Why Should You Avoid Flapless Implants? – GF015

Jaz’s Introduction:
Are flapless implants a thing or are they a fad? I feel like there is a lure of some courses that want to attract the inexperienced GDP who perhaps is afraid of surgery or averse to surgery who can’t raise a flap and they thought you know what, if we start teaching a guided system that doesn’t involve flaps and maybe the dentist will come and learn implants and place our implants so that is the cynic in me thinking that but I got on the main man who knows everything about implants Dr. Pav Khaira on today on this group function about IS THERE A PLACE FOR FLAPLESS IMPLANTS? And of course from that we go into different directions in terms of okay, when is it suitable? When is it contraindicated? What are the problems? And how we can learn more and get into this field of implantology. If you are a novice if you are someone who’s thinking about it, but you’re afraid to make that next commitment. How does one get into the field of implants are huge daily topic for young dentists.

Main Episode:
So let’s join this group function with Dr. Pav Khaira. Dr. Pav Khaira back again for the third time from the dental implant podcast. How are you, my friend?

[Pav]
I’m very good, how you doing?

[Jaz]
Amazing. And last few times you came on you really busted some myths and you helped us to understand some basic things. Can we probe implants? What happens when an implant is bleeding? The soft tissues are bleeding. How can you tell if you’re too worried or not? So you cover these really fundamental topics. And you guys if you haven’t listened to ready, listen to those. And of course we had you on for finding your niche in dentistry. So you’ve done some pretty big topics. And when this topic came along about flapless implants, which what we’re talking about today, and I can’t wait to dig into that. But just for those people who haven’t listened to that those episodes yet, and I will urge them to check out those episodes right now, those watching on YouTube, the thumbnails be flying up, you need to listen to those previous episodes to really appreciate all the wonderful things we’ve covered so far. But just tell them about your week to week, day to day dentistry that you’re passionate about.

[Pav]
Jaz, firstly, thank you for having me back again. Secondly, all I do is place implants. That’s it, I don’t do anything else. So what’s the best way to frame it as an average implantologist and average busy implantologist that quite happy to place 200 implants per year, I’m very fortunate to be in a position where I’m placing about 1800 to 2000 implants per year. So you know, my, in the last few years, you know, my experience is going up significantly. And I say that from a point of being humbled because I thought I knew what I was doing to start with. And then you start placing that volume of implants. And it’s just like, whoa, actually, this is different game. You got to relearn your skill set. So-

[Jaz]
I see the crazy and amazing you know, life-changing transformation that you do on our telegram group, you know, so good at posting notes and the radiograph before and after. And so if you’re a little bit of burst of blood, you probably don’t look at those posts from Pav. But then he’ll show you anatomy that you never knew existed. He’ll show you what the pterygoid plate looks like. He will tell you all these cool stuff. But with the basic stuff as well, which you cover so well. So it’s been great on the telegram group to see your cases.

[Pav]
Yeah, I mean, you’ve seen some of my zygomatic implant cases, you’ve seen some other cases where, you know, patients been in dentures for 40 years, there’s no bone left or have to think outside of the box a little bit. And we showed you that case where you know, the mandible had atrophied where it was only 11 millimeters in height, and we were placing 10-millimeter implants. So yeah, I get to see some crazy stuff now. And again, it’s just transforming people’s lives. It’s just, you can’t put a finger on it. It’s just amazing. It’s fantastic.

[Jaz]
I can see that in the in the postdoc portrait photos in the eyes of the patients, the kind of work you do is very transformational. So it’s great to do any part of that and to see that, and today we’re covering flapless implant courses and just technique of flapless and the position I come from Pav is as a position of being a cynic, in the sense that a few years ago, I started noticing all these like pop up courses, now I don’t place implants, right? But I’m very keen restorative dentist. So I refer out to colleagues who do place implants, but I did see a surge in courses saying, ‘Hey, you don’t even need to be able to raise flaps to base implants, flapless implants.’ And I’m thinking, my worry Pav was, are these courses being set up because they recognize that dentists who don’t raise flaps who can’t raise flaps, this will be an easy lure to get them in to implants. Is that what it was? Or is flapless a valid technique? And that’s a big level question. You’re probably going to break it down which you’re very good at doing, but that’s the position I’m coming from. Is it a fad or is it a thing?

[Pav]
So let me spin this question around for you. So if something sounds too good to be true, is normally too good to be true, right? So there is a position for flapless implants, here’s the key in the correct circumstance, they’re fantastic. Okay? There are a number of courses available now where it’s very much, as you said, you don’t have to be able to raise a flap, we will do it guided, we will plan it for you, all you have to do is a tissue punch, and then you use the guidance system. And then you place the implant, that’s it. Jaz it’ really not as simple as that, right? You need, you need a certain amount of bone volume around implants, you need a certain amount of soft tissue around implants, not only do you need a certain volume of soft tissue, you need a certain quality of soft tissue as well. And if you’re doing flapless, you may end up having just enough soft tissue, and then you do a tissue punch, and all of a sudden, it’s gone. So what do you do, then, because you’re immediately on the backfoot, with this case, this case is likely to start sliding backwards really quite quickly. And here’s the other thing, as well as what do you do if the guide doesn’t fit? You know? There’s a say, when you get into that implant ecosystem, when you get into that implantology world, once you start doing a number of cases, everybody says the same thing. Guided surgery is great. Okay, it’s really, really good. It’s got a great position in implantology. But you should not be using guides unless you can place freehand. Because your guide doesn’t fit, you’re then relying on this, what’s in between your ears, and you’re relying on your hands.

[Jaz]
I see as a non-placing dentist, I didn’t even occur to me that you know, you can put in there just like obviously, it’s acrylic and whatnot. So there’s a good chance it might not fit or chance that the measurements are skewed or whatnot. And so it makes sense to me now thinking as a restorative dentist, but you’re right, if that doesn’t fit, then your whole plan is gone. And therefore we need to be able to pivot onto a Plan B or Plan C, which is where I guess you need to have the knowledge and skills beyond just as one way of doing it. So I guess my next question is, what percentage of implants do you place that are flapless? And maybe because you’re different, I don’t know, what percentage of implants do you think are amenable to flapless technique?

[Pav]
I’d say about 10%, which is quite low. And the reason for that is quite simple. There’s really good data nowadays, that you need a good band of keratinized tissue around implants. But in addition to the good band of keratinized tissue, it needs to be about two to two and a half millimeters thick. And in a lot of areas, particularly in the mandible, that isn’t enough soft tissue height. In order to achieve that two to two and a half millimeters, okay, then it goes back to what we were saying a few minutes ago, if you do a tissue punch, whatever was there all of a sudden you’ve gotten rid of. So when you don’t have enough tissue, there are a number of tricks that you can use to increase the thickness of the tissue. But you can’t do that with guided surgery. Now, you won’t have any significant problems with it in the short term. In the short term, it’s going to be fine, because you’re like, Wow, this is easy. What is everybody complaining about? All you do is tissue punch, place the implant and put it in through the guide. That’s it. But what happens Jaz, is over a period of time, let’s say over about, it’s the medium term that you start to develop problems, right? So probably about three, four or five years down the line. That’s when you start to get the early stages of kind of like perio-implantitis and you’re getting it for no other reason, then you don’t have enough soft tissue around it. Now there are-

[Jaz]
By that you mean like a cuff of keratinized tissue?

[Pav]
Cuff of keratinized tissue, yeah. So you need a cuff of keratinized tissue, but it needs to be about two, two and a half millimeters thick. Now there are so many factors involved in this right? It’s down to the restorative material that you use, it’s how you do your osteotomy. How long you wait for it to heal. It’s how you deal with the connection. It’s how your lab workers were processed. It’s how your lab works cleaned. It’s how everything’s fit together, when it comes back from the lab, there’s many, many factors that are involved in this. But a very big factor is good quality and good thickness of soft tissue. And without that good quality and good thickness of soft tissue, which you can’t always achieve with flapless is you’re starting to ice skate uphill, and it’s gonna go south. So when I see people out there whether turn around say ‘Oh, just do everything flapless.’ Is that is not the right approach. Now as you can appreciate when you do an immediate placement quite often that is flapless. But it’s still a different skill set.

[Jaz]
And perhaps just because of the you know, some students or younger dentists, who you know, just new to the term ‘Immediate Placement’. I know for you, it’s something that you’re very familiar with, define immediate.

[Pav]
So immediate is basically take the tooth out and put the implant in straightaway. It’s a little bit more intricate than that because it’s like, oh, it’s within a certain number of days and weeks, but let’s just keep it simple tooth comes out and go straight in case. So there’s a tick box that’s that I’m looking at, in my mind. So once the tooth out, I’m looking at a number of parameters, and I’m going tick, tick, tick, tick, okay, let’s put the implant in. If I’m going tick cross crosses, like, you know, I’m just going to do delayed placement in this. So the term immediate implant is the implant goes into place, the same visit that the tooth comes out. And what’s the benefit of this to the patient? Is a shorter overall treatment time, because then you’re not waiting for the site to heal. The downside to it as a surgeon is it’s much trickier to do because you’ve got less bone to play around with. Your implant positioning needs to be pinpoint perfect. You can’t do that with a guide. Not always anyway.

[Jaz]
And so in those cases, where you do immediate, what percentage of your cases do you think maybe not your cases, but because they do so much varied work, but the average GDP, what percentage of their cases do you think they’re able to do it as an immediate technique?

[Pav]
So the immediate technique is not actually an easy technique to do. It’s quite advanced. So I always say to the people that I’m mentoring people that I’m teaching, is just start off, taking teeth out, wait for it to heal, and then put it in. As your skill start to expand, then you start to do immediate implants, because what you’re going to notice, soon as you start immediate implants, your failure rate is going to spike, because you’re not used to doing it. But like everything persists. This is something we’ve spoken about before building muscle memory, okay? Is you persist with it, keep learning, it’s a new technique, and eventually your failure rate will start to come down, your success rate will go up. So how many cases do I think the average GDP could probably do immediate placements? Probably about 40%-50%.

[Jaz]
Oh, wow. So once they’re built in, and once they got their first few dozen cases under their belt, and they’re waiting for the correct healing, and follow the protocols that are a bit more basic, and then they start pushing their boundaries a bit. And then eventually, once you have a lot more experience, you think about 40% of implant techniques are probably suitable or meet the criteria for immediate placement. Fascinating.

[Pav]
Yeah, absolutely. So I mean, my immediate placement is much, much higher, I probably push to about 90%. But then I know how to deal with cases where, you know, the textbook, say, ‘Oh, it’s not suitable for an immediate placement.But I know techniques where you can really quite predictably do an immediate placement. Do you always get it right? No, that’s the nature of what we do. But that’s, that’s true in every single field. But, again, again, it comes back to just a stepwise progression in your skill set and your career and your understanding and your knowledge. You know, we all started as novices, you know, there was one point in my career, I was just like, ‘I am never going to place an implant in my life. I hate surgery.’ And here I am, my day doesn’t start until I cut somebody open and they start bleeding. So it’s been a fantastic journey for me.

[Jaz]
Yeah, I always knew you when I was like a dental student, I was like early years and you were like the occlusion restoratives, TMD splint guy, and I’ve seen you, you know, you did the masters. And you’ve been on all these courses around the world. I’ve seen you, I’ve been following your progress. And now the volume of implants you’re doing it’s just been really lean in, gone in, as we discussed in that episode about finding your niche and how you really went all in on it. And then hats off to you and lots of admiration for that. So I think any is a great example to anyone who really wants to commit to one field. But let’s say a young dentist wants to, as we do at some stage we have to then consider, is implant dentistry for me? And we realized that UK undergraduates, you can barely place a crown yet, let alone think about implants. So once you’ve got your basics, your fundamentals, where does the basics of surgery come into it Pav you think?Because I now, I’m happy to raise a flap. Yeah, my flaps aren’t brilliant compared to an oral surgeon. But I’m pro GDP. They’re pretty good, I think. And I can section elevate, I’m very comfortable that I’m happy to even post videos of that which I do on YouTube. So I don’t worry about that. I am now in a position where if I wanted to implant the surgical bit doesn’t worry me and scare me like it did maybe four years ago. So if you’re that young dentist who is considering implants, what advice would you give them? Would you say go down the path of going oral surgery course first, learn how to take out teeth, learn to raise flaps, lift periosteum suturing and then go and implant course? Or go on the implant course where you might then learn those surgical skills as well?

[Pav]
So the answer to that is, is either all you can do either or, probably the easiest way to do it is to get some surgical experience first. But I know plenty of people who have gotten into implants and they’ve just learned the surgery as they’re going along. Here’s the key. Make sure you have a damn good mentor to show you how to do it properly. Okay, so unfortunately. I have a couple of people that I was mentoring and I stopped mentoring them because they weren’t following instruction. Right. And I was saying to him that this is also what we do in implantology. Whilst the core skills are the same. how you execute it can be slightly different depending on the case. So Periodontal Surgery is not the same as implant surgery is not the same as oral surgery. Although the basic tools may be the same because the old design outcomes are different, right? So if you’re executing treatment based upon what your desired outcome is, so why I always say is that look, if you want to get into implants, don’t let anything stop you. But understand it’s not you do a quick course. And then that’s it, you can do everything. So right, here’s a mistake that I made when I was younger, right? Is when I did my first implant course. And this is one where you go for one day a month for 12 months, right? Is the guy who’s teaching me used to do a lot of all-on-four. And what I used to do is I used to go to his practice, I used to sedate his patients, because I wanted to watch do all-on-four. Because as you’re learning implants, you think, ‘Wow, this is the sexy stuff, this-‘

[Jaz]
The pinnacle.

[Pav]
This is the pinnacle, then you start doing all-on-four, you realize it’s not the pinnacle, even remotely. And not only that, but it’s not as easy with what it looks like as well. There are some people out there who make it look easy, right? And this is the mistake, my third solo implant as a case by myself without a mentor, I decided to do upper and lower all-on-four. Because I’ve seen it 15-20 times I was like, ‘That looks easy.’

[Jaz]
Can I just point out to everyone who doesn’t have, I know Pav having a little bit better than someone who might be listening. And I know that perhaps the kind of guy who in his first year of dental school, he was like, you know, did a fullmouth rehab, right? And he you know, I know your story. So like Pav is really good at you know, he’s a massive geek, huge amount of knowledge. And he is not afraid to implement. So that doesn’t surprise me one bit.

[Pav]
And the deal that I came up to with the patient, because I said to the patient, I said, ‘Look, I’ve done an implant course, I haven’t placed many implants.’ But she because she couldn’t afford the treatment. And I said to her, ‘I’ll do the treatment cost for you, which was 7000 pounds.’ Now the treatment, the treatments supposed to cost 36,000 pounds. So for her, it was insane discount. So I did the treatment, and it went wrong. And I didn’t know how to fix the case. And I had to then ask a mate of mine to come in and fix it. And he was like, fine, I don’t mind doing it is gonna cost you 32,000 pounds. So I had to pay that out of my own pocket to fix.

[Jaz]
Wow. You did right by the patient. And I admire and respect you for doing that. Because you have to. When that kind of happens, but then the lesson you learned there was- you need that. Yeah, you need that mentorship for those educators, right?

[Pav]
Yeah. So and this goes back to what I was saying is with the right mentor, and with the right person just guiding you, they should be able to actually make the process really easy. Because to be honest, is if you’ve got let’s say, let’s say an upper five, or an upper six and upper first molar in a healed site where there’s plenty of bone, right, is in those cases that they’re in the ideal cases, they’re out of the smile line, there’s normally plenty of bone is it’s really easy in those cases to teach implants. Because it just like, right, we’ll show you how to do this. And what happens is four or five cases in you start to pick up the nuances of it like how to hold the blade, which blades to use, and your instruments are important as well, right? A lot of people are using the wrong instruments. And if they’re using wrong instruments, you know, I had a mentoring with with a gentleman, I did virtual mentoring with a gentleman from the States. And he was having a lot of problems, because his kit was old and worn. And I said to him, ‘First thing you need to do is buy a brand new kit.’ They bought a brand new kit. I told him exactly what to get half of his problems went away just with decent instruments. All of these things play a factor. All of these things play a role, but you don’t understand it until somebody shows you.

[Jaz]
Yeah, yeah, absolutely. So in that vein of how do you find that person to show you, so the question is, where can you find impart mentorship? Now I do want to talk about the cool plans that you have. And I’m very excited to read about that. And I want to learn about that. But and then that’s something I know he’s gonna be having an international reach and stuff. But if you talk generically, how do you identify a mentor in implant world? And then please tell us about your mentorship services, because I know that they’re very prominent, like you said, you teach that guy in America, but I know you’ve got really grand plans as well.

[Pav]
So firstly, what I always say is that the people that I mentor I’m very picky and choosey with regards to who I mentor. So I’m not I don’t get on well with people who kind of like want a cookbook approach. I like people who think and want to be challenged and are prepared to put in the work, because that’s exactly how I was when I was younger. And I think that you can’t really teach this type of stuff if you’re looking for a cookbook approach. Because if you look at any one single scenario, there’s probably seven different ways to do it. So you need to think well, if I do it this way, what can potentially happen and then if that happens, how do I fix it? So I only really mentor very select people who think. So my mentoring works in a number of ways, either people bring their patients to see me, or for a day, right, I will go to their practice, but it’s easier for them to bring their patients to me, because for me to get a day in my diary is booking months ahead. But-

[Jaz]
Those are the most common ways because I know a few of my colleagues who’ve gone down the implant path, and then I’m very well, but in the early days, from memory, they pretty much made not much money on the first few cases because all that money was going to mentor, but the experience they were getting was worth it. Because then five years later, they can do those cases and much more complex with the experience and knowledge that they gained, right?

[Pav]
So what ends up happening is you pay to learn in one fashion or another. This is something you said before, right, is you either pay your mentor to show you how to do it. And when you do it that way, you’ll avoid most of the pitfalls, okay? Or you don’t pay your mentor, you have things go wrong. And then you’ve got to pay out of your own pocket. Of those two scenarios, one leads to a happy patient and another one leads to an unhappy patient and having to pay out of your own pocket for an unhappy patient. It’s really not worth it. And the issue is as well, Jaz is there’s a lot of times, people want you to think it’s easy, and it’s cheap getting into implants. It’s not like everything. It’s a journey, right? You’re not going to do a two day course on endo, and be as good as what a specialist is, you’re not going to do a six day certificate in perio and be able to do what a periodontist can, right. But if you put, but nobody was born with these skills, it’s all learned. It’s all trained. It’s all mentored. So if you’re prepared to put in the work, if you’re prepared to to execute the steps properly, everything can be taught absolutely, everything can be taught. And then going back to what we said before is a lot of dentists is it’s just a matter of approaching people for mentorship, you know, is unfortunately there’s a lot of people who don’t want to. It’s just like, No, and then there’s other people like yeah, fantastic calm. And sometimes the best way to start the mentoring is start the restorative process first. And for a busy implant practice. They love it when you want to restore. Because as an implant surgeon, I do the restorative as well. But I’d rather not could see-

[Jaz]
I hear that all the time from surgeons.

[Pav]
Yeah, it’s part and parcel. Do it really quite happily. But it’d be better if I was just placing. And so if you went to like your local Implant Center, and you know, approach them, you know, can you train me, can you show me how to do restorations. And then you get proficient at that. And then what happens is, once you understand how to restore, you’ll understand how the surgical feeds into that. And then what you do is you ask them, whether if you do a course they’ll mentor you for some cases as well. It’s just reaching out to enough people, and making sure that you’re happy with the quality of what they’re doing as well. And that’s the issue is, as a novice, it’s hard for you to gauge what’s an appropriate standard. You know-

[Jaz]
I love that tip, you gave that I think anywhere, any dentist listening in the world right now, if you identify the person you probably refer to already. And they probably had the same problem as you having that, you know, they’re so proficient their surgery, and they, they really learn all these techniques to develop their surgery. But then the restorative is like, okay, fine, I’ll do it. But like, I wish there was someone who I could just give this to. So that’s a great stepping stone. The other things that we covered is it’s good to have some basic surgical skills. But if you don’t then find the implant course, or mentorship, which have been the key theme for all the episodes that we covered, but mentorship is what’s going to save you from those expensive mistakes. And I appreciate you sharing your expensive mistake, and how mentorship and perhaps too soon, you started to go solo. So with that in mind, please let us know because I know you’ve got something pretty exciting coming I’d love for you to share with the Protruserati, in terms, of course, a structured course that’s going to have some sort of a graded system and approval from the higher powers in terms of this being you know, I mean, that takes a lot of work what you’re doing, I appreciate that, but to actually make a curriculum huge. I know. Absolutely.

[Pav]
Yeah. So, it’s you know, I’ve taken everything that I’ve learned from my MClinDent in implantology, all of my mistakes, all of the courses that I’ve been on, because you end up with problems in implant dentistry, and you go, ‘Oh, I’ll go on that course. It’ll teach me everything that I need to know to resolve that problem.’ But it won’t teach you everything is you know, it might reduce your problems by 20%. And then you’ve got to go on another course on another course and another course. And I’ve just taken all of that and I’ve put it into a structured program, which I’m actually going to release online. And it’s going to be modular, so there will be a basic module, there’ll be an intermediate module, and then there’ll be a mastery level module as well. And my aim is to take all of my knowledge that I have up here, cut through the marketing BS that there’s a lot, not just in implant dentistry, but across dentistry as a broad, there’s a lot of oh, well, you know, if you use this, it will make everything 1% better. And all of a sudden that 1% is- So I’m cutting through all of that. And I want to give all of my knowledge that I’ve gained over the years in a succinct course as possible. And the reason why this is important for me is it actually goes back to a promise that I made myself from my grandfather, because I was very close to my grandfather as I was growing up. And in his later years, I’d qualified as a dentist. And I mean, he lived into his 90s. But I remember a phone call that he said to me, he asked me, he said, ‘If I come out to see you, can you give me fixed teeth?’ And this was before I was placing implants, I said to him, ‘No, I don’t know how to do that.’ And he went quiet, because he got upset. And then when he spoke, I could hear that the hope had just gone from him. And that’s when he told me something, which even to this day makes me upset, he’s eternal. And essentially, he said, ‘I can’t eat with the family.’ He said, ‘I’ve got to take my food into my room, because I can’t wear my dentures, I take them out and eat by myself.’ He said, ‘I’m so embarrassed about taking my teeth out.’ He said, ‘That’s why I see if you can give me fixed teeth.’ So I never got to help him. But I made a promise that I would help as many people as I possibly can. So for me that promises helping patients directly, but also helping patients indirectly. How do I help patients indirectly? Well, that’s easy. I train other dentists how to do implants as well. But for me, I do that all of in his memory. And I can’t do that by withholding information that’s up here. You know, I can’t do it. Okay, well, we’ll do a little bit of a course. Because, you know, I only want you to do the easy stuff, because I want the referrals, I have to give 100%. So this has been my philosophy when I’ve been building this course, I really, really want to make this an absolutely phenomenal course. And I’m in the process. And like you said, it is not easy. Because there is so much paperwork involved.

[Jaz]
There’s a white tape to get through to get the correct grading for the proper curriculum of the course, behind it, but I mean, for me that the layers of it is great. They’re pursuing letters, but me and you both will agree that the letters is not so much as in terms of the implementation of the knowledge and how you can actually start placing implants, right? Because Pav I’m sure you know, so many dentists who have been on implant courses, and they just placed one or two or just never did, and they just fizzled out. And it’s only maybe someone said about one in eight dentists actually goes and of course, that actually really, you know, flies afterwards and starts placing implants. So what do you think is the secret sauce to make a course like you are, and I’m sure he had been at the very front of your mind to make sure that all the dentists able to implement as much as possible?

[Pav]
So I think the secret sauce is is building real confidence, and making sure that you’re exposed to enough surgery, so that you can actually build that confidence. So for me, a big issue is a lot of the information that’s given in courses is not succinct, it’s a bit wishy washy. And a lot of people come out confused at the end of it, you know, so I’m not saying, please understand, I’m not bashing courses, because the vast majority of them are actually pretty decent, but I’m talking about trying to, you know, I don’t want to be sponsored by any one implant company, because then you know, you because if you’re sponsored by an implant company, you kind of have to be nice to that implant company, right? Whereas I want to, I want to be able to give people the critical thinking, so that I can think to the source, okay, let’s look at this implant system, what’s the pros and cons to it? How could it work? Because, you know Jaz, the vast majority of implants work, but how you execute them is a little bit different and subtle, depending on the implant, if that makes sense. You need to understand the overall principles that if you choose this implant system, you can execute it correctly. If you choose this other implant system, you can still execute it correctly. And that comes from knowledge. And that’s again, that’s the reason why I want to give as much information as what I possibly can in this course, which I’m aiming to get a do call verified, but that’s not an easy process and go through.

[Jaz]
Yeah, and like I said, That’s not as important as it is good that you don’t know it’s not as important as just like you said, given that secret sauce to get people to implement and just as you said, it’s about giving confidence. So if anyone’s interested, how do they learn more about your online sort of modular content?

[Pav]
So the online modular content I’ve written it I’m in the process of recording it. It will probably be ready to release in approximately six months time approximately. It just depends on jumping through hoops with edge and there might be a few tweaks to the course content. What I am doing is because obviously recording a course is not cheap as well. I am for a very, very few people who prepared to sign up sooner rather than later. I’m offering a ridiculous discount on the course. And I’ll message that over to you later Jaz but basically, it’ll be a cheap way to get into implants basically. And the provider is really simple is you pay now, which allows me to record and edit the videos and you just wait a few months for the videos to come out. Because once those videos come out, then there’s not going to be any discounts after that, because I know what I’ve got is going to be good. And so, you know, I’ve taken everything, I’ve sent it to friends who place a lot of implants, and they’ve looked at it and they go, ‘Well, can we do the course?’ I was like, what you’re gonna gain from this? It’s more than what I learned on my master’s degree.

[Jaz]
Is this for like beginners as well, like for beginners?

[Pav]
If you’re a complete novice never placed an implant? Yes, you can do it, the mentoring separate, but it will give you because theories theory, right, you can learn that online, you can learn it from textbooks that I’m going to make it as succinct as possible. I’ve got a number of guests coming on to talk about their niche topics as well. So if you’ve never placed an implant in your life, and you want to start, absolutely. If you’re already placing implants, and you want to up your game, it’ll also be suitable for you. Now, if you’re placing a reasonable number of implants, and you want to start doing more complex grafting, you want to start to get into sinus lifting, you want to do more aesthetic work in the anterior region, it’s going to be for you as well. So this is why I’ve split the course up to be modular. So there’s what I call a gateway module, which is a gateway into implants. There’s an advanced module, and there’s a mastery module as well. So I’ve tried to make it as all encompassing for everybody as I possibly can, respecting the fact that some people are going to be drawn towards some areas as opposed to others.

[Jaz]
Yeah, well, I appreciate that. If anyone is interested, what’s the best way for them to reach out to you to learn more? Because honestly, it’s a bit of a wait until this all happens. But like you said, for those people who are really keen and they love your stuff, and they want to learn, and they know that okay, I want to learn from Pav and if that would make sense to anyone, I suppose to learn from someone, someone is experienced like yourself, which is amazing. But if they’re ready to sort of learn more, how can they reach out to you?

[Pav]
So probably the easiest way to reach out at the moment is through Instagram, send me a direct message. So you can go to either Dr. Pav Khaira, the Dental Implant Podcast, or I’ve also set up the Academy of implant excellence at any one of those three, basically. There is a landing page being built, but again, that’s in the process. So it’s-

[Jaz]
Well I appreciate you sharing that. Yeah.

[Pav]
Yeah, Instagrams probably the easiest way at the moment, yeah.

[Jaz]
Well, that’d be recurring themes of mentorship and not falling into marketing crap. And it’s going flapless because like you said, I learned a few things, you know, about 10% amenable, I also learned that you know, 40% for the general dentist, okay, you could do immediate and there are some intricacies with that. But I like the way that you propose to the young dentist that perhaps even though you could do an immediate in those first few cases, you kind of describe the ideal first few cases and upper molar out of the smile line. So these are really good nuggets to to appreciate. So Pav, thanks so much for coming on and discussing this very interesting topic of flapless implants. I think we’ve now debunked another myth there. So I appreciate your time always my friend and all the best with this huge project. I’ll follow up again with you in about 6-8 months and see how it’s all going but I can see now how much work you have ahead of you but yeah, very exciting because I know this is your passion. This is your real project that you love so much. So I know you’ll do justice to it.

[Pav]
Thank you. Thank you so much.

Jaz’s Outro:
Oh, there we have it guys. If it sounds too good to be true, it probably is. So remember that with implants and with flapless. And anything, anything in dentistry. If it sounds too good to be true, it probably is. So it’s great that you shared themes or mentorship and I appreciate that Pav shared his big mistake, you know, his 32,000 pounds wherever it was the mistake that he made and that really highlights the importance of mentorship when it comes to implants. So if you’d like to learn more reach out with Pav through his Instagram channels. Otherwise, hit the like button, hit subscribe if you enjoyed this episode, and I look forward to making more for you very soon.