The District, Nashville

 AAOMS Conference

On Saturday, April 18, 2015, we attended the AAOMS conference in Nashville titled “The X Factor” presented by Dave Weber of Atlanta, GA.  The X Factor is about setting your practice apart.  It is an exercise in discovering the individual goals, temperaments and behaviors of all who contribute to the practice and how to negotiate these complexities while achieving individual and practice objectives.

Lowes Vanderbilt Hotel, Nashville

Dave sums up his presentation on his website like this:  “Participants will learn the skills and attitudes that all successful people and leaders strive to master in order to positively impact the world around them.”

Dave refers to himself as a Chihuahua on caffeine – small but energetic.  He is a passionate speaker who uses humor, storytelling and personal experience to engage his audience, which included oral surgeons and practice staff.

Dave challenged us to think, listen, role play, journal ideas and examine our own leadership style at work.  He balanced these challenges by being a source of comical distraction with his on stage antics.

Of course, all this good stuff can be applied to our self, our relationships and our family.

On the lighter side, the beautiful Lowes Vanderbilt Hotel, attentive southern hospitality, historic Nashville sites and the “district” (party zone) are all worth revisiting.

And as we are in the business of caring for people, being reminded how we can positively impact the world around us was a great way to spend our weekend!


Yesterday I tried out Navident for the first time. I came by this system as a result of attempting to install a dental implant in a very challenging location – the cuspid site in the right side of the mandible. The original treatment plan was to restore both the cuspid and 1st premolar sites with 2 small diameter dental implants however the space in the patient’s arch was very limiting and due to the inclination of the patient’s lateral incisor which was limited by the path of insertion, placing an implant in the intended ideal location proved to be very difficult. I had initially attempted installing the implant using a CT guided stent with Simplant software however, when I stated preparing the osteotomy site, I found that the stent’s distance from the ridge even with the sleevesDoctor using Navident system

located within the stent was still a source of error. The implant placement was still inaccurate and I removed the implant.

Navident has been used in Medicine as a navigation tool primarily in Neurosurgery to aid in accessing difficult to reach intracranial tumors. Approximately, 4 years ago, I heard about its initial use for dental implant application. Its strength lies in guiding dental implant placement through the use of stationary or ‘fiduciary’ points, which act to help create a “GPS” landmark system of the intended implant site.  Prior to treatment, the patient undergoes a CT scan with a special metal guide covered in putty. Then, once the CBCT scan has been captured, a sensor is clipped onto the guide, which remains in the patient’s mouth for the duration of the procedure. Using an implant hand piece with a special sensor attachment placed on its head, the implant osteotomy site is “guided” into its exact position using this “GPS” system. The depth, angulation in 3 dimensions of space – X, Y, and Z axes are all clearly viewed on a monitor while the implant site is being prepared in real time on the patient’s CT scan. The surgeon makes corrections to the implant drill angulation, depth and even implant location all while viewing the surgical procedure in real time on the monitor.

This system’s appeal was to be able to successfully install an implant in a site with limited access with greater accuracy than that achieved by using any stent. The Navident system proved to be very capable and achieved the goal set out. Like any new technology, there is a learning curve to overcome.  More importantly though, is being able to determine the ‘best fit’ of each technological advancement in terms of its place in the surgical armamentarium. My next step will be to try this system for larger applications such as an edentulous quadrant and then move on to a fully edentulous arch. I’ll keep you posted on the progress.