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In this episode of the All In, All On X Podcast, we sit down with Dr. Zack Brown, a dual-degree oral and maxillofacial surgeon, for a real-world conversation on full-arch implant dentistry beyond the highlight reel. From hospital-based surgery (TMJ, orthognathics, trauma, reconstruction) to advanced implant anchorage, Dr. Brown explains how surgical fundamentals—planning, hemostasis, flap management, and vigilance—translate directly into predictable long-term outcomes.
We get into what actually drives failures and complications in full-arch cases, including occlusion, clenching, and the “it’ll buff out” mindset that can turn into serious problems over time. Dr. Brown shares hard-earned lessons from humbling cases, and he offers a clear perspective on when to avoid aggressive treatment, how to choose the right patient, and why expectation setting is often more important than the surgery itself.
The conversation also goes deep on medical risk: thorough histories, hidden comorbidities, A1C/diabetes considerations, airway evaluation, BMI thresholds, and why sedation is often the most dangerous variable in the dental office. Finally, Dr. Brown speaks candidly about lifestyle, burnout prevention, and how prioritizing fitness, mental health, and family supports high performance in a demanding surgical career.
Topics include: All-on-X decision-making, zygomas vs pterygoids vs transnasals, complication management, occlusion strategy, patient selection, medical history/A1C, sedation safety, mentorship, and continuous learning.
By Adam Hogan5
88 ratings
In this episode of the All In, All On X Podcast, we sit down with Dr. Zack Brown, a dual-degree oral and maxillofacial surgeon, for a real-world conversation on full-arch implant dentistry beyond the highlight reel. From hospital-based surgery (TMJ, orthognathics, trauma, reconstruction) to advanced implant anchorage, Dr. Brown explains how surgical fundamentals—planning, hemostasis, flap management, and vigilance—translate directly into predictable long-term outcomes.
We get into what actually drives failures and complications in full-arch cases, including occlusion, clenching, and the “it’ll buff out” mindset that can turn into serious problems over time. Dr. Brown shares hard-earned lessons from humbling cases, and he offers a clear perspective on when to avoid aggressive treatment, how to choose the right patient, and why expectation setting is often more important than the surgery itself.
The conversation also goes deep on medical risk: thorough histories, hidden comorbidities, A1C/diabetes considerations, airway evaluation, BMI thresholds, and why sedation is often the most dangerous variable in the dental office. Finally, Dr. Brown speaks candidly about lifestyle, burnout prevention, and how prioritizing fitness, mental health, and family supports high performance in a demanding surgical career.
Topics include: All-on-X decision-making, zygomas vs pterygoids vs transnasals, complication management, occlusion strategy, patient selection, medical history/A1C, sedation safety, mentorship, and continuous learning.

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