Prof. Dr. Drauseo Speratti, BDS, DMD
Clinical Assistant Professor, Midwestern University
Good afternoon. Buonasera. Buenas tardes. It’s a pleasure to be here with so many friends and colleagues from the Bicon family. It is an honor for me to be able to present to share some of our experience placing and restoring Bicon implants with undergraduate students. I was talking yesterday with a friend, Dr. Bonfante. And he provided me some very, very interesting information that what we have in our program at Midwestern University, no other university in the world has. Some universities, they teach dental implants where instructor places an implant and the students restore some of them. Other programs, the students, the top classes students only are able to place some implants. Only ten, fourteen percent of the class are able to place one or two implants per year maybe and restore them. But the vast majority of the universities, they only teach the theoretical part of dental implants. And you can see in a few minutes, it’s very different what we do at Midwestern University. But this is all possible because of the simplicity. Simplicity of the implant system that we use, the Bicon system. The brilliant design by Tom Driskell for many years since nineteen eighty five with the sloping shoulders plateau design allow us the simplicity for us to place those implants and restore them. This system and the system itself makes everything works well and everything works well for us on a scholar set, a university set. But before I talk about our system itself, important for you to understand how Midwestern works, how Midwestern University is set up. It’s a different university. The goal for this school is to train clinicians. Make sure the students that graduated, they are able to immediately get jobs and start to work with clinicians. I don’t know, I’m not sure if you’re familiar with this information, but most dental schools in the US are different than that. When the students leave the school upon graduation, they, most students, they have to go to a residency program to get practice. Because most dental schools, they have post grad programs. These programs, all the patients are guided or the majority of the patients are guided to these post grad programs allowing the undergrad to have just basically the leftovers. So the students don’t have enough clinical practice. For you to have an idea, endodontic procedures. Some students, they are lucky enough to do an endodontic procedure in a patient. Most of them are doing models only. Multi rooted tooth or multi rooted teeth is almost impossible. There are schools that students share a molar for example. Molar with three canals. Each student does one canal. In Midwestern, most students do several molar restorations, endodontic treatments. And of course, they also do implants. So it’s important for you to have this idea how Midwestern works. It’s very clinical guided. As you can see here, this is we have two campuses. So I think he jumped. He’s late now. We have two campuses, Midwestern University in Illinois. As you see, this is the main campus is where the administration is and most of the basic science are held. So this university itself was created in nineteen hundreds. It’s a very old university. It has a lot of tradition but it started with osteopathic medicine. Dental school came years later. Here are some other images of the main campus for you to see. And this is in the snow, of course, in Chicago. You know the winter could be brutal there, but we managed to live well. What you see on the center of the screen here, this is the Science Hall as we call, where we have something unique for dental schools. This type of facility is called the SIM Clinic. At the SIM Clinic, the students, they do all the procedures. They’ll the future do in the patient’s mouth, but all done in mannequins and typodonts. So they do that every single procedure including implant placements and restorations. It all concentrated inside the science hall. This is the other campus, the multi specialty clinic. This is where we work. This is where our program is located. The multi specialty clinic dental school occupies three floors and medical school occupies the other three floors at the school. That’s where we work. For the dental program in the Western University, for you to understand, on the first year, the students, they have an intensive curriculum covering all the introductory concepts, subjects in Dentistry. Biochemistry, Anatomy, Dental Anatomy, all that basic science are there. And they have the initial introduction to the SIM Clinic. So they would do some basic procedures on the mannequins just to get their hands dirty a little bit to understand how the instruments work, how the procedures work. They do just a class one occlusal prep, things like that, scaling, something like that. Okay? But they are tested constantly. They have exams and quizzes two, three times a week. So all the heavy load, all the materials, all the didactic portion these students have throughout the four years is done on the first and second year only. Allowing them to save the third and fourth year to work directly in the clinic almost full time. During the second year, continue the heavy theoretical approach. But now extensive hours on the SIM Clinic. So the students work on the SIM Clinic similarly as they work on the patient’s mouth. So do every single procedure they will do in the patient’s mouth. Now constantly they have more hours on the SIM Clinic and less hours in the class. These students will perform nearly all clinical procedures in mannequins and typodonts. What you see on the screen is a picture of the SIM Clinic. Each student have their own patient, their own mannequin, their own station with motors, handpieces, and as I mentioned before, they do all the procedures directly in the SIM Clinic with assisting other faculty members. They also do CAD/CAM restorations either for natural teeth or for implants. They design and mill the crowns themselves. The school uses CEREC. So they scan it, design and mill. Everything is done on the SIM Clinic. So when they come to the clinic, they are very familiarized with all these procedures to do directly in the patient’s mouth. On the third or fourth year, these students, they collaborate in pairs, which is a brilliant idea. When the second year student moves to be a third year student, their partner will be a D4, so a fourth year student. It has been in the clinic for a year. So they know how the clinic operates. They know what they have to do. They are familiarized with most of the procedures. So they work as a mentor to the third year student. When the third year students progress through throughout the year and to the end of the clinic to the year, the d four will be graduated. This d three becomes a d four and will serve as a mentor to the next third year student that comes along. So this eliminates a lot of learning because the D4 can teach a lot to the D3 students. And the students will conduct most clinical procedures typically performed by a general dentist. Everything a general dentist usually do, these students will do in the clinic. With having the faculties to assist them. Everything including of course molar teeth and orthodontic treatments, several of them, and placement and restoration of Bicon implants. The students, they can do any procedures they have as long as they have enough patients for them. Anything can be done as long as a general there’s a general dentist type of treatment. So this is the entrance of our multi specialist clinic. Let’s talk about now about our implant program itself. So the Midwestern implant program is, as I mentioned before, is unique. But it’s possible as well because Dean Haering, which is he was a clinician for many years. He worked and after retirement he went to academia. So Dean Haering knows the importance of having a simple system, an easy way to restore the implants. So Dean Haering decided to use Bicon after extensive review of several dental implant systems. And he chose Bicon to be the simplest and most reliable implant system to teach dental students. And Dean Haering is a personal friend as well. And he always tells me he receives phone calls, daily phone calls from different implant companies trying to get him to university to provide the implants for the school. And Dean Haering is always, “No. We use one system and one system only.” We’re being successful and that’s all we’re going to use. The similar mentality he used for restorative procedures, they have one company that provides and they’re happy with it and works really well. Different to the many other dental schools, the school doesn’t receive any money to choose Bicon. They choose Bicon for the merits, not for the money. Most dental schools receive sponsorships from other companies to use the systems And Midwestern, no. And Bicon doesn’t. Bicon provides all the support but doesn’t pay a dime to anyone just to use the system. So that’s for me is a huge plus. The quality that’s being used, not the money that’s talking to use the system. We have the unique dental implant program at school, which is during the first and second year for the implant program itself. The students, they receive implant training in simulation clinic. So we teach the faculty there at the simulation clinic to learn how to place and restore implant, Bicon implants in models. The students, they have the implant rotations and they do several procedures, implant placements and several restorations of Bicon implants all done in the model prior to coming to the clinic. They also have the opportunity to restore one screw design implant which gives them the knowledge to know how to restore other implants. If they leave the school, they will work for somebody else that doesn’t use Bicon. So they understand how the system works. Other systems work as well. But most of them prefer, of course, Bicon. They see the how the simplicity of the Bicon system in comparing to the screws. Several students come and talk to me and say, wow, that’s so difficult. All the screws, the torques, all that procedures to have done. Bicon just take a quick impression, put the crown in tap and that’s it. Which is true. All of us that use Bicon know how simple the system is and that’s why we fell in love for it. In their third and fourth year, these students, dental students have the opportunity to place and restore their Bicon implants as part of their curriculum. So it’s a daily procedure. That’s not special. They don’t have to go or request a special permission. The same day they do a class two filling, they can place an implant for example. It’s all done directly as part of the normal natural curriculum. After implants placements and uncovering procedures is done with us, these students work on restoring Bicon implants with single crowns, bridges, even full arch trinia restorations or over denture restorations. So everything we do as general dentists, these students can do as well. They do everything naturally. For the placement of implants, we have a personalized one on one structure guidance procedures for implant placements and uncovering procedures. It’s literally a one on one. So we are with the students all the time. Now this coming and say, okay, just do it and I sit down and read a paper. No. It’s a one on one teaching technique. We make sure the students know what they’re doing. They don’t make any mistakes. Make sure the patient receives the best possible treatment they can. This is just a picture showing some images. We have few chairs. We have six chairs in our area there. But intentionally, we didn’t want to be separated in oral surgery department or where they have private rooms or anything like that. We want to be there. We want to be among the clinic. We have a specific area, but it’s just similarly as you have a dental office. That’s nothing different than you have in your own private practice for most people at least. So the students receive the guidance. You can see you always have the work in pairs, a third and fourth year student and they structure it there and have one assistant behind working on the instrumentation. So the system runs really well right now after all these years and we don’t have to speak, but already everybody knows what to do. The students sometimes they literally have to hold their hands just in case to make sure they know the path of insertion. The students do almost the entire procedure and sometimes they do a hundred percent of the procedure. What the students do, we show where the flap should be made. The students make the flap, reflect the tissue, do the retraction suture. I usually do the pilot drill for them because they don’t have the idea, sometimes the direction idea on how to do it. So I prepare the pilot drill and they take over after that with the latch reamers, harvesting bone, placing implants, cutting the plug, and suturing. After some students, they have placed few implants with us. I allow them to do the pilot drill. So they literally do the entire procedure themselves, and they are thrilled. It’s amazing to see their faces when they they place their first implant, not only naturally and when also they place their first implant beginning to the end. They really appreciate that. And it’s for us is rewarding experience to see their eyes. On restorative procedures, after the implants are placed and uncovered, the patient moves to the student suites. For you to understand what a student suite is, the student suite, each class has one hundred and forty students. Since you have the D3 and D4, daily basis we have two eighty students in the clinic. These students, they are separating pairs as I mentioned to you and each suite has fourteen pairs. So we have ten suites. These suites are basically small private practices. They are controlled by three faculty members that help and facilitate the students there to do all the prosthetic procedures for Bicon implants. It’s not a one on one. The students have the freedom. They do a procedure, the faculty check, and go on. Take an impression, faculty check, insert a crown, faculty check, and all like that. It’s not a one on one like the placement and the restoration. So this have a little more space there, room to breathe. And also on their third and fourth year, Bicon generously gave to this each student two implants to offer to their patient of choice. Could be their relative, could be their best friend, could be a great patient they have. So the patient is only responsible to paying for the crown. It is a great benefit. But these two implants, the students, they can place many implants, as many implants as they want. There’s no limitation as long as they have the patients available for and willing to pay. The fees of course are much lower than in private practice. And throughout the years we notice that the students have an average placed seven implants. So of course, some place some students placed twenty, some students placed one. But on average for the class, they placed seven implants which is amazing to leave dental school like that. Remember when you went to dental school, how many implants have you placed? Right? Not many. Certainly. I didn’t. Each academic year, the students in the program place a total of average 936 implants every year. So we work hard, work a lot. It’s a very intense program. So we are constantly working, constantly doing procedures. That’s the average placement for this five year of our program, the statistics I’m about to show you here. Upon graduation, most students, they are very confident in their ability to place and restore dental implants and begin their clinical career. Let’s go for numbers now. So this is a five year retrospective study from October twenty eighteen to October twenty twenty three. These are the dates the implants were placed, not restored. Okay? So this data is for implant placed between twenty eighteen and twenty twenty three. Total number of implants placed during that time was four thousand six hundred and eighty four implants. We have a total number of patients of fifteen sixty eight. Female patients 811 female patients and 757 male patients, a little more females than males. Mean age of the study was sixty years old, as you can see it. The shortest follow-up after the placement is twelve months for this part of the study and the longest six years after the restoration. We only consider implants successful if the implants were restored after one year. After restoration, implants were fine. No bone loss. No bone issues. No problems at all. That’s considered successful implants in this case. So for total successful implants placed: 4,607. Total failure implants: 77. Success rates are 98.36%. So these are students placed implants. That’s where it is. So if the students can do that, surely all of us can do it. And Dr. Mauro always jokes about, oh, you always place implants and patients are perfect. You know, perfect bone or perfect that. It’s not, of course, you know, you can’t guarantee that pressure perfect patient’s perfect bone. Nothing like that. We do sinus lifts. We do ridge splits when needed. What we do is when the patient comes to us, they have technically a healthy mouth. So all the perio issues resolved, decays, anything like that, they come to us already, all this being treated. So this program demonstrates how Bicon implants can be part of regular curriculum in any dental school that wants to provide training to students. This is achieved by a combination of factors. First, a reliable simple implant system. It’s paramount. Without Bicon, would be, in my opinion, it would be almost impossible to replicate these results. Dean, we need to provide implant training. So Dean Herring, as I mentioned, he from the beginning said, no, let’s provide implant training. These students have to leave here knowing how to place and restore implants. And experience in faculty utilizing Bicon implants. You need to have some experience with the system. You need to understand the nuances of the system. Myself, I’ve been fortunate enough to learn a lot from the best. I learned a lot from Dr. Morgan, of course, my dear friend and mentor Dr. Marincola. I learned a lot from them and from other from from other people. So I’m blessed by that. But it’s not about me, it’s about the system and how the system works. We have data for publication. Two of already part of this study was already presented at oral presentations at AADOCR meeting in New York City. And final study, the final numbers, I cannot provide yet because these to be made for presentation for publication and all the information, the full information will be there and hopefully will be published soon. But all this is possible due to the simplicity of the system. Only Bicon will be able to do that. Okay? This is our team. You know, we don’t work alone, but we try to make as simple as possible and as efficient as possible. We have a very small team. It’s these are our two fantastic assistants. One’s Giedre and JoAnn. They are amazing. Giedre is the main assistant. She is Lithuanian. I don’t know if you ever work with Lithuanian assistant, but they are tough. You know, the students try to mess around. She goes for the neck. For the jugular. She doesn’t mess around. They don’t mess with her. They know better not to mess with her. And the other colleague that works with me is Dr. Larry Smith. Larry is a great guy, super fun, and very very good sport. He does most of the uncovering procedures. I do all these placements and some uncovering procedures. But we have a small, concise, and well done team. So we we are very successful and blessed for what we do over there. But more important than that is all the system, what the system does, all of us here, they love the system. It’s not just a little piece of titanium. I’ve been lucky enough to travel for many parts of the world to make so many friends and many of you guys are here. And it’s an honor for me to to share this with you and to be here with all of you. But this is possible because Bicon was a small company. Right? But one person with his own vision, with his own idea, expand this company to over a hundred countries. And this person allow us not only create expanding the system as a commercial standpoint, but he also expanded for a family. We are here all together a Bicon family. That’s where we are. You took a chance on hire a young Brazilian dentist almost twenty five years ago. Big mistake, but it was a pleasure. So I want to thank you, Dr. Morgan, for everything you have done for me, myself, and for all of us. And happy birthday. You did it on your way. Okay? Thank you so much. Thank you.