On the Mic with MAP Podcast: Mapping the Way to Predictable Implant Dentistry

Peri-implantitis is one of the fastest-growing complications in implant dentistry—and one of the most misunderstood.In this episode, Dr. Michael A. Pikos welcomes internationally recognized researcher Dr. George Kotsakis for a powerful discussion on the evidence, misconceptions, and future of peri-implant disease prevention and treatment.From diagnosis and risk factors to implant surface decontamination, prosthetic design, surgical intervention, and emerging host modulation therapies, this conversation delivers practical insight every implant clinician needs now.If you place implants, restore implants, or maintain implant patients—this episode is required listening.00:00 — Introduction to Episode 6 & Guest Introduction00:20 — Dr. George Kotsakis Background: Greece to U.S. Dentistry Journey03:22 — Why Curiosity Led Him into Peri-Implantitis Research05:10 — University of Washington, Texas, and Rutgers Academic Career10:49 — Why Peri-Implantitis Is Now a Clinical Reality12:27 — Modern Evidence-Based Prevention & Diagnostic Frameworks14:42 — The Biggest Modifiable Risk Factors Clinicians Overlook15:23 — Honest Patient Communication & Treatment Reliability17:58 — When Is It Better to Remove the Implant?20:18 — “Less Is More” Around Implant Surface Treatment22:05 — Why Chlorhexidine May Reduce Bone Regeneration23:01 — Lasers in Peri-Implantitis Therapy: Promise vs Reality25:23 — Prosthetic Design & Emergence Profile as a Risk Factor29:05 — Full Arch Bone/Soft Tissue Considerations Often Ignored34:01 — Future of Peri-Implantitis Treatment & Host Modulation36:40 — Closing Thoughts🎧 Listen on Spotify, Apple Podcasts, or watch on YouTube🔗 Explore courses at PikosInstitute.comConnect with us on Social Media: Facebook: https://www.facebook.com/pikosinstituteInstagram: https://www.instagram.com/pikosinstitute/LinkedIn: https://www.linkedin.com/company/pikos-institute/Twitter/X: ⁠https://x.com/PikosInstituteSpotify: https://open.spotify.com/episode/5JmGSwM7eOrOpAKVFY8F0O?si=Nt5MluomQBeCthhRU79zyAApple Podcasts: https://podcasters.spotify.com/pod/show/michael-a-pikosYouTube: https://youtu.be/jeQjIM81jdw

In Episode 5 of On the Mic with MAP, Dr. Michael A. Pikos dives deep into remote anchorage solutions for full arch implant therapy—without relying on zygomatic implants.Following the overwhelming response to Episode 1 on zygomatic implants, this episode explores alternative surgical strategies for treating the atrophic maxilla, including:✅ Pterygoid implants✅ Palatal approach implants✅ Paranasal implants✅ Trans-sinus protocolsDr. Pikos breaks down:When and why to use non-zygomatic approachesHow pterygoid implants eliminate distal cantileverThe role of cortical anchorage in full arch stabilityCommon complications and how to avoid themWhy restorative understanding is critical for surgical successIf you're looking to expand your full-arch capabilities and reduce reliance on zygomatic implants, this episode provides clinical insight, real-world application, and surgical strategy.00:00 – 00:56IntroductionEpisode overviewRecap of zygomatic implant discussion00:56 – 01:49Why this episode mattersDemand for non-zygomatic solutionsImportance of complications in learning01:49 – 02:21Overview of Remote Anchorage OptionsPterygoidPalatalParanasalTrans-sinus02:21 – 05:05Pterygoid Implants Deep DiveEliminates distal cantileverReduces need for zygomasIdeal for atrophic maxilla05:05 – 06:25Clinical AdvantagesEfficiencyReduced morbidityVersatility in revision cases06:25 – 07:39Technical ConsiderationsLearning curveBlind procedureGuided vs freehand07:39 – 08:54Palatal ApproachGame-changing techniqueStrong synergy with pterygoid implants08:54 – 10:02Paranasal + Trans-Sinus ApproachesCortical anchorage principlesExpanding treatment possibilities10:02 – 11:47Restorative IntegrationImportance of surgical-restorative communicationFull-arch workflow considerations11:47 – 14:58Complications OverviewPterygoid risksAnatomy challengesImportance of CBCT + planning14:58 – 16:44Palatal + Paranasal ComplicationsLoss of torqueTrajectory issuesAnchorage failures16:44 – 17:58Key TakeawayFirst drill (pilot bur) is criticalProprioceptive feedback matters17:58 – 20:30Event Promotion + ClosingFull Arch Complications SummitMultidisciplinary approachLegal + anesthesia considerations

In this episode of On the Mic with MAP: Mapping the Way to Predictable Implant Dentistry, Dr. Michael A. Pikos sits down with Dr. Hussein Basma to discuss:✅ Dual specialty training in periodontics and prosthodontics✅ The biggest causes of implant complications✅ Immediate vs delayed implant placement decision-making✅ Soft tissue management in the esthetic zone✅ 3D implant positioning and emergence profile✅ How photography and video improve clinical outcomes✅ The importance of evidence-based, clinically relevant protocolsThis episode is essential for clinicians looking to improve predictability, esthetics, and long-term implant success.🎧 Listen on Spotify, Apple Podcasts, or watch on YouTube🔗 Explore courses at PikosInstitute.comConnect with us on Social Media: Facebook: https://www.facebook.com/pikosinstituteInstagram: https://www.instagram.com/pikosinstitute/LinkedIn: https://www.linkedin.com/company/pikos-institute/Twitter/X: ⁠https://x.com/PikosInstituteSpotify: https://open.spotify.com/episode/5JmGSwM7eOrOpAKVFY8F0O?si=Nt5MluomQBeCthhRU79zyAApple Podcasts: https://podcasters.spotify.com/pod/show/michael-a-pikosYouTube: https://youtu.be/jeQjIM81jdwA Perio-Prosth Approach to Dental Implants with Dr. Hussein Basma https://www.pikosinstitute.com/hard-soft-tissue-gbr-courses/mastering-implants-in-the-esthetic-zone00:00–01:10 — Introduction• Dr. Michael A. Pikos introduces Dr. Hussein Basma• Sets up his unique dual specialty background01:10–03:00 — Prosthodontic Training (Lebanon)• Full-mouth rehab, implants, removable + fixed• Early exposure to comprehensive implant care03:00–04:30 — Periodontics Residency (UAB)• ~400 implants placed during residency• Extensive experience in bone + soft tissue grafting04:30–05:30 — First Exposure to Pikos Institute• Sinus grafting course experience• “Changed the way I look at complications”05:30–07:30 — Dual Training Advantage• Perio + Prostho synergy• Rare combination → full-scope clinician07:30–09:00 — Photography & Education• Importance of documentation• 4K video + photography as teaching tools• Key insight: reviewing complications visually09:00–12:00 — Esthetic Zone Implant Course (A–Z)• Immediate vs delayed decision-making• Emergence profile + prosthetic planning• Major causes of complications:Poor 3D positioningSoft tissue deficiencies12:00–13:30 — Course Success + Demand• Sold-out trajectory• High attendee feedback13:30–16:30 — Education Philosophy (Pikos Standard)• Teaching the “WHY” vs just technique• Evidence-based + clinically relevant• “Monday morning implementation” mindset16:30–20:30 — What Makes Great CE Valuable• Implementation > attendance• Avoiding the “learn and do nothing” trap20:30–23:00 — Social Media & Continuous Learning• Using Instagram the right way• Collaboration > imitation• Evidence-based validation23:00–26:30 — Role in Pikos Institute Programs• Core curriculum + full-arch training• Faculty impact and mentorship26:30–32:00 — Pikos Symposium Discussion• Longer lecture format (90+ mins)• Depth > surface-level education• Structured Q&A = real learning

In Episode 3 of On the Mic with MAP, Dr. Michael A. Pikos explores one of the most critical—and often overlooked—topics in implant dentistry:Full Arch Implant Therapy Complications.Drawing on decades of clinical experience, Dr. Pikos breaks down:Why complications are inevitable in full-arch casesThe critical role of bone and soft tissue graftingThe truth behind “graftless” solutionsHow proper maintenance and follow-up prevent long-term failureWhy prosthesis removal is essential for diagnosisThis episode is essential for any clinician looking to improve predictability and long-term success in implant dentistry.00:00 – IntroductionWelcome + overview of full arch complications00:30 – Why complications are inevitableExperience-based perspective + importance of prevention01:00 – The real issue: Bone & soft tissueThe “elephant in the room”02:00 – The myth of “graftless” solutionsWhy this mindset leads to failure03:15 – Clinical scenario: Thin maxilla caseImplant translucency + risk factors04:30 – Why these cases fail over timeLong-term consequences of under-treatment05:00 – Veneer grafting approach70/30 graft protocol + membrane strategy06:15 – Additional hard tissue concernsPeriodontal defects + trans-sinus cases06:45 – Soft tissue complications (mandible focus)Lack of attached tissue risks07:15 – Connective tissue grafting solutionsAutogenous vs ADM (AlloDerm)08:45 – Key technique: Managing graft relapsePlanning for 50% shrinkage10:00 – Rethinking implant foundationsHard + soft tissue as standard of care11:20 – The importance of follow-upWhy most clinicians miss complications12:00 – Maintenance protocols that work3, 6, 12-month intervals13:00 – Why you must remove the prosthesisHidden complications revealed14:30 – Disagreeing with current guidelinesWhy radiographs alone are not enough15:30 – Additional benefit: Cancer screeningCritical diagnostic opportunity16:00 – Final takeawaysPrevention, maintenance, accountability17:00 – Event invitationFull Arch Complications Symposium (Orlando)

In this episode, Dr. Michael A. Pikos and Dr. Safa Tahmasebi discuss the philosophy and execution of full-arch implant reconstruction through an evidence-based lens. Recorded during a live course at the Pikos Institute, this conversation explores the integration of surgical and restorative principles, evolving techniques, and the importance of structured education in achieving predictable outcomes.Key Topics: Evidence-based dentistry is the foundation of predictable implant outcomesFull-arch success depends on integration of surgery, prosthetics, and biologyHybrid workflows are becoming the new clinical standardEducation and continuous learning are essential for staying at the forefront00:00 – Introduction & Course OverviewDay 3 of the full-arch programParticipant feedback and course structure 01:00 – Building the Foundation: The “Why”Importance of science over “how-to” trainingAvoiding procedural-only education 02:30 – All-on-XYZ Concept ExplainedBeyond implant countRole of bone and soft tissue in long-term success 04:00 – Hands-On Training & Clinical RelevanceRealistic patient-based modelsBridging theory to real-world execution 05:30 – Occlusion-Driven Implant PlanningProsthetic-first approachImplant positioning guided by restorative outcomes 06:30 – Digital vs. Analog WorkflowsHybrid workflow approachIncorporating photogrammetry and evolving technology 07:30 – The 7-Level Education ContinuumStructured progression from beginner to advanced cases 08:30 – The Shift Away from Zygomatic ImplantsWhen they are appropriateRise of alternative anchorage solutions 10:30 – Managing Complex Maxillary & Mandibular CasesLimitations of the mandibleIntroduction to subperiosteal implants 12:30 – The Future of Implant Education & InnovationDigital advancementsContinuous evolution of techniques Connect with us on Social Media: Facebook: https://www.facebook.com/pikosinstituteInstagram: https://www.instagram.com/pikosinstitute/LinkedIn: https://www.linkedin.com/company/pikos-institute/Twitter/X: ⁠https://x.com/PikosInstituteSpotify: https://open.spotify.com/episode/5JmGSwM7eOrOpAKVFY8F0O?si=Nt5MluomQBeCthhRU79zyAApple Podcasts: https://podcasters.spotify.com/pod/show/michael-a-pikosYouTube: https://youtu.be/jeQjIM81jdw

In this inaugural episode of "On the Mic" with MAP: Mapping the Way to Predictable Implant Dentistry, Dr. Michael A. Pikos explores the evolving role of zygomatic implants in full-arch reconstruction. Drawing on decades of experience, he discusses clinical indications, complications, and modern alternatives that can reduce the need for zygomatic implants.Key Topics:The real indications for zygomatic implantsWhy they may be overusedThe “dreaded triad” of complicationsRemote anchorage solutionsPatient-first treatment philosophyTraining pathways for cliniciansYou can watch the video version of this podcast on the Pikos Institute YouTube channel at: https://youtu.be/OQ_YzrUeW0cConnect with us on Social Media: Facebook: https://www.facebook.com/pikosinstituteInstagram: https://www.instagram.com/pikosinstitute/LinkedIn: https://www.linkedin.com/company/pikos-institute/Twitter/X: https://x.com/PikosInstitute