“The real reward is in the patient experience”
Can you tell us about your practice?
I’m the founder and owner of Mehranfar Dental Group based in Phoenix, Arizona. We specialize in cutting-edge implant treatment but have general dentists’ offices across Arizona as well. We perform a high volume of full-arch reconstructions and employ a full gamut of digital technologies to ensure that we deliver the highest possible outcomes for our patients. I’m also a big proponent of education and am honored to serve as the Chairperson-Elect of the implant division of the American Dental Education Association. As the Director of Dental Implant Education at the Brighter Way Institute, I enjoy mentoring residents and conducting live implant training. I’m also the Clinical Director of the Dental/Partner Implant Education Company.
What is the most rewarding aspect of your practice?
For me, the real reward is in the patient experience. I started in general dentistry over 20 years ago but found my true passion for implant dentistry after realizing how transformative these procedures can be. A full-arch reconstruction can completely change not just a person’s smile, but their entire life. I see this in particular in the procedures I perform for veterans and low-income residents through my nonprofit center, Dental Hearts.
Can you tell us more about Dental Hearts?
I cofounded Dental Hearts as a nonprofit implant practice that serves Arizona’s large population of low-income veterans and other underserved individuals, many of whom cannot afford private practice fees. We offer no-fee extractions, bone grafting, sinus lifts, and dental implant surgery; and patients pay for what goes on top of the implants at a discounted rate. Patients have come to us saying that they’re too embarrassed to smile, that their grandkids are scared of their missing teeth, or that they don’t have the confidence to go on job interviews. It’s incredibly rewarding to help these heroes turn their lives around and give them back their smiles.
By teaching other doctors more advanced implant procedures and surgeries, we’re doing more than helping them advance their careers.
What do you enjoy about teaching other doctors?
As pioneers in this field, I feel it’s only right and fair for us to keep the doors open and not to pull up the ladder behind us. By teaching other doctors more advanced implant procedures and surgeries, we’re doing more than helping them advance their careers. We’re helping them treat more patients better, and that’s good for the population. My teaching practice through my Dental/Partner Implant Education Company goes hand-in-hand with my nonprofit Dental Hearts as well. It’s what allows me to offer free dental services and surgeries to this underserved population while teaching doctors to perform these procedures.
Why is it important to teach others what you know?
Before dental school, I completed two master’s degrees. I also had the opportunity to teach nursing students and really enjoyed passing knowledge on to them. I understand firsthand the power of teaching. I am where I am today because of others took the time to teach me. So I’m passing it forward.
What do your colleagues say about your courses?
What I hear most from doctors who participate in my courses is that live training is key for them. Working on actual patients gives them the confidence that they can perform these procedures in their own practices. We know they’re not going to become experts over a few days. But the courses we offer are a part of that journey to becoming better doctors. When they’ve completed the course, they go back to their practices, and they’re comfortable and confident that they can continue that journey.
When do you begin using digital technologies?
I started like most implant dentists with 2D X-rays and stone models to bone-map what we could do. Around 2008, I introduced intraoral scanners into my practice and have never looked back. For full-arch procedures, digital technology is a must. My digital brand of choice is DEXIS™ — the i-CAT™ CBCT scanner, the OP 3D™ imaging X-ray system for panoramic images, the smart DEXIS Titanium intraoral sensors, all integrated with DTX Studio™ treatment planning software, and X-Guide™ by X-Nav for navigated surgery. DEXIS solutions work together to create a seamless digital workflow from preplanning to surgery to final delivery.
What does your digital workflow look like?
I started introducing digital technology into my practice back in 2008 with intraoral scanners. Today my workflow is entirely digital. We start by capturing a CBCT scan with the i-CAT or panoramic image with the OP 3D imaging system and utilize DTX Suite for surgical preplanning. We can then merge images captured with our intraoral scanners inside the DTX Studio Implant for a complete picture and use that to create a prosthetic on the spot. Using photogrammetry as well, we have all the dimensions we need minutes after surgery to make sure patients can leave the same day with a prosthesis that they can comfortably wear.
How has digital technology transformed your practice?
The DEXIS digital technology has turned our world upside down, especially when it comes to full arches. The level of detail in the images we capture is unheard of. Having all the digital technology we need to preplan the surgery, perform the guided procedures, design and deliver temporary prosthesis on-site all on the same day has allowed us to be a one-stop shop and keep everything inside our practice. I don’t have to send patients elsewhere. That’s the true power of DEXIS technology.
How do you ensure the success of your full-arch procedures?
Patient selection is key. You must first assess the patients’ medical state and their readiness for surgery. I look at the CBCT scan from my i-CAT to assess available bone. I’m looking to make sure that the procedure can be done in one sitting, and that the patients can walk out that day with a temporary prosthesis. Positioning is also critical, and that’s where X-Guide and DTX Suite come into play.
How do DTX Suite and X-Guide help you improve outcomes?
Working together, DTX Suite and X-Guide allow me to plan the implant virtually and then with guided surgery, navigate the implant more precisely. With 3D navigation, I get turn-by-turn guidance that results in greater precision. I also get a 360° view of the drill position, and can then apply my 3D treatment plan to the patient. If I’m performing surgery without that dynamic guide or navigation, there’s no way I can tell if I’m accurate or inaccurate in my positioning. With DTX Suite and X-Guide, I can pick a spot and hit that spot 10 out of 10 times. Drilling freehand, you don’t realize how much vibration, movement, and tilt can affect your accuracy. With X-Guide, that’s no longer an issue, and you don’t have to worry about overdrilling. You’re consistently accurate.
How did you become interested in photogrammetry?
I was introduced to photogrammetry by my mentor. I really saw how amazing it is when it was brought into the homeless shelter where I was treating patients. Within seconds, I had collected the data needed to design and create a prosthesis that fit almost perfectly. It blew my mind, and it’s been a key component of my practice ever since.
What do your patients think of your digital technology?
To be honest, when patients first come in, they don’t notice or care whether you’re using the latest digital technology. They just want their teeth fixed. But then once you start showing patients the incredible images that you capture so quickly with the intraoral scanners or i-CAT CBCT scanner right at their side, they will leave with a prosthesis. That’s when it clicks that your practice is something special. There’s a wow factor.
What advice would you give dentists who perform implants?
I would say to definitely invest in the digital technology. It’s worth it. DTX software is robust, but embracing it has made my life easier. There’s a bit of a learning curve for intraoral scanners and the i-CAT CBCT scanner, but the benefits of these products show after you adapt to the curve. Photogrammetry is probably the easiest to learn and use — just point and go, and within 20 seconds all the data is there. With DTX Studio Implant, all you need to do is press a few buttons and print. After a few cases, using the technology becomes second nature. If you’re looking to be competitive, self-sufficient, and economically successful in the full-arch world, then investing in these technologies and capabilities in-house is the way to go. I would add that investing in digital technology, including X-Guide with DTX Studio, can be an effective way to lower your exposure to litigation by avoiding nerve injury and misplacement of the implant.
What is the future direction of implant dentistry?
I’d like to think it’s going the direction our practice has gone with a full embrace of digital technology. I see even more advancements and developments in terms of the digital practice, with AI-assisted planning and guided surgeries. I envision DTX Studio Suite merging data from other emerging digital technologies with fantastic results. It’s very exciting.