Through the Keyhole - Dr. Neal S. Patel

Dr. Patel describes His Passion for the Art of Implant Dentistry

Tell us about your background.

I am a young, enthusiastic, general dentist who wants to perform optimal dentistry. I want access to the best technology, materials, and clinical results. I have a passion for what I do, and am eager to learn. My background is originally in art and molecular genetics, a mix of freedom of expression and precision science. I strived to find a career that would allow me to express both and found dentistry to be the perfect fit. I graduated from Ohio State University with degrees in molecular genetics and dentistry. I have established multiple techniques and protocols for digital implantology and prosthetics. Before opening my private practice in Powell, I served as a consultant, educating surgeons in the field of 3-D imaging, computer-guided implant surgery, and the art of stereolithography in dental applications. I lecture internationally on advanced digitization in dentistry, cone beam computed tomography (CBCT) and its applications, and dental practice management. To reflect my passion for dentistry, I have incorporated state-of-the-art technology into a cutting-edge facility. I am also a consultant for a number of dental manufacturers and work closely with them on product development and enhancement. I am a clinical trainer for Sirona Dental Systems and an Advanced Trainer for GALILEOS CBCT (Sirona). I offer in-office training for clinicians who want to master GALILEOS CBCT dentistry. In addition to my lecturing and training courses, I enjoy publishing clinical articles on comprehensive dental techniques for oral implantology and prosthetic reconstruction.

What training have you undertaken?

My training includes a full-time fellowship position at the Ohio State University Implant Prosthodontic department from 2006-2007. My experience within this program elevated my understanding of implant dentistry and allowed me to fully recognize the potential of it. I have additional training in surgical placement of endosseous implants, CBCT analysis and treatment planning, sterolithography in dentistry, airway assessment and sleep dentistry, short-term orthodontics, maxillofacial prosthodontics and facial esthetics, dermal fillers and botox dental therapy, dental laser therapy (hard and soft tissue), neuromuscular dentistry, sedation dentistry, chairside CAD/CAM, digital-impression technology, microscope-enhanced dentistry, and use of autogenous bioactive modifiers.

Is your practice limited solely to implants, or do you practice other types of dentistry?

My practice is not limited, but rather provides comprehensive cosmetic and reconstructive care. I do provide all stages of care, but often rely on specialists to provide a team approach to patient care.  Interdisciplinary care is critical to optimal outcomes. As a general dentist, providing comprehensive and multidisciplinary care is becoming more popular with patients, but being able to decipher the need for support and specialty referral distinguishes clinicians in their final stages of treatment.

Why did you decide to focus on implants?

I decided to focus on implants because I knew that patients demanded this clinical therapy in certain scenarios. Through literature research, it became evident that dental implant therapy was predicable and successful long-term. Quite frankly, I asked myself: What clinical therapy would you prescribe for yourself or your own family? Implant dentistry was at the very top of my list.

Do you use guided surgery, and what impact does that have?

I use guided surgery for all of my planned implant cases. It is very rare for me to place an implant using conventional surgical protocol (usually emergency extraction with opportunity for immediate placement).  The systems I have in place, a combination of CBCT and CAD/CAM technology, allow me to provide complete guided surgery within two appointments. The integration of GALILEOS and CEREC (Sirona) absolutely increase productivity for my practice. In one simple patient consultation visit, I am able to obtain both GALILEOS and CEREC data, design a virtual proposal to allow for precise implant positioning within the GALILEOS scan, and order a surgical guide to allow for precision implant placement. The integration software eliminates the need for a separate diagnostic-records appointment, scanning appliance fabrication, a patient scan appointment, and exporting the data to third-party software for implant planning. Essentially, to replicate this workflow without GALILEOS or with another CBCT unit may require multiple appointments (three to four) over the span of several weeks. With GALILEOS and CEREC integration, we are able to complete guided implant surgery in two appointments (initial consult and then actual surgery) with as little as 5 to 7 days between appointments. The costs savings are significant compared to other workflows. The increased productivity due to the decrease in clinical and appointment complexity, as seen in the eyes of the patient, makes them more receptive to clinical therapy, and the clinician is able to increase case acceptance rates significantly. My personal favorite technique is complete SICAT-guided implant placement using GALILEOS and CEREC technology. The implantation procedure itself is simplified because the SICAT guide provides surgical precision of both osteotomy sequence and implant placement. Being compatible with multiple systems, one has the ability to select a guided-implant system of his/her choice and minimize the need for conventional implant placement technique. The accuracy of the guides simplifies procedural complexity and streamlines the process. This, in turn, reduces surgical time significantly. Without guided surgery, a simple single implant appointment may take 45 minutes using a conventional technique. With GALILEOS guided surgery, my surgical appointments are 15 minutes for the same implant, with far less stress, and far greater accuracy! In addition, GALILEOS has a library of multiple implant systems from various implant manufacturers, so the clinician is not limited to any given implant system. The advantage of this is that the clinician can rely on GALILEOS to help streamline implant inventory. With the ability to plan cases with GALILEOS and CEREC data prior to implant placement, one can predictably position an implant in a fashion that allows for adequate all-ceramic material thickness upon the restorative phase of treatment. With such planning, we are able to maximize technology and deliver custom CEREC restorations using IPS e.max^Ò CAD (Ivoclar Vivadent), a lithium disilicate glass-ceramic. Such high-strength ceramic restorations can be provided chairside using CEREC.

Do your patients come through referrals?

I do receive referrals from specialists as well as general dentists. The technology I have implemented into my practice is often critical in certain case types. My office is designed for and caters to patients who want the most advanced technology and treatment options for any given dental condition. The level of care that we strive to provide is at a level that most dentists would want for their own oral health. Dentistry is a field that offers multiple treatment modalities and levels of therapy. When I decided to open my practice, I implemented the technology and amenities I would want for my own or for my family’s dental needs. Put simply, only the best!

What are your relationships with local colleagues, now that you’re placing implants?

My relationships are fantastic! I feel that specialists truly support my endeavor in wanting to elevate my clinical skill-set in oral implantology. The support and education I receive from local specialists allows me to clearly identify clinical cases that require specialty care.

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

I have been practicing for 3 years and treatment plan and restore multiple implant systems. My in-office system of choice for surgical placement is Astra Tech Dental Implant System™ and the Facilitate™ guided kit (Astra Tech). I use Sirona Implant treatment planning software with guides fabricated by SICAT. Currently I use zirconium as the material of choice for all anterior restorations and select posterior restorations. For individual crowns, my personal preference for single unit implant restorations is IPS e.max^Ò CAD (Ivoclar Vivadent).

Who has inspired you?

I have been inspired by multiple clinicians, laboratory technicians, and key leaders in the dental profession. Some names include: Drs. Maurice Salama, Edwin McGlumphy, David Garber, Arun Garg, Robert Marx, Michael Pikos.

What is the most satisfying aspect of your practice?

Changing people’s lives. We must accept that for years, dentists were feared in the general public’s eye.  To this day, we have patients who still have dental fear. With technology like CBCT, CAD/CAM, and sedation dentistry, we are able to provide precision therapy with complete patient comfort. We see a reduction in complications and postoperative discomfort due to our ability to diagnose and treat using 3-D technology. This changes the lives of our patients and their perspective on progressive dentistry.

Professionally what are you most proud of?

Professionally, I am simply proud to be a dentist. In the past 5 years alone, technology has revolutionized dentistry and is continuing to make a significant impact in treatment modalities and clinical results for our patients.

What do you think is unique about your practice?

The way the technology is integrated and used for comprehensive care. As dentists, we often invest in technology and end up not completely integrating it due to problems in workflow and streamlining dental care. Far too often, technology only complicates our day-to-day workflow. I feel that my practice is unique in that we have invested in technology that actually integrates with other technology and significantly improves our workflow, treatment-planning ability, treatment presentation, and clinical therapy. My office also has its own dental lab outfitted with technology for both fixed and removable lab work. We have the ability to fabricate complex implant prosthetics and ceramic restorations.

What has been your biggest challenge?

My biggest challenge was starting my practice from scratch. I knew I wanted to provide a different level of dentistry that relied heavily on sound technology. My decision to build my practice with CBCT and CAD/CAM from day one was fundamental to the level of service I wanted to offer my patients. Another challenge I find is keeping up with the rapid release and availability of new dental technology.

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

An artist. Specifically, I have always enjoyed the art of duplicated/replicated nature. It’s interesting, I will tell you, most dentists find they also excel at this and find some sense of satisfaction in having the ability to duplicate what nature presents us.

What is the future of implants and dentistry?

The future of implants is truly bright. From a diagnostic standpoint, I see the future of imaging changing from conventional radiographic imaging to radiowave frequency and ultrasound imaging for zero-radiation imaging. Such imaging may allow clinicians a higher level of resolution that images soft tissue as well as hard tissue, thus potentially bypassing the need to take analog and optical impressions. I anticipate that CAD/CAM technology will allow clinicians to have control of patient-specific endosseous implants that may also be milled in-office.

What are your top tips for maintaining a successful specialty practice?

To maintain a successful specialty practice, I feel it is imperative that the clinician invest in sound technology to improve clinical therapy and long-term prognosis. It is not only important to keep pace with rapidly developing CBCT and CAD/CAM technology, but to also maintain a high level of education and understanding as to how the technology functions and is applied for clinical dentistry. To bring your “A” game, you must be properly equipped!

What advice would you give budding implant dentists?

There is no better time to invest in an educational program that covers the wide range of topics related to dental implantology. We often tend to hide during times of economic stress, but this is the time to shine and set yourself apart.

What are your hobbies?

This is going to sound geeky, but I will say it anyway. My work is my hobby. I feel that in order to do your best work, you must enjoy doing the work.

TOP 10 List

Sirona GALILEOS CBCT Comfort Unit

Sirona CEREC AC with Bluecam Technology

Acteon Implant Center™ 2 with Piezosurgery

Astra Tech Dental Implant System™ with Facilitate™ kit for Guided Surgery

Atlantis™ Abutments (Astra Tech)

Sirona inLab Abutments

MiniStar S^® Thermal-forming Unit (Great Lakes Orthodontics)

SiroLASER Advance (Sirona Dental Systems)

SICAT Surgical Guides

e.MAX CAD restorative material (Ivoclar Vivadent)

Neal S Patel, DDS, owns Infinite Smiles in Powell, Ohio. His practice is limited to cosmetic and reconstructive dentistry. He is involved with and actively participates in the American Dental Association, the Ohio Dental Association, the Columbus Dental Society, the Academy of General Dentistry, the Academy of Cosmetic Dentistry, the World Clinical Laser Institute, the Seattle Study Club, the Academy of Clinical Sleep Disorder Dentistry, the American Academy of Facial Esthetics, and the Academy of Osseointegration. He can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .