Read More - Tatum Surgical Inc.

Volume 3, Issue 2
June, 2010
4500 140th Avenue North, Suite 112 Phone: 888-360-5550
Clearwater, Florida 33762 Fax: 727-531-6005
www.tatumsurgical.com
tatumimplants@verizon.net
The Tatum Times
A personal note from Dr. Tatum...
“As many of you know, in 1975, I developed the Sinus Augmentation procedure. Many said this
"maverick" surgery would not accomplish anything positive and cause great harm to patients.
But after observing results and predictability, I realized that this procedure was going to have a
great impact on the future options and benefits of implant treatment. My goal in dentistry has
been to care for my patients to the best of my ability and to treat them with the respect and
compassion that I would like to receive. My goals are to restore and maintain my patients to
natural contour, comfort, function, esthetics and health. How can we provide this extraordinary
care for each and every one of our patients without our implant field growing and becoming
more educated and aware? For several years, I have felt that a major part of what is currently
being taught and practiced in implantology can be done simpler, safer, more naturally and less
expensive. I call this approach, NIRISAB. (Natural Implant Restoration In Stable Alveolar
Bone) NIRISAB has resulted from a 40 year attempt to restore bone loss, achieve natural
esthetics and have long-term success. Today, I feel that this concept and the techniques it utilizes
can change implant dentistry as we know it. This is a positive and much needed change from the
excessive commercial influence which I feel is promoting entry level education and techniques as
advanced education. I long to see an increase of ethics and integrity return to our implant
field. For those of you who have explored this concept and have sought further education
utilizing the NIRISAB philosophy, I am so proud of you. I urge the remainder of our readers to
realize how this will change your practice for the better and also change the relationships that
you have with your patients. We are teaching NIRISAB in several locations and on several
different levels. I look forward to spending time with each of you hearing your NIRISAB success
stories!”
Inside this issue: Our latest graduates
from the “Journey to
Case
2
Remember” class of
Presentation by -
May 2010. These
Dr. Bernee 5
participants gained over
Dunson
40 hours of NIRISAB
training with Dr. Tatum.
Upcoming Events 5
Our next group will be
joining us the first week
of August. We are only
Users of the 6
three rooms short of
Month
capacity. This is a once
in a lifetime opportunity
and should not be
ADII Update 6
missed.

The Tatum Times
www.tatumsurgical.com
Restorative Dentistry:
Using the NIRISAB Concept
Dr. Bernee Dunson
Restorative Director
Tatum Institute, USA
For more than 50 years, Hilt Tatum Jr. has pioneered the field of Implant Dentistry. Within the past decade he has
entitled his approach to the field “NIRISAB”. NIRISAB is an acronym for ­Natural Implant Restoration in Stable Alveolar
Bone. “NIRISAB” is a philosophy, a concept of how to approach the end goal of restoring the presenting patient to
normal contour, esthetics, speech, and health, regardless of the degree of atrophy, disease, or injury to the
stomatognathic system. Dr. Tatum expresses that he arrived at this name simply because every word both collectively
and independently takes on an important meaning for the field of implant dentistry. “Natural Implant Restoration” is of
obvious importance because the goal for all modern dentists should be to have the final prosthesis appear and function
as natural as possible. Alveolar bone is crucial to success because it possesses the genetic coding to allow for greater
predictability of integration, functional load capacity and long term stability, therefore providing meaning to the latter part
of the NIRISAB name, “Stable Alveolar Bone.” This philosophy or concept includes but is not limited to Sinus Grafting
(lateral wall subantral augmentation), Bone Expansion (Compaction and Manipulation), Soft Tissue Grafting, Bone
Grafting through remote incisions, Vascularized Segmental Osteotomies and Nerve Lateralization.
For the past 17 years I have been a student of Dr. Tatum, Dr. Borgner and others who subscribe to this philosophy to
improve the quality of our patients’ lives. Through the vehicle of the “Tatum Times” we here at Tatum Institute
International -Atlanta and The Atlanta Academy of Reconstructive Dentistry would like to present a series of cases that
utilize “NIRISAB” to predictability serves our patients.
This Case Report:
Pre-Operative Sinus Panorex
Our case for this issue is a familiar
scenario for all restoring dentists.
Our patient is a 53 year old female
who presents with a Kennedy Class
III partial edentulous maxillary arch
(Fig. 1).
She currently has a combination of
a Fixed Prosthesis in her anterior
segment with precision attachments
and a removable prosthetic
replacing her edentulous segments
support by posterior crowns with
mesial rest seats
(Fig. 2).
Her desire is simply to improve her
smile and if possible eliminate her
removable partial denture.
Page 2
Figure 1
(Pre-operative
clinical without
prosthesis)
Figure 2
(Pre-operative
clinical with
prosthesis)

Volume 3, Issue 2
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The approach to this case embodies the NIRISAB
philosophy with a particular embrace to the “Sinus
Grafting “and the “Bone Expansion/Manipulation”
components. Under a surgical aseptic field and via
the use of conscious I.V. sedation and local
anesthesia, a crestal incision along with a Tatum
papilla releasing incision was created on the
patient’s right maxillary arch (Fig 3a).Then following
careful periosteal reflection a window was made into
the maxillary sinus via the use of a #10 round bur
under copious irrigation. This was followed by a
series of specially designed Tatum sinus elevators
used to elevate the schneiderian lining. A collagen
membrane from Salvin Dental and seven grams of
irradiated cortical cancellous particulate bone from
the Rocky Mountain Tissue Bank were placed into
the sinus window (Fig 3b-3c). Closure was
accomplished by a continuous 3-0 vicryl suture.
Figure 3a (Revealing the
window to the sinus cavity)
Figure 3c (7 gms of irradiated
cancellous particulate bone
mixed with patient’s PRP in
Sinus cavity)
Figure 3b (Collagen membrane
placed into the sinus cavity)
Figure 3d (Closure was accomplished
by a continuous 3-0
vicryl suture.)
Following a period of four months, eight (8) endosseous transmucosal Tatum implants were placed. Seven (7) tapered
in the posterior edentulous segments and one specially designed D-2 implant at the severely atrophic (2mm) edentulous
right central incisor via bone expansion (Fig 4-8). Following a six month integration period the case was restored with the
uniquely patented “unipost” prosthetic system with its varying post angles for ease of restorative execution (Fig 9-11).
Figure 4 (Pre-operative image displaying
a narrow atrophic ridge)
Figure 5 (#15 blade is utilized to bisect
the crestal bone to gain access
to the interstitial bone)
Figure 6 (Channel former is inserted
in the osteotomy)
Figure 7 (The osteotomy expansion
is completed to depth with a D-2
bone socket former)
Page 3
Figure 8 (Tatum D-2 implant is lace
with Biogran and patient’s PRP to
provide a barrier against epithelial
migration into the Osteotomy)
Figure 9 (Mirror view: D-2 implant
placed in site #8 to maximize bone to
implant surface area for strength in a
narrow atrophic ridge site)

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Figure 10 (Occlusal view post
implant integration with healing
abutments removed)
Figure 11 (Evaluating the opposing
dentition by using Tatum post guide
try-in. This evaluation will allow the
restored implants to have a nontraumatic
occlusal relationship with
the opposing teeth)
Figure 12 (Selected post components
prepped for final impression)
Figure 13 (Left lateral view: Prepped
post displaying normal contour for
anatomically correct final restorations)
Figure 14 (Right lateral view:
prepped post displaying normal
contour for anatomically correct final
restorations)
Figure 15 (Right lateral view)
Figure 16 (Left lateral view)
Figure 17 (Frontal view: Displaying
the prepared abutments allowing
normal contour for anatomically
correct final restorations)
Figure 18 (Final Image of frontal
view: Displaying proper material
dimensions for strength and
longevity of restorations while
maintain the normal emergence
profile)
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Volume 3, Issue 2
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Kodak 9500
CBCT
Image/
Panorex/
Final
Images
The occlusal scheme was designed to be a mutually-protected implant occlusion. The centric contacts on the implant
restorations were nonexistent in light- centric and present in tight- centric. Lateral excursion provided disclusion of the
implant restorations. Ultimately, the use of NIRISAB philosophy provided a predictable approach to restore this patient to
a state of health, contour, function and esthetics. She has tolerated the course of the procedures well and expressed
extreme pleasure with the restorative outcome.
Natural
Implant
Restoration
In
Stable
Alveolar
Bone
Page 5
Congratulations to the 2009-2010
graduating class of
The Advanced Dental Implant Institute’s
AAID Maxi-course.
Did you know?
We now offer Tatum
analogs and transfers to
allow less chair time for
preparations.
Did you know?
If you refer a dentist
to our
“Implant 101”
course,
you will receive a
Free Implant.
Upcoming Events
Atlanta, Georgia
July 23 - 24, 2010
Implant 101
NIRISAB Concepts:
Dx and Tx planning,
Anatomy, Case Selection,
Osteotomy Preparation,
Implant Placement, Post
Placement, Impressions,
And Lab Considerations.
Atlanta, Georgia
Sept. 10 –11 , 2010
Sinus Manipulation
Bone Expansion
Atlanta, Georgia
Nov. 5-6, 2010
Bone Grafting
Nerve Repositioning
Segmental
Osteotomy

The Tatum Times
Users of the Month
We are pleased to announce our Users of the Month for January, February,
and March 2010. For this accomplishment, these clinicians will receive
4 complimentary implants of their choice.
January
Dr. Norman Peets
Gainesville, GA
March
Dr. Akash Lapsi
Mission Viejo, CA
February
Dr. Thomas Carroll
Galveston, TX
www.tatumsurgical.com
Did you know?
Rocky Mountain Tissue
Bank has developed a great
predictable alternative to
particulate bone grafts...
Cortical/Cancellous
Bone Blocks
Visit us at:
www.tatumsurgical.com
Dr. José Pedroza: Surgical Director of Tatum
Institute, USA and Founder and Director of
The Advanced Dental Implant Institute.
Miriam Montes-Mock: The Advanced Implant
Institute Program Coordinator
The Puerto Rico MaxiCourse is an
excellent experience that I highly
recommend. It has expanded my
surgical skills and improved my ability
to treat complex situations. The course
is distinguished by the practical
surgical orientation. Participants see
many different surgical procedures and
management of complications. Thanks
to the course I feel comfortable doing
bone grafting procedures and posterior
mandibular bone manipulation in my
office that I had not done before. I
appreciate the camaraderie with all
involved in the course."
Dr. Greg Cyra
Minocqua, Wisconsin
Dear Doctors:
It is such a pleasure for me to witness the enthusiasm and sense of
satisfaction of the doctors participating in A Comprehensive Training
Program on Oral Rehabilitation and Implant Dentistry! Just picture the
scene: Dr. Tatum and Dr. Pedroza, absolutely immersed in teaching what
has become their mission; to pass on to other passionate doctors their huge
knowledge and expertise in oral implantology. Not to a crowd, but to you. Not
from the podium, but next to you, while you watch, assist or perform surgery.
Five days every month, for ten months. By the time they complete the
Program, they would have participated in around fifty (50!) surgeries, from
implant placement to soft tissue and sinus grafting, bone manipulation, to
Ramus Frame implants. They also get a robust training on IV Sedation, plus
anatomy, pharmacology, surgical complications, complex case discussions,
lab exercises, among other topics and activities. The students don’t want to
end the training!
Our 2009-2010 program will be concluding this month and we will celebrate
with a Graduation and Awards Ceremony. It will be as highly rewarding for
them as for us, the directors, instructors and coordinator. They should be able
to maintain the close mentorship developed during the Program and keep
bringing their surgical patients to future sessions at no additional cost! Our
mantra is that each of our students should be challenged; again and again,
and according to your own level of expertise, until you reach a higher level
of proficiency. Great clinicians and mentors such as Dr. Tatum and Dr.
Pedroza won’t settle for less.
Our next program begins September 23, 2010. If you are ready for an
extraordinary training program, then this opportunity is for you! Contact me
for more information. Email: miriam.montes59@yahoo.com, or
call 787-642-2708. www.theadii.com
I’ll be more than pleased to assist you!
Best Regards,
Miriam Montes-Mock
Program Coordinator
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