The trail to innovation hardly ever begins in splendid circumstances. After graduating from NYU’s Faculty of Dentistry in 2011, Dr. Randy Roberts moved to Utah to begin a follow together with his brother, John. The 2 youngest of eight youngsters, they prioritized staying near household, even when it meant beginning a dental enterprise in one of many nation’s best areas for dentistry.
They bought a bank-owned dental workplace in Taylorsville and launched what would ultimately grow to be Utah Smile Clinic. Like most common dentists, Dr. Roberts supplied the standard array of providers: fillings, crowns, veneers, and orthodontic aligners. However it wasn’t lengthy earlier than his curiosity pushed him to discover the world of implants. After a sequence of superior implant programs and a whole lot of profitable surgical procedures, he found a ardour — and a selected aptitude — for dental implant restoration. In brief order, he grew to become certainly one of Utah’s high dental implant suppliers.
In 2013, Dr. Roberts confronted a crossroads that will redefine his profession and affect the way forward for full-mouth rehabilitation. His cousin, worn down by years of dental neglect and substance abuse, turned to him with a mouth filled with failing enamel and a remedy plan he couldn’t afford. The one broadly accepted resolution was an All-on-4, however Dr. Roberts knew the process got here with compromises: aggressive bone discount, detachable dentures that trapped meals, and an unnatural-feeling prosthetic. Moreover, the splinted design minimized physiological bone stimulation, doubtlessly accelerating resorption over time.
All-on-4 modified the sport when it was launched, providing edentulous sufferers a set resolution supported by simply 4 implants. However like most issues, it got here with trade-offs. When confronted with restoring the enamel of a detailed member of the family, Dr. Roberts didn’t like the thought of eradicating his wholesome bone. He puzzled, “If I can exchange three or 4 enamel with a natural-looking bridge with out bone elimination or synthetic gums, why can’t I restore a complete arch of enamel utilizing the identical strategies?”
His cousin’s case was the catalyst, and he started creating a protocol that will clear up a number of the frequent ache factors of All-on-4 whereas staying in an identical value vary. Drawing on his intensive implant expertise and a deep understanding of restorative biomechanics, Dr. Roberts envisioned a brand new sort of everlasting smile resolution. As a substitute of counting on a monolithic prosthesis, he imagined three particular person zirconia bridges, every supported by two implants, preserving native bone, bettering hygiene and phonetics, and making a extra natural-feeling outcome.
Over the course of a number of months, he started engineering what would grow to be a defining development in FP1 restoration — the three on 6™. On January 28, 2014 — his birthday — he carried out the primary 3 on 6™ process. The result was transformative, and never only for his cousin. What began as an act of household service rapidly advanced right into a paradigm shift in implant dentistry.
The idea behind the three on 6™ is elegantly easy and biomechanically sound: six dental implants are positioned to assist one stable arch of enamel, offering cross-arch stabilization. After permitting time for osseointegration, the one arch is changed with three segmented zirconia bridges — one on the anterior and one on every posterior quadrant. No bone elimination crucial. No synthetic gum materials. No cumbersome prosthetics. Simply everlasting, implant-supported enamel that really feel and performance extra like the actual factor.
This segmentation turned out to be a game-changer. In contrast to a monolithic denture-like restoration, segmented bridges allowed for more healthy power distribution, improved hygiene, and superior phonetics. Sufferers retained their pure bone structure, which allowed for higher esthetics and long-term oral well being. As a result of the bridges sat immediately over the ridge slightly than floating over pink acrylic, meals impaction was minimized — and when it did happen, cleansing was much more manageable. There have been additionally practically no instances of prosthetic fractures with the ultimate segmented zirconia bridges, and in instances the place there have been wants for substitute, it was less expensive and simpler to interchange a 4-unit bridge than a complete full-arch mounted prosthetic.
Most significantly, sufferers cherished the texture. The three on 6™ doesn’t depend on the palate for stability, doesn’t must be eliminated for cleansing, and doesn’t simulate tissue — it replaces solely the enamel. For sufferers who had struggled with dentures or the “false” feeling of All-on-4, this was a restoration that felt like that they had their actual enamel again.
In contrast to All-on-4 hybrids, which frequently require advanced elimination and upkeep protocols, the three on 6 system shouldn’t must be eliminated. In truth, the ultra-polished tissue floor of the bridges can truly adhere to the gums making it considerably tougher for meals and micro organism to get beneath the bridges or across the implants. This reduces long-term prosthetic problems that will in any other case lead to surgical re-intervention.
Because the variety of profitable 3 on 6™ instances grew, so did demand for this revolutionary strategy to full-arch restoration. Dr. Roberts started seeing sufferers from throughout the nation and even internationally. The demand from sufferers and recognition of the remedy strategy led to inquiries from colleagues who wished to learn the way they may supply 3 on 6™ in their very own practices. In response, Smile Programs was based in 2019 to function the official coaching, assist, and innovation platform for the three on 6™ process.
The success of the three on 6™ process is due largely to its adaptability to trendy digital workflows. Applied sciences comparable to CBCT imaging, intraoral scanning, 3D facial scanning, 3D printing, and photogrammetry enable for excessive precision in surgical planning and prosthetic fabrication. The usage of zirconia — a sturdy and esthetically superior materials — ensures long-term stability with out sacrificing look.
Smile Programs continues to push boundaries by integrating rising instruments and strategies into the three on 6™ course of. Similar-day design and supply of screw-retained temporaries is now frequent follow, permitting sufferers to go away surgical procedure with a stupendous, mounted smile. The result’s a course of that looks like the way forward for restorative dentistry — minimally invasive, extremely esthetic, and customised to every affected person’s anatomy.
For many years, FP1 restorations — these changing solely the crowns of the enamel, with out synthetic gums — have been thought-about splendid however usually impractical for full-arch instances. They required exact implant placement, wonderful affected person anatomy, and meticulous restorative planning. Many dentists would use the time period “unicorns” when describing how uncommon they felt it was for a affected person to qualify for FP1 remedy. Over 10 years of three on 6™ remedy has confirmed that isn’t the case. At present, Dr Roberts believes the overwhelming majority of sufferers in want of full arch enamel restoration qualify for FP1 or FP2 remedy. Many sufferers have even transformed from All-on-4 prosthetics that they hated to extra pure feeling 3 on 6™ bridges that they love.
If there’s one factor the three on 6 has achieved, it has proven that there isn’t a one-size- fits-all resolution to full arch restoration. The three on 6™ makes FP1 predictable and accessible for a variety of sufferers. It supplies dentists with a repeatable, trainable course of that may be built-in into their follow with the best coaching and instruments. It doesn’t simply supply a substitute for All-on-4 — it redefines what full-mouth implant dentistry can appear to be when guided by sound prosthodontic ideas and trendy digital dentistry.
Whereas the three on 6 was offering unbelievable outcomes, Dr. Roberts confronted an uphill battle to search out an implant system designed for FP1 remedy. Most implant producers cater to the wants of dentists offering single implants or the All-on-4 remedy, neglecting the distinctive remedy protocols and desires of dentists performing FP1 restorations. Dr. Roberts felt that he had two unresolved ache factors together with his 3 on 6™ remedy protocol: weak abutments and prosthetic screws coming free.
A full-arch splinted prosthetic reduces the forces on implants and abutments. However with segmented bridges, they obtain considerably greater forces. Whereas the rise in forces was an necessary a part of 3 on 6™ remedy in rising bone stimulation modeling, it additionally meant elevated stresses on weaker abutments and screws. After making an attempt dozens of implant designs from a mess of producers, he thought his solely choice is likely to be to create his personal implants. That was when he found the implant he had been in search of, TRI®.
The TRI implant was revolutionary in that it doesn’t require an abutment. The direct-to-connection design meant one much less weak level to fret about. As well as, the prosthetic screws of TRI are practically 10x bigger than conventional screws, designed to resist the total forces of oral operate and decreasing the probability of the screw loosening over time. Most prosthetic screws really useful torque worth is 15-20ncm. TRI’s, nonetheless, is about double at 35ncm.
Dr. Roberts started testing the implants with 3 on 6 remedy and fell in love with the outcomes. In contrast to conventional implant programs that depend on middleman abutments, TRI implants enable for direct-to-implant screw-retained restorations — eliminating the necessity for an abutment altogether. For FP1 remedies, the place prosthetics sit immediately on the ridge, and precision is vital, this simplification reduces potential factors of failure whereas bettering esthetics and stability. By eradicating the abutment layer, there’s much less micromovement, fewer alternatives for bacterial infiltration, and a extra passive match between the implant and the ultimate zirconia bridge. These advantages are extraordinarily helpful in full-arch instances, the place long-term peri-implantitis can compromise all the restoration.
One other standout function Dr. Roberts gravitated to was TRI’s proprietary connection system, which makes use of a strong screw and deep conical interface. The design is considerably extra proof against mechanical fatigue, making it splendid for full-arch load situations. In high-function instances like the three on 6™, the place sufferers anticipate their enamel to carry out like pure ones, the power of this connection helps keep away from loosening or screw fracture over time. The result’s a restorative system that’s not solely sturdy and hygienic, but in addition superbly appropriate with trendy FP1 philosophy — prioritizing tissue preservation, esthetics, and affected person consolation.
At present, the three on 6 is being carried out in clinics throughout the U.S. and Canada by educated and licensed suppliers. 1000’s of sufferers every year are receiving everlasting smile restorations which can be extra inexpensive, extra hygienic, and extra natural-feeling than conventional choices. Sufferers love that their enamel by no means need to be eliminated. They love that there isn’t any transition line beneath their gums, they usually love the way it feels inside their mouth. In a avenue survey the place sufferers had been proven side-by-side retracted pictures of All-on-4 and three on 6 smiles, 98% of respondents mentioned they felt the three on 6 regarded higher and extra pure.
Dr. Roberts and his crew at Smile Programs proceed to speed up the adoption of FP1 remedy protocols by implant dentists throughout the nation. By means of their rigorous coaching program, they’re increasing entry to remedy whereas preserving the values that impressed the unique innovation: compassion, practicality, and a dedication to long-term oral well being.
For dentists, the three on 6 represents greater than only a new remedy choice — it’s an opportunity to supply one thing higher. Think about being one of many first dentists to supply All-on-4 to the market 25 years in the past. 3 on 6 clinicians are on the tip of the spear in the case of smile rehabilitation. The way forward for dentistry is extra hygienic, extra esthetic, and extra pure feeling.
In case you are enthusiastic about changing into a 3 on 6 Supplier, you possibly can go to SmileSystems.com for extra data or to register for an upcoming course.
