Implant Restorative 2 Review with Dr. Vahik Meserkhani Sydney 4/2010.

Implant Restorative 2 Review with Dr. Vahik Meserkhani Sydney 4/2010.

Dr Meserkhani started with a brief introduction where he mentioned he is cross trained as a dual specialist in implants and prosthodontics at Loma Linda University. He teaches on the faculty at Loma Linda, and runs a busy specialist practice in LA. He also has a strong background in labwork where he worked alongside his brother, who is also a lab technician, and learnt the ropes in that field.

After the introduction Dr Meserkhani asked each of the students in the class to give a brief introduction of themselves. Some of the common threads that came through amongst the students were that most had had some complication with implant treatment that had spurred them to want to know far more before diving into the field. Examples of other specialists or dentists doing the surgery resulting in poor implant placement or even failure were common with the subsequent loss of money time and confidence of the dentist in the class. Many students mentioned they had noticed an explosion of patients interested in implant options and services. Some students mentioned the limited nature of most courses available in implant training with mostly simple restorative and surgical techniques taught. It was also noted that courses often emphasized complications which scared many practitioners off from the field- much the same as in the orthodontic world.

Dr Meserkhani mentioned that complications are common to all areas of dentistry to put things in perspective. During the 3 days a large number of restorative case complications were gone over and we were shown how the cases were resolved.

There was a heavy emphasis on case diagnosis and treatment planning prior to treatment (much the same as with POS ortho training). There was a common treatment planning sequence of comprehensive records (history, mounted casts, radiographs, photos, etc.), diagnostic wax up for radiographic template construction, cone beam, case presentation, surgical template construction, then provisional planning. Because of class interest some aspects not listed for the course were covered- eg. socket preservation. Incidentally Dr Meserkhani also has a strong surgical background and does all of his own implant and graft surgery.

We covered partial denture case treatment planning, open tray / closed tray impression techniques, splinting was covered with hands on impression exercises, cement vs screw retained, abutment selection (prefab, custom, engaging/ non engaging, CAD CAM), full mouth rehab cases and an introduction to overdentures (locators recommended).

By the way two students (including myself) had had problems previously with being unable to remove overdentures, after taking pickup impressions of locators, with cold cure acrylic in the mouth. So we were very attentive during the locator impression pickup technique tip section and hands on exercise.

The last day was mostly focused on student cases where some students had brought records for diagnosis. Dr Meserkhani encouraged students to get up present their cases to the class and give an ideal treatment plan for the patient. This is how the resident prosthodontists are trained at Loma Linda with group case presentation. A variety of cases were gone over from full mouth reconstruction cases with severe wear and some missing teeth or an upper fixed reconstruction in complexity to simple single tooth replacement cases. Again there was an emphasis to go through the same planning sequence for each case. Much the same way principles are reiterated in the POS ortho course until they become ingrained, the same approach is taken during the implant course.

Dr Meserkhani certainly engendered enthusiasm in the students to make them want to go out there and start cases. I expect there will be a lot more case records from students at the next Implant Surgery 2 seminar with Bart Polder in Sydney. Another report on this seminar from me will follow.

Regards Terry Rose