Secure Dental-Dr. Gerald Niznick.mp3: Audio automatically transcribed by Sonix

Secure Dental-Dr. Gerald Niznick.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Dr. Noel Liu:
Welcome to the Secure Dental Podcast. Through conversations with the brightest minds in the dental and business communities, we'll share practical tips you can use to scale your practice and create financial freedom for yourself and your family. My name is Dr. Noel Liu, CEO and Dentist at Secure Dental, and also co-founder of DentVia. I'm your host for the Secure Dental Podcast and I'm so glad you're joining in.

Dr. Noel Liu:
Welcome to another episode of our Secure Dental podcast, where we bring in many bright talents from all over, both inside and outside the dental profession. Today we have a very, very special guest. But before we go on, this podcast is sponsored by DentVia, a dental virtual administration company that focuses on back-end dental office tasks like calls, claims, AR, etc., to assist our front desk and office managers with their daily tasks. Visit them at www.DentVia.com. That's www.DentVia.com. Now let's dive right in. Dr. Niznick, it's such an honor and a treat to have you, and I'm very excited to be with you today. I mean, you are considered to be the godfather and a pioneer of American implant dentistry. And with over 35 US implant patents, I mean, is that more than 35 right now or?

Dr. Gerald Niznick:
I have three new pending patents that I'll share with you.

Dr. Noel Liu:
I love it. I mean, ladies and gentlemen, this man literally needs no introduction in the implant and dentistry world. He is the backbone and the man behind the scenes for what we know today as Zimmer Dental Implant and Implant Direct Implant Systems. Actually, he founded Core-Vent bioengineering and Paragon dental implant companies. Doctor Niznick is responsible for the so-called the price shift in the dental implant world, making dental implants more affordable than its competitors and ultimately for our patients through its innovation and unique talents in marketing. I mean, graduated from University of Manitoba in '66 and then obtained his master's from Indiana University in 68. Doctor Niznick has had many achievements throughout his career, and one of the main ones is his philanthropy, including giving back to his dental school where he graduated from. And I'm so proud that that school is named Doctor Gerald Niznick College of Dentistry in Manitoba. I mean, you're such a blessing to our profession; I don't even know where to start. So Doctor Niznick, welcome, and thank you for doing this, and let's dive right in. I would just like to ask you, like, what inspired you to enter the field of dental implantology and become the pioneer in this industry?

Dr. Gerald Niznick:
They say necessity is the mother of invention. And I finished my master's degree in prosthetics in the late '68, started a practice in Los Angeles, and I was the only prosthodontist in a geographical area of a thousand dentists. So everybody was sending me their denture problems. I wanted to do Crown and Bridge, but I was getting all kinds of referrals for dentures, and there's no good way to stabilize the lower denture. So I sent them a case to a dentist that was doing some periosteal implants at the time. That's where they do a chrome casting that gets trapped under the tissue. And he never sent the case back to me to restore. And he says, Oh, I never let anybody restore on my implants. So I said, Well, I guess I didn't need to know how to place them. So I started placing implants. And all through the 90s, all through the 70s, I was placing subperiosteals, blades, I went to all the symposiums, training courses that I could. Every other year, I'd spend a week in Doctor Lenny Lincoln's office in New York. And by the end of the 70s, I was somewhat disenchanted with the predictability that I was getting. But I had good experience. If I could just save a couple of teeth, do root canals, cut them down so that there was not much leverage on them, and use a overdenture attachment, I could stabilize the denture. So I said, If I could only come up with two implants in the symphysis to hold the implant and hold the denture, I'd be happy; that's all I really need from implants, I thought. So from that came the Corbin system, which was an implant with a hex hole that you could cement an overdenture abutment in it, and did the first case of two free standing implants to hold an overdenture. And I found that the implants, if I did the surgery a certain way, the implants would become ankylose, very firm. You could tap on it with a mirror, that ring. If I did something else, they wouldn't. So I figured out what that something was and that was not overheating the bone and not prematurely loading the implant. So that was the development of the Core-Vent I launched in 1982, the Core-Vent, and by that time I had developed other abutments that could be cemented. So what the Core-Vent introduced is implant prosthodontics, the ability to have an implant with a variety of application-specific abutments. If you want to do a single tooth, there was a tapered abutment for that. If you want an angled abutment, you could bend the abutment. If you want to do a screwed-in case, there's an abutment that received a screw. So that, the Core-Vent was launched in '82. By 1990, it was the largest-selling implant in the world. It was everywhere. I had offices in different countries, distributors around the world. I traveled and lectured everywhere. That got me to 1990. '91, Dense ... came along and they wanted to distribute my product. So they took over the distribution and I just did the manufacturing for six years. But then I took back distribution because they were not focused on education. And I thought education was really critical. So I thought education was critical. So I took it back in '97, renamed it Paragon, launched a bunch of other Do implants, including the tapered Screw-Vent in 1999. I forgot to mention, in 1986, I developed a second implant called the Screw-Vent, and that one had a lead in bevel, internal hex, and internal thread. So the core meant you had to cement abutments, but the screw bends was all screwed in abutments, and I developed a whole series of abutments for that. That became the conical connection. I got a patent on that which I licensed to many companies, and that became the first conical connection that patent covered, whether it was 45 degrees or whether it was 78 degrees. Nobel Active really popularized it even more in 2007. When the patent expired, Nobel Active launched with a, it's conical connection.

Dr. Noel Liu:
So it's fair to say that you were the first one.

Dr. Gerald Niznick:
Yeah, I had the patent on it. They couldn't sell in the States until that patent expired. And I licensed a number of companies. In 2000, a company called Calcitek came along and wanted to buy my company, and they did. And that later became Zimmer Dental, which became ZimVie. And the Screw-Vent, tapered Screw-Vent is the flagship product today, 20 some years later of ZimVie. It's, they called it the tf tapered Screw-Vent and TSB. Now they've come up with a newer version called the TSX. They just made the threads a little deeper at the bottom. That's about the only difference in the implant. So then moving forward, once I sold that company in 2001, I was under a non-compete for five years. But fortunately, my attorneys advised me that I gave up my right to compete, but not my right to prepare to compete. So in 2004, when Zimmer Dental, Zimmer Dental by that time, decided to move out of the factory that I had built, that I was renting to them and consolidate with their San Diego office and all these employees that I had were going to be let go, I started a new company called Implant Direct and hired 90 of my former employees, went back into my factory, and spent the next two years waiting out the non-compete and developing what became Implant Direct, ultimately the most popular implant in the United States, especially among GPs. What I did with Implant Direct is I did all-in-one packaging. To end the confusion and give more value, I would include the implant and abutment, the healing collar or transfer to cover screw at one reasonable price; $150 it started out, and went up to $200 eventually over many years, over six years. And that created what they called the value segment in the implant industry. Because another company started lowering their price. It was not a discount company because I never discounted the price. It was the same for everybody. You ordered on the internet. So if you're going to have internet sales, you can't be messing with the price, giving everybody a different price. So I had one low price. So that was Implant Direct. 2010, Sybron came along and wanted to buy the company, and at the end of 2010, I sold them 75% of the company, and I stayed on for three years as the president, and I became Implant Direct Sybron. And then, at the end of 2013, they bought my remaining 25%, and I retired. The next year, the company that owns Sybron and old me, bought Nobel. So now you had Nobel and Implant Direct owned by the same people, which was a tricky thing because we were competing with them, and I even had compatible implants to their implants. So they really did not help Implant Direct growth for many years. Now, they finally figured out how valuable it is that they're focusing their marketing attention on it. And it's back to growing mode. So that's Implant Direct. Now, when my non-compete expired from that, which was March 2022, I still have the factory. Factory building was sitting empty because they had moved out. My other three, two facilities, the customer service facility, and the shipping facility were sitting empty. So I figured, well, I'll go back in the implant business. So I started a Paragon implant company. I took the name that I had used before. Started Paragon and started developing a new implant system. 30 of my former employees left the implant direct and came back to work for me. So I had an entire brain transfer. All the key people that I wanted came back. And after the last two years, we've been manufacturing the new Paragon implant system, which I call Gen-5 for generation five. And there's one other implant in there, a one-piece implant, which I call Nizplant, which is a very unique implant. It's a one-piece implant with the head of a locator attachment, but it can be converted to a multi-unit abutment. The idea being that you could put in four implants, do an overdenture at it for a lower cost; at any time later, come back, and convert that to a fixed case. So that brings you up to where I am today. I'm still probably nine months away from being able to hit the market, where we're building different products and getting regulatory approvals. And that's the implant story.

Dr. Noel Liu:
So three times, right?

Dr. Gerald Niznick:
Maybe four.

Dr. Noel Liu:
Maybe four. Love it, love it.

Dr. Gerald Niznick:
Core-Vent, Paragon, Implant Direct. And now Paragon again.

Dr. Noel Liu:
That's such a fascinating story. These guys moving out of your facility, and then you're going back in there. I mean, this is true entrepreneur and a business mind kind of attitude there that you got. I love it. So how is this new Paragon different from what Implant Direct and what Zimmer's are carrying right now. Is it pretty much the same basis or is it something totally revamped?

Dr. Gerald Niznick:
It's new from anything on the market. And what I did is I took the body of the legacy-two implant, which was the next generation of the tapered screw-vent, and it had progressively deeper threads, double lead threads, progressively deeper threads, and it had micro threads. So I took off the micro threads, and I put a 2.5mm smooth neck on it, and I added a millimeter to each implant, and I put score lines on the neck of the implant. And here's the reason behind all this. What's the biggest problem today in implants? Peri-implantitis. Bone loss leading to inflammation of the tissue and patient doesn't clean it, can't clean it because the rough surface gets exposed. So you get progressive bone loss. So at every meeting you go to they're talking about how to treat peri-implantitis. I think the key is how to avoid it and prevent it. And the answer to that really comes from a Straumann with their two millimeter, two and a half, they got a 1.8 and a 2.8mm smooth neck. They're tissue-level implants, but not the way they intended the implant to be used. One of their key clinicians, Doctor Daniel Buser, explained that he takes that implant and he pushes about half the smooth surface below the crest of the bone. And he does it because he knows, he does bone grafting. There's going to be remodeling. He does extraction, there's going to be remodeling. Oftentimes the ridge is not level, so he's pushing the top, leaving a millimeter above the bone, and 1.8mm is really below the bone. We've got this on videos explaining this. And that is, so that when it's finally healing, there'll be this smooth surface exposed to the ... You got a rough ... So I built that concept into this implant in a rather unique way with score lines. Now, the other thing, do you place implants?

Dr. Noel Liu:
Correct. We do.

Dr. Gerald Niznick:
Okay. Do you put them level with the bone or below the crest?

Dr. Noel Liu:
So right now all my implants are below the crest of the bone okay.

Dr. Gerald Niznick:
Wrong!

Dr. Noel Liu:
I know I that's why I wanted to hear, I'm so excited to hear your concept and your theory because we are always in the process of evolution. We're always trying to find better ways and better techniques.

Dr. Gerald Niznick:
Well, that's the way implants are being taught. And the reason is because they have the blasted surface and the threads to the top. So they know they're going to get some bone loss so they're trying to push the implant down a little bit. So when they get bone loss, they'll end up at the top of the implant. Then they show it at the top and they say, See, no bone loss. Wrong. You lost a millimeter or two of bone because the bone will ... the junction. It can't attach above the junction. And now if you sink it below the bone and you've got a flared abutment, you need to contour the bone at the crest so that you can get that flared healing collar or buttonhole seated. So you're cutting away that bone. The answer is: keep the implant and the implant abutment junction at or above the crest of the ridge. It just simplifies everything. You can do that if you've got a 2.5mm smooth neck.

Dr. Noel Liu:
Smooth neck. Okay.

Dr. Gerald Niznick:
Now a lot of times there's the bone on the labial is resorbed and you got your high point on the lingual. So you could put the implant level with the bone on the lingual and have a couple of millimeters of the neck of the implant exposed. And it's still smooth. If you did that with a blasted surface, you'd have to graft to cover that surface. So you eliminate a lot of grafting with this. And if it's a millimeter above, you have the advantage that the soft tissue will attach to it. And when you take off a healing call or put it above a non, you're not tearing that soft tissue, you're not disrupting that soft tissue attachment in that millimeter of exposed titanium. So the whole philosophy of the design of the implant is built around changing the thinking of the industry to keep the implant a millimeter above. And guess what? The Core-Vent in 1982 was placed a millimeter above. I had a 16 millimeter implant and we drilled 15mm. Back then I did it because the implants were always buried, and I want to make it easier to find. So I could run my finger along the crest of the ridge, heal the bump of the implant, and then just make a little hole in the tissue. It had a plastic post. I put the diamond drill into the post, pull it out without disrupting the soft tissue, attach an abutment. So I've incorporated that.

Dr. Noel Liu:
What about the cortical plate on the top, where a lot of times, they have shown studies that after drilling, the bone heats up for whatever reason and it dies. And what are your thoughts on that? The smooth collar will that prevent that from happening?

Dr. Gerald Niznick:
Well, you shouldn't have died back. Today, you're using progressive drills. You're going through a half-millimeter sequence of drills. If you've overheated it with the first one, you're following it with another one that's just shaving a little bit. The hole is open so the water can get in. So I'm not worried about ... You'll go to lose bone if the labial plate is less than a millimeter, maybe even less than two millimeters. Study that I funded, called the VA study, put in 3000 implants on 900 veterans, this is in the 90s, and when they drilled the hole, they would measure the labial plate, put the implant in, bury all the implants at that time, and when they uncovered, they could correlate bone loss relative to how thick the labial plate was. And if you had two millimeters of labial plate, there was no bone loss, a millimeter, lost the millimeter. And if it was less than that, you'd lose more. So it's how thick the labial plate is. But so often you go in and there is no labial plate or it's way down. And that's why having a smooth neck on the implant instead of microthreads or blasting is just the smart way to go.

Dr. Noel Liu:
That's such a great concept. You know, I'm taking notes too, right?

Dr. Gerald Niznick:
Okay.

Dr. Noel Liu:
So we're going to share some screen later on. I had a few questions I wanted to ask you. What are some of the key moments or challenges that you had while you were developing all these companies and going through them and exiting out of them? I know that is like totally a different mindset, right?

Dr. Gerald Niznick:
Well, I came on the market in 1982. The Nobel system didn't really hit the market till '83 or '84. And I was very pleased to read the broad market research. I was getting an ankylosed implant. He proved that if you get an ankylosed implant, which he called osseointegration, it had long terme predictability. So I was talking about his research and my implant and they didn't like that. So they figured out how they're going to slow me down or stop me, and they sued me for infringing on their surface patent. They had a patent that they got through. So in '86, they filed a suit against me. I filed a lawsuit against them for false advertising, claiming that Branemark discovered Osseointegration; he didn't. There's 77 textbook references of French orthopedist that did and a few other things that were doing. So we had a very expensive litigation for '86, '87, and '88. And finally they were spending me into the ground. So I did a settlement with them, and I agreed to a 10% royalty on my pure titanium implants. But most of what I was selling was alloys, so I didn't have to pay anything on that. It turns out that they went on to shoot three eye implant innovations, which is also today's ZimVie, and they wouldn't give them a license. There was on a litigation, went to trial, and Nobel lost, and the patent was declared invalid by fraud, and they ended up having to pay three I $15 million: $3 million in damages tripled because they violated what they call a Lanham Act, and 5 million in legal fees. And that patent that I was paying a royalty on was declared invalid. And I couldn't get out of the payments, and totally, their patent expired. So we've had a long, cantankerous relationship with Nobel. When I started Implant Direct, oh, then they violated the patent, or at least I thought they did, the patent, the internal connection patent with their tri-lo implant. So I sued them for violating that, and they got out of it because they didn't have a lead-in bevel on their implant. But in the process, I learned that they were filing a patent on the tri-lobe. So I got out ahead of them and found my own patent on a different way to do the tri-lo. So it was compatible but didn't infringe their patent. And when I launched the Implant Direct and I couldn't sell the Legacy until 2007 because my old patent was stopping me, I focused on the tri-lo, and I took a lot of business away for the lower-cost tri-lobe, which I called the replant. So that friction went back and forth a few times. Now Nobel really controls Implant Direct. Now they just launched the new implant, they call the Iconic. And what they did is they took my Legacy implant and my Interactive implant, both of which had the same body, but the interactive had a Nobel-compatible platform so that I could go after the Nobel customers. Once Nobel got implants and Implant Direct, they stopped claiming that that was compatible with theirs. But it is. We got FDA approval that it was compatible. I even posted that FDA notice on my website, Niznick.com. So they are pushing away from Legacy into the Iconic. I say they should have called it the Ironic because when you take, the legacy had four different platforms so that the platform got wider as the implant got wider, so that you'd always have a good emergence profile. But the Nobel Active, which I copied the connection in my Interactive, only has two platforms, so it's got a five point, a 4.7 implant with a 3.0 platform, and you got a big undercut, which I don't care for. So I pointed that out on Paragon-implant.com. We post all of my analysis of the various implant systems in the controversy section, and I go into great lengths on the Ironic implant. So I'm still in conflict with the Nobel people because they're trying to make my Legacy, which was a damn good implant, into something that gives more credibility to their conical connection for the 78-degree connection.

Dr. Noel Liu:
Well, I guess it depends who has a better relationship, right, with the guys who own it. Is it Envista right now, I think?

Dr. Gerald Niznick:
Envista, yes. Envista, and they've got a president for Nobel and a president for Implant Direct. But the president of Nobel is also the president of Envista. So they just ... Yeah. So they're trying to balance these conflicting stories. Now, one of the improvements on my Gen-five is I went from four platforms to two. So I dramatically reduced it. And I got the Gen-five, and then I've got what I call the Gen-five plus. And that's, I think, going be a big winner. What it is, is the same implant, but I got a two millimeter extender that's friction fitted at the factory that adds two millimeters and flares out to four millimeters. And it is the transmucosal part of a standard multi-unit abutment. So you just insert a screw into it and you turn it into a Nobel compatible multi-unit abutment. And then you can add a variety of abutments to it, which I'll show you if we get into the slides.

Dr. Noel Liu:
No, definitely. I got one other question. Then we'll definitely get into the slides, because I have a lot of questions about your Paragon system. Is that in the market yet or is it still under development?

Dr. Gerald Niznick:
Well, it's being manufactured. We've developed it all. I've got 25 new machines, about 80 people in the factory, and we're making it. It takes a long time. You got a program, it set up the machines. So we're probably nine months away from launch.

Dr. Noel Liu:
All in Los Angeles, right?

Dr. Gerald Niznick:
Yes. It's all being done in Los Angeles. Now, my go-to market strategy is also different than anybody else's. Let me just get rid of that. I'm only going to sell in North America. I'm not going international. I'm only going to sell on the internet with a shopping cart so I can keep the prices very low. The implant will be $100, which is the same that I charge for a screw-vent in 1986, and the Gen-five plus with the extender will be $135. A prosthetic screw that would convert it to a multi-unit abutment would be $25. So you're at $160 for an implant at a multi-unit apartment, which is less than a lot of companies charge us for the abutment itself. The new plant with a dual-function platform, will come with all the cap attachments that are compatible to the locator in that it grabs the outside but also has an inside connection, and that all those components will come with the implant for $160, which is less than what ... charges for a locator attachment. So what's happened in the industry is that everybody's discounting. For example, NeoDent sells for $229 in the United States. They'll sell it to a DSO for $100 and to Clearchoice for less than that. And that implant sells for $23 in Brazil. So you really buying a $23 implant and paying $229? I believe that everybody should be able to pay the same price, whether it be a single GP or a busy oral surgery practice that can afford to inventory or DSOs. One price for everybody. Shopping cart will have 50 to 75 inside customer service people that can answer your questions. And that's the new business model staying just in North America.

Dr. Noel Liu:
And Doctor Niznick, is there any kind of educational component through your Paragon, your new system, Gen-five, or is it like just strictly just implanted parts?

Dr. Gerald Niznick:
I'm going after experienced dentists. I'm not going after, you know, somebody says, I have to learn to drill on a plastic jaw. I'll leave the education to so many people out there today that want to teach. In Vegas, tomorrow, I'm lecturing at the maxi course, the AAID MaxiCourse. There's Zimmer, ZimVie built a whole training center in Miami, and you can learn how to do implants there; you can learn from Implant Direct. The new implant is surgically compatible with the screw-vent and the Legacy. The same drills would work with our implants, although we do have a new drilling system. So no, I'm not going after education. This is how you can afford to sell a high-quality implant at a discount, low price by eliminating the extraneous stuff, and by making a million implants a year so that you can mass market. Nobody other than me is going to buy 25 machines and spend 25 million before you spend, you sell your first implant and build a big inventory. It's because I know that when I hit the market, people are going to appreciate this implant. Well, I'll just tell you a few other things that I'm doing. Besides the implant industry, I'm in aerospace manufacturing. So I have two factories about 200,000ft², and we make parts for Boeing, Lockheed, Airbus, F-35. So one part I make is 14ft long. And I say if I can make a 14-foot part for a 777X airplane, I can make a 14-millimeter implant. So I've been in the aerospace business since 2002, I think. And I'm also in the hotel business. I have a hotel in Bristol, Connecticut, and we just added a second hotel and a convention center. So implants are part of what I do, but I have other ventures as well.

Dr. Noel Liu:
So what's your legacy like? What are you shooting for?

Dr. Gerald Niznick:
To live a little longer.

Dr. Noel Liu:
Like obviously a retirement does not exist for you. That is what I love about you. But you keep going and it's like never ending. It's just amazing. So what is the ultimate outcome?

Dr. Gerald Niznick:
Well, I want to get this system to the market. I mean, you are placing an implant sub-crest because somebody told you to, and even the companies are telling you to do that because they know that their stupid designs with threads and blasting to the top is going to be a problem. So they want you to bury the implant, that which creates other problems. Then they have to have a long, narrow abutment that flares out, and they need running room to get to the diameter that they need. I'm coming back in to try and share my experience and knowledge and implants and get people doing it the least expensive way. I just saw somebody post a case with four near-dead implants, the dentures jaw for an overdenture, and they buried it two millimeters below the crest. And then they attached the healing collar, which just brought the implant level with the crest. Now how stupid is that? Why not use a one-piece implant that comes through the tissue and already has the attachment in it? If you know it's going to be an overdenture, or I made an implant called the screw-in Direct Implant, which is the one-piece implant with the multi-unit abutment on it, and you already have screw receiving abutment. So it reduces the cost. It improves the clinical results that you can get thinner implants if they're one piece, you can have a three millimeter implant for strength, and you're not cutting away the crystal bone. They say it preserves crystal bone, but you've already lost two millimeters of bone contact.

Dr. Noel Liu:
And which is an elite to the implant anyways.

Dr. Gerald Niznick:
Yes. And you lose the contact with the cortical bone which give you the highest level of.

Dr. Noel Liu:
So maybe in the future, maybe in the future, you might want to think about like selling it to Straumann, right? So that they can incorporate your design with ...

Dr. Gerald Niznick:
Well, I have a very good relationship with Straumann and I have a lot of respect for that company and their management. They invited me over to lecture to their executives in 2019 on how I built the value segment. I told them, The first thing you need to do, they brought all their world executives in. I was like, the surprise speaker. And I said, First thing you need to do is put value in your packaging, okay? In other words, the value segment is built on offering value, and your value is dependent on convincing somebody is worth $500 if you just package it with other component at the time, this is what I was thinking of. So I had a good relationship and they invited me back one other time. And who knows what the future will bring? But if any company is going to buy my company, or that I would put the new products in the hands of somebody that I know that would represent it well, it would be Straumann.

Dr. Noel Liu:
No, that's great, because I think ... is one of those companies where they're great, but they don't have that what you got. So is your connection like internal hex or is it like still sort of?

Dr. Gerald Niznick:
Exact same as the screw-vent, as the Legacy.

Dr. Noel Liu:
Got it.

Dr. Gerald Niznick:
45 degrees. But in 1994 I developed the friction-fit connection. And that's where you take the male hex and tapered one degree. When you see it in, it doesn't fully seat. You have to tighten the 30 Newton centimeters and drives it together. That was a flagship feature of ZimVie's proven. If you go and watch our videos or whatever they're talking about that, I got away from it because the precision that I could reach didn't require that with every abutment. But I'm bringing that back, that same friction fit for my extender. And I'm going to make this extender for other implant companies. So what do I learn in 40 years in implant evolution? So on the left, you see the first ad for the Core-Vent, and the right you see why I call it Gen-five. The first gen was Core-Vent in 1982. The second-gen was the screw-vent in 1986. The third generation was the tapered screw-vent in 1999. Then the Legacy in 2007. And now Gen-five is the new implant. How did Implant Direct build its business? It was on the internet and we could provide good customer service by having well-trained customer service people. We eventually built a sales force of 90 people as well, or 70 people, and every inside person had a partner on the outside. An independent study showed that we had the highest customer satisfaction of any company. Here's the image showing the new implant system on the left at $100 is the Gen-five, then the Gen-five plus, and then the Nizplant. All three of them have exactly the same implant body. So the Gen-five plus has a two millimeter friction-fit healing collar, and the Nizplant, it's all one-piece implant and the top has the outside of a locator. Locator attachments would fit. It has an internal lead-in bevel and a receptacle for a socket. So it's got a ball and socket as well as the outside attachment. Here's the patent that I filed on the implant, putting score lines on the neck. As I said, each implant is a millimeter longer than the standard that a 13 is 14. We don't go to 16. I've eliminated the 16-millimeter implant and I've eliminated the seven millimeters. So I'm just getting down to the basic implants that you need. So I've got the score lines to help you determine where you want it relative to the crest of the ridge. This is the patent application on the extender. That's friction-fit to the implant. Here is the Gen-five plus with the extender in place. The gold represents the platform of a 3.5 screw-vent, and the pink represents the platform of a 4.7 screw-vent, which is 4.5. So you got 3.5 and 4.5 platform, two platforms. And this shows the extenders. And you'll notice on the widest implant, the extender fits flush with the outside of the implant. Normally what's happening with these wider implants is you get a real big ledge there which I don't like. That's even worse on companies that have just one connection. But with the friction-fit, I can set it on the platform and it's still engaging, the friction-fit. I'm not relying on the lead-in bevel for stability. Now this shows six different positions for the Gen-five plus. It's got a two millimeter neck. You could place the implant level with the crest that it would project up two millimeters above the bone. You could do it to the first score line. It would be three millimeters. Second score line, it'd be four millimeters. To the blast line, it'd be four and a half. And it also comes with screws of different heights. So you could go to five-and-a-half and six-and-a-half, or you could put them all with one millimeter above the bone and just vary the height based on the screw. So instead of holding an inventory of abutments, all you need to do is hold an inventory of screws of different heights. For screws that are for $100, $300, you got 12 screws and you can vary the height of it so the tremendous savings on the abutment inventory that you need to deal with. Now, this shows that that platform also can accept a variety of other abutments. So we're making angles straight temporary abutments, angled-screw channel abutments, locator-compatible abutments. They'll all screw into the top of that extender. Now, what this extender gives you is what no other company is doing. If you put this implant in and the tissue recedes and you want to lower the platform, you take off the extender and go right to the top of the implant. So it's a healing collar and the transmucosal partybut abutment. This is like Nobel's on one. They sell a healing collar that's screwed in and raises up the platform make it easier to restore to scan. So that's the Gen-five plus. Here's the case going. I think they were mega chins put in by Doctor Ganz. And you see all the exposed threads on these implants and the extraction socket; you're going to get it every time. You would have to go back and graft all of that to cover those threads of the blasted surface. On the right, I've superimposed the Gen-five plus implant into those sockets, and you don't need to do any grafting because the therapist is exposed. On the left, now, you see, he's detached the abutments, but he's attaching it in a pool of blood. On the right, the abutment connection is already attached at the factory and is friction-fit, so you're getting the best connection you can, and then you just add on whatever height screw you want and you're all set. This is the Nizplant. I was just going to make it in a couple diameters. And I said, I figured I'd make it in all six diameters and all with the same platform, and it can be used like a locator with our attachment. If you need more height, you could screw in an extender that brought up the height a little bit on the locator. You could attach a multi-unit abutment, or just attach directly to the top of the implant with a angled screw channel. So let the lab do the angle correction when they're building the full-arch case instead if you worrying about angling your implants. You know, I'm not a big fan of putting an implant at a 45-degree angle to tip it back from the mental foramen. If you want to tip it back, tip it back 15, 20 degrees. Really, when you think about cantilevering, Branemark said, You could cantilever back to the tonsils from four implants in the front. So this business's about dramatically tipping to shorten the AP spread is being carried too far. When you think of zygomatic implants, you got a 40-millimeter cantilever off of those implants. So this Gen-five has got a lead-in, I mean, the Nizplant has got a lead-in bevel internal hex connection, just like an implant. And it's got a rib on the outside, just like the locator. So that's that implant. And I got a patent pending on that. And you can see the chamber inside the implant where a ball would snap into as well as grab on the outside. And here's the case where they did four locators. I superimposed my implant on it to show that you could use it as a locator, a multi-unit abutment connect directly to it. This is the packaging of the implant. The surface wasn't put on this particular implant, and all the components will come in the bottom of the vial for $160. This is the surgical tray, which is going to be very neat and guide you to soft ball or hard ball surgical protocol, which is the same as the screw-vent and the Legacy. It will come with drill stops at two heights. So if you want to place that level with the bone, you select one drill stop. If you wanted a millimeter above the bone, there's a different drill stop, a different color drill stop. And the outside diameter of the drill stops will go through a surgical tray. So you don't need to use keys in order to step up your drills; you just change drill, put the same drill stop on the different sized drills; goes through the sleeve in the surgical tray till it hits the bone; depending on which drill stop, it'll place the depth of the implants so that the implant would be one millimeter above the bone or level with the bone.

Dr. Noel Liu:
When you have like 11-millimeter implant or 11.5 whatever size you have for the Paragon system, is that including the soft, the smooth collar as well?

Dr. Gerald Niznick:
Yeah, yeah. It's actually 12.5mm to the top of the implant.

Dr. Noel Liu:
Basically the blasted surface is about ten and a half, right?

Dr. Gerald Niznick:
On a 12.5 it would be 10. So you can go anywhere from placing the blasted surface level with the bone and have 2.5mm projecting above, if you wanted it to project through the tissue for one stage. I would recommend, if you wanted, that you're better off using the Gen-five plus. Put the smooth neck below the crest of carbonate for bone loss, and have the extender be the one stage. So this is out Straumann really because Straumann has a bone-level implant which is blasted and threaded to the top, which violates the principles that Doctor Buser advocates of putting the smooth neck below the crest. So he is using their tissue-level implant all the time and uses it like a ...-level implant, whereas my system has figured this all out for you. So the last, this slide shows my aerospace company, and like I said, if I could make that 14-foot part for a 777X, I could make an implant. On the right, we were just in 2023, we were Spirit Aerospace as number one supplier, not in volume, but quality and on-time delivery. And Spirit is the biggest supplier to Boeing. They make the fuselages for that. On the right is a fuel floor for a Ep-35 and a picture of my two Factories. This is a picture of the implants, and this is a picture of my convention center in Bristol, Connecticut.

Dr. Noel Liu:
That was great information there, doctor Niznik. It was really, really good to see like there is an implant system that is going to be like at the $100 mark. Any implant system nowadays with a price hike year after year is just getting ridiculous.

Dr. Gerald Niznick:
All right. So I hope this covered what you wanted.

Dr. Noel Liu:
I just got one last question for you. What do you got for young professionals aspiring to make a mark in the dental implantology world?

Dr. Gerald Niznick:
That's easy. First of all, I'm 81 years old, so I'm not going to be around forever. So I need young guys like you to carry the message. Don't believe everything you're told. Don't believe the last speaker that you heard. Don't believe the salesperson. Do your own studying and every question you can have on implant dentistry is answered on my website on the Niznick.com. In the controversy section, we've got articles, there's another section on articles, and whatever I'm answering somebody I'm putting links on all the time. We were adding all this material to the new Paragon website, Paragon-Implant.com. What system are you using?

Dr. Noel Liu:
Currently, we are with NeoDent.

Dr. Gerald Niznick:
NeoDent. Okay. Took me 11 pages to list everything goes wrong with that system.

Dr. Noel Liu:
I'm going there to check it out right now after this.

Dr. Gerald Niznick:
First of all, is not a fully-tapered implant. It's straight and then tapered at the end. So getting initial stability is not guaranteed. Whereas you can take my six-millimeter implant and get good initial stability because the whole thing is tapered and it's spreading and compacting the bone. So that's one thing. It's got a long taper on the connection, which they call the Grand Maurice. Well, it's not a Maurice taper. Maurice taper is 1 to 1-and-a-half degrees. That's 16 degrees. All you get when you have a long taper like that is very thin walls. It's got threads all the way to the top and blasts it all the way top. So it's forcing you to put the implant sub-crystal and it's got only one connection, which they tell you, Oh, this is wonderful. You could reduce your abutment inventory because it'll only have one connection, but it's creating emergence profile nightmares that are going to be a problem to clean for the patient. And then again, I don't know what you're paying for the implant, they probably tell you you're special. We're going to give you a 30% discount. You don't have to share your discount.

Dr. Noel Liu:
You're kind of nailed it. Yeah. Discount is some sort of discount. For sure. Yeah. ...

Dr. Gerald Niznick:
They're selling it to ClearChoice for $70 and is selling it to you for 150 and is selling it in Brazil for $23. Do you think you can make an implant that the majority of your sales are going out at $23 and be able to put the attention that you need for the precision? I've looked at those implants under microscope, and maybe they got a lot better after Strölin bought them, but they weren't that good before. And why buy an implant in Brazil when you could buy American and know the source? We were just.

Dr. Noel Liu:
I know the source now.

Dr. Gerald Niznick:
You know the source. We were just written up in a magazine which is also posted a manufacturer magazine: This is where precision meets innovation. So I think we're going to have an impact on the market. If there's smart guys like you want to do the best you can for the patient; that's the first. Thing you want to avoid complications down the road. And if you're putting in an implant with Microthreads and blasted at the top and countersinking. For instance, ClearChoice posted a case they're so proud of for implants. And I posted can't you see you got peri-implantitis and inflamed tissue on three of them? They took it down right away. So everybody's going to get problems with implants. You need to figure out how to minimize that. And having a smooth neck and a super crystal connection is a good start.

Dr. Noel Liu:
Got it. No, definitely. I mean that's good info. I'm definitely going to keep that in mind. And if there's any way I can be of any assistance I mean definitely, you know I'm available. I would really appreciate you and what you shared with us today. I think this was like really eye-opener for a lot of us. Thank you again for all the information.

Dr. Gerald Niznick:
You're welcome. Thank you for asking me. I'm always happy to share my information with young people. What I see, what's being done in the field today is so aggravating with the misinformation from the companies and dentists just following what they're told. So I'm really changing the industry again, I hope. And changing for the better.

Dr. Noel Liu:
Yes, you are. Which is why your profile just caught my eye and I'm like, I got to reach out to you. Well, again, thank you very much for your time. We're going to land the plane, and we can definitely collaborate if there's anything in the future.

Dr. Gerald Niznick:
Great. Thank you. And have a good day.

Dr. Noel Liu:
Yep. You too. God bless. This is the end of our Secure Dental podcast. Make sure you like and subscribe. And this is Doctor Gerald Niznick and your host, Noel Liu.

Dr. Noel Liu:
Thanks for tuning in to the Secure Dental Podcast. We hope you found today's podcast inspiring and useful to your practice and financial growth. For show notes, resources, and ways to stay engaged with us, visit us at NoelLiuDDS.com. That's N O E L L I U D D S.com.

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