AO Diplomate Certificate application form NON-member -

AO Diplomate Certificate Application Form – Non-member

The AO Diplomate Certificate requires that you have completed the following:

General Dentist or Non-NCRDSCB Specialists – Successfully pass an implant program through one of the AO designated training centers
Complete the online application including your two cases
Successfully pass a one-hour online comprehensive examination
Successfully pass a one-hour oral examination at the upcoming AO Annual Meeting where the applicant will be scheduled to meet with at least two AO Credentialing Board Members to review committee-selected cases and provide and defend treatment decisions
Application Fee – $3,750 (Non-member)

The deadline to apply and be recognized at the 2027 AO Annual Meeting is October 31, 2026.

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General info - Step 1 of 8

Name *

First

Last

Email *

Primary Phone *

Cell Phone

If not your primary phone

Current employment *

Name of private practice or university

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

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SECTION 2 - Professional identification

I am applying for (select one) *

AO Diplomate Certificate - Surgical
AO Diplomate Certificate - Restorative
AO Diplomate Certificate - Surgical and Restorative

Please indicate your specialty (select one) *

GP
Periodontist
Prosthodontist
Oral & Maxillofacial Surgeon
Other

If other, please provide more information here

University where you received your dental degree *

University where you received your specialty dental degree

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I intend to take the online exam this year *

After passing the online exam, I intend to take the oral exam offered in Washington, DC in March 2026 *

Please select one of the following: *

I have attended at least 1 AO Annual Meeting within the past 3 years
I have NOT attended at least 1 AO Annual Meeting within the past 3 years

Please indicate which Annual Meetings you've attended:

2026
2025
2024

Is English your primary (preferred) language?

Yes
No, I prefer to have the online exam translated

Please list your primary (preferred) language:

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Required Implant Case Presentations

Applicants must submit two (2) case presentations. Case examples should be based on the following criteria:

Surgical Certificate Cases - 1 case should be without grafting and 1 with grafting with 2 implants per arch
Restorative Certificate Cases - 1 single unit, 1 multiple either fixed or removable implant supported prostheses
GP or combined Surgical and Restorative Certificate Cases - 1 case with grafting and either 1 single unit restoration, 1 multiple unit restoration or 1 implant supported overdenture or fixed partial denture

Diplomate applicants must have attended 2 AO Annual Meetings in a 5-year period.

To submit each case presentation, please enter the requested information in the fields below.

Accompanying photographs and radiographs can be uploaded using the Image/File Uploads section at the end of this application. (NOTE: file uploads will only be saved when the form is submitted in its entirety.)

CASE #1

Title - Case #1

Clinician Name - Case #1

Summary - Case #1

Background - up to 60 words about why you think this case is important

Case Presentation - Case #1

Presenting features, dental/social/family history

Investigations / Evidence-based Research - Case #1

This is required to support your treatment. Limit the literature review to 4 - 5 key articles

Outcome and Follow-up - Case #1

Provide 150-word description for the final treatment outcome and whether or not the goals of your treatment have been achieved

Discussion - Case #1

Include a brief review, 100 words or less, of any complications or problems and how they were handled.

Learning Points / Take-home Messages - Case #1

List 3-5 bullet points

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Title - Case #2

Clinician Name - Case #2

Summary - Case #2

Background - up to 60 words about why you think this case is important.

Case Presentation - Case #2

Presenting features, dental/social/family history

Investigations / Evidence-based Research - Case #2

This is required to support your treatment. Limit the literature review to 4-5 key articles.

Outcome and Follow-up - Case #2

Provide 150-word description for the final treatment outcome and whether or not the goals of your treatment have been achieved.

Discussion - Case #2

Include a brief review - 100 words or less - of any complications or problems and how they were handled.

Learning Points / Take-home Messages - Case #2

List 3-5 bullet points

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Image / File Uploads

Please upload a copy of your AO approved Training Center completion certificate OR your Specialty Certificate (in Periodontics, Prosthodontics or Oral Maxillofacial Surgery) from a North American accredited University.

General Dentists or Non-NCRDSCB Specialists - Please upload documents showing proof of AO Training Center certification:

Drag & Drop Files, Choose Files to Upload

General Dentists or Non-NCRDSCB Specialists (National Commission on Recognition of Dental Specialties and Certifying Boards) - Please upload documents showing proof of AO Training Center certification.

Specialists - Please upload your Specialty Certificate:

Drag & Drop Files, Choose Files to Upload

Please upload your Specialty Certificate (in Periodontics, Prosthodontics or Oral Maxillofacial Surgery) from a North-American based accredited university only. No other certificates will be accepted including certifications from ICOI and AAID as well as university-based implant programs.

Image Upload - Case #1

Drag & Drop Files, Choose Files to Upload

Please place all images for each case together in a PowerPoint, Keynote or Word document. PowerPoint and Keynote files will need to be converted to a .pdf file for upload.

Image Upload - Case #2

Drag & Drop Files, Choose Files to Upload

Please place all images for each case together in a PowerPoint, Keynote or Word document. PowerPoint and Keynote files will need to be converted to a .pdf file for upload.

IMPORTANT - Save and Resume Later will not work for this section. Once all file uploads are completed, please click the NEXT button to proceed to finalize the application.

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Statement of Truth *

I attest to being the providing clinician for all treatment indicated in these submitted case presentations. I further confirm that all clinical photographs and radiographs are original and have not been tampered with or materially altered in any way to enhance the appearance or outcome of the cases presented.

I agree that I will not video/audio record any portion of the online or oral exam. Failure to comply will result in disqualification from the program. *

I acknowledge and agree

Acknowledgement of Renewal *

I acknowledge that this Certificate is valid for six (6) years and I must reapply for renewal. (AO will notify all Certificate holders at the time of renewal.)

Digital Signature *

This serves as my electronic signature, verifying that all information submitted in this format is accurate and truthful (please enter your full name in signature box).

Date *

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Checkbox Items *

$3,750

I understand this amount includes the non-refundable $1,250 application fee

Credit Card *

Card

Name on Card

AO accepts these credit cards: VISA, Mastercard, American Express

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