Through the Keyhole - Dr. Ara Nazarian

Dr. Ara Nazarian discusses the value of keeping current on new procedures, developing trends, and advances in technology

Tell us about your background

A Michigan native, I attended the University of Michigan for my undergraduate studies in microbiology and completed my dental education at the University of Detroit-Mercy School of Dentistry. Upon graduation from dental school, I enlisted in the US Navy. My first year consisted of an AEGD (Advanced Education in General Dentistry) residency allowing me to further my education in the various disciplines of operative, endodontic, periodontic, and surgical dentistry. The last 2 years of my military commitment was completed in Twenty Nine Palms, California, where I focused on comprehensive dental treatment for the Marines.

Returning to Michigan, I worked as an associate for 2 years, gaining insight into the business aspect of dentistry. Shortly after that, I opened my practice, named Premier Dental Center, from scratch, focusing on comprehensive and restorative care.

Within the last decade, I have had the opportunity to consult with a variety of dental manufacturers, assisting them on product development and enhancement. In fact, in 2002, I created the DemoDent® patient education model system that is distributed worldwide through a variety of dental suppliers. Most importantly, I have had the honor of being able to share my passion of full-mouth rehabilitation, cosmetics, and implant dentistry by educating fellow dentists globally via lectures and seminars. Recently, I established the Reconstructive Dentistry Institute to help set and elevate the standard of care in all areas of dentistry, ranging from single-implant placement to full-mouth reconstruction using a hands-on approach.

What training have you taken?

My interests with implant dentistry started more than 14 years ago with the application of small-diameter implants for denture stabilization. Receiving further training in this new modality, I quickly gained the knowledge and experience to train other dentists. To date, I have personally trained several thousand dentists in this treatment. Having already restored traditional implant restorations, my goal was to seek formal education on the placement of traditional implants as well as the grafting necessary to build the foundation for complicated cases. In order to fulfill this desire, I enrolled at the Misch International Implant Institute, led by the world-renowned Dr. Carl E. Misch. With its well-trained faculty, the institute has provided me with the most progressive and documented information on bone grafting as well as implant placement and restoration through education that is based on research. In addition to this program, I have also received training in rotary endodontics, cone beam computed tomography (CBCT) analysis and treatment planning, short-term orthodontics, sedation dentistry, full-mouth rehabilitation, minimal preparation veneers, and maxillofacial prosthodontics through a variety of teaching institutions and courses.

Is your practice limited solely to implants?

Reconstructive dentistry is probably the broadest and most inclusive term used to describe the concept of replacing, rebuilding, or creating, for the first time, the elements and relationships between teeth, the upper and lower jaws, and overall facial structures. In order to provide this type of care, my practice is not limited to implants. As a general dentist, my goal is to utilize a wide variety of dental services, such as restorative, endodontic, periodontic, and prosthetic care, in order to produce the precise outcome desired, with no exceptions. However, I do rely on specialists to provide a team approach to patient care if it is needed.

Why did you decide to focus on implants?

According to a variety of statistics, age and tooth loss are totally related. As we mature, the probability of losing a tooth or multiple teeth is high. Being able to assist this group of patients with implant treatment that is researched, proven, and predictable is what I want to be able to provide for my patients. Giving a patient the ability to smile, function, and eat again is most gratifying!

Do your patients come through referrals?

I do receive several referrals a month through general dentists as well as specialists. General dentists that refer may have either attended one of my seminars or read one of my articles in the professional journals and found that a particular case was much too involved for them. Also, I work with a great team of orthodontists who refer patients who may be congenitally missing teeth that need implant replacement or patients who may need porcelain veneers to enhance their teeth once they have been orthodontically corrected.

How long have you been practicing, and what systems do you use?

I have been practicing dentistry for 15 years, and I enjoy every minute of it! Helping patients achieve their smiles through implant, cosmetic, or restorative dentistry is what I practice every day. With implant therapy, my implant system of choice recently has been the TSI Dental Implant from OCO Biomedical. This implant is so versatile that it can be placed in any bone type with minimal surgery, offering a multiple array of prosthetic options to meet today’s esthetic demands. Utilizing the most advanced restorative bonding agents and cements from Kerr (Sybron Dental) has allowed me to deliver restorations without complication or error. Having a programmable and predictable surgical motor and handpiece from Aseptico® has allowed me to adjust speed and torque through any bone type without compromise. Sheer Vision® Headlight and Surgical Loupes enlighten and magnify the surgical field with razor-sharp images and startling high-definition clarity. With 3-D imaging becoming the preferred diagnostic and planning tool for many dentists, 3D Diagnostix provides me with support services such as high quality 3-D conversions, radiographic interpretations from OMF radiologists, virtual treatment plans, and surgical guide ordering. In fact, at a recent live, hands-on lecture at the Greater New York Dental Meeting, I was able to place eight TSI OCO Biomedical dental implants utilizing the virtual treatment plan and surgical guide created by 3D Diagnostix within 80 minutes. Burbank Dental Lab has been my primary lab for implant restorations and cosmetics for the last 10 years, always offering natural-looking restorations that fit precisely.

Who has inspired you?

Many clinicians and key opinion leaders in the implant field have inspired me. These individuals include, but are not limited to, Dr. Carl Misch, Dr. Hilt Tatum, Dr. Ken Judy, Dr. Scott Ganz, Dr. Paulo Malo, Dr. Mike Pikos, Dr. Alvaro Ordonez, and Dr. David D’Alise.

What is the most satisfying aspect of your practice?

Many times we don’t realize how much we can affect people’s lives by enhancing their smiles and bites, allowing them to speak and function without pain or discomfort. Having the ability to utilize CBCT planning through 3D Diagnostix, placing dental implants, and delivering a CAD/CAM restoration in one visit while the patient is under IV sedation is probably the most satisfying aspect in my practice. These patients present with edentulous with nonfunctional prosthetics, and awake to find themselves with fixed teeth secured on dental implants.

Professionally, what are you most proud of?

Professionally, I am most proud of earning my fellowship and mastership in the ICOI (International Congress of Oral Implantologists). Devoted to providing implant education to the entire team to better serve its patients, the ICOI is not only the world’s largest dental implant organization, but also the world’s largest provider of continuing dental implant education. My goals are to work toward getting credentialed with Diplomate status within the organization and to share my implant experience with fellow dentists.

What do you think is unique about your practice?

Having the ability to offer a variety of different dental services under one roof is what is unique about my practice. Many patients have put off treatment due to the economy. When they finally return to the dentist, they have a variety of multiple problems that need care. These problems may require root canals, scaling and root planing, extractions, grafting, fillings, or implant placement. In my practice, we are able to address all these concerns utilizing IV sedation within a couple of appointments, whereas before they would be referred out to various specialties and have taken more time or multiple visits. In other words, patients who have the least amount of time for what seems to be a considerable amount of dentistry (multiple implants or reconstructive procedures) are accommodated with special appointments. Our office’s ability to schedule these appointment blocks enables patients with overflowing work schedules or active lifestyles to obtain needed treatments with the least amount of visits and the least inconvenience.

What would you have been if you didn’t become a dentist?

As a process, architecture is the activity of designing and constructing buildings or some other physical structure primarily to provide a purpose. I have always enjoyed the creation and construction of things. Even today, I appreciate the huge variety of architectural buildings and wonder at the planning and thought that went into the development. Like dentistry, these buildings must be constructed on a solid foundation (e.g., bone), have some stabilization (e.g., implants) and follow some form (e.g., porcelain teeth) that is not only beautiful, but also functional. I would have definitely studied architecture of some sort. It is a lot like implant and reconstructive dentistry!

What is the future of implant dentistry?

The future of implant dentistry is very bright with the newer developments in bone grafting and regenerative cells. Having the ability to grow bone in areas that are deficient without major surgery or a donor site is around the corner. With CBCT treatment planning and software getting better every day, we will eventually be able to do live surgery with simultaneous 3-D views of the bone as we are working on it. Also, the dental implant designs and materials will allow us to shorten healing times in order to provide functional teeth in a shorter amount of time for our patients.

What are your tips for maintaining a successful implant practice?

Investing in modern technology as well as education is very important in staying abreast of the newest trends in your specialty. However, the most important aspect of maintaining a successful practice is treating every patient who seeks your professional expertise with consideration and respect. Many times, patients present embarrassed about their current dental condition due to missing teeth, periodontal disease, or neglect, fearing that we may prejudge them. My goal as their provider is to help them find a solution to their dental problems and correct them in an efficient and cost-effective manner while offering the best comfort and care.

What advice would you give budding implant dentists?

Now is the best time to invest in your continuing education in not only implant dentistry and grafting, but also in endodontics, orthodontics, and periodontics. Today, patients are presenting with debilitating dental conditions that require comprehensive treatment plans to return them to proper form, function, and health. Because of time constraints, fear of going to multiple offices, and increasing costs, patients will seek providers who are reconstructive in nature.

What are your hobbies?

When I am not in the office providing dentistry for my patients, lecturing to fellow dentists around the world about the latest techniques in dentistry, or learning about new dental materials myself, I prefer to spend my free time with my wife and two sons. My hobby is to enjoy their love and company at home, away on vacations, or skiing and traveling. Now is the time to enjoy them, since they are still very young. Later on, I can enjoy the traditional hobby stuff when they are away at college.

Top 10 List

OCO Biomedical Dual Stabilization® Dental Implant System

3D Diagnostix treatment planning services and surgical guides

SheerVision® Surgical Loupes and Fiber Optic Light

Aseptico® Surgical Motor and Handpiece

Maxcem Elite^TM Cement and Take 1® Advanced^TM (Kerr Dental)

Golden Misch Physics Forceps®

DynaBlast^TM Putty (Keystone Dental)

Burbank Dental Laboratory Inc.

Kodak 9000 3D Imaging System (Practice Works)

Dental USA Surgical Instruments

Ara Nazarian, DDS, FICOI, MICOI, maintains a private practice in Troy, Michigan, with an emphasis on comprehensive and restorative care. He has earned a Fellowship and Mastership in the International Congress of Oral Implantologists (ICOI). His articles have appeared in many of today’s popular dental publications worldwide. Dr. Nazarian is the director of the Reconstructive Dentistry Institute. He has conducted lectures and hands-on workshops on esthetic materials, bone grafting and dental implants throughout the United States, Europe, New Zealand, and Australia. Dr. Nazarian is also the creator of the DemoDent® patient education model system. He can be reached at (248) 457-0500 or www.aranazariandds.com.