san diego annual meeting showcases presentation innovations, february 26-28 volume 20, number 1 †...

www.osseo.org

San Diego Annual Meeting showcasespresentation innovations, February 26-28

A quarterly publication of the Academy of OsseointegrationVolume 20, Number 1 • 2009

In This Issue

President’s Message:Automobiles, motorcycles,and implants . . . . . . . . . . . . . .2

Dr. Sevetz has a tall taleabout Zygoma implant . . . . . .3

In Memoriam:Dr. Willi Schulte . . . . . . . . . . .5

Practice Profile:Pi Dental Implant Center . . . . .6

Dr. Stephen Wallace seesopportunities in Iran . . . . . . . .8

OF charitable grant introduction:Dr. Robert Lemke . . . . . . . . . . .9

Committee Chair Profile:Dr. Luis Fujimoto . . . . . . . . . .11

Dr. Kenji Higuchirecommends internationalmeeting in Berlin . . . . . . . . . .13

Editor’s Editorial:What happens when implantplacement turns catastrophic .14

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

EditorJohn P. Schmitz, DDS, MS, PhD

Editorial ConsultantsKevin T. McNally, DDSAlfonso Monarres, DDS, MSOender Solakoglu, DMD, MS, PhD

© The Academy of Osseointegration. All rights reserved.

The Academy’s 2009 Annual Meeting willintroduce presentation innovations,designed toenhance the valueof the February 26-28 event for atten-dees at the SanDiego ConventionCenter.“High definitionprojection will befeatured again thisyear in the mainballrooms on a 20-foot by 60-footscreen, the largesttransportable seamless screen available forthe convention center,” says AO ExecutiveDirector Kevin P. Smith.

Innovations introduced this year includeelectronic signage and live presentation of

sessions from themain ballroomsfrom a specialviewing area inthe exhibit hall.

Four electronicdigital signs willbe located instrategic placesthroughout theconvention cen-ter. “These newelectronic signs

will enhance the communication featuresof the Annual Meeting, giving attendees

…continued on page 8

Spaces open for bike tour, golf outingSpaces are still open for the motorcycletour and golf outing that can turn theAcademy’s 2009 San Diego AnnualMeeting into the business-pleasure experi-ence of a lifetime. Attendees are invited totour scenic San Diego County on a HarleyDavidson motorcycle and play one ofSouthern California’s top golf coursesbefore and after the meeting.

Harley Bike Ride – Get your motor run-ning, head out on the highway! Eaglerider

Rentals and Tours, of San Diego, hasagreed to reserve up to 20 motorcycles fora “Harley Bike Ride.” (Tuesday, February24, 10 a.m. – 3 p.m.)

Guests will enjoy a day ride through SanDiego County’s scenic back roads, includ-ing a stop for lunch, following routesmapped by host Dr. Stephen Wheeler,Encinitas, CA. Reserve bikes at 619/222-8822 or www.eaglerider.com. Cost is $150,including insurance.


Battle-tested aircraft carrier USS Midway has opened as afascinating museum on San Diego’s waterfront.

The purpose of the Academy of Osseointegration is to advance the science and application of tissue replacement in oral and facial care.


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A number of years ago, I hit my first midlife crisis. I becameinterested in buying a car with a high performance engine. Iwas very excited and started to explore the Internet to get as

much information as possible. I founda forum that was comprised of peoplewho owned the type of car I was inter-ested in buying. I found out what agood price would be and what the bestoptions were.

Once I bought the car, I continued toparticipate in the forum. I learnedwhat tires were good for the car, whattype of oil to use, etc. And when Ibegan to have problems with the car,

the forum became invaluable. On several occasions, the servicedepartment at the dealership couldn’t figure out the cause ofthe problem; yet I already knew, based on other people’s expe-riences that had been discussed in great detail on the forum.

Sometimes, I actuallyprinted pages off theforum and brought thatinformation to my ser-vice department. Onevery occasion, thisresolved the issues. Butultimately I got tired ofthe problems that thiscar gave me, so I sold it.

A few years later, I hit my second midlife crisis and got inter-ested in motorcycles. Once again I searched and ultimatelyfound a very useful forum. It told me how to get started,where to take a riding course, what to look for in a bike. Ihave spent a great deal of time on this forum learning moreand more about riding, places to go, bike accessories, etc.

Participating in these forums has not only been extremelyeducational for me, but fun as well. I would hate to admit toanyone exactly how much time I have spent on these forums. Iactually found my experience so valuable that a few years ago Iwas one of several who encouraged the Academy ofOsseointegration Board of Directors to look into creating aforum of its own.

Dr. Steve Wheeler investigated the process and then helpedcreate a forum that can be found on our Website. It’s rightthere on the main page—a direct link entitled “DentalImplant Forum” in between the Academy News link and theIJOMI link.

We have had the Dental Implant Forum for several yearsand I must say, one of my biggest disappointments has beenthe lack of participation in this forum. I want to use my last

“President’s Message” to get the word out. The Academy ofOsseointegration has a Forum!!! I believe it has the poten-tial to be one of the best member services that the Academyhas to offer.

There is no better way to learn than by experience and thereis no better way to teach than by experience. The forum is agreat place for all of us to ask questions and share our experi-ences. Through this medium, we can all share our successes,and perhaps more importantly, our failures.

Currently, there are a number of different discussion topicslisted, such as early loading, occlusion, site development, andcomputer-guided surgical procedures. There are actually twosections on complications. One has no posts and the other hastwo! Now I don’t know about you, but I have had enoughcomplications in my implant experience to write a book.

The Internet isn’t the future; it’s the present. It has been one ofmy goals this year to try to develop a better Website for our

membership, with the forum beingjust one aspect of it. Dr. AlanPollack and his committee havebeen developing ideas that will bepresented at our San Diego Board ofDirectors meeting. My hope is thatthe Academy of Osseointegrationcan develop a Website that offersits members a great variety ofvaluable information.

Dr. Frank Higginbottom is heading a committee to developcontinuing education programs. My hope is to combine theefforts of the two committees, so that our Website can provideour members with world class continuing education, helpingfulfill our mission of “advancing oral health and well being bydisseminating state-of-the-art clinical and scientific knowledgeof implant dentistry and tissue engineering and by definingexpertise in the field of implant dentistry.”

While it may take a little while to get some of these initiativesup and running, the Forum is already there and waiting to beused. I encourage everyone to explore it and participate in it.I’ve been hoping for a kick-start because I know once it getsstarted it will gain momentum on its own.

With this said, I want to thank my fellow board members, pastand present, for making my experience on the board one ofthe highlights of my professional career. It has truly been anhonor for me, and I hope that I have served the Academy well.I would also like to thank Kevin Smith, our executive director,and his staff at EAI for their management and guidance year-in and year-out. AO wouldn’t be where it is today withoutthem, and it is because of them that I end my term as presi-dent knowing that the Academy is in good hands.

President’s Message

Automobiles, motorcycles, and implantsBy Dr. Steven G. Lewis

2

Dr. Steven Lewis

“There is no better way to learn thanby experience and there is no betterway to teach than by experience.The forum is a great place to askquestions and share our experiences.”


3

One of the stories Dr. Edward B.Sevetz, Jr., Orange Park, FL, will beable to tell when he presents on theZygoma implant during the San DiegoAnnual Meeting (Friday, February 27,3:40 p.m.) is how this picture was taken.

A prosthodontist and fellow AO mem-ber, many miles from Florida, Dr.George J. Schuetz, Wilder, VT,referred a patient to Dr. Sevetz because“no one in that neck of the woods”could perform the kind of implantsurgery that his patient needed. “Hesent her and her husband down to me inFlorida, where I was able to place fourZygoma implants,” says Dr. Sevetz.

“I guess I’ve done more of these longones that go up into the cheekbonewhen there isn’t enough bone in theupper jaw to anchor implants thanalmost any surgeon in the U.S.Professor Per-Ingvar Brånemark him-self showed me how to do these in 1991during one of the times I assisted him inthe O.R. in Sweden,” Dr. Sevetz says.

The patient in this case “went from beingbarely able to wear an upper removabledenture to havingfixed-in-place upperteeth,” says Dr. Sevetz.She was so thrilledthat she and her hus-band, a big gamehunter, threw a partyfor Dr. Sevetz and Dr.Schuetz at their homein New Hampshire,the occasion when thispicture was taken.

Here’s the rest ofDr. Sevetz’s story:

“The food at theparty was all wild ani-mals he’d shot, pre-pared by a veryknowledgeable gourmet chef. Delicious.Thanks to the fixed prosthesis that Dr.Schuetz fabricated and anchored to thefour Zygoma implants, the patient hadno difficulty eating the prepared feast.

“This patient’s husband has shot big game,including mountain lions, elephants, water

buffalo, ostriches, andmoose, on all continents.He shot the bear in thispicture north of the ArcticCircle. It’s one of the largerones on record. I’m about6'4", and I stood in front ofit to give the photo somescale. The bear’s paw isabout the size of my head,and the claws are longerthan human fingers.

He’s decorated his wholeliving room, with stuffed,and posed animals. It has avaulted ceiling with beamsrunning across the room.He has a stuffed mountain

lion poised to “pounce” up on one ofthe rafters. The house is built out ofwood, all harvested on their property.”

Rarely does the practice of implant den-tistry yield such a tall tale.

Dr. Sevetz has a tall tale about placing a Zygoma implant

Dr. Edward Sevetz stands before a bear,shot by the husband of one of his patients.

2009 Annual Meeting Highlights on CD-ROMHighlights of the Academy ofOsseointegration’s 2009 AnnualMeeting, February 26 – 28, will be available on CD-ROM soon after this year’s meeting.

The CD-ROM, which is supported by a grant from Biomet 3i, will contain26 hours of state-of-the-art lectures and speakers’ slides from this year’sAnnual Meeting that you can view in the convenience of your home or office.

This year, the CD-ROM set will alsofeature transferable MP3 files whichallows you to listen to the presentationson your iPod or similar type portablemedia player.

The CD-ROM set allows you to search via keyword, title or speaker.

Viewers can pause, rewind, and fast-forward from anywhere in the presentation.

To order your copy of the CD-ROM,please visit the Academy’s websitewww.osseo.org to download the order form.

Supported by a grant from:

Sessions included on the CD-ROM include:

• Opening Symposium: A New Wave in Implant Therapy: From Diagnostics to FinalRestoration

• Six individual LimitedAttendance Lectures

• Treatment Approaches

• Surgical Track

• Restorative Track

• Closing Symposium

• Biomet 3i’s Corporate Forum

CD-ROM AVAILABLE JUNE, 2009

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5

In Memoriam

Dr. Willi Schulte, 1929-2008, AO’s third Honorary Fellow(Editor’s Note: The following obituary is adapted from a remem-brance prepared by three of Dr. Schulte’s colleagues – Bernd d’Hoedt,Mainz, Jörg Meyle, Gießen, and German Gómez-Róman,Tübingen – and published in The International Journal of Oraland Maxillofacial Implants (Volume 24, Number 1, 2009).

Dr. Willi Schulte, of Tübingen,Germany, who became the Academy’sthird Honorary Fellow in 1998 inrecognition of his unique contributionsin the field of osseointegration, died inDecember, just a month before his80th birthday.

He studied dentistry in Tübingen,where he also received his doctoraldegree in 1953. In 1972, he was

appointed professor and head of the Department of OralSurgery and Periodontology at the University of Tübingen.In 1974, he introduced the “Tübingen implant” made ofaluminum oxide ceramic. A paradigm change resulted in aswitch from the belief that dental implants are indicatedonly if the conventional prosthetic therapy fails to one thatproposed an early implantation to retain the alveolar boneafter dental extraction.

In 1983, he was elected Dean of the Faculty of Medicine atthe University of Tübingen. Upon his initiative, the priorityprogram “Clinical Surveillance and Further Advancement ofDental Implants” had been established at the Universities ofAachen, Berlin, Düsseldorf, and Mainz. He contributed muchto the integration of scientific associations dealing with dentalimplantology in Germany.

Professor Schulte retired in 1995. He authored and co-authored290 publications and received many honors and awards forresearch activity. Three times, the German Society of Dental,Oral, and Craniomandibular Sciences (DGZMK) awarded himthe best research paper. He received the golden badge of honorfrom the German Dental Association and the Grand Cross ofthe Order of Merit of the Federal Republic of Germany. In2004, he received an honorary doctoral degree from the Facultyof Medicine at the Johannes Gutenberg University of Mainz.

Science was never an end-in-itself goal for him. Rather, all hisbasic research activities aimed to finally result in clinicallyapplicable products or treatments. As a dedicated dental sur-geon, he treated a huge and highly satisfied patient communi-ty, sometimes including several generations in one family.

He is survived by his wife, Dr. Margaret Schulte, and hischildren, Anja and Dr. Markus Schulte.

Dr. Willi Schulte


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FORT WASHINGTON, PA – Dr. Thomas J. Balshi foundedthe Institute for Facial Esthetics in 1985, just as the Academy ofOsseointegration, in which he was one of the early leaders, wasstarting to organize. The dream to house collegial specialtypractices under a single roof materialized a year later when thedoors to 467 Pennsylvania Avenue in Fort Washington opened,showcasing prosthodontics, periodontics, orthodontics, and oralmaxillofacial and esthetic facial plastic surgery.

In addition, Fort Washington Dental Laboratory started mak-ing the first restorations of Brånemark implants in the UnitedStates. Two decades later, the building is brimming with scoresof happy patients treated with a multi-disciplinary approachand unique team dynamics.

Prosthodontics Intermedica,now known simply as PiDental Implant Center,began at the Institute as aresource for comprehensiveboard-certified prostheticsand has evolved to become acutting edge implant treat-ment center, the home ofTeeth In a Day. A team of 41dedicated individuals blendclinical expertise, administra-tive prowess, refined labora-tory skills, creativemarketing and academicchallenge to establish anenvironment pulsating withexcitement. New technologyand old-fashioned compas-sion are the operativephilosophies that shape eachnew day in this Philadelphiasuburb.

Eleven of the 30 treatment rooms at the Institute are devotedto implant prosthodontics and buzz daily with diverse clinicalprotocols designed to engineer healthy smiles with distinctiveesthetics. The Center’s motto is Luceat, which means “let itshine,” according to Dr. Balshi. “Our center has been designedto blend the most sophisticated and successful system in den-tistry with a sensitive and comfortable environment that putseven your most anxious patient completely at ease,” he says.

The largest of the center’s operating rooms is the core ofViewpoint, the Institute’s state of the art teaching center. Herefellow specialists observe the treatment of unique cases andoffer their own “viewpoint,” brought through wide glass pan-

els directly into themouth of thepatient. The inti-macies of the surgi-cal procedure areclearly visible fromeven the far cor-ners of the class-room. Additionally,the Viewpointoperating theaterhouses the I-Catcone beam scannerwith the capability of projecting its results on flat screen mon-itors throughout the center.

Pi Dental Center’s receptionarea is inviting and comfort-able, envisioned and designedby Joanne Balshi. The themeis “oasis,” reminiscent of aBritish respite amidst theAfrican plains. Patients cansink into a chocolate alligatorsofa or lean back into wovenpalm chairs. The vast openspace is appointed with gen-uine African artifacts. Thewalls are adorned with severaldozen artistic animal pho-tographs, seen through Dr.Balshi’s own lens while onsafari in Kenya.

No glass doors or windowsseparate the administrativestaff from the patients theywelcome. The atmosphere at

the Pi Dental Center is deliberate hospitality, and those whocreate new smiles will warmly beam their own into the mix oftravelers. Patients frequently come long distances for care;therefore, the multilingual staff members (offering fluency inEnglish, Spanish, German, Russian, Chinese, Italian, andPortuguese) are specifically trained to extend unparalleledcomfort and service.

The newest dimension to Pi is Smiles Bistro, located adjacentto Viewpoint. The Bistro provides creative home cooking andinnovative cuisine for the Institute’s 140 employees as well asfor patient family members with time to fill. It is also thecatering resource for the many implant courses regularly

Practice Profile

Team of 41 creates excitementat Pi Dental Implant CenterBy Dr. Alfonso Monarres, Academy News Editorial Consultant

The reception area recreates an African oasis.

Outside view of Pi Dental Implant Center in FortWashington, a Philadelphia suburb.



7

Golf at The Crosby Club at Rancho Santa Fe – A mid-morning tee time at the picturesque Crosby Club at RanchoSanta Fe – one of the top private courses in SouthernCalifornia – will serve as the perfect way to unwind followingthe 2009 Annual Meeting. (Sunday, March 1)

Following the golf outing, Dr. Wheeler will host a cocktailreception for participants at his home nearby. Cost is $100,including cart and range balls. Add $25 - $50 if requesting acaddie. For reservations, contact Dr. Wheeler at [email protected], or 760/942-1333.

Spaces open for bike tour, golf outing …continued from page 1

offered in Viewpoint. Post-operative implant cases particularlyappreciate the soft touch of Smiles Bistro after surgery. Themilkshake menu is just what the doctor ordered for flavor,nourishment, and a touch of fun.

Drs. Tom Balshi and Glenn J. Wolfinger stand at the helm ofthe Pi philosophy for excellence in implant and prosthodonticcare. Their team also includes the research director, StephenF. Balshi, whose master’s degree in biomedical engineering isinvaluable in the planning of guided surgery cases, and Dr.Gary Morreale, the in-house board certified endodontist.Drs. Jim Bowers and Jack Thaler round out the team, withfortes in traditional crown and bridge restoration and theapplication of exquisite veneers.

The Pi Dental Care Center also houses the Pi Foundation.Each year, six to eight patients with dire dental conditions andno financial resources are granted complete smile makeovers.Funds are provided by public support via lively fundraisingactivities. The staff donates time, and dental support compa-nies regularly contribute materials and services.

Pi was born as Prosthodontics Intermedica. It is now recog-nized simply as Pi, a haven for education, research, clinicalachievement, and philanthropy, thrust toward the advance-ment of dental medicine and hopefully making people smilefrom somewhere deep inside.

Practice Profile …continued from page 6

Viewpoint’s I-Cat cone beam scanner can project results throughout the center.

Specialists offer their own “viewpoint” during surgery at the Institute’s state of theart teaching center.

Dr. Balshi works in Viewpoint operating room.

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Dr. Stephen Wallace sees opportunitiesto build cultural bridges following Iran visitAO Hands-On Workshop CommitteeChair Dr. Stephen S. Wallace,Waterbury, CT, spent nearly a yeardebating whether to accept an invitationto present at an educational conferencein the Islamic Republic of Iran.

Concerned about his personal safety, yetcurious about the opportunities such atrip might offer, Dr. Wallace finallyagreed to take part in the 8th AnnualCongress of the Iranian Academy ofPeriodontology (IAP) in December 2008.

“I had been hemming and hawingabout it for quite a while,” Dr.Wallace recalls. “The initial invitationcame from Dr. Peyman Shahidi,Scientific Committee Chair of theIranian Academy, whom I had met at aconference a few months prior.”

Because of current political realities,the Middle East is probably not at thetop, middle or bottom of mostAmericans’ lists of places to visit. Dr.Wallace felt no differently.

“Media coverage of Iran is not flattering,so my initial reaction was to decline theoffer. I reconsidered after a colleague,who runs an advanced dental program inDubai, told me that he visits the countryall the time and that I’d be perfectlysafe,” he explains.

Dr. Wallace’s journey to the IranianAcademy of Periodontology’s first-everinternational Congress began with aseven-hour flight from New York Cityto Paris, then a ten-hour flight to Dubai(United Arab Emirates). Following aone-night stay at the airport hotel, hewas escorted by Iranian Academy repre-sentatives to another plane that flew himto Kish Island – located less than 12miles off the Iranian coast in the PersianGulf and site of the IAP Congress.

“IAP officials treated me as if I werea visiting head of state. A limousine metme at the tarmac, drove me to the ter-minal where my passport was processed,then whisked me to a 5-star hotel.”

One of the meeting’s “Special GuestSpeakers,” Dr. Wallace – who runs a pri-vate practice in Connecticut and isAssociate Professor, Department ofImplant Dentistry at New York University– led a hands-on course in maxillary sinuselevation using a piezoelectric surgicaldevice. He presented a four-hour lectureon this topic the following morning.

“The professionalism and camaraderie Iwitnessed at the IAP Congress matchesthat of any meeting I’ve ever attended,”he says. “It was an incredibly positiveexperience. After years of seeing Iranportrayed in an unflattering manner by

the news media,I was amazed bythe Iranian peo-ple and theirlevel of clinicalknowledge.”

Perhaps moreimportant thanthe sharing ofprofessionalknowledge was a spirit of camaraderieestablished between Dr. Wallace and fel-low colleagues at the meeting. This fel-lowship helped build a bridge of culturalunderstanding.

“The condition of the world today isone caused primarily by political consid-erations,” Dr. Wallace believes. “TheIranian people are dismayed thatAmericans are hesitant to visit theircountry. They want better relationshipswith us. While our respective leadershipmay disagree on a great many things,those of us at the IAP Congress under-stood that we can begin building com-mon ground between nations on apersonal and professional level.”

Dr. Wallace has already accepted an invi-tation to return to Iran. He plans to par-ticipate in a joint sinus research project atShaheed Beheshti University, in Tehran.

Dr. Stephen Wallace

up-to-date information on last minuteprogram or meeting changes andreminders about social gatherings andother special events,” Smith says.

Signs located in the meeting section ofthe convention center will displayinformation about the current andnext upcoming plenary session pro-grams. Announcements will be postedthroughout the day. “In addition, tokeep attendees from being caught in atime warp by being isolated in theconvention center all day, CNN newsbriefs will crawl at the bottom of theelectronic sign screens, reporting the

day’s latest national and internationalnews,” he adds.

“Live presentations of plenary sessionsin the exhibit area will allow attendees toincrease the time they can spend withour record number of exhibitors. Forthe first time, attendees can stay in theexhibit area, learning about new prod-ucts and services, and not miss a plenarysession presentation,” Smith says.

“Each speaker has been carefully cho-sen to address recent advances in lightof existing, scientifically substantiated,protocols,” says Program Chair Dr.

David L. Guichet, Orange, CA. Themeeting’s theme is “A New Wave inImplant Therapy.”

The meeting kicks off Thursdaymorning with AO’s Corporate Forums.These sessions give implant manufac-turers an opportunity to present theirnewest products and latest develop-ments. Attendees will discover the lat-est in craniofacial implant technologyresearch and development.

Complete program and registrationinformation is available on theAcademy’s Website, www.osseo.org.

2009 Annual Meeting showcases presentation innovations…continued from page 1

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9

OF charitable grant introduction:Dr. Robert R. LemkeAcademy News previously published caseintroductions for OsseointegrationFoundation (OF) charitable grantsreceived by two Academy members, Drs.Sameh K. El-Ebrashi, Portland, OR, andJohn J. Richard, Crystal Lake, IL. In thisedition, we add a charitable grant intro-duction from a third OF charitable grantawardee, Dr. Robert R. Lemke, SanAntonio, TX.Charitablegrants areawarded toprovideimplant treat-ment topatients whootherwisecould notafford it. Dr.Lemke provid-ed the caseintroductionafter discus-sion withAcademy NewsEditorialConsultantDr. OenderSolakoglu, Edina, MN.

Dr. Lemke’s $10,000 grant was for treat-ment of a 33-year-old female patient,who is congenitally missing all anteriormaxillary and mandibular teeth.

Medical and Dental historyOne of the most challenging implantrestoration cases is the recreation of anocclusion where none existed before.

J.M. is such apatient: at age33, she wascongenitallymissing thir-teen anteriorteeth in bothher maxillaand mandible.This conditionalso affectedher motherand her sister.Her treatmentplan involvedevaluation byan orthodon-tist, prostho-dontist, and an

oral and maxillofacial surgeon.

Treatment provided

• Staged bone grafts in the mandible.

• Implant placements in the mandible.

• Fabrication of fixed restorations on themandibular implants.

• Bone graft in the maxilla using BMP’s.

• Upon healing of the maxillary bonegraft, implants will be placed and afixed restoration will be fabricated.

OF charitable grants of up to $10,000are made directly to member dentists,but the funds may not be applied totheir fees or used for products providedby corporate partners, who receiverecognition for their contributions.Further information about grant appli-cation guidelines can be found on theAcademy’s website at www.osseo.org.

An Osseointegration Foundation check for $10,000 brought widesmiles to Dr. Lemke and his grateful patient.

Pre-treatment. Congenitally missing teeth with poorridge relationship.

Lateral cephalogram demonstrating poor arch relation-ship pre-operatively.

A surgical guide created by Dr. Mickey Calverly, aprosthodontist, helps direct implant placement.

Four months after implant placement – significantatrophy adjacent to implant.

Resorbable membrane over graft. Results pending.

Implant positions verified in lower jaw.

BMP and allogeneic bone placed with tenting screws.

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It is quite evident that Dr. Luis J.Fujimoto, New York, NY, takes serious-ly his responsibility as chair of AO’s

Membership andAwardsCommittee.

When theAcademy’s Boardof Directorsassembled for itsmidyear meetingin 2007, reportsand proposals

from the Membership and AwardsCommittee took 29 pages. Tabs ranfrom “A” to “I” for all the committee’srecommendations, ranging from a NewMember Briefing Breakfast (which theBoard approved) to an exhibit at theCalifornia Dental Association (rejectedas too costly for AO’s budget).

You couldn’t blame Dr. Fujimoto for giv-ing it his all. Many committees routinelysubmit two-three page reports thatscarcely attract the Board’s attention. Noone leaving that 2007 Board meetingwould forget that Dr. Fujimoto’s com-mittee had been working hard.

“I’m passionate about whatever I do. IfI’m going to do something, I’m going todo it right,” he says, noting that afterintense one-on-one skiing lessons lastyear, he progressed from edging downthe beginners’ hill doing a classic “snow-plow” to swishing down the tough inter-mediate slopes in a matter of days.

He organized the MembershipCommittee into task forces “for account-ability, follow up, and continuity of pro-jects.” Nearly everyone on the committeehad a specific responsibility, starting withVice Chair Dr. Amerian D. Sones, SantaMaria, CA, named to head the Sub-Committee for General Practitioners.

Other subcommittees were assigned to theNew Member Briefing Breakfast, DentalMeetings, Endodontists, Orthodontists,Allied Health, Postdoctoral Resident

Outreach, Predoctoral Students Outreach,Grass Roots Support Program (directedby current Board Liaison Dr. Frank L.Higginbottom, Dallas, TX), Member-Bring-A-Member & Member-Get-A-Member, Overseas Outreach Program,Speakers Bureau Program, and SpecialtyOutreach. The committee’s comprehen-sive structure covered the waterfront, andDr. Fujimoto’s passion for accountabilityand follow up made sure things got done.

The New Member Briefing Breakfast,regarded somewhat skeptically at first bysome AO Board members, was aresounding success at last year’s AnnualMeeting in Boston and will be repeatedthis year at San Diego.

Dr. Fujimoto brings extensive experienceto committee leadership. He’s been anactive AO member for 16 years and acommittee participant from the beginning,first serving under Drs. Patrick J. Henry,West Perth,WSA, Australia,and SpencerN. Woolfe,Dublin, Ireland,on the Ad-Hoc Committee onInternational Relations.

“He’s a tireless worker with seeminglyendless energy who’s ready to join everycommittee,” says Dr. James H.Doundoulakis, New York, NY, an AOpast president who has worked with Dr.Fujimoto on many implant cases. “He’sthe kind of guy you really want in yourcommittee structure. He’s also verylikeable and pleasant to work with.”

At home in New York, he has beenactive in the Japanese Medical Society ofAmerica, Inc., and serves as Japan Chairof the Asian-American Advisory Councilof the City of New York. He currentlyholds 14 Board of Director positions,including the Board of theOsseointegration Foundation.

“I don’t know how he finds time to get itall done,” Dr. Doundoulakis says.

Dr. Fujimoto’s AO committee workincludes the Committee on Education,Research Committee, GovernmentRelations Key Contact Network, DentalRelations Committee, Chair of the Ad-Hoc Committee Eat & Learn Lunches,IJOMI Award Committee, PredoctoralEducation Forum Committee, 2001 AOProgram Committee, William R. LaneyAward Committee, and the Ad HocCommittee on Nominating Practices.

Dr. Fujimoto received a bachelor’sdegree in zoology from GeorgeWashington University before enteringthe University of Pennsylvania School ofDental Medicine, where he received aDMD degree and a certificate in peri-odontics. He received his GeneralPractice Residency certificate fromNassau County Medical Center.

He is currently Clinical AssociateProfessor at the Ashman Department of

Periodontologyand ImplantDentistry of theNew YorkUniversity College

of Dentistry. He serves on the New YorkState Board for Dentistry. He is past presi-dent of both the North Eastern Society ofPeriodontists, the second largest peri-odontal specialty society in the U.S., andthe Eastern Dental Society.

Dr. Fujimoto has a private practice inperiodontics and implant dentistry inNew York City.

Son of a Japanese diplomat, he was bornand grew up in Cochabamba, Bolivia, thecountry where his father was assigned,and attended an English school.

Skiing is a new hobby. His passionremains scuba diving. He’s certified andhis dived in oceans around the world—night diving, wreck diving, you name it,and Dr. Fujimoto has probably done it.He also enjoys photography.

Dr. Fujimoto’s family includes his wife,Yukiko, and their son, L. Gabriel.

Committee Chair Profile

Dr. Luis J. Fujimoto leads activeMembership and Awards Committee

Dr. Luis Fujimoto

“Son of a Japanese diplomat,he was born and grew upin Cochabamba, Bolivia.”


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13

and a resorbable membrane when theimplant was already infected!Unfortunately, an infection developedthat was not managed appropriately.

The salvage of this case includedremoval of a mobile implant, anddelaminated graft and membrane. It lefta significant osseous defect (Figure 3).Drainage from the area finally ceasedafter the surgical debridement, with IVand oral antibiotics. Once again, thepatient left the dental provider whomshe had been traveling 50 miles to seefor the past 12 years.

The question I ask is: “Who is sup-posed to treat a serious, catastrophic,but not life-threatening implant com-plication?” Sometimes I ask, why me?This time I asked, if I as a surgeonstopped treating these complications,

where would they go? To the emer-gency room? Who would treat thesepatients? A medical provider?

What if these patients are managed by amedical provider in the hospital, andthey don’t have medical insurance? Whois going to pay? I guess everyone canfigure that one out.

Finally, is all this good for implant den-tistry? Is someone or some organizationeventually going to step up to the plateand address the issue of implant compli-cations and the training needed to man-age them? The AO took an importantstep in the creation and publication ofits Dental Implant Guidelines. We stillneed a a discussion of potential compli-cations in implant dentistry, referralhierarchy, and some anatomical limita-tion of those surgically placing implants.

This discussion leads to the followingquestion: “Should all dentists place allimplants in all locations (anterior vs.posterior; maxilla vs. mandible)?”Obviously not, because as InspectorHarry Callahan (aka Dirty Harry)says: “A man’s got to know his limita-tions.”1 However, most non-surgeonimplant placers these days don’t rec-ognize their limitations. They justrecognize economics.

References1Magnum Force, The Movie, 1973.

Readers who would like to comment orexpress a point of view on the editorial areinvited to write via e-mail to the editor [email protected]. We willendeavor to publish pertinent comments orviews when space permits.

Editor’s Editorial …continued from page 14

One of osseointegration’s pioneers andan early AO member, Dr. Kenji W.Higuchi, Spokane, WA, is activelyinvolved in a joint meeting of implantol-ogists planned for May 14-16 in Berlin,Germany. Debates and invited lectureswill focus on the decision between surgi-cal and prosthodontic treatment, vali-date tools for the evaluation oftreatment results and provide the latestupdates on the cutting edge of develop-ing technology, according to the meet-ing planners.

“I am on the advisory board for theInternational Association for Oral andFacial Reconstruction, a group ofAmerican and European oral and max-illofacial surgeons, prosthodontists, andallied specialists who share interests inoral and facial rehabilitation,” Dr.Higuchi says.

“Our chairman is Professor PaulStoelinga from The Netherlands. Formany years, we have sponsored a confer-ence on preprosthetic surgery in the

U.S. (Palm Springs, CA, and mostrecently, Charleston, SC) and inEurope,” he adds.

“This year, we are joining forces with alarge implantology meeting in Germany,chaired by Dr. Henning Schliephake,who represents the InternationalAcademy for Oral and FacialRehabilitation (IAOFR),” Dr. Higuchiexplains. “The meeting will bringtogether a large community of specialistsin oral implantology from CentralEurope and a strong international groupfocused on oral rehabilitation.” Othersponsors are DGI (German Associationof Oral Implantology), GI (AustrianSociety of Oral Implantology), and SGI(Swiss Society of Oral Implantology).

”We all share the sincere conviction thatcurrent standards of treatment as well asclinical advances can only be successfullyestablished by a multidisciplinary collab-oration,” the meeting planners say. “Alarge number of innovations have great-ly enlarged the knowledge and treat-

ment options of the different disciplines,and it is our task to jointly use thisknowledge to deliver the best possiblecare to our patients. The aim of thismeeting is, thus, to make clear that inorder to arrive at real interdisciplinarytreatment we have to cross borders andsometimes even need to change welladapted personal views.”

The conference opens Thursday, May14, with Gold Sponsors’ workshops fol-lowed by the opening ceremony. Thescientific program will run all dayFriday, May 15, and Saturday, May 16.

The conference venue, Maritim HotelBerlin, is located in the center of the citynear the Potsdamer Platz, an area rebuiltin spectacular architecture. “Plenty ofspots for leisure add to the unique urbanatmosphere of Berlin and make thislocation a perfect place for the confer-ence,” the joint planners say.

For information, go tohttp://jointmeeting2009.dgi-event.de.

Dr. Kenji Higuchi recommends internationalmeeting on oral and facial rehabilitationin Berlin, Germany, May 14-16


14

Everywhere I go and everywhere I lecture, I hear of more andmore dentists placing their own implants. I finally felt that Ishould “address” the issue, even though I am hesitant to air

my own views. First, let me say that Itrained during the “Team Concept”era. I am still a big believer in the teamconcept as Professor Per-IngvarBrånemarkespoused it.

Most oral andmaxillofacialsurgeons andperiodontistsstill rigidlyadhere to the

team concept and will continue to staythat way. Rather than address the rea-sons why adherence to the team con-cept is changing or has beenabandoned, I want to take it to the nextlevel, the complication issue.Complications are the things neveraddressed when the advertisement says,“Anyone can place implants,” or“Learn to place implants in our nine-month mini-residency.”

In my surgical residency, I trained withDr. Gil Triplett at one of the firstBrånemark teaching centers. Weplaced a lot of implants, most in theOR under sterile conditions exactly asBrånemark prescribed. We alsolearned and performed a lot of ridgeaugmentation procedures. Our successrate was pretty remarkable. Most ofthat success was due to a great team ofprosthodontists (among them Dr.Stephen Parel), who were exact aboutrestoring implants and tackling somevery complex cases.

Despite our willingness to take thesecomplex cases, our complication ratewas very, very low. When we had a sur-gical complication, we just dealt with it.I learned to treat infections, jaw frac-tures, and nerve paresthesias, to name afew. Now, however, my colleagues and Icontinue to see many very seriousimplant complications, including some I

can’t even dream or envision how they occurred. Personally, I’mgetting tired of seeing all of it. It’s just bad practice, bad den-tistry, and bad for implant dentistry in general.

As osseointegration gains greater acceptance, there are anincreasing number of surgical implant “placers.” Let me pre-sent what I see in my practice several times a year. The firstcase is a 47-year-old male who underwent removal of 9 teeth

and placement of two dentalimplants to the right maxilla.These were performed by a gen-eral dentist in my area who hasattended many dental implantCE courses. The procedure wasperformed under local anesthe-sia, took three hours, and washighlighted by the #3 implantbeing dislodged into the maxil-lary sinus (Figure 1).

I removed the implant endoscop-ically in the office (Figure 2) andclosed what potentially couldhave developed into a seriousoro-antral fistula. The patientwas miserable, disillusioned, andfelt he had been deceived by hisgeneral dentist. His commentto me was: “If they do surgery,they should manage their owncomplications.”

This patient ultimately took hisentire family and left that officefor another family dentist. As aresult, his “implant placer” lostthe entire family’s routineexams, dental hygiene, and allof their restorative services.Forever! I just wonder if man-agement of that complicationwas taught in the mini-residen-cy at the local university.

The second case was a maxillaryinfection with a draining fistulaafter implant placement to the#14 area. An implant was placedand became mobile secondary tothread stripping during insertion.All the buccal bone resorbed, andwas treated with bone substitutes

Editor’s Editorial

What happens when implant placement turns catastrophic?Do we need to call Dirty Harry?By John P. Schmitz, DDS, MS, PhD, Newsletter Editor

Dr. John Schmitz


Figure 3: Salvage of this case left a significant osseous defect.

Figure 2: Removal of dislodged implant.

Figure 1: The #3 implant was dislodged into the maxillary sinus.


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