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Whenever I go to Tulsa, there’s one guy I just have to go see, @david.wong.dds

It’s just so hard to say goodbye. But my heart will go on . . .

Shane ❤️ David 😂😂😂

#bromance #myheartwillgoon #tulsalove #route66

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BioHorizons Mastermind. Innovation, new products, and constant improvement. There were so many talented, like-minded, and respectful people that genuinely cared about patients and our practices in a single room together - docs, engineers, and executives. It was an honor to be amongst them, meet many of them in person for the first time, and catch up with others after many years.

Something I greatly appreciate as a business owner is an amazing company culture - that’s something you cannot fake. I’ve experienced these types of meetings many times elsewhere in the past with various companies over the years, and It’s evident that this is something very different in the best way possible. Looking forward to the future!

Oh, and being able to drive a Porsche on the track and seeing what they can do off-road is always a plus too 😁.

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1.5–2 mm from the crest.

That’s how much vertical room the tissue needs before you’re allowed to get aggressive with contour.

Everybody wants to blame 30°, but as you’ve all probably heard before, “biology doesn’t read books.” The number isn’t the issue, it’s the effect it often has - invading space for crestal tissues.

Take a wide emergence angle and give it space above the crest — a longer abutment, or a gradual build to it’s final contour — and statistically, nothing happens. The bone doesn’t care.

Take that exact same angle and drop it on a crest, and you’re looking at 4x the peri-implantitis compared to that same wide angle with height above the crest (Misch et al. 2025).

Same degrees. Two completely different outcomes.

It was never the angle. It was the room.

That’s why it’s important we don’t use the platform of the implant as the reference point. An implant can be placed subcrestal at a varying amount. Using the crest as a fixed reference creates a much more predictable scenario. This was shown by Nam et al. 2025 - the impact of emergence angle was more related to relation to the bone crest vs relation to the implant platform.

That’s why, it was never the angle, it was the ROOM.

Special thank you to our team of clinical faculty who performed the research these findings are based on.
@drjmisch @abureyal.sawsan @danjel.popaj @oba_mand97 @dr.junyingli @dr.muhammad.saleh @homlaywang @ravida_andrea

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Over forty years ago, Carl Misch built the foundation we all stand on today.

In 1984, implant education wasn’t something you could find at every corner, being hosted by anyone that’s ever placed an implant.

There were no institutes, no continuum, no curriculum, no standard to teach from. Carl Misch built one — and then spent the rest of his life sharing his knowledge.

He wrote the textbook that trained a generation. He gave the profession a language it didn’t have before — terms like D1 through D4, implant body, cover screw, implant analog, impression coping, crown-height-space — because of him, clinician anywhere could look at a case and know exactly what they were working with and how to describe it to another dentist.

He taught that the prosthesis leads and the surgery follows, which only sounds obvious now because he made it obvious.

Half of implant dentistry is speaking his language. Most of them don’t know whose it was.

Four decades on, the Misch Implant Institute is still the oldest implant continuum in the world, still carries his name, and still teaches the way he did — faculty standing at the table beside you, not lecturing from a stage. Everything he knew, plus everything we’ve learned since.

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Meet Dr. Muhammad Saleh — our Co-Course Director at the Misch Implant Institute.

Before the papers and the podium, he spent 8 years in private practice. And he’s still in private practice today — operating, alongside everything else.

The rest of the story:
→ Dental degree, general residency, and a dentoalveolar surgery residency in Cairo. → Then he walked away from an established career to start over — implantology diploma in Germany (DGZI), post-doc in Ann Arbor, then Louisville for periodontics: master’s, board certified, Diplomate. → Back to University of Michigan as faculty. → 140+ peer-reviewed publications. 4,000+ citations. Reviewer for the most respected journals in the field of implantology and periodontology.
→ When the AAP and the Academy of Osseointegration set the guidelines on preventing and managing peri-implant disease, he was one of the lead authors — and he wrote the systematic review the panel’s surgical recommendations were built on
→ Same story at the 1st Global Consensus for Clinical Guidelines in Implant Dentistry: he’s on the Working Group 3 consensus report for the edentulous maxilla, and that group’s recommendations rest on two systematic reviews — he led one and co-authored the other.

Today, he’s regarded as one of the world’s greatest experts in the field.

Most courses teach you what the guidelines say. He helped write them.

This isn’t just a clinician operating at the highest level attainable. It’s an educator who can give you the answer to why we do things the way we do them. Not only because he studied the literature, but because he leads the studies that the field is built on today.

Attend any of our courses to learn from Dr. Saleh directly.

5 sessions. 18 CE credits each. Miami and Dallas. Link in bio.

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The beauty of the temporary. Immediate loading of dental implants helps us maintain the natural emergence of the tissue helping our restorative counterparts give their patients beautiful results.

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Some of the most meaningful parts of this career happen outside of the office or surgery center.

Mentoring future clinicians. Sitting in rooms full of people pushing dentistry forward. Exchanging ideas with colleagues who challenge and inspire me. Creating spaces where women in dentistry feel supported, seen, and empowered to lead.

The learning never stops and honestly, that’s one of the things I love most about this field.

Every conference, lecture, conversation, and patient experience makes me a better periodontist for the people who trust me with their care. 🦷

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Why see @drcurryleavitt and me @plaquechyna teach in Vegas? Because you get lectures like this one ☝️ that we can’t give on big stages and huge meetings. We’re way more fun around 25-30 people 😬… FATSAC was so 2024…. In 2026, I’m talking about GERTH.

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Ludwig angina is a rapidly progressing, bilateral cellulitis of the floor of the mouth, involving the submandibular, sublingual, and submentalspaces. It acts as a compartment syndrome, causing “woody” neck induration, superior tongue displacement, and potential airway obstruction by spreading through these interconnected spaces.

Primary Fascial Spaces Involved
🔵Submandibular Space: Located below the mylohyoid muscle, this is the primary site of involvement, surrounding the submandibular gland.
🟢Sublingual Space: Located above the mylohyoid muscle, this space becomes involved, leading to the elevation of the tongue.
🟣Submental Space: Involved in the anterior-inferior spreading of the infection, often arising from mandibular teeth.

Pathways of Spread
The infection primarily spreads via the continuity of these spaces:
↔️Contiguous Spread: The sublingual and submandibular spaces communicate around the posterior border of the mylohyoid muscle, facilitating the rapid spread of infection.
2️⃣Secondary Spaces: In severe cases, the infection can spread further to the parapharyngeal and retropharyngealspaces, as well as the “danger space” leading down into the chest.

The infection is typically caused by odontogenic infections (specifically the second or third molars), which penetrate these spaces because the tooth root lies below the attachment of the mylohyoid muscle.

#headandneckanatomy #medicalillustration #digitalart #oralsurgery #infections

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Last weekend was a blast as my best periodontist friends gathered in Austin for sone fun, friendship, and masterminding. I’m so grateful to be blessed with these gentlemen (I use that term loosely😝) in my life. Off to New Orleans next year. Special thanks to @drcurryleavitt for organizing this and thanks to everyone else for making the time. Love you, bastards.

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This is easily one of the top 5 hardest situations I’ve ever had to treat that only a periodontist would probably appreciate… and of course I took ZERO pictures of the surgery.

The challenges:
1. Implant #10 placed when she was 18 years old. She’s now 37.
2. Teeth shifted/moved/erupted leaving the crown in an apical position
3. Papilla between 9-10 was lost
4. Abutment/crown design is no longer appropriate for the situation
5. Fair amount of bone loss on the distal of #9

Soft tissue graft… New restoration…. Time… Prayer… Check out my baby papilla lol 😝
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Credit to @steffendental for the excellent restorative work. He’s a relatively new addition to @levinsonsullivan BTW. Fantastic team over there 👏👏👏

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Fun case involving a SmartShape healer by @biohorizons for improved soft tissue shaping and smoother digital workflow. Save the date for the next socket management and GBR course this November 6-7 (SIX SEVEN 😝) in Las Vegas with @drcurryleavitt and me. Be there!

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