Latest / Straumann® ProTalk / Evidence and immediacy in implant dentistry : Dr. France Lambert as periodontist and researcher (video version)

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Evidence and immediacy in implant dentistry : Dr. France Lambert as periodontist and researcher (video version) · Straumann® ProTalk

0:00
It is true.
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It is true that when I was a postgrad, we were already doing immediate implants.
0:04
And we were not understanding fully the biology.
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And we've learned from our mistakes.
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You are very well known.
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You are one of the most recognized clinical educators and researchers
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in Europe and globally.
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What are the defining moments or projects or people have shaped
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the France Lambert we see today?
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I wanted to explore the world and, then a tipping experience
0:26
was was the ITI scholarship.
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And for me that was really opening to the world and it was an amazing experience.
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Yes.
0:49
Welcome to ProTalk.
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Welcome to the Pules of Dentistry.
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Today, George and myself have the pleasure to have France
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Lambert from Belgium as a guest.
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Welcome France.
1:00
Welcome France.
1:01
Welcome to Basel.
1:02
Hello Andreas.
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Hello, George.
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I'm very happy to be here.
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This is a great privilege.
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This proTalk has become very famous.
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We hope,
1:12
it sounds good, we hope.
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Exactly.
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Yeah.
1:14
And we hope it creates some inspiration, for people out there.
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So thanks a lot for coming.
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France.
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You are very well known.
1:20
You are one of the most recognized clinical educators and researchers
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in Europe and globally.
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You are leading the department for periodontology, for oral
1:28
surgery and implant surgery in the University of Liege in Belgium.
1:34
But beyond this, you're very active also in associations.
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I think the, it is a very good example.
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I'm impressed about your journey there from being an ITI fellow in
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Harvard now to leading the global ITI research committee and we come to this.
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And yeah.
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Beyond this, you are also a family person and you're very active in sports.
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It's going to be a very exciting conversation with you today.
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So for the people that don't know you, France, who is
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France Lambert in one minute?
2:02
Yeah.
2:02
You've already said a lot from a professional perspective
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but more personality.
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I would say that maybe I'm a dreamer.
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I'm a dreamer, but I'm also an achiever and a doer, so I can get my act together.
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And I usually like to do that as a team.
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I really sharing, co-creating in my work.
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And the team approach is very important.
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And you said I'm a family person.
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I'm also a mom of two little boys, and this takes a part of my life.
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Yes.
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We notice having three boys and two boys there's always energy around.
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I can imagine.
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In your professional life you focused on the field of periodontology.
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How did it start?
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How did you draw your attention to this very exciting field?
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Yeah, that's actually a good question because it started
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actually with implant dentistry.
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And I was at high school I was an average student, I was not very motivated.
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I was one year in advance, but I was not the brightest, let's say.
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How does that fit together?
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I had to choose a topic for thesis.
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And I knew already that I was attracted by the medical field and also a
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little bit by dentistry because this crafting thing, you can, you work
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with your hands when you're a dentist.
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So I was attracted to that and I wanted to choose a topic that was new.
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It was in 1996.
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And.
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I decided to explore implant dentistry when I was 16, basically.
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Really?
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Wow.
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Yes.
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And and I started to, to go in clinics and assist the surgeries.
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I also fainted during the surgery.
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You fainted because of the blood.
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Exactly.
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But and at the end I did a really good job and I succeed really well at the end.
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I was really bad in German and this has erased my bad notes in German.
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Compensated basically with the German.
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Yeah.
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So then I decided to go in dentistry.
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Okay.
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So then you decided to study the dentistry.
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And focus on periodontology.
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Where did you do your profess your specialization?
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In Belgium, you actually have the opportunity to do
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it directly after the study.
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So I have to say that when it comes to perio in third of dentistry, I had a
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wonderful professor is also my mentor.
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And Eric is, he's a storyteller.
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And when I was there at the, in the class of Perio, I was like eating
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everything, that he was explaining.
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So this was very clear from that third year that I would do a specialty
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perio, and I had the opportunity to do it directly after my dental studies.
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So I was a dentist, what, 22 and I was a periodontist at 25.
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And everything went really fast.
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What is it that you learned from Eric Rompen?
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He's no doubt is one of the greatest I'd say, and it's amazing
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to have a mentor like Eric Rompen.
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What is it that how did he influence you?
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He is a professor that is an excellent surgeon and clinician.
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So I think this is why, when I'm an academic, but I always like to
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say that I am first a clinician.
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And I treat patient and I love treating patients.
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I love to do other things like teaching research, and we
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are going to talk about that.
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But he's an excellent clinician and he really, understand the biology and
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I think he was always biology driven.
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And this is an heritage I got from him very early on.
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So from there studying and, having the possibility in early stages to
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work with Eric Rompen to who you are today, what are the defining moments
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or projects or people have shaped the France Lambert we see today?
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But after the specialty, I was very local and I could speak French and
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I didn't know English really well, but I wanted to explore the world.
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And and then a tipping experience was was the ITI scholarship.
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And I was very lucky that I was basically selected to go there in Boston at
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Harvard School of Dental Medicine, H.P. Weber was the program director.
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And for me that was really an opening to the world.
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And this program is really amazing.
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I think now when you look at the KOL in our field in implant dentistry, a
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lot of them went through this program
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and this program is an incredible track record.
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If you look at the important let's say dental influences today and professors.
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On the academic side, but also in prior practice.
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And for me that was really the start of a career.
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And I've learned English there because my English was not good.
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And I met many people and I was also very lucky that year.
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Also German O. Gallucci just arrived from Geneva.
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Yeah.
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Okay.
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So I had the opportunity to work with him and Urs Belser was there
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for a sabbatical, so a dream team.
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I couldn't be, I couldn't be in a bad place, and it was an amazing experience.
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Yes.
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So I can imagine you shaped your prosthetic muscle then, sounds like, if
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you have those three together, is it?
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So does this influence the way you look at patients today being
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focused on perio and implant surgery?
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I'm a periodontist and I'm exclusive.
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I'm exclusively per and surgeries.
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On, I'm very curious about the overall field I work, working with, colleagues
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and I love pure disciplinary treatment.
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And I think you need to understand I. As a periodontist we know the
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importance also of the provisionals.
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I also do the provisional part.
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Sometimes, not always, but sometimes.
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And I think if you are a specialist, you also really need to be
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curious about the other field
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and the onset of immediacy probably changed also a lot.
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So maybe in the past there was less of interest in the restorative part
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when you did the surgery, but now it's so tightly linked together.
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So you actually want the patient to walk out with the temporary.
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So you have to basically also be curious and interested in the prosthetic part.
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The prosthetic component are so important to guide the soft tissue healing
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that it is for me, really something between Surgical and Prosthetic.
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I have a question here.
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So you started with Eric Rompen and I know that Liege was very early in terms of
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immediacy, and then you've been in hard.
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Those are very different philosophies if it comes to an immediacy or let's
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say a loading protocol perspective.
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How did you perceive this?
8:08
It is true.
8:09
It is true that when I was a post grad, we were already doing immediate implant.
8:13
And we were not understanding fully the biology.
8:16
And we've learned from our mistakes.
8:18
And it's true that I faced, during my scholarship another philosophy,
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also another valid philosophy.
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And I think in my profession, I like to be open-minded.
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I would not say, okay, there is like one way to do, and this is the best way.
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There are different routes to Rome.
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And you need to basically feel where, which way you want to take.
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And, my way is I would always want to go for minimally invasiveness.
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Respecting the biology.
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And if possible, be as, as fast as possible if you
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don't compromise the results.
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Yeah.
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So very patient centric, then, finally.
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Let's go back to the ITI fellow or the ITI, internship that you did in Harvard.
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So you grew from, having this ITI scholarship in Harvard now to be one
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of the board members, actually the global board members leading the ITI,
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which is a very prestigious position.
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How do you look at the ITI what makes the ITI such a special community
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for professional development?
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Yeah, I think the ITI is an amazing community.
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It is, there is a place for everybody.
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I think whether you are an academic a young experienced clinician, I think there
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is like so many things you can get there.
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It's, it is really a wonderful organization and I also like very much
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the way it has developed over the years because if I have to be truly honest.
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When I was a scholar I was not fully into this very conservative approach.
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And because I was not trained initially like that.
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So I think now the ITI has really developed and is now much more
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open minded and also building.
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Help building some evidence.
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The evidence based approaches is very important because, this is a way to, to
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provide safe treatments for the patients.
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But I also like to be progressive.
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I, for me I always want to challenge what we are doing today.
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I hope that in five years, 10 years, 20 years from now we
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changing and we are in an era where.
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Everything is changing and there are so many opportunities.
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So I'm very excited about, about what we have in front of us, actually.
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Yeah.
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No, and I agree.
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Scientific data is something to do to create, let's say safety for
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the patient, but also progress.
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It's both.
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And now you're leading the global ITI research committee, which is
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actually the position that shapes also the vision and the strategy
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behind the research focus of DI.
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What is your vision?
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Be behind this, if you look back in five years from now, what
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would you wish to have achieved?
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Yeah.
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And when we were talking from scholarship to being here now in the
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board and leading a committee that I, yeah it's really inspirational
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to shape this because the research committee was, always granting research.
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Which we are still doing, but we also now try to go beyond that and propose new
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opportunities for the young researchers.
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We have now developed a research mentoring program.
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Because we don't want only.
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In, want to invest in, in some specific research project, but we also want to
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invest in, in people we want to, the goal, the ultimate goal is basically
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to improve the quality of research in implant dentistry worldwide.
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And we know that there are some groups that are in very good environments
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that have good mentors but there are also out there lots of young
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researcher that, that need to
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have less guidance
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to have guidance.
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And this is what we want to provide and bring talents
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together like mentees and mentors.
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And when I like to say bringing talents together because we also in a time
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now where experienced people, and I don't feel yet fully experienced.
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I'm a little bit in the middle of my career,
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We always learn
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but there is this intergenerational exchanges.
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Yeah.
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I actually today learn.
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A lot from my post grads.
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I learn a lot from the younger generation.
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And I think it's all about an exchange today.
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We learn from each other particularly
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in this area of digitization, where actually you have some
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digital natives that, it's just natural for them to use some tools.
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And for us we have actually have to make sure that we keep up
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with with this young generation.
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So I think this exchange has become even more important nowadays
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that technology advances so fast.
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Yeah, I think that's a very important finding.
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To be honest, I think this is, I mean it's written in many books that we
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are in an age and where we, let's say, are in a generation where we'll learn
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probably a lot, much more from the young generation than any generation before us.
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And I think we need to be very mindful of this because technology is evolving so
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fast and comes probably a bit more natural to younger people than and to us that,
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that are growing up with this technology.
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And I really believe that also investing into the people makes a lot of sense
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because the knowledge has become omnipresent and omniac accessible.
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So it's not that you actually need to have access to very specific knowledge,
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and you go to a group and only that group can help you with that topic.
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You can read that everywhere.
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So now it's about the smart people are think, thinking in the right way
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and actually then doing the research.
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So I think
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Critical thinking.
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Exactly.
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Makes a lot of sense.
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That's, and also curating knowledge.
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I think that's what the it TI also does.
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It's not about asking the AI and just believing what's written
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there, but to make sure that there is really the data behind.
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And then I think this is also what the ITI is doing.
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Very strongly.
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Yeah.
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And having the right interpretation.
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This is, this relates to critical thinking,
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But I like what you said to, to help to bring together talent and, to mentor
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young talents in the research career.
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And I have to say, I'm truly impressed by what I saw at the
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idea annual meeting in Paris.
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You know that a lot of young talents, a lot of young energy
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that is driving the idea.
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And I think this is what you guys in the board are doing very well to have
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this focus and to make the idea very.
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Attractive, a good place to be for the young generation.
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So that was very impressive to see beyond the itt.
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There more, you're very active in the EFP, you're doing local education, how, what
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is the motivation behind your passion for mentoring and helping people to progress?
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Yeah.
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I think being an academic, it's different jobs actually.
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You have the clinical part, you have the research parts and of
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course you have the education parts.
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And I think seeing people growing is fulfilling.
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And and yeah, this is what makes me happy, I think at the end.
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Is to see, some of my team member that we are doing a good job together
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and to see some of them growing.
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I think this is what I like about, about teaching.
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And teaching is different setups and different sizes of rooms.
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And then you are feeling some of the biggest audiences in in congresses.
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So you speak in front of a lot of people, how important is this for you and, how
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much is this shaping your purpose for, let's say, dentistry and educating people?
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Yeah, I think I'm very privileged to have this opportunity to have big audience
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and and this is a, an opportunity of sharing what we are doing, what
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we are developing and basically also share how to do it in a proper way.
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Because at the end the.
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The people that benefit from this is the patients, is the population.
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And it's a very nice role.
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And opportunity.
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Yeah.
15:29
Yeah.
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Another thing we have to speak about one topic as well because we
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are very passionate also to help.
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More female talents and leaders, to progress.
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And I think you are a great role model for us in this sense.
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You are one of the female leaders in academia.
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You're on stage, you are famous today.
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You do great work and you love it.
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I sense this, and you have the passion for this.
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So how did you get to this point and what were some defining moments for this?
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Some supporting systems that have been important for you to develop a
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career you have developed because you, in, as you said, in parallel you, you
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also, let's say, created a family.
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You, you are a mother of two boys.
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So what was really critical for you to be able to go this way?
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I am very passionate about my work.
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I love it.
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And for me, it doesn't have to be, but for me, this is part of
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my balance and my family knows it.
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My kids know it.
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And we were yesterday evening talking about maternity leave.
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And and I feel very close to my kids and I spend a wonderful.
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Few months during the maternity leave, but I was also very keen to go back to work.
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And not everybody want that.
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First of all it's a choice.
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There is no external pressure.
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But this is true that in our field, and especially in the surgical aspect,
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it's very often that I'm in, in a room or in an environment with more.
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More males, male than female.
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That's but I don't feel we, we are in a country in Belgium where I never
17:03
felt treated different, but I also see from my students or in general,
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that we are not behaving the same, we don't have the same approach and
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we need to be approached differently.
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A woman would not spontaneously stand up to say, oh, I wanna do that because
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we need to be pushed a little bit.
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And there, and there are, I think, science around that as well.
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So yeah I'm very happy to be considered as a role model.
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And I would always, support women and not only women of course, huh?
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It is a little bit, sometimes a tricky topic.
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Yeah.
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Should they be treated differently?
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But I think the environment should be, we should address them differently.
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In what way?
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For example, if there is an open position, maybe a woman will not
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feel confident to even apply.
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And if someone tells her, you have the right profile, you should
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do it, then this is helping,
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that can change a lot.
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These are little things, yeah,
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exactly.
17:59
It's so similar to what we observe, when we, let's say
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recruit for leadership positions.
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That it needs a lot of support and encouragement actually.
18:08
Who encouraged you then to do this?
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You said?
18:10
There was people encouraging you.
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Who was the people encouraging you?
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I think I have an inner desire to to go there.
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That was very clear.
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Even when I was a student, I knew that I wanted to have an academic career.
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My grandmother was a physician and she was one of the first female, first physician,
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so probably now that you ask me, yeah.
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Maybe that has become influence.
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Yeah.
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During the war, she was a student and she was in the resistance and,
18:39
I, it's true that I was I, when I was a kid, I, I interacted with
18:43
her and probably she's role model.
18:45
So you were looking up to her.
18:46
Yeah.
18:47
Which is a, she must have been a great person.
18:49
From what you're saying, there is also community question on this
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topic, and I'm not surprised from Kelly, from actually Australia.
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Any advice for female clinicians looking to advance into leadership
19:02
and, being an opinion leader.
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That's a very good question.
19:05
Thank you for the question.
19:07
Yes, you can, yes you can.
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Believe in yourself.
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Don't be shy.
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Ask for advice.
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But there, if there is like a, even a very small wish to to get there
19:19
we, yeah, they have to go for it.
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Go and try.
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Yeah.
19:24
Yeah, that's a good advice.
19:25
Excellent.
19:27
So you also a very good example, force of building a collaboration
19:31
between academia and industry.
19:34
It's no seeker.
19:35
We are collaborating a lot.
19:36
We do research projects together.
19:39
But you build an ecosystem around you, which I think is important and brings a
19:42
lot of exciting projects to your team.
19:44
I can imagine.
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How do you do this?
19:47
How do you create this ecosystem and how do you look at the
19:49
collaboration, academia and industry?
19:53
I think, I would with the industry or with others, it's
19:56
always nice to look at synergies.
19:58
Collaboration and synergies.
20:01
I. I would also, want to have trust.
20:05
For me the stress and to be on good foundations is something an important
20:10
and then it brings good vibes.
20:12
But we always stronger together than alone.
20:16
I was telling at the beginning, I am a team person.
20:19
I have, some of my I'm creative, I have ideas.
20:23
I was telling I'm a dreamer, but I need to be sometimes a little bit put
20:28
back on the track and if it doesn't always come naturally from my side and
20:32
some of my colleagues sometimes do.
20:34
And then together we find a good strategy with the industry.
20:37
This is very similar actually.
20:40
I'm learning a lot from the industry and I want to learn more because
20:43
the approach is very different and you and you in the industry are
20:46
much more advanced when it comes to strategy compared to the academic.
20:50
Sometimes the academic is a little bit slow to my taste.
20:54
So I think it's an next change and a win-win.
20:56
The way we know you, you always, as you said in the beginning, you are
20:59
in a dream state and you try to, you wish to, to push things forward.
21:03
So that's always appreciated.
21:04
And let's face it, I think at the end and I think a lot of
21:07
people that have not disclosed collaboration, underestimate this.
21:11
It's a symbiosis between industry and academia.
21:14
We.
21:15
Do good research on products and stuff that we have in the
21:18
pipeline without you guys.
21:19
So we need each other.
21:20
It's a coexistence that, that for us is success critical, especially if
21:24
you really want to innovate, right?
21:26
It doesn't go without.
21:27
So this symbiosis is very strong and it's also for us.
21:31
Being close enough to what we call the problems we're solving.
21:33
Who can better describe that?
21:35
What does not work?
21:36
What is, what are, what is your clinical dream that how can we do
21:39
dentistry in 10 years from now?
21:41
That's something that needs to come from academia, from clinicians.
21:44
And I think, to have this understanding of how you can formulate those things
21:48
that you want to be solved so that we actually understand it and vice versa.
21:51
How can we explain what input we need?
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I think that makes the collaboration strong.
21:55
And and we see this with some of the clinicians working extremely well.
21:58
And then also there is innovation.
22:00
There is all of a sudden in this intersection, most of it I think happens.
22:04
So if you stand for yourself and alone.
22:06
I think there will be no progress.
22:08
Yeah.
22:08
This is a complementarity.
22:09
Yeah,
22:09
absolutely.
22:10
Yeah.
22:11
To close on the personal chapter, we have a question from someone
22:15
that is named Eik Scheignitz and I think we know it very well.
22:18
His question's very simple.
22:19
Why triathlon as a aports?
22:22
Yeah, we haven't talked yet about sport.
22:23
I'm also trying to integrate that a little bit in, in my
22:26
life, in the complex equation.
22:28
I'm, because I'm sportive, but, actually I was talking, I like to work as a team,
22:32
but for sports, I'm not a team player.
22:36
I'm very bad with everything like ball and most of the team sports are with a ball.
22:40
I like under run sport.
22:43
I'm not as crazy as Eik.
22:44
I'm not doing Ironman and so on, but I, the triathlon is a complete sport.
22:50
You, swimming is known to be very good, biking as well.
22:53
And in Belgium we have, biking culture.
22:55
In south of Belgium we have mountain biking culture.
22:57
So this is something I grew up with and the running is the
23:00
easiest to do just to train.
23:03
So I thought it's, it was a good mix because if you do
23:07
only running, for example, it's not very good for your joints.
23:10
And so yeah, yeah.
23:11
Complete work sports, but I'm not a crazy person.
23:15
I just do little triathlons to have an objective and to keep up on moving.
23:20
But why does it matter to you?
23:21
The sports?
23:22
Is it something to do with your balance?
23:24
I imagine with, your family the research, the speaking activities.
23:29
Yeah.
23:31
You need to focus your energy somewhere.
23:33
But I think it helps me reflecting it.
23:35
It's also a little bit part of my competitive, I have a little bit
23:39
of a competitive mindset as well.
23:42
But it's not a competition with others.
23:43
It's a competition with myself mainly, I would say.
23:46
So yeah, we have to integrate the body in life, and.
23:50
Yes.
23:50
It's something to do with longevity for sure.
23:52
Yeah.
23:53
Yeah.
23:53
We touched upon this also with Eik, so that's yeah.
23:56
Okay, good.
23:58
So then let's also dive a bit into your clinical work.
24:02
So clinical research particularly, and as a professor and also as the chair of
24:07
the ITI research committee, you see a lot of ideas actually coming and also going,
24:13
but what do you believe is important topics for dental implantology in the next
24:19
years to come where should, our industry, but also your profession focus on?
24:23
There is a boom now we have, of course there was all this digital era that has
24:29
progressed a lot over the last years.
24:31
And it will continue.
24:32
And I think it did change a lot.
24:35
What we are doing and.
24:36
Precision, I think, and the quality of care when it comes to implant dentistry.
24:41
We this, for me, this, I feel it like a huge benefit.
24:45
And now you have all the ai era coming and integrating all this together.
24:51
We will shift towards like more personalized, targeted treatments and,
24:57
i'm very curious how the medical field, not only the dental or the implant
25:02
dentistry field is going to move.
25:04
We have to the profession is going to change.
25:07
Change to change, yeah.
25:08
And we need to and I think it's a good thing because it's
25:11
for a better in principle.
25:14
But we also have to integrate that ethically talking and, i'm not sure I
25:18
have, I realize fully how it's going to be in, in the next 10, 20 years.
25:24
Yeah.
25:24
Maybe we can touch upon this a little bit later as well, because I, it's very
25:27
fascinating to also hear from you how you could envision being also a dreamer
25:31
person this to actually change our profession and maybe particularly that's.
25:38
Oral health has a stronger link than we believe with general
25:41
health than it is maybe lift today.
25:44
And maybe some of these movements here also go in the direction to
25:47
change the profession of dentists 'cause the more you're involved
25:50
also in general health, the more you have a broader responsibility.
25:53
So how could that evolve?
25:55
But maybe you have some time on in the last question
25:57
because we're there of course.
25:58
We want to know a bit more how you see dentistry in 10 years from now.
26:02
You are also very active in creating guidelines in different ways.
26:07
And just recently also the ITI treatment guide number 14 became published.
26:12
It's about immediate implants.
26:14
And here maybe for the audience, could you share what are the one to two key
26:18
takeaways that every implantologist should actually know today?
26:23
Yeah, it was, for me, it was a very good, nice opportunity, a privilege
26:27
to introduce this this treatment guy together with Adam Hamilton.
26:30
It, it was very nice also to.
26:34
Structure the ideas when it comes to the immediacy.
26:37
And and it was nice also that Adam and I, we didn't have lots of arguments.
26:41
We were really having a very similar vision.
26:44
And I'm very happy with what we came with.
26:47
This is really like a nice little cooking book for immediacy
26:50
and also in a way that it's.
26:53
Safe and predictable.
26:54
Because we don't want to compromise the outcomes.
26:58
I'm not saying this is the only way we can do that we should do.
27:01
But now definitely immediate implant.
27:05
We, especially the single, here in the book we treat we consider single tooth
27:12
replacement is something reliable.
27:14
It's something that works, of course.
27:18
You need to do it in a proper way.
27:21
You should not compromise implant position.
27:23
We know that prosthetically driven, but also biologically driven implant
27:29
positioning is important and this is what might be a little bit more complex to do.
27:33
With immediate implant.
27:34
But on the other hand, immediate implant goes.
27:37
To with a flatless surgery.
27:39
So at the end the procedure invasive topic, straightforward and less invasive.
27:43
And this is what I like about that.
27:45
But the key message is, yes, this is predictable in certain cases
27:51
when it's favorable, but definitely the in indications as ground,
27:56
we have the evidence for that.
27:58
And the planning is really a key to be successful.
28:01
In a few words, this is what I would say.
28:03
Excellent.
28:03
So for everyone invited to look into if they haven't yet done that.
28:08
In mid June this year, there was in Boston the GCCG the global consensus
28:12
for clinical guidelines, and you are one of the around, about 120 selected
28:18
clinicians that actually participated.
28:20
Can you share a bit what you discussed there and, what you
28:23
hope that these guidelines will actually have an impact in terms of
28:27
benefit to the patient in the end?
28:30
The GCCG is particularly an important consensus.
28:34
There are many consensus workshop or, organized by different organizations.
28:38
But here, what was very special and unique is that this was bringing
28:43
organizations that are linked to implant dentistry from all over the world.
28:47
So it's really, okay, we all sit together.
28:49
And we discuss a specific topic.
28:52
And in this case, for the first one, it was about edentulous patients.
28:56
How to restore edentulous patients.
28:58
And it also brought scientists, academics, but also clinicians like experts, and we
29:07
don't have the evidence for everything.
29:09
So of course for a consensus, we look at the evidence, we look what is out
29:14
there, but we don't have all the answers.
29:16
And then we complete the questions with some of the opinions from experts.
29:23
And based on that, we all agree with a treatment guideline,
29:27
like A frame that at some point.
29:30
Patient can be treated in d different part of the world
29:34
with a certain standard of care.
29:36
And this is also going to be very important in order that patients are
29:41
are treated well all over the world.
29:44
But it, it also gives a mainstream, of course, at the end, you need to
29:49
adjust that because you're not, you're treating a patient, you treat the
29:53
human being that has specificities.
29:56
Which is, of course, we talked about her health.
29:59
We can talk about personality economics or demand.
30:03
It's very individual
30:04
so we need a mainstream.
30:06
But then at the end it's is the clinician and maybe in the future a bit more of AI
30:10
as well helping to shape the proper plan, the proper treatment plan and procedure.
30:17
I find it very interesting when you say it's also becoming clear
30:20
at those consensus conferences, what evidence is lacking.
30:23
So you're probably looking for evidence and I didn't realize, but it's not
30:26
covered to the degree that I would wish for to come up with guidelines.
30:30
So how do you see the link between that work and also your work in
30:35
the ITI research committee meeting?
30:36
Does it give you some guidance where to invest in research?
30:42
Absolutely.
30:42
And actually this is sometimes one of my big frustration is that, sometimes
30:48
we doing things since years in, in practice, but there, there is not
30:54
strong evidence and actually doing research to to demonstrate something
30:59
it's not so easy and it's quite slow.
31:01
And sometimes it can be a little bit disappointing and you can also, you
31:05
don't need to demonstrate everything, some questions are logic or so yeah,
31:11
then I don't remember the question.
31:13
Those are probably the guidelines also can fill in some of these gaps that
31:16
you don't need to research everything, but it's just common practice and
31:20
you actually put it into into.
31:22
Cookbook not to oversimplify, but I think that's that's an important element.
31:26
Yeah.
31:26
And it gives also the guidance for what is missing and what
31:29
is important to to demonstrate.
31:31
Yeah it helps shaping the future also of research.
31:35
Definitely.
31:36
I think a very interesting topic is, the different speeds that we see now, you
31:39
said, look, sometimes your frustration is how slow it is to generate good evidence.
31:43
It just takes time and it we, we know it, it's a demanding process.
31:48
And on the other side, you have the speed of innovation, driven by
31:51
digital ecosystems, ai technology that is outpacing the speed of
31:58
how fast we can create evidence.
32:00
How do you see this one?
32:02
Absolutely.
32:03
Now this is going so fast in, in the technological developments that.
32:09
Building the evidence behind that at the same pace is really complex.
32:13
It's incredible, difficulty.
32:14
And also when you do a very well designed study, it's a very specific environment.
32:18
And this is important studies to, to answer like a specific research
32:22
question but it's not necessarily what's happening out there.
32:26
And I am convinced that the real world data is also super important and
32:31
can help to build evidence quicker.
32:36
And it's a different type of of research question, I would say but it represents
32:41
what, what is really happening.
32:43
So now with all these building of this big data and I think this is
32:48
almost our responsibility to collect the data of what we are doing and
32:54
have some large scale data that will help understanding what's going on.
32:59
On the real life, the real world.
33:01
But also we can integrate all this data in order to implement
33:07
and to learn from them having predictive models and in the future.
33:11
This will happen a lot.
33:12
That's the perfect segue also to the registry, right?
33:14
So when you're talking about real world data you need to collect it and
33:18
you need to have a system behind that.
33:20
You are using the Strong registry.
33:22
Can you tell a bit more about what you're actually expecting out of it?
33:26
Why are you using it and has it already impacted how you do clinical work?
33:32
So basically with the Implant Registry, registry from Straumann, you
33:36
bring a lot of data into a registry into a digital chart, let's say.
33:40
All patients related to the patients, like the medical history, the risk factors
33:44
and everything that relates to your procedures, the type of implant surface
33:48
and so on, but also type of procedure, adjunctive procedures and so on.
33:54
And the idea is also to do the follow up of this.
33:57
It is a wonderful tool that I actually implement in our clinic at the
34:03
university for traceability because it's, it was something required.
34:07
So the first golden, the first reason we brought it to the
34:10
hospital for was for that reason.
34:12
Okay.
34:13
But then of course it's also like a good management tool.
34:16
It, it's always good to have the real, data type of implants.
34:19
I think for a practice, this is definitely very useful, and you don't need to work
34:22
with Excel sheets anymore if you do it.
34:26
But then as an academic, this is a wonderful source of research data.
34:31
Real world data.
34:33
And, but for that, of course, we want to look with, not necessarily want to look
34:37
at what type of implants we've placed.
34:38
We want to look at the outcomes we want to see.
34:40
And then there is, the challenge now in our clinic is really to have
34:44
a proper follow up and to every time we recall the patients to
34:50
fill out, the is there mucositis?
34:52
Is there peri-implatitis?
34:54
But in a few years from now, I think we, this will be very interesting data.
34:59
Maybe just to promote the registry a bit, I think it's an amazing tool for
35:02
all the practices and clinics and I think we started two and a half years
35:06
really ago and today it's I think we have more than 40,000 patients.
35:10
45,000 yeah.
35:11
Patients entries.
35:13
And that's a lot.
35:13
Imagine, very soon we'll be at a hundred thousand.
35:15
And it's a very powerful pool of data for researchers all over the world.
35:20
And for those people that are actually really stringently managing
35:23
their clinical outcomes as you say.
35:24
Exactly.
35:24
So we are in contact with a lot of clinicians that have been working
35:28
with Excel sheets for years.
35:29
And now this is also we can help to bring that data to actually the registry.
35:34
And I think it makes it much more, I would say, controlled.
35:39
If you want to evolve your treatment protocol, and you
35:41
want to know, am I doing, am I walking in the right direction?
35:44
Am I actually improving things?
35:46
You need to be very patient.
35:47
Your, your recall scheme.
35:50
Maybe after a year you can say now I changed protocol.
35:52
Does it have a positive impact that I expected?
35:55
Now you can measure it, and I think it's this actually a big improvement.
35:59
Now let's also look a bit into the future.
36:01
You, we had discussed yesterday, also quite a interesting vision of your future.
36:06
Maybe you can summarize a bit.
36:07
When you look at, implant dentistry in 10 years from now, how do you
36:11
believe that you're going to practice?
36:13
What's going to be the biggest difference to today?
36:16
And what are you most looking forward to?
36:22
When you look back, 20 years ago, there were some changes, but it's not as fast
36:28
as we hoped, maybe wanted or hoped.
36:31
Yeah.
36:31
For example, if we talking about.
36:33
Cross factors or, or building evidence.
36:36
But on the other hand, I think here we have a kick from AI.
36:39
And what I find very fascinating now is all the whole field of personalized
36:45
medicine and how you, we will be able to implement all type of data,
36:50
whether this is imaging, whether this is just a, data from patient health,
36:56
risk factors or biology biomarkers.
36:59
And at some point we will be able to integrate all this and really do
37:04
targeted treatments and personalized medicine patient specific materials
37:10
or, protocols, procedures, follow ups.
37:13
And that's a very fascinating future.
37:15
So I believe that could make a big impact.
37:17
And we're just scratching the surface now with aggregating the data.
37:21
Yeah.
37:21
These virtual patients or they become more and more I would say
37:25
complete, but it's very strongly based today on static imaging data.
37:31
But now in the future, maybe there is more data that we can gather, as we said
37:35
from the oral cavity because there is so many biomarkers that, as we touched
37:39
on before, are not only linked to oral health, but also to general health.
37:42
I'm very excited also about that future and I think their
37:45
regenerative biomaterials, they could also have a big role.
37:48
What do you see coming in this direction?
37:50
So when we're talking about regenerative biomaterials?
37:53
Yeah.
37:54
It's true that actually my, one of my core topic in implant dentistry
37:59
of research topic is related to biomaterials and our field is also very
38:04
specific because the dental field is not oncology or it's not orthopedics.
38:09
We treat healthy patients in principle, and it needs to be affordable.
38:14
There is in most of the country, not the social security system paying for that.
38:19
When it comes to regenerative, materials, it needs to be
38:23
simple, cheap but efficient.
38:27
We all dream of, for example, growth factors of cell therapy and this works.
38:31
But I'm not sure we're gonna see it especially in Europe, soon in time
38:35
in dentistry because it's expensive.
38:37
And there, this is considered.
38:40
At least in Europe, a little bit as a risk as well.
38:42
, Growth factors and this can invade the body.
38:46
So we have to keep things simple.
38:48
Yeah.
38:48
And then another thing that is patient specific also for biomaterials, because
38:52
in dentistry we are patient specific already since a long time when it
38:57
comes to crown and prosthetic and in the regenerative field, because now
39:01
we have all these 3D imaging and this, it's just almost a demand that is not
39:06
there because the tools are there.
39:08
From the pro production methods like 3D printing meshes that are patient specific
39:13
but also bone regrowth elements that, that can be made fit to the patient.
39:18
But I agree.
39:19
When we talk about cell based therapies it's very quickly or tissue engineered
39:23
therapies, it's very quickly becoming super expensive and, I think here
39:27
dentistry is maybe also standing in its own way because what we're doing today
39:30
is super efficient and also working well.
39:32
Why would a patient spend 10,000, maybe $20,000 for a single tooth
39:38
replacement if it could be done simpler.
39:41
So I believe there is some fascinating topics that could be done, but is it,
39:47
viable from a health economic perspective.
39:49
I believe it's a very good question that we're raising.
39:50
We always need to think of the clinical translation.
39:54
And this is where I always say I'm a scientist, but I'm clinically driven.
40:00
It is really the clinic that needs to inspire the research
40:04
and the teaching as well.
40:06
And sometimes research that are trapped in the world cannot be
40:10
critical in the implementation to of the technology and to the clinic.
40:14
Very true.
40:15
Thanks a lot for sharing all of those knowledge and
40:17
insights and into your journey.
40:19
For us, there is also an invitation for you to ask a question that you always
40:22
wanted to ask us as an industry partner.
40:26
Yeah, thank you.
40:27
Thank you for letting also me challenging you a little bit, let's say.
40:31
Huh?
40:32
No, I wanted to ask you I'm a periodontist.
40:35
Definitely implants are important tools to replace missing teeth, but
40:41
as a period as a dentist, and even more as a periodontist, what I want is
40:45
preserve and keep teeth as, as much as we can because they are the standard
40:51
of care or the No, they are the given.
40:53
That's what we start with.
40:54
Yeah.
40:54
Yeah, exactly.
40:55
As an implant company, a manufacturer, how do you.
41:01
How do you integrate, or how do you see tooth preservation or even maybe
41:06
implant preservation in your strategy?
41:08
How do you integrate this whole health component in your philosophy?
41:14
That's a very good question.
41:15
That's a very good question.
41:17
It's a question we get actually, also quite often now, there's
41:19
a lot of assumptions in this.
41:20
I think, the assumption that, we wanna push, the usage of implants over,
41:25
let's say healthy teeth that have to go even though they should stay.
41:28
And I think, when we start with implant industry, there was the, from the
41:32
founders, the idea to create a solution for a problem that was not solved.
41:36
And there was, if there's a tooth gap, you know what to do.
41:39
And I think, still dental implants are a good choice there today, but it's not
41:43
our motivation to, to let's say teeth go that, have hope and in the future.
41:48
And I think we still see the tooth as the best option today probably.
41:53
So there's a lot of dimensions to it.
41:55
What I like is actually what I observe at the moment is the tendency
41:58
to minimal invasive dentistry.
42:00
And not only to in the surgical field, but also if it comes to the
42:04
two structures that we eliminate when we do veneers and crowns like this.
42:08
So I think this is a trend that, that we are very passionate about.
42:11
Yeah.
42:12
But there's a lot and we have Emdogain as an example to, to preserve tooth,
42:15
even though I know it's not preserving all the teeth, but it's a great, has
42:18
proven to be a great tool there as well.
42:22
To start with I fully agree.
42:23
Nothing can beat, biology.
42:25
So if you have a natural tooth that can be saved, I think that's
42:29
the go-to treatment procedure.
42:32
Now, when we look at market data, there is an incredible number of already
42:36
missing teeth and that's fueled by perio carriers, et cetera, and has a lot to
42:41
do with, the the behavior of of people.
42:44
So how they, how they take care of their teeth whether
42:47
they're eating healthy or not.
42:48
And also their means of in, in their environment that they grew up, whether
42:52
they had the chance actually to learn about, how to maintain your health.
42:56
And I think as a company, we have the obligation to make sure that
43:01
these kind of very basic prevention topics, they are also taken care of.
43:06
And I think this is what we're doing with some of let's say our work, there
43:08
is a actually the foundation, strongman foundation that also looks into those
43:12
kind of education topics that really help to prevent the onset of, a history that
43:18
you will lose over years than your teeth.
43:21
Now, on the other hand, I think it's, as Andreas you mentioned,
43:23
it's very, you need to have partners that are very conscious about.
43:28
What are the right teeth to eradicate and take out, and what are
43:33
healthy teeth that should stay in?
43:35
And I think the guidelines that we touched upon as well, this is so important and
43:39
it needs to come, I think also from the medical part, so you as partners as
43:44
educators, you need to take a lot of care, and you do this by making sure that people
43:49
are not just eradicating healthy teeth.
43:52
Now, there is always compromises, and I'm, for example, if you could choose between
43:56
a three unit bridge or an implant, I think also from biological perspective and from
44:00
how much you are invasive, the implant is a very good choice because it maintains
44:05
tissue, it doesn't, take down the tooth substance from the neighboring teeth.
44:11
It maintains bone height, et cetera.
44:12
So it is a very valuable option.
44:15
And now the next step is often the patients that are losing teeth, they are
44:19
also prone to get implant complications.
44:22
So this is where I think then it's also our obligation to come with means
44:26
to detect, prevent, and also treat if there is implant complications.
44:31
So I think this is a bit how I see our role as a company to contribute to.
44:37
Not just creating more tooth gaps, but serving the ones
44:40
that are there in a proper way.
44:42
Absolutely.
44:43
But this is very reassuring to, to see, because I think it's a, it's almost
44:47
an ethical thing and it's important to integrate and as you mentioned in, in most
44:52
of the guidelines in implant dentistry, and especially when we considering implant
44:56
timing and to replacement, the first headline is always, if you can preserve
45:02
it, this is still the number one option.
45:05
I think it's a really great question.
45:06
The more you think about it you realize, we said implant industry came
45:10
a long way, it's working very well, success survival rates are very good.
45:14
But if we discuss it in this context, you still see how much and
45:18
how many things we can still do, developments we can do in innovation
45:23
in treatment guidelines, education of clinicians, education of patients.
45:27
There's still so much to be done, right?
45:29
It's still implant industry in many ways in the early stages, because
45:33
if you look in the penetration, and these are data from the EFP, it's
45:37
only, 15% of the patients that could receive an implant, and 85% of those
45:42
patients are not receiving an implant.
45:45
So I think there's a lot that we still can do together.
45:48
Yeah.
45:48
Yeah.
45:49
There is no doubt that we don't want to prep this and,
45:52
yeah.
45:52
Exactly.
45:53
Yeah.
45:54
So thanks a lot.
45:55
That was an exciting hour.
45:56
Thank you.
45:57
Thanks a lot for sharing deep insights into your journey and your beliefs
46:00
and how you build your career with a lot of passion for the field, wanting,
46:04
going back as soon as possible and having the dreamer mode combined.
46:09
Also with the focus on execution which I think you need both of them and
46:12
having a strong team in your back.
46:14
So many thanks for sharing all of this, and to our listeners, thanks a
46:18
lot for listening in to this episode.
46:21
So watch out to more episodes to come around.
46:24
And then whenever you want to comment, we are happy to receive your comments
46:27
on any of the podcast platforms and also to receive your questions to this
46:31
podcast, but also to future podcast.
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So thanks a lot.