previously served as Treasurerand Vice President. He is a nationalspokesperson for the AmericanAcademy of Periodontology, where heserved as a trustee for six years. He ispast president of the PennsylvaniaSociety of Periodontists, PhiladelphiaSociety of Periodontology, and theDelaware Valley Academy ofOsseointegration.

Dr. Gian-Grasso holds a B.A. from theUniversity of Pennsylvania, a D.M.D.from the University of Pennsylvania’sSchool of Dental Medicine, and aCertificate of Advanced Graduate Studyin Periodontics from the BostonUniversity School of Graduate Dentistry.

AO Vice President: Dr. Russell NishimuraDr. Nishimura maintains a private practice limited to prosthodontics and implant dentistry in WestlakeVillage, CA.

He is Professor Emeritus at the UCLASchool of Dentistry, where he taughtremovable prosthodontics and chairedthe RPD, Immediate Denture andImplant courses.

A Fellow of the Academy, Dr.Nishimura was elected to the Board in2005 and previously served as Secretary.He is past chair of the Membership andInternational Relations committees. Heis a member of Omicron Kappa UpsilonNational Dental Honor Society, andPierre Fauchard Academy, InternationalHonor Society.

Dr. Nishimura received his BS and DDSdegrees from UCLA. He completedpost-graduate programs in HospitalDentistry, Prosthodontics, andMaxillofacial Prosthetics at the UCLAMedical Center and School of Dentistry.

AO Secretary: Dr. Michael NortonDr. Norton runs a practice dedicated toimplant and reconstructive dentistry inLondon. He is a specialist in oralsurgery and in 2007 was awarded theprestigious Fellowship of the RoyalCollege of Surgeons, Edinburgh, for his

contribution to the field ofimplant dentistry.

He is a Fellow of theAcademy and is PastPresident and HonoraryLife Member of theAssociation of DentalImplantology (ADI), UK.He is a past Editor of theAcademy News and is currently an AssociateEditor of the Inter nationalJournal of Oral &Maxillofacial Implants(JOMI). He also serves as a referee for a numberof other peer-review journals.

Dr. Norton graduatedfrom the University of

Wales, School of Dental Medicine, in1988. He lectures internationally and is widely published in literature, includ-ing one of the earliest Quintessencetextbooks on dental implants, publishedin 1995.

AO Treasurer: Dr. Alan PollackDr. Pollack devotes his Manhattan-based private practice to periodonticsand implant dentistry. He joined theAcademy’s Research Committee in 1998and chaired it from 2002-2004. Heserved on the Nominations Committee,became a Board Director in 2006 andwas elected Treasurer in 2012. He serveson the Editorial Review Board of theInternational Journal of Oral andMaxillofacial Implants. He is a Fellow ofthe Academy and of the InternationalTeam for Implantology (ITI).

Dr. Pollack holds a B.A. in biology fromQueens College-CUNY. He earned aDDS from the Columbia UniversitySchool of Dental & Oral Surgery.

AO’s 2013-14 Board of Directors (front row, left to right): Drs. Tara Aghaloo, JosephGian-Grasso, Amerian Sones, and David Cochran. Second row, left to right: Dr. StevenRosenstein, Executive Director Kevin Smith, Drs. Stephen Wheeler, Russell Nishimura, Jay Malmquist, Clark Stanford, Alan Pollack, and Michael Norton. Dr. Lyndon Cooper ispictured on page 7.

…continued on page 7

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Do generic implants dream of offshore labs?By Bruce Barr, DDS, Academy News Editorial Consultant

In the Phillip K. Dick novel Do AndroidsDream of Electric Sheep?, the human

detective RickDeckhardendeavors toidentify andeliminate sixthird generationrenegadeandroids escapedfrom Mars, whopose as humansin post-apocalyp-

tic San Francisco. Unlike more primitiveandroids, industry had developed thesemodels to a level where the old testspreviously used to easily differentiatemachines from humans were not as sen-sitive and, ultimately, the only the defin-itive determination between human andmachine was a postmortem biopsy .

This famous science fiction scenario hasa corollary in one of internationalimplant dentistry’s more perplexingdevelopments: the proliferation of gener-ic dental implant products. Familiararguments, sometimes accompanied byincendiary invective wrapped in diffract-ed industry claims that trumpet quality,clinical results, service, and sustainablebusiness models, abound. We dentists,regardless of the brands used, must nowconsider whether these advertorial decla-rations have substance or are mere hype.

Unstandardized terminology compli-cates even discussing these products.What constitutes a premium, generic,discount, copy, value, compatible, valueadded, improved, or clone implant andcomponents? Does a generic implantbecome a premium when all or part ofits company is purchased by one of theestablished brands? According to an arti-cle by Vandeweghe, et al, in the October2012 issue of Clinical Implant Dentistry,there were 1,300 options when selectingdental implants, with variations in shape,thread design, material composition ofthe surfaces, and prosthetic connection.

A recent Morgan Stanley Europeanresearch report cited an increase of 29%in the last two years from 183 to 215

separate implant companies. Whilethere is no consensus on just how manyimplant companies actually exist world-wide, the numbers are certainly ascen-dant. Many have their own multilayeredevolving product lines, making noattempt to be compatible, only statingcomparability in success at lower costthan their more renowned competitors.Others exist solely to be interchangeablewith the name brands at significantlylower prices.

Numbers circulated through the indus-try place the five main premium brandsin the United States as Nobel Biocare(about 22%), Straumann (21%), Biomet(which not many years ago was itselfconsidered a copy implant company,11%), DENTSPLY (9%), and Zimmer(6%). These leaders account for some-where between 67% and 75% of the USmarket that is valued at least $877 mil-lion. The remaining brands make upabout 33%. It has been estimated thatabutments and other componentsaccount for approximately 40% of thismoney spent, thus providing an incen-tive for providing compatible parts byenterprises both large and small.

International statistics are even moreopaque. Again according to a MorganStanley European report coming out ofthe huge 2012 International DentalShow in Germany, author Jungiing esti-mated the world implant market atabout $3 billion. He reported on a num-ber of implant companies growing at15%, some selling implants for as low as40 Euros.

That generics are interchangeably iden-tical to established brands is an enduringbut false assertion. That they may bebetter, worse, or the same as a marginal-ly different alloy, a deeper groove, arougher surface texture, tighter connec-tion, or any variation in manufacturingparameters affirms this conclusion. Dr.Daniel Buser, in a recent AO presenta-tion, commented that the Swiss are evencurrently challenging the very termgeneric as it implies an exact pharma-ceutical molecular replica.

This campaign raises further issues con-cerning nomenclature of products,emphasizing the need for a classificationsystem rooted in biological testing, aswell as cost. Industry has already adopt-ed a financial nomenclature, using theterms “premium,” “value,” “discount,”and others, implying the same biologicperformance and service but at lowerprice.

Obviously, if there were no disparity inprice there would be less appeal to thepoorly documented value or discountimplants. Thus, the critical question is:“Do the poorly documented genericshave a significant impact in any negativeor positive manner on the clinical resultswe have come to expect from the welldocumented name brands?” Once thisinformation is known, individual dentistsmay be able to determine if their ownfinancial savings or expenditures arecompatible with these results.

If experienced dentists worldwide canpredict about a 95% five-year surgicalsuccess rate and higher for multi-unitprosthetics, are we willing to accept a2% lower survival rate or one millimetermore crestal bone loss due to implantitisfor a 50% reduction in implant cost? Isit possible that some poorly documentedbrands, due to some specific innovation,indeed have a higher success rate thansome of the name brands on which wehave come to depend? Taking intoaccount the constant spectra of humanerror and patient variation, how highcan the surgical success rate go regard-less of design improvements and howmuch are we willing to pay for theseincremental changes?

Although it is seldom discussed, ifindeed more dentists adopt a lower priceimplant – which is obviously occurringjudging by the proliferation of thesecompanies – how much of the savingsare we willing to pass on to the patient?

Dentists who have been placing andrestoring implants for years are under-standably wary of having patients andreputations used yet again as an unwit-

Dr. Bruce Barr

…continued on page 10

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In a first for both organizations, AO will hold a symposiumwithin the FDI World Dental Federation’s Annual WorldDental Congress, 9:00 am – noon, August 30, in Istanbul,Turkey. The Congress runs from August 28-31.

“The AO Committee on GlobalProgram Development has arrangedthis symposium in keeping with ourmission of advancing oral health andwellbeing globally by disseminatingstate-of-the-art clinical and scientificknowledge of implant dentistry andtissue engineering,” says Dr. JamesC. Taylor, Ottawa, ON, Canada,who will moderate the AO panel.

The three AO members who willcomprise the panel are:

• Sreenivas Koka, DDS, MS, PhD,of the Mayo Clinic, Rochester,MN, who will address “Oral-sys-temic Considerations in theContext of Osseointegration.”

• The topic for David Holmes, BDS, MS, in private practice in London, UK, will be, “Challenges in the Maxilla: From Sinus Surgery to the High Lip Line Smile –What’s Possible.”

• Fouad Khoury, DMD, PhD, Olsberg, Germany, Professorat the University of Muenster, will speak on “CurrentConcepts in Bone Grafting & Soft Tissue Management.”

The FDI World Dental Federation is a federation of approxi-mately 200 national dental associations and specialist groups.

Its mission is to be the authoritative,professional, independent, world-wide voice of dentistry.

FDI serves as the principal represen-tative body for more than one mil-lion dentists worldwide, developinghealth policy and continuing educa-tion programs, speaking as a unifiedvoice for dentistry in internationaladvocacy, and supporting memberassociations in oral health promotionactivities worldwide.

FDI works at the international andnational levels through its own activ-ities and those of its members. FDIhas official relations with the WorldHealth Organization and is a mem-

ber of the World Health Professionals Alliance. The AO hasbeen a Supporting Member of the FDI since 2011.

First AO Symposium featured August 30 at FDIAnnual Congress

AO’s FDI panel moderator Dr. James Taylor (center) received a plaque to honor his service on the Board from incomingPresident Dr. Stephen Wheeler (left) and outgoing President Dr. David Cochran.

Dr. Stephen Wheeler heads slate of newly-elected officers …continued from page 5

AO Director: Dr. Lyndon CooperDr. Cooper is the StallingsDistinguished Professor of Dentistry ofthe Department of Prosthodontics atthe University ofNorth Carolina,Chapel Hill,where he servesas Director ofGraduateProstho dontics.He is aDiplomate ofthe AmericanBoard ofProstho donticsand served as the 2010 President of the American College of Prostho -dontics (ACP).

Dr. Cooper’s Bone Biology and ImplantTherapy Laboratory focuses on bonebiology, adult stem cell bone regenera-

tion, and clinical evaluation of dentalimplant therapies.

AO Director: Dr. Amerian SonesDr. Sones, DMD, MS, is Director,Continuing Education, Texas A&MUniversity, Baylor College of Dentistry,Dallas. She teaches removable prostho-dontics and undergraduate implant den-tistry and is organizing a maxillofacialdental clinic at Sammons CancerCenter, Baylor Medical Center.

After completing dental training at theTufts School of Dental Medicine in1979, she spent two years at the USPHSPapago Indian Reservation as ChiefDental Officer, serving a remote popula-tion 60 miles southwest of Tucson, AZ.She pursued her interest in prosthodon-tics at UCLA School of Dentistry, com-pleting a two-year residency inprosthodontics, followed by a one-year

residency in maxillofacial prosthodon-tics, and earned a Masters of OralBiology in 1984.

She is a Fellow of the Academy andchaired its Membership Committee. Sheis also an active member of the:American College of Prosthodontics;California Dental Association; TexasDental Association; American DentalAssociation; and Pacific Coast Society of Prosthodontics.

Academy Officers and Directors contin-uing their service on the Board ofDirectors are Past President David L.Cochran, DDS, PhD, San Antonio, TX;and Directors Tara L. Aghaloo, DDS,MD, PhD, Los Angeles, CA; Jay P.Malmquist, DMD, Portland, OR;Steven J. Rosenstein, DMD, Aventura,FL; and Clark M. Stanford, DDS,PhD, Iowa City, IA.

Dr. Lyndon Cooper

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Tampa Annual Meeting attendance approaches 3,100Total attendance at the Tampa Annual Meeting hit 3,094, including 1,605 dentists, almost exactly the same number as last year, Executive Director KevinP. Smith reports. While not a record, attendance met expectations, consideringthe southern location and the economy. AO’s membership is largest along theEast Coast. Smith was encouraged to see the increase in attendance by studentmembers, up 33 percent from last year. International attendance was only 52 under last year’s numbers at 525, represent-ing 31 percent of the dental attendance from 44 countries, led by Brazil (127),Mexico (84), Japan (68), Canada (33), Italy (23), South Korea (18), and England(13). States sending the most registrants were host Florida (286), New York(156), California (131), Pennsylvania (73), Massachusetts (64), and Texas (64).Exhibit sales rose, and many programs had an up year, including Corporate Forums, Limited Attendance Lectures, Roundtables, andLunch and Learns. Exhibitor attendance of 1,075 was slightly down from the previous three years.

It was outgoing President Dr. David Cochran’s moment to enjoy with his daughter Melissa (left) and wife Monica (right).

Stimulating speakers kept the audience’s attention. President Dr. Stephen Wheeler (left) thanks PastPresident Dr. Kenneth Hinds for years of Board service.

One of the program’s highlights was the LaboratoryTechnician program.

Representatives of DENTSPLY Implants enjoy thePresident’s Reception, held at the Florida Aquariumwhich featured singing mermaids.

Exciting person-to-person interaction typifies the action in AO’sbusy exhibit hall.

Nobel Biocare’s Melker Nilsson (left) presents a symbolic check toOsseointegration Foundation President Dr. Luis Fujimoto, represent-ing the completion of his company’s 5-year Foundation contribution.

New AO President Dr. StephenWheeler takes the podium.

Dr. Takashi Sumi (left) accepts the award for Best ClinicalInnovations Presentation from Dr. Joerg Neugebauer.

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Past President Dr. Peter Moy (left) and his wife, Irene, welcomenew Board Member Dr. Amerian Sones and her husband,Lawrence Wolinsky.

Dr. Edward Amet and Lorraine Lindquist, enjoy a beautiful eveningduring one of the social events.

Registration was humming (far left), as attendees came to enjoy the beauty of the Tampa Convention Center (far right). Dr. Daniel Buser (second left) received the 2013 NobelBiocare Brånemark Osseointegration Award for his impact on implant dentistry. New technologies gave posters a fresh, exciting look (above).

Outgoing President Dr. David Cochranreviews a year of accomplishments.

The Academy’s MembershipCommittee held another success-ful New Member Breakfast dur-ing the Tampa Annual Meeting,reports Committee chair Dr.Jeffrey D. Lloyd, RanchoCucamonga, CA.

Project Head Dr. Julie K.Geiger, Orange Park, FL, andher committee “worked tirelesslyto ensure that all of theAcademy’s newest members wereinvited and made welcome at the breakfast,” says Dr. Lloyd. “It’s not surprising toread comments from the attendee surveys that say, ‘enjoyed the program, madenew friends, had a good time socializing with the Academy’s officers and directors.’

“The personal contact, raffle of prizes, fantastic breakfast, feeling very welcome, and meeting the Academy’s ‘big wigs’ are all reasons the New MemberBreakfast has become such a popular event at the Annual Meeting each year,”Dr. Lloyd says.

“Everyone especially enjoyed the warm and personal greeting delivered by AOPresident Dr. David L. Cochran, San Antonio, TX. The Membership Com -mittee looks forward to hosting the breakfast again next year, in Seattle,” he adds.

AO Membership Committee hostssuccessful New Member Breakfast

Among the Annual Meeting’s many honorees were (top left)Dr. Kajita Nelson, who accepted the Best Oral ClinicalPresentation on behalf of Dr. Tabea Fluegge; (and clockwise tothe right) Dr. Alexandra Tsigarida, accepting the Best Posteraward from Research Submissions Committee Chair Dr.Wendy Halpern (right); Dr. Yoichi Yamada, the William R.Laney Award winner; Dr. Junro Yamashita, recipient of theBest Oral Scientific Presentation Award.

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ting beta testing site for “new improved“products. These products, often fromwell established companies, are intro-duced with the “latest“ innovation (butlimited clinical data) for the sole purposeof netting more of that burgeoning bil-lion dollar implant market.

Of course, the long term scrupulouslycollected data of Brånemark forever tookimplant dentistry out of the realm ofconjural arts into the world of repro-ducible measurable standards, wheresimilar surgical and prosthetic resultswere achievable worldwide.

Almost from the beginning, however, therecipe was altered. As many remember,the daring deviation from the teleologi-cal protocol of not performing cases in ahospital, or exposing a radiograph duringsurgery, or uncovering early, or immedi-ate loading, or placing an abutment withno counter torque device, was almost amortal sin. It was not long beforerestorative demands required going out-side limited existing components result-ing in the eventual establishment of anentire new company manufacturing notonly compatible components butimplants as well. Their products wereused almost interchangeably, with no realapparent negative results.

Original and innovative research includ-ing surface, shape, and connectionsaccelerated, resulting in a rapid “survivalof the fittest” technologic evolutionaryselection. Inferior product designs van-ished and new designs proven attractiveor biologically beneficial, such asmicrogrooves, rough surfaces, internalconnections in one brand, were quicklyincorporated to some degree throughoutthe industry.

Although implants seldom give rise tolife and death issues, no one questionsthe importance for our patients of hav-ing dependable standards. Yet even someof the most respected pharmaceuticaland medical supply companies have beentested with an array of media reportedlegal and quality issues, from hip jointsto anti-inflammatories. lf implant com-panies are in the business of sellingimplant products at a profit – a perfectlylegitimate enterprise – the reality of the

market does not abate when it comes tothe sale of these products. Fluctuationsin the business ecosystem will alwaysexist and we will continue to be lured byfinancial considerations masquerading ascommon sense.

Viewing a technology market “S” curveprovided in a Morgan Stanley ImplantUpdate research report from October2012, it is obvious the exponentialgrowth phase of the premium brands isover. Their projected yearly growth,according to some financial reports, isexpected to be around 3% in 2013. Thepoorly documented value and discountsegment, on the other hand, is filling thevoid of the price differential and grow-ing at maybe 13 to 18 percent. Clearly, adichotomy in the market has developed.

One would expect premium implantcompanies have a higher commitment toquality consistency in production, clean-liness, and service than others and thattheir premium price allows that. It isreasonable to assume in any industry theestablished well documented brandshave much to protect and by definitionbe the standard until proven otherwise.

Characteristics such as variance of sur-face texture between $100 discount copyimplants and the premium brand theyreplicated were explored in a recentApril 2013 International Journal of ImplantDentistry article from Brazil by Rosa, etal. They found large variations. It isexpected that many of the poorly docu-mented compatibles or copies will notbe in business in five years or will bemerged with other companies. It is pro-jected that the premium brands, due toprice pressures, will either lower theiractual costs or offer even deeper dis-counts and continue to diversify theirproduct lines. Will they also diversifytheir quality?

This begs the question introduced earli-er: Does a poorly documented discountproduct line become legitimate when itis taken over by an established well doc-umented company? Any number ofexamples could be cited in just the lastfew years. The recent report of implantsfrom a major manufacturer in Brazilhaving different surface topography than

those developed in its U.S. facilitymakes this dilemma clear.

Unlike the auto industry that consolidat-ed from many companies in the 1900s tojust a few, the dental implant market willlikely continue to develop, fragment,and stratify with high, medium and lowlevel suppliers within a number of newand established brands. However, as inthe auto industry, some companies willproduce many different models at vari-ous price points. It is incumbent on usto keep our skills and education at alevel where we can make what seems tobe the best decision for our patients andourselves, seeing through the blandish-ments of the market place.

In the years ahead, independent researchby both educational institutions and pri-vate practitioners, along with an interna-tional professional forum such as theAcademy of Osseointegration, shouldcontinue to debut and discuss conceptsas well as results that will be critical forour profession in terms of addressingdevelopments in implant dentistry.

All are aware the day is not far off whenscrewing metal into mouths to holdteeth will be considered barbaric, asdentists of the near future may injectnano carbon fiber reinforced liquid intosockets and design the attachments builtfrom a 3-D office printer or will gentlyimplant the tooth bud derived from theDNA scraped from the inside of theirpatient’s cheek that will soon be a per-fectly formed tooth. Which DNAretrieval kit will they buy – the well-researched name brand or the poorlydocumented copy?

Until there are well documented studiespertaining to the individual products,the most important questions involvingthe success of various implants and theircomponents that base their existence onprevious research of similar name branddesigns can only be definitivelyanswered within our own practices.Using our patients and our reputations,at our expense or our profit, the realcost and answers can unfortunately onlybe determined in the same mannerdetective Deckhard applied to androids,at the case post mortem.

Do generic implants dream of offshore labs? …continued from page 6

11

The Osseointegration Foundation (OF) has named officersfor 2013-14: this year’s President is Dr. Luis J. Fujimoto,New York, NY, and Dr. Clarence C. “Lindy” Lindquist,Washington, DC, advances to Vice President. Dr. Mollie A.Winston, Atlanta, GA will be Secretary/Treasurer. Dr. Jonathan H. Orenstein, Marlton, NJ, is Immediate Past President.

In addition to these officers, fiveDirectors-At-Large serve in a supportive capacity. New to the Board are Drs. Barry R. Franzen,West Allis, WI, and Edward B.Sevetz, Jr., Orange Park, FL, and theAO Immediate Past President, Dr.David L. Cochran, San Antonio, TX,who serves one year. They will joincurrent Directors Drs. MyronNevins, Swampscott, NJ, and MichaelA. Pikos, Palm Harbor, FL.

Dr. Fujimoto was born in a Japanese family and grew up in Cochabamba, Bolivia. He received a bachelor’s degreefrom George Washington University before entering theSchool of Dental Medicine at the University of Pennsylvania,where he received a DMD degree and a certificate in

periodontics. He is President of the New York State Boardfor Dentistry.

OF is the philanthropic arm of the Academy ofOsseointegration and is chartered to develop and providefinancial support for the art and science of osseointegration.Grants are awarded annually for research as well as patient

treatment. Its operation is guided by aBoard of Directors made up ofAcademy members.

The OF receives its financial supportfrom corporate contributions and gifts from Academy members andothers. The Titanium Society is agroup of Academy members who havecommitted support at the $10,000level, although there are many levelsof OF participation.

Members interested in becoming a Titanium Society membercan find a downloadable Titanium Society application on theOsseointegration Foundation section of the Academy’s WebSite (www.osseo.org) or by contacting the Academy ofOsseointegration Executive Office at 847-439-1919, or byemail at academy@osseo.org.

Osseointegration Foundation announces new officers,headed by Drs. Luis Fujimoto, Clarence Lindquist

As dentists, we often encounter the situation that we have recommended a critical and necessary implant treatment forrestoring the patient’s dental functions and quality of life, butthe individual cannot accept the treatment due to financial difficulties. The Osseointegration Foundation CharitableGrant program might offer a solution to the dilemma.

The OF Charitable Grant provides financial assistance (up to$10,000) to improve the quality of life for those who havebeen diagnosed with a lifetime dental deficit or suffered fromsevere dental trauma and are unable to receive needed dentaltherapy due to economic restraints. Grants will be determinedbased on three major requirements: 1) care providers, 2) patients, and 3) corporate partners.

Care Provider Requirements:1. The primary care provider in each grant application must be a mem-

ber of the Academy of Osseointegration.

2. The funds provided will be used for the care and treatment of onlythe individual (i.e., patient) specified in the application. These fundsshould subsidize all or part of the care needed by the patient, and acommitment to complete therapy and including a 3 year follow-up is

implied and required when the provider accepts the grant funding. The patient should not incur any financial obligations. Allteam members must agree to relieve the patient of any financialresponsibilities.

3. Proposals will only be funded if the diagnosis and full treatment plan(including a restorative plan) for a particular patient is submitted forevaluation as part of the proposal. The identity of a patient is irrele-vant to the evaluation of any proposal (see attached sample applica-tion), so anonymity can be assured.

4. Documentation, both pre- and post-operative, in the form of projec-tion-quality slides and radiographs, is required for each grant-fundedcase. Patients may be asked to agree to be photographed or filmedfor promotional activities by the Osseointegration Foundation. Apatient release form will be required for this purpose.

5. Three years of follow-up to the Osseointegration Foundation isrequired. Follow-up should be submitted to the OsseointegrationFoundation on an annual basis.

6. Care providers who receive an OF Charitable Grant will not be eligi-ble to reapply for 2 years following receipt of the grant.

Patient Eligibility Requirements: The patient must meet the eligibility requirements in each category:

OF Charitable Grant may offer solution for patient withlimited financial resourcesBy Luis J. Fujimoto, DMD, Osseointegration Foundation President

…continued on page 13

Dr. Luis Fujimoto Dr. Clarence Lindquist

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13

This year’s Academy of Osseointegration Annual Meeting washeld in sunny Tampa, Florida. As always, there was an exciting

line-up of the world’s best cliniciansand researchers presenting the latesttechnology in implant dentistry.

The meeting began with the NewMember Breakfast. Basking in the glorious Floridian sunshine new mem-bers mingled and discussed the excit-ing program ahead.

Next up were the Corporate Forums –all the big players were there, display-

ing their latest product offerings. Of particular mention wasthe incorporation of 3D surgical videos into a number of thepresentations – Spielberg would have been proud!

Delegates then flooded upstairs to the exhibit hall for a com-plimentary lunch and a first stroll through the poster presenta-tions and corporate displays. This year’s posters were of a highstandard as always and required a few visits to take in. Thewinning poster by Dr. Alexandra Tsigarida, DDS, (USA) wastitled: “Subject-specific Analysis of Periodontal and Peri-implant Biofilms in Health and Disease.”

The Opening Symposium, moderated by Dr. Dean Morton,began after lunch and set the tone for the rest of the meeting.The session titled ‘Quality Evidence – Quality Treatment –Quality Outcomes’ included presentations from Drs. Lyndon

Cooper, Daniel Buser, Clark Stanford, Richard Roblee,Edward Allen and Robert Winter. Later that night, therewas a somewhat impromptu cocktail hour, organized on thefly only hours earlier by members of the Young CliniciansCommittee. It was a great opportunity to get together andmeet new people. Hopefully, this years’ spontaneous gatheringmight just turn into a yearly cocktail hour (watch this space!).

Although all of the presentations on day two were outstand-ing, particular mention must go to this year’s winners Drs.Takashi Sumi, DDS, PhD (Japan, Best Clinical InnovationsPresentation), Junro Yamashita, DDS, PhD (United States,Best Oral Scientific Presentation) and Tabea Fluegge, DMD(Germany, Best Oral Clinical Presentation).

Later that evening, the President’s Reception was held at thejaw dropping Florida Aquarium. Guests enjoyed wanderingthrough the aquarium admiring the enormous glass-frontedfish tanks. The two mermaids swimming with baby sharks,stingrays and a huge school of little fish were a particularcrowd pleaser.

The final day of the symposium once again had surgical andrestorative tracks, along with programs for dental techniciansand allied staff. As I write this article, I am reminded that themeeting is over for another year. How great it is to know thatwe’ll all be back again next March in Seattle, to enjoy oncemore the lectures, research presentations, social events andwarm company of colleagues and friends from around theworld. I can’t wait!

Young Clinicians Corner

2013 AO Annual Meeting features exciting presenters,latest technologyBy David Holmes, BDS, MS, Young Clinicians Committee

1. Physical Disability: There must be the presence of a disability thatis amenable to implant therapy and for which implant treatmentwould significantly improve the patient’s dental deficit and quality of life.

2. Economic Status: Documents providing evidence of the patient’sinability to receive needed implant therapy because of economic con-straints must be presented. Economic hardship, however, is not theprimary or sole criterion for awarding a grant.

3. Emotional Wellbeing: The benefits of psychological or emotionalimprovement from implant therapy will be considered in the awardselection process.

Corporate Partner Participation:The design of this program requires involvement of OF’s commercialpartners to provide service and/or hardware for the patients who become grant-funded. All materials should be donated by the specifiedcompany. Grant applicants must specify the particular products (includ-ing manufacturer names) at the time of grant application. Commercialentities should be contacted by the applicant to obtain donations for the required materials. If the applicant does not have a specific companyor contact to obtain these donations, the OF will provide a list of potential suppliers.

The OF Charitable Grant is now accepting applications fromAO members. An independent committee, appointed by theOsseointegration Foundation, will review all grant applicationsannually. The number of grants awarded each year is based onthe funds available as determined by the OsseointegrationFoundation Board of Directors. The grant recipients will benotified in January of each year.

The OF Charitable Grant has helped many financially chal-lenged individuals to complete their implant therapy and dental work to improve their chewing, digestion, nutrition aswell as to enhance their health, well-being, and social lives. If you have a patient who might be a potential beneficiary,please consider applying for the OF Charitable Grant. Theapplication information and related forms can be found at:www.osseo.org/NEWfoundation.html or by contactingKim Scroggs, AO Manager of Education, at kimscroggs@osseo.org or at 847-439-1919.

OF Charitable Grant …continued from page 11

Dr. David Holmes

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14

It seems appropriate, from time to time, to reflect on ourimpact on this third rock from the Sun. With respect toimplant dentistry, the obvious theme of these pages, this

means stepping back and assessing thepast efforts that led us to the presentand, more importantly, what we desirein the days to come.

The well-known history of osseointe-gration, for dentists at least, is a truestory of innovation, hard work, longhours, and many years of commitmenton the part of researchers, scientists,engineers, and dentists throughout theworld. The trial and error, profit andloss of this endeavor are hallmarks of

true innovation. Without getting too political, the quest toresearch and develop ideas that promise to change the way welive for the better requires a freeenterprise philosophy or at thevery least the tolerance of one.

Along the way, however, wehuman beings can get distractedfrom the greater purpose of good,and a little old fashioned self-interest and greed can corrupt theprogress. There is nothing wrongwith profiting from one’s efforts. Indeed, the notion of profit is what drives the innovation engine in many cases.Nonetheless, with regard to dental implant development, the balance of goodness and profit seem to be reasonably balanced.

When there is a lot of profit, there are a lot of players and themarketplace sooner or later speaks on the success or failure ofeach participant. Witness the plethora of generic implantsavailable around the world. True innovation, on the otherhand, often involves fewer players, sometimes in collaborationwith each other in an effort to achieve a nobler cause – to fixthe failures that we see, and to make the world a better place.

As simplistic as this sounds, it is a notion that is easy to under-stand. Many of us subscribe to this greater good in our day today practices, perhaps not always literally, but certainly in ourhearts, as we try to make our patient’s mouths and lives a bitbetter. In reality, however, at least on the restorative side,much of what we do daily is a re-make or repair of some sortof treatment delivered in the past, sometimes the not too dis-tant past. Is this due to patient neglect and abuse? Sometimes.Is it due to the inhospitable nature of the oral cavity? Likely. Isit a failure of practitioner skill and judgment? Occasionally.Indeed, it is all of the above. This is our present and can be adisappointment, if we dwell too much on this aspect of it.

Fortunately, if we get all our ducks in a row, our treatmentoften performs admirably well.

Our past serves up creation and innovation to make our pre-sent better. Our present must therefore be worthy of the con-tributions of the past. All the while our vision – the way we seeourselves and our patients tomorrow – drives us toward thefuture. A future without failure is an enticing, if not currentlyrealistic, proposition. The promise of such a future is a worthydream and one all of us in the trenches know can’t come soonenough. What will it take?

Since dental implants have been around for a while, we nowget to see how they perform in the “long run.” Darned if theydon’t behave much the way teeth do. Although decay or cariesis thankfully not an issue, “periodontal” or peri-implant dis-ease is. While it is easy to implicate excess dental adhesivessubgingivally around the implant/restoration junction, clearlythat is not the only insult involved.

Early and late term osseointegra-tion failures have been reported aslong as implants have been in exis-tence. The longer implants are inexistence the more complicationswe will see with them. Can we fixthis? Faced with the conundrum ofthe human organism and its many

systems, is it unrealistic to think we can solve the issue of den-tal implant osseo and mucosal integration failure? The futuresolution I suspect will lie not so much in the configuration ofmetal or ceramic, screw retained or adhesively bonded, splint-ed or freestanding, but in the basic building blocks of life. Ourgenetics versus those of the microbes that call us home presentthe final frontier. Come to think of it, that has always been thepast, present, and future challenge. Solve this and we mayindeed see the future without failure.

The Editor’s Editorial is intended to contribute to the dialogue onissues important to implant dentists. The views expressed in the editorial do not necessarily reflect the policy of the Academy ofOsseointegration or its Board of Directors. Readers who would like tocomment or express a point of view on the editorial are invited to writeto the editor via email at kevinmcnallydds@hotmail.com. We willendeavor to publish pertinent comments or views when space permits.

Editor’s Editorial

Past, present, futureBy Kevin T. McNally, DDS, Newsletter Editor

Dr. Kevin McNally

“A future without failure isan enticing, if not currentlyrealistic, proposition. Thepromise of such a future isa worthy dream…”

Update member contact info at www.osseo.orgDo we have your most current information for theMembership Directory? Members may update their contactinformation online at www.osseo.org, or send an email toBarbara Hartmann, barbarahartmann@osseo.org.

Introducing the

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1. Östman PO†, Wennerberg A, Albrektsson T. Immediate Occlusal Loading Of NanoTite Prevail Implants: A Prospective 1-Year Clinical And Radiographic Study. Clin Implant Dent Relat Res. 2010 Mar;12(1):39-47.

2. Suttin†† et al. A novel method for assessing implant-abutment connection seal robustness. Poster Presentation: Academy of Osseointegration, 27th Annual Meeting; March 2012; Phoenix, AZ. http://biomet3i.com/Pdf/Posters/Poster_Seal%20Study_ZS_AO2012_no%20logo.pdf

3. Suttin Z††, Towse R††. Dynamic loading fluid leakage characterization of dental implant systems. ART1205EU BIOMET 3i White Paper. BIOMET 3i, Palm Beach Gardens, Florida, USA. http://biomet3i.com/Pdf/EMEA/ART1205EU%20Dynamic%20Loading%20T3%20White%20Paper.pdf

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Preservation By Design is a registered trademark and 3i T3 Implant design and Providing Solutions - One Patient At A Time are trademarks of BIOMET 3i LLC. ©2013 BIOMET 3i LLC. All trademarks herein are the property of BIOMET 3i LLC unless otherwise indicated. This material is intended for clinicians only and is NOT intended for patient distribution. This material is not to be redistributed, duplicated, or disclosed without the express written consent of BIOMET 3i. For additional product information, including indications, contraindications, warnings, precautions, and potential adverse effects, see the product package insert and the BIOMET 3i Website.

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