Peri-implantitis is one of the fastest-growing complications in implant dentistry—and one of the most misunderstood.

In this episode, Dr. Michael A. Pikos welcomes internationally recognized researcher Dr. George Kotsakis for a powerful discussion on the evidence, misconceptions, and future of peri-implant disease prevention and treatment.

From diagnosis and risk factors to implant surface decontamination, prosthetic design, surgical intervention, and emerging host modulation therapies, this conversation delivers practical insight every implant clinician needs now.

If you place implants, restore implants, or maintain implant patients—this episode is required listening.

00:00 — Introduction to Episode 6 & Guest Introduction
00:20 — Dr. George Kotsakis Background: Greece to U.S. Dentistry Journey
03:22 — Why Curiosity Led Him into Peri-Implantitis Research
05:10 — University of Washington, Texas, and Rutgers Academic Career
10:49 — Why Peri-Implantitis Is Now a Clinical Reality
12:27 — Modern Evidence-Based Prevention & Diagnostic Frameworks
14:42 — The Biggest Modifiable Risk Factors Clinicians Overlook
15:23 — Honest Patient Communication & Treatment Reliability
17:58 — When Is It Better to Remove the Implant?
20:18 — “Less Is More” Around Implant Surface Treatment
22:05 — Why Chlorhexidine May Reduce Bone Regeneration
23:01 — Lasers in Peri-Implantitis Therapy: Promise vs Reality
25:23 — Prosthetic Design & Emergence Profile as a Risk Factor
29:05 — Full Arch Bone/Soft Tissue Considerations Often Ignored
34:01 — Future of Peri-Implantitis Treatment & Host Modulation
36:40 — Closing Thoughts🎧 Listen on Spotify, Apple Podcasts, or watch on YouTube🔗 Explore courses at PikosInstitute.com

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In Episode 5 of On the Mic with MAP, Dr. Michael A. Pikos dives deep into remote anchorage solutions for full arch implant therapy—without relying on zygomatic implants.

Following the overwhelming response to Episode 1 on zygomatic implants, this episode explores alternative surgical strategies for treating the atrophic maxilla, including:

✅ Pterygoid implants
✅ Palatal approach implants
✅ Paranasal implants
✅ Trans-sinus protocols

Dr. Pikos breaks down:

• When and why to use non-zygomatic approaches
• How pterygoid implants eliminate distal cantilever
• The role of cortical anchorage in full arch stability
• Common complications and how to avoid them
• Why restorative understanding is critical for surgical success

If you're looking to expand your full-arch capabilities and reduce reliance on zygomatic implants, this episode provides clinical insight, real-world application, and surgical strategy.

00:00 – 00:56

Introduction

• Episode overview
• Recap of zygomatic implant discussion

00:56 – 01:49Why this episode matters

• Demand for non-zygomatic solutions
• Importance of complications in learning

01:49 – 02:21Overview of Remote Anchorage Options

• Pterygoid
• Palatal
• Paranasal
• Trans-sinus

02:21 – 05:05

Pterygoid Implants Deep Dive

• Eliminates distal cantilever
• Reduces need for zygomas
• Ideal for atrophic maxilla

05:05 – 06:25Clinical Advantages

• Efficiency
• Reduced morbidity
• Versatility in revision cases

06:25 – 07:39Technical Considerations

• Learning curve
• Blind procedure
• Guided vs freehand

07:39 – 08:54Palatal Approach

• Game-changing technique
• Strong synergy with pterygoid implants

08:54 – 10:02Paranasal + Trans-Sinus Approaches

• Cortical anchorage principles
• Expanding treatment possibilities

10:02 – 11:47Restorative Integration

• Importance of surgical-restorative communication
• Full-arch workflow considerations

11:47 – 14:58Complications Overview

• Pterygoid risks
• Anatomy challenges
• Importance of CBCT + planning

14:58 – 16:44Palatal + Paranasal Complications

• Loss of torque
• Trajectory issues
• Anchorage failures

16:44 – 17:58Key Takeaway

• First drill (pilot bur) is critical
• Proprioceptive feedback matters

17:58 – 20:30Event Promotion + Closing

• Full Arch Complications Summit
• Multidisciplinary approach
• Legal + anesthesia considerations

In this episode of On the Mic with MAP: Mapping the Way to Predictable Implant Dentistry, Dr. Michael A. Pikos sits down with Dr. Hussein Basma to discuss:

✅ Dual specialty training in periodontics and prosthodontics
✅ The biggest causes of implant complications
✅ Immediate vs delayed implant placement decision-making
✅ Soft tissue management in the esthetic zone
✅ 3D implant positioning and emergence profile
✅ How photography and video improve clinical outcomes
✅ The importance of evidence-based, clinically relevant protocols

This episode is essential for clinicians looking to improve predictability, esthetics, and long-term implant success.

🎧 Listen on Spotify, Apple Podcasts, or watch on YouTube
🔗 Explore courses at PikosInstitute.com

Connect with us on Social Media:

Facebook: https://www.facebook.com/pikosinstitute

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Spotify: https://open.spotify.com/episode/5JmGSwM7eOrOpAKVFY8F0O?si=Nt5MluomQBeCthhRU79zyA

Apple Podcasts: https://podcasters.spotify.com/pod/show/michael-a-pikosYouTube: https://youtu.be/jeQjIM81jdw

A Perio-Prosth Approach to Dental Implants with Dr. Hussein Basma https://www.pikosinstitute.com/hard-soft-tissue-gbr-courses/mastering-implants-in-the-esthetic-zone

00:00–01:10 — Introduction
• Dr. Michael A. Pikos introduces Dr. Hussein Basma
• Sets up his unique dual specialty background

01:10–03:00 — Prosthodontic Training (Lebanon)
• Full-mouth rehab, implants, removable + fixed
• Early exposure to comprehensive implant care

03:00–04:30 — Periodontics Residency (UAB)
• ~400 implants placed during residency
• Extensive experience in bone + soft tissue grafting

04:30–05:30 — First Exposure to Pikos Institute
• Sinus grafting course experience
• “Changed the way I look at complications”

05:30–07:30 — Dual Training Advantage
• Perio + Prostho synergy
• Rare combination → full-scope clinician

07:30–09:00 — Photography & Education
• Importance of documentation
• 4K video + photography as teaching tools
• Key insight: reviewing complications visually

09:00–12:00 — Esthetic Zone Implant Course (A–Z)
• Immediate vs delayed decision-making
• Emergence profile + prosthetic planning
• Major causes of complications:

• Poor 3D positioning
• Soft tissue deficiencies

12:00–13:30 — Course Success + Demand
• Sold-out trajectory
• High attendee feedback

13:30–16:30 — Education Philosophy (Pikos Standard)
• Teaching the “WHY” vs just technique
• Evidence-based + clinically relevant
• “Monday morning implementation” mindset

16:30–20:30 — What Makes Great CE Valuable
• Implementation > attendance
• Avoiding the “learn and do nothing” trap

20:30–23:00 — Social Media & Continuous Learning
• Using Instagram the right way
• Collaboration > imitation
• Evidence-based validation

23:00–26:30 — Role in Pikos Institute Programs
• Core curriculum + full-arch training
• Faculty impact and mentorship

26:30–32:00 — Pikos Symposium Discussion
• Longer lecture format (90+ mins)
• Depth > surface-level education
• Structured Q&A = real learning

In Episode 3 of On the Mic with MAP, Dr. Michael A. Pikos explores one of the most critical—and often overlooked—topics in implant dentistry:

Full Arch Implant Therapy Complications.

Drawing on decades of clinical experience, Dr. Pikos breaks down:

• Why complications are inevitable in full-arch cases

• The critical role of bone and soft tissue grafting

• The truth behind “graftless” solutions

• How proper maintenance and follow-up prevent long-term failure

• Why prosthesis removal is essential for diagnosis

This episode is essential for any clinician looking to improve predictability and long-term success in implant dentistry.

00:00 – Introduction
Welcome + overview of full arch complications

00:30 – Why complications are inevitable
Experience-based perspective + importance of prevention

01:00 – The real issue: Bone & soft tissue
The “elephant in the room”

02:00 – The myth of “graftless” solutions
Why this mindset leads to failure

03:15 – Clinical scenario: Thin maxilla case
Implant translucency + risk factors

04:30 – Why these cases fail over time
Long-term consequences of under-treatment

05:00 – Veneer grafting approach
70/30 graft protocol + membrane strategy

06:15 – Additional hard tissue concerns
Periodontal defects + trans-sinus cases

06:45 – Soft tissue complications (mandible focus)
Lack of attached tissue risks

07:15 – Connective tissue grafting solutions
Autogenous vs ADM (AlloDerm)

08:45 – Key technique: Managing graft relapse
Planning for 50% shrinkage

10:00 – Rethinking implant foundations
Hard + soft tissue as standard of care

11:20 – The importance of follow-up
Why most clinicians miss complications

12:00 – Maintenance protocols that work
3, 6, 12-month intervals

13:00 – Why you must remove the prosthesis
Hidden complications revealed

14:30 – Disagreeing with current guidelines
Why radiographs alone are not enough

15:30 – Additional benefit: Cancer screening
Critical diagnostic opportunity

16:00 – Final takeaways
Prevention, maintenance, accountability

17:00 – Event invitation
Full Arch Complications Symposium (Orlando)

In this episode, Dr. Michael A. Pikos and Dr. Safa Tahmasebi discuss the philosophy and execution of full-arch implant reconstruction through an evidence-based lens. Recorded during a live course at the Pikos Institute, this conversation explores the integration of surgical and restorative principles, evolving techniques, and the importance of structured education in achieving predictable outcomes.

Key Topics:

• Evidence-based dentistry is the foundation of predictable implant outcomes

• Full-arch success depends on integration of surgery, prosthetics, and biology

• Hybrid workflows are becoming the new clinical standard

• Education and continuous learning are essential for staying at the forefront

00:00 – Introduction & Course Overview

• Day 3 of the full-arch program

• Participant feedback and course structure

01:00 – Building the Foundation: The “Why”

• Importance of science over “how-to” training

• Avoiding procedural-only education

02:30 – All-on-XYZ Concept Explained

• Beyond implant count

• Role of bone and soft tissue in long-term success

04:00 – Hands-On Training & Clinical Relevance

• Realistic patient-based models

• Bridging theory to real-world execution

05:30 – Occlusion-Driven Implant Planning

• Prosthetic-first approach

• Implant positioning guided by restorative outcomes

06:30 – Digital vs. Analog Workflows

• Hybrid workflow approach

• Incorporating photogrammetry and evolving technology

07:30 – The 7-Level Education Continuum

• Structured progression from beginner to advanced cases

08:30 – The Shift Away from Zygomatic Implants

• When they are appropriate

• Rise of alternative anchorage solutions

10:30 – Managing Complex Maxillary & Mandibular Cases

• Limitations of the mandible

• Introduction to subperiosteal implants

12:30 – The Future of Implant Education & Innovation

• Digital advancements

• Continuous evolution of techniques

  
  

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  Spotify: https://open.spotify.com/episode/5JmGSwM7eOrOpAKVFY8F0O?si=Nt5MluomQBeCthhRU79zyA

  Apple Podcasts: https://podcasters.spotify.com/pod/show/michael-a-pikosYouTube: https://youtu.be/jeQjIM81jdw

In this inaugural episode of "On the Mic" with MAP: Mapping the Way to Predictable Implant Dentistry, Dr. Michael A. Pikos explores the evolving role of zygomatic implants in full-arch reconstruction. Drawing on decades of experience, he discusses clinical indications, complications, and modern alternatives that can reduce the need for zygomatic implants.

Key Topics:

• The real indications for zygomatic implants

• Why they may be overused

• The “dreaded triad” of complications

• Remote anchorage solutions

• Patient-first treatment philosophy

• Training pathways for clinicians

  
  

  You can watch the video version of this podcast on the Pikos Institute YouTube channel at: https://youtu.be/OQ_YzrUeW0c

  Connect with us on Social Media: Facebook: https://www.facebook.com/pikosinstituteInstagram: https://www.instagram.com/pikosinstitute/LinkedIn: https://www.linkedin.com/company/pikos-institute/Twitter/X: https://x.com/PikosInstitute