Osteotomy technique and 'feel' in immediates

Better implant outcomes start with how we shape tissue from day one. In this episode of Everyday Oral Surgery, host Dr. Grant Stucki welcomes return guest Dr. Richard Akin, an oral and maxillofacial surgeon from Louisiana, to explore immediate implants and the art of crafting custom healing abutments. Dr. Akin explains how years of refinement shaped his chairside method for building custom healing abutments with bulk-fill composite. This approach helps capture and maintain the natural tissue contours during healing. He shares practical lessons on case selection, torque control, and grafting, and unpacks why wide-platform implants play such a critical role in the long-term success of posterior and second molar cases. Beyond surgical precision, Dr. Akin reflects on how collaboration with restorative dentists and lab technicians helps bridge knowledge gaps, streamline workflows, and ultimately improve patient outcomes. Tune in for a masterclass in technique, teamwork, and continual learning within oral surgery!

Key Points From This Episode:

• An introduction to Dr. Richard Akin, an OMS practicing in Louisiana.
• How a 2010 course sparked his interest in immediate provisionals.
• The evolution of his chairside custom healing abutment technique.
• Using bulk-fill composite to capture patient-specific tissue contours.
• Publishing the “anatomic harmony abutment” concept in 2016.
• Why soft-tissue management is as critical as implant stability.
• Key benefits from his custom healing abutment technique.
• Dr. Akin’s full immediate implant workflow from extraction to final abutment.
• Optimizing insertion torque for predictable immediate placement.
• Case selection, grafting, and managing buccal gaps for success.
• Preference for wide-platform implants in posterior and molar cases.
• Long-term recall data showing success in second-molar implants.
• Prioritizing thorough socket debridement and irrigation to achieve clean, bleeding bone.
• Avoiding over-drilling through feel and control during osteotomy preparation.
• Collaborating with restorative dentists and other specialists for improved patient outcomes.
• The importance of actively bridging gaps between surgeons, labs, and restorative teams.
• A breakdown of Dr. Akin’s approach to maxillary immediate implants.
• Final reflections on teamwork, gratitude, and patient-centered care.

Links Mentioned in Today’s Episode:

Dr. Richard Akin — https://www.drakin.com/

Dr. Richard Akin on LinkedIn — https://www.linkedin.com/in/rick-akin-644aa932/

Dr. Richard Akin email — rick@drakin.com

‘A New Concept in Maintaining the Emergence Profile in Immediate Posterior Implant Placement: The Anatomic Harmony Abutment’ — https://www.researchgate.net/publication/304779134_A_New_Concept_in_Maintaining_the_Emergence_Profile_in_Immediate_Posterior_Implant_Placement_The_Anatomic_Harmony_Abutment

‘Clinical Advantages of Immediate Posterior Implants With Custom Healing Abutments: Up to 8-Year Follow-Up of 115 Cases’ — https://www.researchgate.net/publication/363099744_Clinical_Advantages_of_Immediate_Posterior_Implants_with_Custom_Healing_Abutments_Up_to_8_Year_Follow_Up_of_115_Cases

Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ 

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