I have been professionally involved in the use of CT scanning technology since it was introduced to the dental professional by Drs. Stephen Rothman and Melvin Schwarz. I was introduced to the DentaScan technology by Dr. Rothman in 1988. Being one of the earliest adopters of MPR DICOM data was a career turning point in diagnosis and treatment planning for dental implants and later expanded to include maxillofacial assessment. This breakthrough event led to the development of SimPlant surgical planning software in 2000. The SimPlant planning software led to the incorporation of stereolithography to create medical models of maxillary and mandibular bony anatomy and identification of vital structures essential for patient safety. I have been privileged to contribute to the first book on “Dental Application of Computerized Tomography” and editor/author the first book written on guided implant surgery “The Art of Computer Guided Implantology”. Other books, journal papers, domestic and international presentations have occurred over the past 28 years. This technological journey has led to immediate implant placement and interim prosthesis delivery as a single integrated therapeutic delivery system call nSequence.

Unfortunately, this process was not previously integrated into a seamless delivery system. This resulted in stressful reactionary conflicts between surgical delivery of implants and prosthesis fabrication. With the development of the nSequence system which incorporates clinical photos, facial recognition software, bone reduction and surgical guides, interim and final prosthesis fabrication in an efficient the prosthetic outcome drives the surgical planning. This system requires high level of accountable presurgical planning from a prosthodontic perspective. Thanks to the developer Daniel Llop CDT and first publisher and lecturer Dr. Michael Pikos this has become a clinical reality in my private practice.

In an effort to understand the intimate details of the process I was fortunate to study with Drs. Joel Burger, oral surgeon and Ian Aires, prosthodontist. In an intimate setting in their office in San Diego California I was able to gain the confidence and insight necessary to simplify and provide regimented and repeatable results which were largely unimaginable. I learned firsthand how this brilliant system could help me overcome the frustrations and problems I was not able to overcome myself despite the use of surgical guides on hundreds of patients.

Dr. Aires was the mentor who arrived when the student was ready to learn. Ian has been the consummate coach for my practice and staff. He has mentored me and the treating prosthodontist in my first two recent cases. In both patient scenarios he was involved in the case planning with the nSequence team. He provided invaluable insight and suggestions leading to outstanding success. His experience was so important and reassuring that we invited him to extend his expertise to our private office. A reasonable compensation package fee enabled my office team to perform two complex surgical procedures with confidence and efficiency. The first patient required a new maxillary denture (atrophic severely resorbed maxilla) and extraction of #21-29.

The nSequence system allowed fabrication of a coordinated maxillary denture with extraction, bone reduction and immediate mandibular prosthesis delivery. The second patient, advanced periodontitis, extraction of 27 maxillary and mandibular teeth, bone reduction, guided implant placement and interim prostheses delivery under general anesthesia was uneventfully completed. His mentorship and guidance was masterful and empowering. Having such an experienced coach was an asset that motivated and excited our entire team.

Dr. Aires enabled us to acquire the confidence and skill set to provide the most sophisticated seamless surgical-prosthetic integrated delivery system available today. His unique ability to understand and customize mentoring was invaluable. If you want to simplify the learning curve of the nSequence system without frustration and aggravation of trial and error learning, he is the colleague you need as your mentor.

–Alan L. Rosenfeld, DDS, FACD
Diplomate American Board of Periodontology
November 2016