Dr. Nicholas Egbert: Managing Complications in Full-Arch Implants

Episode summary

Dr. Nicholas Egbert, a surgically trained board-certified prosthodontist in Salt Lake City, discusses managing complications in full-arch implant dentistry ahead of his Edentulism 2025 session in Barcelona. Because low-cost implants are common locally, over half of his cases are revisions, and he performs many zygomatic and pterygoid implants. He argues that the best way to manage complications is to avoid them through thorough front-end diagnosis spanning systemic health, local bone quality and quantity, and patient factors. He identifies patient compliance and bruxism as the neglected wild cards, noting modern dentistry often treats any patient rather than applying exclusion criteria. He will present a single case in which surgical infections, broken drills, and failed prosthetic components cascaded, largely driven by poor compliance. He stresses that no consensus protocol yet exists for peri-implantitis or ideal implant numbers, and that each patient requires an individualized plan.

Key takeaways

Dr. Nicholas Egbert is a surgically trained, board-certified prosthodontist in Salt Lake City, Utah, whose practice focuses exclusively on implant dentistry.
Over half of Egbert's cases are revisions or re-dos, and he performs a high volume of zygomatic and pterygoid implants.
Egbert argues the best way to manage complications is to avoid them through thorough front-end diagnosis of systemic, local, and patient factors.
Bruxism, clenching, osteoporosis, and smoking were historically treated as contraindications to implant dentistry under stricter Branemark-era exclusion criteria.
Patient compliance is a critical but often-neglected factor; a study found only 31% of patients complied with post-op instructions after simple wisdom tooth removal.
There is still no consensus protocol for treating peri-implantitis and no consensus on the ideal number of implants per arch.
Egbert maintains that each patient requires an individualized implant plan rather than a single optimal number of implants.

What you'll learn

Why thorough front-end diagnosis (systemic, local, and patient factors) prevents most complications
How bruxism, clenching, and comorbidities summate to raise full-arch failure risk
Recognizing critical exclusion criteria and when to decline immediate load or implant therapy
Assessing and improving patient compliance with post-op soft-diet instructions
Why there is still no consensus protocol for peri-implantitis or ideal implant numbers per arch

About the guest