The quick answer
A great deal. Experience doesn't make a surgeon's hands steadier. It makes their decisions faster and surer. An experienced full-arch surgeon spots a problem sooner, disturbs less to fix it, and stays calm when something unexpected happens. You feel that as an easier recovery.
In this answer
What gets better with practice
People assume an experienced surgeon has better hands. Mostly, it's better decisions.
With practice, a surgeon needs less information to make a call, recognizes a surprise as something ordinary, and disturbs less tissue to fix a problem. Every case is a puzzle, and the more times you've solved it, the faster you go. After thousands of cases, most of it is recognition.
For you, that means a smaller operation. Less disturbance means less trauma, and less trauma means an easier week afterward. Patients rarely notice the surgery itself. They notice how good they feel after.
Every surgeon's first cases
This applies to every surgeon who has ever done this procedure, including ours.
When a surgeon starts doing full-arch work, complications are noticeably more common in the early cases than they will be later, and more common than they expect. They care just as much. They're still building their routine and still making decisions during surgery that later get settled beforehand.
Some surgeons push through that stage. Others decide the procedure doesn't work and stop offering it. So if a practice tells you full-arch is unreliable, they may be describing their own early cases.
A surgeon’s first cases
Implants that failed in the first nine cases
Every surgeon has a learning curve. In this study, implants placed by surgeons with fewer than 50 behind them failed twice as often. The gap showed most in their first nine cases.
A 1997 study by the Dental Implant Clinical Research Group. It counted implants still in place at the second, follow-up surgery, not long-term results. It is not about full arch in particular. Experience means implants placed of any kind. The summary does not say how many surgeons or implants there were.
- Lambert PM, Morris HF, Ochi S. Positive effect of surgical experience with implants on second-stage implant survival. J Oral Maxillofac Surg. 1997;55(12 Suppl 5):12-8. doi:10.1016/s0278-2391(16)31192-2. PMID 9393421.
Experience belongs to the whole team
When an implant fails at a practice that rarely sees it, you can feel it. Voices change, the schedule stops, and a worried patient becomes more worried.
At a practice that has handled it many times, it's a routine visit. The implant is removed, a new one goes in or another spot is used, the teeth are adjusted, and the day carries on. Patients still arrive worried. They usually leave relieved.
The dentistry is the same in both rooms. The difference is a team that knows exactly what to do.
Fewer implants is usually the experienced answer
More implants can look like more care. Over the years we've gone the other way: from six implants, to five, to four in most cases, with more where the bone calls for it.
Four isn't always right and six isn't wrong. If a practice recommends six, they may be seeing something in your scan, and they should be able to tell you what. But if the number seems high, ask why. Each implant is another site in your bone that can't be undone, and a full arch doesn't need one implant per tooth.
Ask what each implant is doing, not just how many there are.
The skills of the surgeon, Dr. Noorthoek, are exemplary.
Why a focused practice works differently
A practice that does almost nothing but full-arch can't do everything. We aren't the place for a single crown, and we'll tell you so.
What you get instead is a whole practice built around one treatment. The lab, the surgery, the schedule and the team training are all set up for exactly your case.
Better questions than "how many?"
Anyone can quote a case count. These questions are harder to answer vaguely:
- How many of these do you do in a normal month?
- If an implant fails in the first year, who replaces it, how soon, and what will it cost me?
- Who makes the teeth, and where?
- Can I change how they look before they're final?
The answers show you whether a practice has a settled plan for when things don't go to plan.
Quick answers
How many full-arch cases should a surgeon have done?
There's no official number, so any figure you hear is someone's opinion. A better question is how many they do in a normal month now, and whether full-arch is most of their work or something they do now and then.
Does a surgeon who does other procedures do full-arch worse?
Not necessarily. Plenty of excellent surgeons do several kinds of work. What matters is repetition. Something done every week runs differently from something done occasionally, because the decisions have been made hundreds of times.
Should I ask about complication rates?
You can, but be as careful with a very low number as with a very high one. Any practice doing difficult cases will have complications. Ask what happens when one occurs: who fixes it, how quickly, and who pays.
Is a newer surgeon always the wrong choice?
No. Every good surgeon once did their first case, and many newer surgeons work under supervision in an experienced practice. What stands behind them matters more than their own case count.
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Read next
Does it matter which implant system my dentist uses?
Yes, though not in the way you'd expect. The brand makes little difference to how your surgery feels. It makes a big difference to whether anyone can help you in fifteen years: whether the parts still exist, whether another practice can work on it, and whether the design leaves places for bacteria to collect. We'll tell you what to ask rather than name a brand, because brands come and go.
Answered by Dr. Daniel R. Noorthoek
Read the full answerAll-on-4 vs All-on-6: how many implants do I actually need?
Four per arch, in most cases. More implants aren't better. Extra implants sit closer together, reach further back into bone that handles chewing poorly, and each one adds another screw hole through your teeth, which makes them weaker. Adding implants doesn't add teeth, either. We look at your scan before we settle on a number.
Answered by Dr. Daniel R. Noorthoek
Read the full answerWhat happens if something goes wrong?
We fix it, and we don't waste time on whose fault it was. Every practice that does surgery has complications sometimes. What matters is whether you were told about them beforehand, and how you're looked after when one happens.
Answered by Dr. Daniel R. Noorthoek
Read the full answer