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Transforming patients and practices through a seamless digital workflow

June 16, 2022
M. Joe Mehranfar, DMD, MS, talks to Joshua Austin, DMD, MAGD, about technologic innovations for full-arch replacements and other complex dental implant procedures that have changed not only his patients, but his practice.

For M. Joe Mehranfar, DMD, MS, transforming patients’ smiles is perhaps the most rewarding part of his dental implant practice. Owner of Mehranfar Dental Group in Phoenix, Arizona, Dr. Mehranfar has dedicated more than 20 years to advancing dental implant procedures, including complex full-arch reconstruction. He has seen firsthand how important it is for patients to feel confident and comfortable with their own smiles.  

“A full-arch reconstruction can completely change not only a person’s face, but their entire life,” says Dr. Mehranfar. “I’ve especially seen this in the work I do with Phoenix’s veteran and low-income populations.” 

Dr. Mehranfar has been performing dental implants at his private practice as well as through Dental Hearts, the nonprofit implant practice he cofounded to serve patients who otherwise would not be able to afford these procedures. 

“Patients have come to us saying they’re too embarrassed to smile, or that their grandkids are scared of their missing teeth, or they don’t have the confidence to go on job interviews,” he recalls. “Through Dental Hearts, we offer no-fee extractions, bone grafting, sinus lifts, and dental implant surgery, and patients just pay for what goes on top of the implants at a discounted rate. It’s incredibly rewarding to help these heroes turn their lives around and give them back their confidence.” 

Also transforming his practice 

While transforming smiles, Dr. Mehranfar has seen his own practice undergo a transformation as well, propelled by the latest digital technologies. This process started around 2008, when he added his first piece of digital equipment. 

“Around that time, I introduced intraoral scanners to our practice, and have never looked back,” he explains. “Prior to that, we had been using 2D x-rays and stone models to bone-map what we could. Digital technologies have completely transformed the way we diagnose patients and plan treatments.” 

Dr. Mehranfar’s tech stack has evolved over the years and now employs an array of technologic innovations for full-arch replacements and other complex dental implant procedures. 

“We rely on a CBCT scanner, 3D imaging x-ray system for panoramic images, and intraoral sensors, which are all integrated with the manufacturer’s (DEXIS) treatment planning software. We also use a navigated surgery system,” he says. “These tools work together to create a seamless digital workflow from preplanning to surgery to final delivery.” 

Dr. Mehranfar’s embrace of an all-digital All-on-4 workflow is an ongoing journey as technology continues to improve each year. Merging his CBCT and IOS scans, Dr. Mehranfar and his team have the in-house capacity to create well-fitting prostheses for his implant patients, on the spot. 

“We have all the digital technology we need to preplan the surgery, perform the guided procedures, design, and deliver a temporary prosthesis on-site, all on the same day,” he explains. “This has allowed us to be a one-stop shop and keep everything inside our practice. We don’t have to send patients elsewhere.” 

Using an integrated treatment planning software and navigated surgery system, Dr. Mehranfar can virtually plan the implant and then complete the surgery with turn-by-turn 3D guided navigation and a 360-degree view of the drill position. “Without that dynamic guide, there’s no way I can tell if I’m accurate or inaccurate in my positioning,” he says. “With navigated surgery, I can pick a spot and hit that spot 10 out of 10 times.” Along with greater precision, Dr. Mehranfar points out that the guided navigation helps minimize the risk of nerve injury and enhances patient safety. 

Dr. Mehranfar often uses photogrammetry for complex implant surgeries, such as edentulous cases, to evaluate the good registry of the patient’s soft tissues. Photogrammetry is a new measuring technique that takes images from different perspectives to obtain 3D coordinates and identify repeated characteristic points. 

“This technique has really revolutionized my workflow for multi-implant restorations. 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. The benefits of the new and exciting technology not only benefit me but also my patients, eliminating implant impressions and improving comfort with the quality of the fit with the final restoration,” says Dr. Mehranfar. 

His patients have certainly noticed the difference. While they may not understand the value of digital technologies at first, patients quickly come to appreciate having detailed, understandable images of their anatomy to look at right from the chair and being able to leave the appointment wearing a prosthesis. “There’s a wow factor to that,” he says. 

As an early adopter and enthusiastic advocate of the digital workflow, Dr. Mehranfar wants to see other doctors achieve the same success he’s seen in his own practice. To that end, he urges doctors to make the investment in acquiring and learning digital technologies. 

“There’s a bit of a learning curve for intraoral scanners and solutions such as CBCT scanners,” he concedes. “But the benefits these technologies deliver after you adapt to the curve are excellent. After a few cases, using the technology becomes second nature.” 

A key to practices’ survival 

Since the future of implant dentistry seems to be moving toward more digitization, with AI-assisted planning and guided surgeries, Dr. Mehranfar goes as far as to say that embracing digital is key to survival for practices. “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.” 

More than preaching the advantages of digital technologies, Dr. Mehranfar is teaching them. As the chairperson-elect of the implant division of the American Dental Education Association and the clinical director of the Dental/Partner Implant Education Company, he is passionate about sharing knowledge and best practices with the next generation of dentists. 

He recalls the mentors and instructors who helped him become the doctor he is now. “I am where I am today because of others who took the time to teach me, so I’m passing it forward,” he says. “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 forward their careers. We’re helping them treat more patients, better, and that’s good for the population.”

To learn more about Dr. Mehranfar’s private dental implant practice, visit his website. To learn more about his nonprofit dental implant practice, visit Dental Hearts

(DEXIS is a financial supporter of Dental Economics.)

Editor's note: This article appeared in the June 2022 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.

About the Author

Joshua Austin, DDS, MAGD

Joshua Austin, DDS, MAGD, is a graduate and former faculty member of the University of Texas Health Science Center at San Antonio School of Dentistry. Author of Dental Economics’ Pearls for Your Practice column, Dr. Austin lectures nationally on products, dental technology, online reputation management, and social media. He maintains a full-time restorative dentistry private practice in San Antonio, Texas. You may contact Dr. Austin at [email protected].

Updated June 21, 2023

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