Advertise on podcast: The Fixed Podcast

If your full-arch workflow still depends on flexible printed temps, multiple rescans, and lab back-and-forth, you might be fighting problems you accidentally created. We talk through a different model: move to rigid zirconia provisionals fast, keep occlusion even, and let the biology and the data stay stable instead of chasing corrections at stage two. Along the way, we unpack why “the temp is really the final” becomes believable once tissue stops changing and remakes drop from frequent to rare. We get specific about the mechanics: full occlusion even in cantilever cases, the bracing effect of zirconia versus plastic flex, and how a rigid provisional can reduce the need to repeat photogrammetry later because implants are not healing under tension. Then we shift into soft tissue strategy, including the “shoeless” suturing approach, seating the prosthesis with the flap open to confirm no binding, and healing by secondary intention to preserve keratinized gingiva and create a flat, stable tissue shelf under a polished intaglio. On the workflow side, we outline the DeciSplint approach with two quick photogrammetry captures, rapid conversion in RapidArch, and fast printing so suturing and restoration prep happen in parallel. We also cover rapid revision for picky patients so you can sit with them, show limits in real time, and get true buy-in instead of endless redesign loops. We close with what’s next: tighter end-to-end integration, a preview of upcoming guidance for choosing MUAs, and a brief note that some features may be available for evaluation use only while FDA clearance is in process. Subscribe, share this with a full-arch friend, and leave a review with your biggest workflow bottleneck so we can tackle it next.

“AI full-arch designs in 2 to 5 minutes” sounds like hype until you hear the workflow behind it. We sit down with Dr. Naeem Etemadi and Dr. Deep Desai, the founders of RapidArch, to unpack how they’re compressing full-arch conversion steps that many labs quote at 45 to 60 minutes into a process that can run in seconds to a few minutes, depending on the records. If you care about same-day All-on-4, All-on-X predictability, and getting patients out of the chair faster without gambling on fit, this conversation is for you. We start with the real pain point that pushed them toward automation: patients paying tens of thousands of dollars, then showing up for delivery with teeth that are simply off because the handoffs and alignments break down. From there, we get specific about the digital dentistry stack that matters for full-arch implants: exocad, 3D printing, intraoral scanning, CBCT DICOM segmentation, fiducial workflows, and especially photogrammetry. They explain why photogrammetry reduces mid-surgery chaos, how the DeciSplint concept helps “breadcrumb” back to the wax-up, and why cutting steps is often more impactful than chasing new gadgets. We also talk practical implementation. What happens at the consult, what gets captured on surgery day, how revisions can be turned around quickly when the bite is open or canted, and how their roadmap extends into denture workflows for fully edentulous patients. We close with a strong perspective on going to zirconia full-arch finals sooner, including why a well-polished zirconia surface may support healthier-looking tissue outcomes. Subscribe for more on implant dentistry workflows, share this with a colleague who lives in conversion purgatory, and leave a review with one question you want answered next.

The fastest way to lose a case is to treat a consultation like a transaction. We talk through how a simple shift in environment and language can change everything in implant dentistry, from case acceptance to patient trust. Privacy matters more than most practices admit, and we share practical ways to create it even if you don’t have a dedicated consult room, plus why patients open up when the door closes and they feel safe enough to tell the truth about what happened over the years.  We also get tactical about treatment planning and patient communication. We walk through a two-path framework that respects autonomy: one plan that puts out the fire with foundational general dentistry, and another that aims for real long-term oral health through comprehensive care like full arch implants or broader reconstructive options. The distinction between being “disease-free” and being “healthy” lands hard, and it gives you a clear, ethical way to present higher-value care without dictating it.  On the practice management side, we cover how to protect the schedule with a red yellow green consult grading system, why no-shows are an opportunity-cost problem, and how a trained team and treatment coordinator can keep the practice moving without sacrificing the patient experience. Then we dig into what high-translation continuing education looks like, including case selection, post-course mentorship, course tracks from IV sedation to single implants and full arch, and what it takes to responsibly approach advanced procedures like pterygoid implants. We end with the part nobody talks about enough: building a career that includes peace, not just growth. Subscribe, share this with a colleague, and leave a review with the one consult change you’re going to try next.

Full-arch implant dentistry can feel like two jobs at once: delivering precise clinical outcomes while also running a business that swings month to month. We talk through a deceptively simple question that affects everything downstream: should the patient be awake, lightly sedated, or deeply sedated when you’re doing big full-arch work? The answer isn’t about our preference, it’s about nerves, chair time, communication, and protecting occlusion so the final prosthetics start on the right foundation. From there, we zoom out to ownership realities inside a fixed full-arch practice model. When volume dips, is it the economy, marketing performance, or new competitors undercutting price? We share how we think about “levers” without overcorrecting, why small sample sizes can make normal fluctuations look dramatic, and how we try to win on patient trust instead of joining a race to the bottom. A key idea shows up again and again: people choose the team that feels right, and that “match” often beats a $500 discount. We also get practical for clinicians and students: prosthodontics in the 2020s increasingly rewards surgical competence. We break down what skills matter, how to evaluate residencies by talking to current and former residents, and why mentorship accelerates learning more than almost anything else. Finally, we dig into efficiency systems, assistant training, hygiene recall, and the prosthetic complications that actually show up over time, from access hole closure details to rare zirconia failures. If you got value from this, subscribe to The FIXED Podcast, share it with a colleague, and leave a review so more implant dentists can find it. What part of full-arch care feels most unpredictable for you right now?

A patient walks in asking for full arch dental implants, but their teeth are not quite “terminal.” Another patient has one arch that is clearly headed for All On X, while the other could be saved with a full mouth rehabilitation. Those are the moments where implant dentistry stops being a procedure and becomes a decision making framework. We talk with prosthodontist Dr. Ryan Sloan of Smile Now Boise about how a prosthodontist plus surgical GP team expands options without overwhelming patients or compromising ethics.  We get specific about the gray zone between saving teeth and extracting for a fixed hybrid. Ryan shares how he starts with dental fatigue, patient values, and a clear problem list before he ever sells a solution. We also unpack what happens when the dentist and patient disagree, how to honor patient autonomy without abandoning clinical standards, and why the ability to say “we’re not the right practice” can protect everyone involved.  From there, we dive into the technical workflow of combination cases: sequencing an All On X arch against crown-and-bridge FMR, leveraging sedation wisely, coordinating multiple dental labs, and using temporaries as the proving ground for occlusion, vertical changes, and design. Ryan also explains his occlusion priorities and why he prefers milled PMMA temps over printed provisionals for natural teeth right now. If you’re building a more comprehensive implant practice or refining your full mouth treatment planning, this conversation is packed with practical takeaways. Subscribe to the FIXED Podcast, share this with a colleague, and leave a review with the one treatment planning principle you refuse to compromise on.

Your full-arch case can look perfect in CAD and still land in the mouth with a crooked bite and hours of adjustment. We get specific about why that happens and what to change, starting with a simple discipline that pays off fast: retorque multi-unit abutments before phase two photogrammetry and before you commit to the next prosthetic step. When insertion torque is low, we talk through the most underused tool in implant dentistry, waiting longer, so stability drives your timeline instead of your schedule. Then we dig into a stage two records workflow that can dramatically improve accuracy when you move from PMMA to zirconia. The big shift is scanning what stays the same. Instead of trying to align worn provisionals and “garbage” soft tissue landmarks, we remove the prosthesis, clean it, and 360 scan the intaglio as the primary fiducial marker. We pair that with arch scanning, scan caps, and photogrammetry, keeping the intraoral prosthetic scan focused on the bite. The goal is simple: fewer alignment errors, fewer reprints, and a delivery that needs little to no bite adjustment. We also break down a CBCT alignment approach that uses segmented skull data as the fiducial, plus practical details on radiopaque caps, sandblasting shiny markers, and even sedation timing so a stable post-op cone beam happens without chaos. We wrap with gear choices, 3D printing speed versus accuracy, and zirconia design lessons like softening embrasures so “pretty” doesn’t become “broken.” If this helped you rethink your workflow, subscribe, share it with a colleague doing full-arch, and leave a review. What part of your stage two process are you most ready to change?

A full-arch case can look “digital” on paper and still fall apart on the day that matters. We bring on prosthodontist Dr. Tony Pollotto to get brutally specific about what makes All-on-X predictable and what quietly creates chaos, especially when you’re trying to deliver same-day teeth and keep the bite right. From his early years in a high-volume ClearChoice model to launching his own implant and prosthodontic center, Tony shares the operational decisions that separate a smooth surgery day from an exhausting one. We dig into analog versus digital dentistry workflows, why scan-based systems can be great for provisionals yet risky when you push them into finals, and what it really takes to become fluent in Exocad. Tony makes the case that “design” is the hardest problem in full-arch implant dentistry because it sits at the intersection of tissue, phonetics, hygiene, esthetics, implant position, and biomechanics. We also talk AI in dental CAD design, where it’s genuinely useful today, and why knowing what an ideal prosthesis should look like matters more than knowing every click path to build it. You’ll also hear a thoughtful shift toward conservative treatment planning: when a patient wants a double-arch, but the smarter long-term play is a combination case that saves restorable teeth. We wrap with Tony’s current same-day workflow preferences, why he has doubled down on CBCT-based alignment for efficiency, and how he thinks about PMMA, early zirconia, and timing finals around tissue stability. If you’re building a full-arch implant workflow, refining your digital process, or debating in-house design versus outsourcing, this one will sharpen your playbook. Subscribe to The FIXED Podcast, share this with a colleague, and leave a review with the biggest workflow change you’re making this year.

The uncomfortable truth about full-arch implant dentistry is that the hardest moments often have nothing to do with placing implants. They happen when a patient isn’t getting numb, oral conscious sedation starts to feel thin, and you’re working in a state where CRNAs aren’t an option and anesthesiologists are booked out or priced out. We talk candidly about why certain markets (like Reno) can be a different animal and how patient factors like smoking and anxiety meds can change the way local anesthetic behaves.  From there, we get practical. We share a simple anesthesia protocol that can prevent a bad day before it starts: get the patient numb and wait a full ten minutes before you begin. That “boring” pause can improve hemostasis, reduce breakthrough pain, and keep you from chasing anesthesia late with too many carpules and tough decisions like stopping after one arch. We also connect patient comfort to something most clinicians underestimate, team workflow. When assistants understand implants at a fundamental level and can anticipate the next step, your surgery time drops, organization improves, and outcomes get more predictable.  We also zoom out to scaling a busy full-arch clinic: staffing turnover, when an associate actually makes sense, and why restorative troubleshooting can create the majority of downstream problems. Finally, we get real about business transparency and equity, and why clinicians must verify numbers and leadership competence in an industry where clinics can close fast and patients can be left stranded. If you found this helpful, subscribe, share it with a colleague in full-arch, and leave a review with your biggest sedation or staffing challenge.

Teeth don’t get predictable just because you bought better tech, and full-arch dentistry doesn’t get safe just because someone watched a few surgeries online. We’re joined by Dr. Aaron Berger, lead surgeon at Smile Now Reno, to tell the full story of how he went from a specialty-heavy dental school background with limited extraction experience to doing high-volume full arch dental implants with calm, repeatable execution. We talk about the unglamorous skills that make or break All-on-X results: efficient full-mouth extractions, flap control, hemostasis, alveoloplasty, and the removable prosthodontic principles that still run the show when you move into fixed full arch. Aaron shares why the “1% better” mindset matters, how mentorship changes your learning curve, and why mental rehearsal before surgery helps when the case gets messy and time pressure hits. Then we get practical about digital dentistry. Analog-to-digital transitions can be painful, scanners can double-scan, and labs can only work with the data you capture. We walk through VDO records, what to do when a patient forgets their denture, and how to build a workable bite using mush bites, photos, measurements, and multi-unit healing cap captures. Finally, we zoom out to Reno: what a month of 19 arches looks like, how you scale capacity, and how Nevada’s CRNA limitation impacts sedation planning and patient comfort. If you care about full arch implants, digital workflow reliability, and long-term surgical outcomes, hit subscribe, share this with a colleague, and leave a review with the skill you’re working on next.

What if your membrane actually stayed put and your grafts healed the way you planned? We sat down with Dr. Sean Lan to map a practical path from soft tissue basics to hard tissue confidence, focusing on the decisions that make full-arch treatment predictable rather than precarious. We start where results begin: donor thickness and visibility. Sean explains why 3–4 mm palatal tissue unlocks pedicled options, when a free CTG is the better bet, and how loupes transform half‑millimeter judgment calls. On maxillary implants, we compare buccal soft tissue strategies—pedicled wrap to bone vs tack‑on CTG—and share when a large palatal flap after reduction can be repurposed for added volume. Stability threads through everything: quick transosseous anchor points, when to suture to abutments, and how to get tension‑free closure with thoughtful flap advancement. Then we shift to bone. Think “wet sand in a cup” for within‑contour grafts, and why going outside the contour changes physics, risk, and membrane demands. We unpack buckle veneer grafts, sticky bone myths, autogenous techniques like split bone blocks, and realistic membrane choices guided by PASS principles. If you’ve ever fought a floating membrane, you’ll get step‑by‑step tactics: periosteal slings, apical tacking sutures, fixation screws, double‑membrane shortcuts, and using implants or transosseous holes as smart anchor points. Sean also shares a practical cortical plate save—his “poor man’s plate”—to avoid over‑reduction and set up a site that later needs only soft tissue finishing. Mandibles get honest airtime: fewer escape routes, more muscle pull, higher stakes. We talk training that actually helps—Pink Bible, Zucchelli’s volumes, selective live courses—and how to build reps ethically. Zygomatic implants enter as a necessary but rare tool, best learned with supervision and careful indications. We close on subperiosteals in the most atrophic jaws, urging product decisions to follow biology and evidence, not marketing. Sometimes the most patient‑centered answer is a bar overdenture instead of “fixed at all costs.” Subscribe, share with a colleague who wrestles membranes, and leave a review with your favorite stabilization trick—we’ll feature the best ones in a future episode.