|Archive: Martin Paley Joins - Edinburgh Dental Specialists|
GDC No. 64778
Martin is a Consultant Oral & Maxillofacial Surgeon for NHS Lothian based in the Regional Maxillofacial Unit at St Johns Hospital. His main NHS area of interest is head & neck cancer and he performs the often complex reconstruction and oral rehabilitation these patients require using free tissue transfer techniques and dental implantology.
He has recently introduced to the unit, the newer minimally invasive techniques of sialoendoscopy to manage salivary gland disease. He also works at the Western General Hospital Oncology Centre and has a weekly clinic at the Spire Murrayfield Hospital.
He is a graduate of Dundee and Aberdeen Universities and his specialty training was in Wales with time at the Vrije University in Amsterdam. Following this he completed a fellowship in head and neck surgical oncology in Liverpool before taking up his consultant post in Edinburgh in 2005.
End of Year Analysis by Kevin Lochhead
2010 an "interesting" year.....
This past year has been particularly challenging for all of us:
Looking forward to 2011.....
Thanks to your continued referrals, and at the request of a number of practitioners, we have been able to expand the provision of services at the practice, with additional specialists contributing their expertise and also allowing extended, more convenient opening hours.
Towards the middle of 2011 we hope to be opening a dedicated surgical and endodontic floor. Integral to this will be the introduction of Mr. Martin Paley (consultant Maxillofacial Surgeon) who will be joining Dr. Gillian Ainsworth on the surgical team.
Our tele-dentist email service has proved very popular and we are happy to continue to offer this service next year. If you have any dental problems or questions about your patients then this service is by far the quickest way to get an answer. (usually within 24hrs)
We have an expanded programme of postgraduate courses coming in the new year, including our round table evenings, which will next year be themed to cover areas of popular concern.
The economic downturn has been challenging for all of us and as we all know doesn't show any sign of abating in the near future. As a result we have all had to work especially hard just to maintain the status quo. I am more aware than ever, that in running a large practice, many people's livelihoods depend on the practice being guided in the right direction.
In this environment it was always questionable as to how wise it would be to expand the premises into the ground and basement floors of the building. It has been (albeit tentatively) the plan, since starting the practice in 1994. Our position was forced however by the previous tenants leaving last year and I am pleased to say that the new surgical and endodontic suites opened in September.
As anyone, who has tried modernising an old building will know, this has not been without its challenges. Why are there always cables to run after the decorating has been done? We now simply have to agree with the planning department over the "shop" frontage and the project will be complete.
The opening of the surgical suites coincided with two new surgical specialists starting with us.
Gillian Ainsworth; one of the first two oral surgeons to complete the specialist training programme in surgical dentistry in 2003. Gillian has been carrying out minor oral and dental implant surgery in Glasgow dental hospital over the last 8yrs.
Prof. Lars Sennerby started with us at the same time and brings a quite staggering amount of dental implant knowledge and experience. Lars worked with Prof. Branemark ( the pioneer of modern dental implantology)in Gothenberg, where he has been for over 20yrs, during which time he has authored over 300 academic papers and mentored many students through their Phd's. He is a Professor of clinical and experimental oral implantology.
Our educational side expanded quite considerably in 2011 offering double the number of courses on many aspects of restorative dentistry as well as dental implantology. We will be continuing this in 2012 with more themed round table evenings as well as the, much requested, hands on courses.
Dental Implant Laboratory
In the laboratory we have been incredibly fortunate to attract a second fully trained master ceramist to join the team. This allows us to expand the service and provide the same quality of laboratory work, that we enjoy, to more outside practitioners. We have never expected clinicians to use the laboratory as their primary provider, but rather for those "special" jobs that really need the individual attention that we can offer. If you have such a case coming up let us know, we really would like to help you, and let you see the difference we can make. Our prices are comparable with the commercial laboratories.
One of the growing referral areas we have seen over the last year is in practitioners asking us to help manage their implant cases which have, for whatever reason, failed to meet patients expectations. This is entirely natural; there are many more practitioners starting to introduce dental implants to their practices and there is a huge learning curve that can take many years to assail, both on the surgical and restorative side. Please remember that with the experience and skills of our prosthodontists, surgeons and technicians we are more than happy to help or advise any practitioner who finds that a case has become problematic. The best way, of course, is to prevent problems from ever arising for which we would recommend our surgical and prosthetic mentoring.
We have over the last few months been running a number of "all-on-four" implant courses for one of our implant suppliers; NobelBiocare.
We have been carrying out this actual procedure for over ten years but it is only now that it has really come of age. Essentially it entails replacing all the teeth in one jaw with a fixed implant supported bridge on the same day. Critical to being able to carry this out, are:
An oral surgeon
An onsite laboratory
A team, and facility, capable of managing a patient's care through the procedure
As you might imagine our experience of patients seeking this treatment are those with hopeless dentitions, many of whom have "given up" on regular dental care many years ago. With this in mind we are venturing into "awareness marketing" to the general public, through a short radio advertisement. This is not something we have done before and I would like to reassure you that it in no way changes our "referral only" status. Should any patients contact the practice they will need a referral before they are seen. Our goal is to educate and inform.
This year we have had one baby born to Jennifer and Neil. Jennifer started with us as a trainee dental nurse over 10yrs ago and we are looking forward to having her back once her maternity leave is over.
There are, so far, two babies due for 2012, one to Dawn who is one of our surgical and sedation nurses. Like Jennifer, Dawn has been with us for more than 10yrs. Everyone is really excited for her and looking forward to the summer when she is due. The other is to Bruce (one of our prosthodontic technicians) and his wife Ashley. This will be their second.
Onwards to 2012
2011 has been challenging but in its own way exciting - realising the end of what has been in effect an 18 year building project. Next year our primary goal is to continue to find out from you; what services you need from us and then to provide these to the very best of our ability. We are, of course, nothing without your continued support and in these challenging financial times every referral is really very much appreciated.
I hope you have a relaxing Christmas and fantastic New Year.
Why do some implant crowns have endo access holes?
A question that we have been asked on more than one occasion is: "Why do some implant crowns have endo access holes?"
If you have been referring implant cases regularly to us you too will have seen this (although with the advent of all ceramic/zirconia restorations its becoming more difficult to see the composite). The reason is that where possible we make our implant restorations in one piece with a single screw holding it in place. The "endo-hole" is where we place a packing material and composite for easy access if required.
Having an implant based restoration screw retained (as opposed to cement retained) has been shown to be the optimum solution:
The restoration is much more easily retrievable (porcelain can chip on implant crowns more than on natural teeth)
There is no cement to aggravate the tissues or lead to periimplantitis
Provisionalisation is much more straightforward
Crowns don't "fall off"
Margin location is much more predictable
The main disadvantage is that it is more challenging for the surgeon.
Screw retained implant crown
Composite covering the access hole
Implant crown with direct access to retaining screw
Last week the laboratory took delivery of a brand new Ivoclar pressing furnace. "Pressing" ceramics have been around since 1988 with Empress and Empress 2 being the most common. If you have been unsure about where these materials fit in your restorative arsenal then please take a look at the "Pressing Ceramics" item below.
For your information; along with our master technician, Gerhardt Van der Vis, Dr. Pierluigi Coli also has a postgraduate degree in material science. Please do call or email if you would like to know what materials best lend themselves to cases that you may be working on. If you would like to come to the lab and see how we process these materials, it will be our pleasure to show you round.
Conference season is upon us and in order to keep abreast of current developments, in March we will be attending:
The Academy of Osseointegration annual meeting - This is the biggest dental implant meeting in the world where most of the implant companies choose to release their latest research data and product innovations.
The NobelBiocare 60th anniversary of osseointegration in Gothenberg (yes really - 60yrs)