Latest / Straumann® ProTalk / Dentistry is medicine: Why oral health drives overall health with Dr. Samir Abou-Ayash (video version)

Transcript

Dentistry is medicine: Why oral health drives overall health with Dr. Samir Abou-Ayash (video version) · Straumann® ProTalk

• 0:00
  What happens if you're not able to chew properly, you will not
• 0:03
  get everything out of the food in a way as if it would be possible.
• 0:08
  So what happens with your immune system?
• 0:11
  What happens with your general health?
• 0:13
  Yeah.
• 0:13
  Do you really changes the way patients are treated?
• 0:17
  What would you wish that you could measure in the future to
• 0:20
  make implant treatment closer?
• 0:24
  I would say rated by general health topics.
• 0:27
  And I think this is something we have to bring back to the people's minds that, the
• 0:33
  things that they are doing in dentistry, or let's say dental medicine Is medicine.
• 0:41
  And not only dentistry.
• 0:57
  Welcome to ProTalk.
• 0:58
  Welcome to the parts of the industry.
• 1:00
  Welcome to this episode of our podcast series.
• 1:04
  today George and myself have the pleasure to welcome Prof. Dr.
• 1:08
  Samir Abou-Ayash to Basel, and to be guest in our podcast today.
• 1:13
  Welcome, Samir.
• 1:14
  Thank you so much for the invitation.
• 1:16
  great pleasure.
• 1:17
  Thanks for coming over.
• 1:19
  And, to our listeners today, you will learn how the young generation of
• 1:24
  academic leaders looks into dentistry.
• 1:27
  We will speak obviously a lot about, digital dentistry and
• 1:30
  the future of digital industry.
• 1:31
  We speak about the aging population and we speak about how Samir's work, academic
• 1:38
  work, has a very, practical influence on your day-to-day practice out there.
• 1:43
  But first, to start with Samir.
• 1:46
  Who are you in one minute?
• 1:47
  One minute is hard.
• 1:50
  that's why we do it.
• 1:51
  Oh, perfect.
• 1:52
  I would say I am very much of a family person.
• 1:56
  So that is, comes wha what comes to my mind first.
• 1:58
  So I love to live with my family, but I also love life.
• 2:03
  So I am, enjoy the beautiful things.
• 2:06
  I love eating, I love drinking.
• 2:08
  I love going out.
• 2:10
  So this is still my routine, like my balance to dentistry.
• 2:15
  But it's also when I go back in, in time, I think I'm also, I was raised by
• 2:25
  my parents to be, highly responsible.
• 2:27
  So I was, quite different back in the days my parents were both working, so I had to
• 2:34
  take responsibility from the beginning.
• 2:36
  And this goes.
• 2:37
  Through everything.
• 2:38
  So I took responsibility in sports.
• 2:41
  I'm a very competitive person, so it has also stayed within me, and
• 2:48
  at the other side.
• 2:49
  I, think I'm a very unpretentious person and I think these are the main
• 2:53
  characteristics that describe myself best.
• 2:57
  What was the sports that you are competitive in?
• 2:59
  Just that
• 3:00
  you mentioned?
• 3:00
  I was, very much football.
• 3:02
  Okay.
• 3:03
  And, responsibility.
• 3:04
  I was always the youngest, but I had to lead the team.
• 3:07
  So I, in my small village, I was very good.
• 3:10
  So I was not good in a high level, but in my small village.
• 3:13
  So I was the one who was always the go-to guy.
• 3:16
  Last minute ball goes to me.
• 3:17
  And, you
• 3:19
  had to finish
• 3:19
  basically.
• 3:20
  I had to finish.
• 3:20
  You had to score.
• 3:21
  Most of the time it didn't work out, but a different story.
• 3:24
  Yeah, that's, exactly, but that's also a good learning, huh?
• 3:28
  Exactly.
• 3:29
  Zama, you grew very quickly in clinical practice and, also in
• 3:33
  academia, and we come to this later, you have an impressive,
• 3:36
  track record also of publications.
• 3:39
  what drew your attention to, the academic world and the decision finally
• 3:44
  to, to continue your career in an academic, let's say, environment?
• 3:51
  I wouldn't say that it was like a, moment or a actual decision in one moment.
• 3:56
  It was a, let's say it was a process.
• 4:00
  So the process when I started at the university, when I got in involved with,
• 4:07
  research more and more, and, then it came the time when I realized, okay, when
• 4:14
  you're at the university, you can really work on the future of something so shape
• 4:21
  something that you are really looking for.
• 4:23
  And the beginning was absolutely not my idea to stay in academia.
• 4:27
  So it was very clear for me, I will do my specialization training and then continue
• 4:31
  in a private practice or I wanted to have a very high level of education, but, then.
• 4:38
  It went like in a direction when I realized what you can
• 4:42
  do with research, what impact research has on your surroundings.
• 4:47
  So when you have a finding and you can tell the people, don't
• 4:51
  do this, don't do that, and.
• 4:54
  That's always the thing.
• 4:55
  What I'm saying is the, let's say the greater good of being in academia,
• 4:58
  you can really educate people.
• 5:01
  You can like recruit people to be a multiplicator of the things you're doing.
• 5:07
  And this is something you cannot do in private practice.
• 5:10
  And I think that was the, time point when I decided to stay at
• 5:15
  the university to stay in academia.
• 5:18
  Yeah.
• 5:18
  It really changes the way patients are treated.
• 5:21
  Exactly.
• 5:21
  Because we learn with each study, we learn something that hopefully is
• 5:25
  applied in private practice then, later.
• 5:28
  But if you're saying it like this, do you have a, great
• 5:32
  objective in your mind already?
• 5:34
  when you are asking me about a great OB objective, I think this
• 5:38
  may have been the decisive moment.
• 5:40
  So when I realized what is the thing that I want to achieve with my work, so the
• 5:46
  way I'm seeing dentistry currently is.
• 5:49
  I want to promote health for the people.
• 5:52
  And when I say health, it's general health.
• 5:54
  So in dentistry we are like focusing on the oral cavity and we stay in
• 6:00
  the oral cavity with our ideas.
• 6:03
  So we do our treatments, restorative implant treatments, whatever.
• 6:07
  And then we measure the effect.
• 6:08
  But we stay with the effect just in the oral cavity.
• 6:11
  Yeah.
• 6:11
  but the oral cavity, the mouth is the most important thing for life, I think.
• 6:17
  'cause we breathe, we eat, we chew.
• 6:20
  And the thing is, what happens if you're not able to breathe?
• 6:23
  You will die.
• 6:24
  What happens if you're not able to, chew properly?
• 6:27
  You will not get everything out of the food in a way as if it would be possible.
• 6:33
  So what happens with your immune system?
• 6:35
  What happens with your general health?
• 6:38
  And I think this is something we have to bring back to the people's minds that the
• 6:44
  things that they are doing in dentistry.
• 6:48
  Or let's say dental medicine.
• 6:50
  Is medicine.
• 6:52
  And not only dentistry.
• 6:53
  And this is a decisive change that people have to make.
• 6:57
  And maybe also, like when I'm in a group of general practitioners
• 7:02
  and I'm saying, I'm a dentist, you always get the ah, a dentist,
• 7:08
  you always get this feeling right.
• 7:09
  Yeah.
• 7:09
  but the decisive part that we have for general health
• 7:13
  is very much underestimated.
• 7:15
  And not only by general medicine, it's.
• 7:17
  Even underestimated by us.
• 7:19
  And I think that's the important thing to put the light on this and that we
• 7:24
  also understand how valuable our work is.
• 7:28
  That's very exciting and big theme, and it's great to put some data behind this.
• 7:32
  I think this is also probably what is missing.
• 7:34
  Today's sometimes the data to, to prove this, where we believe our health
• 7:39
  has a big impact on, general health.
• 7:43
  I have to ask you one question because you, I know you, you've been studying
• 7:47
  and living in Freiburg, you've been working for and with Joerg Strub there,
• 7:51
  you've been in Bern with Martin Schimmel and Danny Buser with both of them.
• 7:56
  You worked a lot and now you are with Bilal Al-Nawas in Mainz.
• 8:00
  So a lot of great people you surround yourself with and you
• 8:04
  have been able to learn from.
• 8:07
  how have these different schools been different and how did they
• 8:10
  influence the somnia that we see today?
• 8:13
  All of them had a major impact on everything that I'm doing today.
• 8:17
  But first of all, I have to admit, you cannot be luckier
• 8:22
  than me having such an education.
• 8:24
  So when I, started in framework, there was this say, this stroke vibe.
• 8:31
  So Professor Strub was very clear.
• 8:35
  It's all about excellence, but you have to be excellent in everything.
• 8:38
  And only the ones working at the pro department are excellent.
• 8:42
  Yeah.
• 8:42
  So everybody else is doing shit.
• 8:45
  So like we had to do everything by ourselves.
• 8:48
  Our, let's say implant surgery, our, perio surgery, our prosthetics.
• 8:55
  'cause we are the best in everything.
• 8:57
  So that was the attitude that was there and that was something, this vibe that
• 9:03
  was really lifted us to another level.
• 9:05
  When we went to Congress, it was the Freiburg team.
• 9:08
  We were walking around while we are Freiburg, come on, eh.
• 9:12
  Yeah.
• 9:12
  Yeah.
• 9:12
  So that was our attitude, but it was not, I have to admit it, it was not
• 9:17
  only tro back in the days who was there, there were other great minds.
• 9:20
  There was Ralph Kohal, one of the pioneers in, ceramic ceramics
• 9:24
  implants, and there was pet gimo.
• 9:29
  another pioneer, especially in the field of lithium di silicate.
• 9:33
  And so ceramic restorations there was
• 9:37
  with his brilliant mind in the field of digital dentistry.
• 9:43
  And the thing in Freiburg was what Strub created was an atmosphere, like a
• 9:49
  competitive, atmosphere among his seniors.
• 9:51
  And I said, I'm a competitive person, but the thing is, I'm
• 9:56
  competitive when there's competition.
• 9:58
  Yeah.
• 9:59
  And when there, when you're working basically in one team, there should
• 10:01
  not be that much competition.
• 10:03
  So I had the opportunity, and this is maybe one of my biggest strengths,
• 10:10
  that I was good with everyone.
• 10:12
  And so I worked with Ralph Kohal, with Petra Gierthmühlen, with Wael Att I
• 10:16
  still have a very good relation to all of them, and I had the opportunity
• 10:21
  to take everything of their knowledge out that I could get and still.
• 10:28
  You felt that this, atmosphere, this competition was maybe not
• 10:34
  the best atmosphere for a common growth for individual growth.
• 10:40
  Amazing for common growth as a clinics.
• 10:43
  It was hard.
• 10:45
  And then I came to burn and it was the completely other way around.
• 10:51
  So there was Danny, in surgery and you would expect, Danny, we know him.
• 10:58
  Very strong attitude.
• 11:00
  But I was so impressed of his, let's say, of his mind, of
• 11:07
  his ideas and how he, behaved.
• 11:10
  You have to imagine you're there in the first week, you hear knocking on the door,
• 11:15
  Danny Buser, that you know from stage, like an idol standing in front of you
• 11:21
  and ah-huh, I heard you're the new guy.
• 11:24
  can we plan an implant case?
• 11:25
  Ah, by the way.
• 11:26
  You won't do surgery here.
• 11:28
  I know you learned it in Freiburg.
• 11:30
  I show you the right way.
• 11:31
  So that was Danny's attitude.
• 11:32
  But what I found impressive was he was not calling, saying,
• 11:37
  come down, I'm Danny Buser.
• 11:39
  We do an implant case, we plan together.
• 11:42
  He came up to me sitting next to me, not knowing each other.
• 11:47
  And it was really impressive how grounded Dani, Dani behaved.
• 11:52
  And to be honest, when I first saw his seniors operating, I was like, okay.
• 12:01
  I thought I'm excellent.
• 12:02
  'cause I learned surgery under Strub, I saw Ziana operating.
• 12:09
  It was like, oh wow, okay.
• 12:10
  Next level.
• 12:12
  So this is what changed my mind a lot.
• 12:15
  So my mind today is a little bit more like prosthodontist, focus on
• 12:20
  pros, surgeon, focus on surgery.
• 12:23
  So otherwise, when you focus on both fields, you will never get as
• 12:27
  good as somebody who's like focusing a hundred percent just on pros.
• 12:31
  if you do both impossible, you won't have enough time.
• 12:35
  And that was the mindset that came in Bern and then was in Pros
• 12:38
  department Urs Belser, amazing person.
• 12:44
  When I, got to know him at the end of his career, very humble and not
• 12:50
  this fancy type of research was, always about cost efficiency, no
• 12:55
  complications and all this stuff.
• 12:57
  And I learned a lot from him.
• 12:59
  he always said when I wanted to do a clinical study who was always
• 13:04
  questioning, is this actually relevant really clinically for a patient
• 13:09
  just to research that is relevant for the patient, I was a mindset.
• 13:13
  And then came Burg.
• 13:16
  Great researcher.
• 13:17
  I learned from him to do structured research in a way I
• 13:22
  could have never imagined it.
• 13:23
  It was so hard to kick off my academic career.
• 13:26
  And with Burg we had I had 20, 30 publications in one
• 13:30
  year, just relevant topics.
• 13:34
  And just because I learned from him how to collab and how to structure
• 13:42
  research in a way that it's efficient.
• 13:44
  So he helped me a lot to become what I am in the field of research.
• 13:49
  And then Martin Schimmel cannot say that words are not enough
• 13:55
  to describe what he has done.
• 13:56
  Like he completely changed my mind Freiburg, focus aesthetics.
• 14:02
  And we are perfect in aesthetics and we can do everything nicely.
• 14:06
  In Martin completely different way was very much about oral function.
• 14:12
  The thing that I was mentioning before, striving for the bigger good.
• 14:16
  So when we rehabilitate a patient, it may look nice, but what is
• 14:22
  like the benefit for the patient?
• 14:23
  Can he chew better?
• 14:25
  all this relation also in, in relation with the work with the
• 14:29
  elderly patients, where the, general health gets more and more important.
• 14:33
  That was a mindset.
• 14:34
  Martin really branded me and was maybe the most influential
• 14:40
  person in my, academic life.
• 14:44
  And now coming to mines, mines, one of the big German universities.
• 14:51
  I was so impressed and negatively impressed of the pro department, not
• 14:56
  because of the department itself.
• 14:57
  I love the people there, but the atmosphere was like
• 15:01
  research, hostile the research.
• 15:03
  Nobody, so the old boss didn't want to see research 'cause.
• 15:08
  You wanted to have patient treatment.
• 15:10
  'cause that's the thing.
• 15:11
  What gives you money?
• 15:13
  And that, that, that was the focus.
• 15:15
  And now I have to change the mind in the department a little bit.
• 15:19
  But the base is there so everybody can perfectly treat patients there.
• 15:23
  Now we have to implement research.
• 15:25
  We're doing that together with Bilal.
• 15:27
  And this interaction with Bilal is amazing.
• 15:29
  So we know each other for years.
• 15:32
  and he has a very similar way of thinking as I have.
• 15:34
  And I said before, the topic of general health is pretty much in my mind.
• 15:39
  So mines is now for the first time a real hospital.
• 15:42
  So we are working now in a real hospital surrounding with all the other fields
• 15:46
  around, but also like with maxillofacial patients, those are the ones I think that
• 15:52
  can really, benefit from our treatments.
• 15:54
  And now it feels too as if I would be on the right place now to, go the next step.
• 16:00
  Huh?
• 16:00
  Working in the hospital.
• 16:02
  It
• 16:02
  sounds like you bring a very, let's say, field backpack to minds at least.
• 16:08
  I was lucky, as I said.
• 16:09
  Yes.
• 16:11
  Let's go a bit deeper on the publication topics because, you mentioned several,
• 16:17
  very interesting points in terms of how you actually select what
• 16:20
  to publish, what to work on, and you already now have quite a long
• 16:25
  publication list, at the, young age.
• 16:28
  Obviously it must have been something that really sparked your interest, not just
• 16:32
  to do research, but obviously to publish things that have an impact for patients.
• 16:37
  So how do you select your projects?
• 16:39
  How do you make sure that actually you stay true to this, let's say,
• 16:44
  Aspiration that you want to do research, not for the research purpose.
• 16:48
  And there is a lot of publications out there that just are
• 16:51
  Right.
• 16:51
  Not having a direct impact on patient.
• 16:53
  Absolutely.
• 16:54
  So maybe can you do some examples of also projects that you considered
• 16:58
  but then did not do because they did not have a clear impact on patients.
• 17:04
  It's mostly those, there are so many in vitro studies with things you,
• 17:10
  you may consider in dentistry, but it's not actually a real question.
• 17:14
  This is, these are questions coming by the industry.
• 17:17
  Like when new materials come on the market and you don't see the indication
• 17:20
  for the material at all, why should you investigate in that material?
• 17:24
  Just because of the industry that supports you with the materials and
• 17:28
  you can do the research with it.
• 17:29
  So I think time is too precious to do that.
• 17:32
  So when you do research for these things, it's just to increase
• 17:37
  the number of publications.
• 17:39
  But.
• 17:40
  This may be the interest in the beginning 'cause people need to get started.
• 17:44
  But the more you spend time with, with research, you have so many
• 17:50
  opportunities to do research.
• 17:52
  You have to select for the things you're really interested in.
• 17:55
  And when you're asking me how I select my research projects, it's very easy.
• 17:58
  So I'm working really, so my wife always complains why, I'm still working on such
• 18:05
  a high level, clinically, so high level in which means, this high frequency.
• 18:10
  'cause she says when she sees other department chairs, they're not.
• 18:13
  So we're working that closely with the patient that often on the patient.
• 18:17
  So it takes everything, takes time.
• 18:19
  But the thing is, you're not losing the focus on the clinical reality.
• 18:25
  So most of my research ideas come from something went wrong.
• 18:30
  And so something went wrong.
• 18:31
  The question is why?
• 18:32
  So what was the problem here?
• 18:34
  Did I do the mistake?
• 18:35
  Did I select the, material that was not supposed to go there?
• 18:42
  or is it a material problem itself?
• 18:44
  Is it something how I treated the material?
• 18:49
  things like that.
• 18:50
  Or also like when you have, fractures, screw fractures, abutment fractures,
• 18:56
  you have to question these things.
• 18:58
  And these are the things where my questions come from.
• 19:01
  So patients come with complaints or I have an actual problem with
• 19:05
  the, with something that I did.
• 19:08
  So these are my, basic ideas for research.
• 19:12
  And then the development of the bigger good, questioning always, as I said, the
• 19:17
  next level, like I name, for example, eating, biting, chewing, so we measure.
• 19:24
  With Martin Trim's help, we know now how to measure chewing efficiency, but we
• 19:28
  don't know how we measure the impact of a better chewing efficiency on our health.
• 19:33
  So now we need to collaborate with the, let's say, the
• 19:38
  neighboring fields of medicine.
• 19:41
  But if you don't have a publication record before, and you come to
• 19:45
  them, they were, who's this guy who wants to do something now on health?
• 19:50
  What, is this, crazy dentist idea?
• 19:53
  They, don't.
• 19:54
  Actually, take you for full.
• 19:57
  And therefore it's also important to develop first a publication
• 20:01
  record that the people say, ah, he has done something in the field.
• 20:04
  And it's also for the acquisition of funding, I cannot go as, Samira Boash
• 20:10
  15 years before and apply for, like a state funded project of 10 million.
• 20:18
  it's like I will, I'm sure I get the answer within one day, so Okay.
• 20:22
  we won't consider further.
• 20:24
  So I, that's important.
• 20:26
  That's important.
• 20:27
  Yeah.
• 20:28
  I, really like how you actually choose your projects on, impact.
• 20:31
  And, I would wish that in academia this is more often the case because, often
• 20:36
  there is also just a pressure to actually.
• 20:38
  Publish in order that you get enough, ranking, et cetera, that you can
• 20:42
  also, apply for further position.
• 20:44
  So I would wish that it's, it's more considered like this,
• 20:47
  but you know how it is.
• 20:48
  The thing is, I can do it now.
• 20:50
  To get there.
• 20:51
  To get there.
• 20:52
  It's not easy.
• 20:52
  Yeah, exactly.
• 20:52
  It's crazy.
• 20:53
  So to get there, you have to publish, publish, and then you're
• 20:56
  just the reading application.
• 20:58
  Oh, he has published a lot.
• 20:59
  Ah, maybe we can consider him for a position.
• 21:02
  So it's crazy for me that you first have to get into this position.
• 21:06
  You have so many young researchers that would be eager
• 21:10
  To maybe focus on more clinically irrelevant research, but to do it.
• 21:16
  they first have to get there that they can do it.
• 21:19
  And, this is a vicious circle that we have, like a catch 22 basically.
• 21:24
  Yeah.
• 21:24
  We have to question why, we only support, or why researchers in high
• 21:29
  positions just get this high support.
• 21:31
  And not junior researchers maybe that have a good support from their mentors.
• 21:37
  But now you have it also in your hands.
• 21:38
  So it's, I think, yeah.
• 21:40
  Now let's, go a bit deeper into, some of your work.
• 21:44
  actually the ITI Consensus conference, 2023, the seventh one, and you
• 21:48
  were in one of the groups that actually looked at patient benefits.
• 21:51
  So it comes back to your, statement before.
• 21:55
  What was the basic finding out of this group?
• 21:57
  So what are patient benefits of implant treatments?
• 22:02
  It was, for me, it was the first time that the ITI actually really
• 22:07
  in a consensus conference, tried to address patient benefits, not actually
• 22:13
  focusing on just the clinical outcome.
• 22:15
  But also on broader outcomes.
• 22:17
  The outcomes that we defined before the consensus conference was the
• 22:21
  patient reported outcomes, how pa, how patients feel with removable or
• 22:27
  fixed complete dentures on implants.
• 22:29
  so patient reported outcomes, then it was about oral function.
• 22:33
  So if you rehabilitate patients with implants or not, what
• 22:37
  is the effect or what has the bigger effect on oral function?
• 22:40
  Oral function, like chewing, tongue pressure, lip pressure, all this stuff
• 22:45
  that is mainly measured in the Asian world, which is not so common here.
• 22:50
  And then also about, the impact of implant treatment, of keeping the own teeth.
• 22:56
  So if you have tooth loss in the back, so what happens to the
• 23:00
  remaining teeth if you put a denture?
• 23:03
  That gives an unphysiologic load on the remaining teeth, or you put an implant,
• 23:08
  does this preserve the teeth more?
• 23:11
  So they ask questions that are a little bit abroad from the common things that
• 23:16
  we are measuring in implant dentistry.
• 23:18
  And the main outcome was chewing efficiency, can be or is increased
• 23:25
  by implant treatment, at least in ous patients, which was pretty clear.
• 23:29
  What was interesting was, was a hard discussion, that
• 23:35
  patients actually estimated.
• 23:38
  Removable over dentures similarly to fixed complete arch restoration on implants.
• 23:46
  and the, interesting thing is we had severe discussions on that.
• 23:49
  'cause there are people consensus conferences who created their
• 23:53
  business model on it now.
• 23:55
  we are just doing all on four.
• 23:57
  All on six, but needs
• 23:58
  to be fixed.
• 23:59
  they don't want to hear something like, Hey, patients like
• 24:03
  overdentures on the same level as fixed restorations, at least.
• 24:07
  When it comes to the results of patient reported outcome measures
• 24:11
  that we are currently using.
• 24:12
  So you can ask now two questions.
• 24:14
  So is the patient reported
• 24:16
  age dependent?
• 24:17
  So you know, which age, cohort do you, are you taking?
• 24:19
  And are you asking
• 24:20
  this is what we always thought?
• 24:22
  But in the end, it's not age cohort dependent.
• 24:26
  It is age cohort dependent, but you're not, the thing is the ous
• 24:29
  patients nowadays are rather old.
• 24:32
  So you have the cohort from the beginning.
• 24:34
  When you focus on edentulous patients, you normally focus on elderly patients.
• 24:38
  But, the thing is the question that we have to ask, is it
• 24:42
  really like that is, found by the patients to be a similar treatment?
• 24:48
  Or do we just not ask the right questions to the patients?
• 24:52
  Yeah, I, have a little bit my problem then the most common.
• 24:57
  Patient reported outcome measure that we are using is the OIP
• 25:00
  questionnaire focusing on our health related quality of life.
• 25:02
  And there's not a single question on implant in there.
• 25:07
  Yeah.
• 25:07
  And nowadays, it's not only important what the outcome of a treatment is that
• 25:13
  we have a shift in mind of the patient.
• 25:15
  Also, the actual journey there is very important how the patient in
• 25:20
  the end evaluate the treatment.
• 25:22
  So nowadays it's not only about the patient reported outcome, it's also
• 25:26
  about the patient reported experience.
• 25:28
  And this is something that has to get more clearly in our minds and also
• 25:34
  in the minds of the general dentist population, that this matters actually,
• 25:39
  we even have praxis concepts that focus on the experience of the patient.
• 25:44
  Because we realize it's getting more and more
• 25:45
  important de fully agreed.
• 25:46
  It's, so important and there's a nice link to what you said before in terms
• 25:51
  of your goal in, general health.
• 25:54
  What would you wish that you could measure in the future to
• 25:58
  make implant treatment closer?
• 26:02
  I would say rated by general health topics, because right now it seems
• 26:05
  to be very much linked to, I got an implant treatment and I look
• 26:09
  at oral health and, but general health is maybe less considered.
• 26:13
  So what are your wishes for future measurements that go beyond that?
• 26:17
  I, you have to see, I think it, it stands and falls with, what the consequence
• 26:24
  of implant treatment is for me.
• 26:25
  It's clear the food uptake may change.
• 26:29
  we know that especially elderly patients need consulting for that.
• 26:33
  So even if they have better chewing or potentially better chewing efficiency.
• 26:39
  They will not change their behavior.
• 26:42
  but when they change their behavior, we have to measure this impact
• 26:45
  on, we can do this, for example, by, blood values, but we can also
• 26:49
  do that by the body composition.
• 26:53
  when you, have, bad nutrition, you will have more fat mass.
• 26:58
  Yeah.
• 26:58
  And you will see when you, measure it, that you have a
• 27:01
  transition from fat to muscle mass.
• 27:04
  But we are not measuring it in general.
• 27:05
  We are doing this maybe in one of a million studies.
• 27:10
  But the outcome is so interesting and it's actually easy to measure.
• 27:14
  But the thing is, we need this link, what I'm talking
• 27:17
  about, it's require a much broader, I would say, holistic view on
• 27:19
  the patient and collaboration between different, specialties.
• 27:22
  Yeah.
• 27:22
  Yeah.
• 27:23
  And, the thing is, dentistry or dental medicine, we were very good
• 27:28
  in keeping all other people out.
• 27:30
  And so we wanted to keep all other people out.
• 27:33
  We didn't want anybody to tell us what to do.
• 27:35
  And we were happy with it, but I think it has to change a little bit.
• 27:40
  I would like to focus a bit on elderly patients, as you mentioned,
• 27:43
  let's say 65, years of age and plus.
• 27:49
  So how do you see these age group covered in today, let's say
• 27:54
  implant dentistry focus and what we developed over the last years.
• 27:58
  Do you think they, they get enough intention or do you think that's
• 28:00
  something that is underdeveloped?
• 28:02
  How do you look at this group?
• 28:04
  I think they're not sufficiently covered, like especially in research,
• 28:07
  but when we look, it's very interesting when we look, there is something
• 28:12
  Dny has done brilliantly in burn.
• 28:15
  He published trends in implant dentistry in burn and focused on different criteria.
• 28:22
  and then when you see the newest evaluation for the last time
• 28:25
  period, that every second patient who receives implant is older than
• 28:31
  65 years every second patient.
• 28:34
  And so that brings me back to my beginning and I remember it was.
• 28:39
  The discussion back then if a patient older than 65 years should get implants.
• 28:45
  So it was just 15 years ago.
• 28:47
  Yeah.
• 28:48
  And when you look at that, we see the development, but
• 28:52
  we also see some uncertainty.
• 28:55
  And I think what we have to make clear is that implants in elderly patients,
• 29:01
  65 plus, 75 plus they work so well.
• 29:06
  that it was a rumor that they wouldn't work as well as in younger patients.
• 29:11
  But maybe it's even the contrary.
• 29:13
  We see implants in those patients when you go to a nursing home,
• 29:16
  something like that, carriers all around and then you see one implant.
• 29:19
  Implant covered with calculus, with plaque and you have to scratch it
• 29:24
  away and oh, there's an implant below.
• 29:26
  Very interesting.
• 29:27
  Everything is bleeding.
• 29:29
  And you think, okay, maybe I can take the implant just out 'cause
• 29:32
  it was covered so long by calculus.
• 29:35
  And you take, and then you make the p the patient come to the practice.
• 29:38
  You take an x-ray and you see it's fully perforated, a perfectly stable bone.
• 29:44
  and the thing is, this is something that we also found in elderly patients.
• 29:48
  We have more plaque, more bleeding and probing, but we have less perim.
• 29:54
  Implantitis.
• 29:56
  and you think plaque and so on, oral hygiene is a major factor for
• 30:01
  the development of periimplantitis.
• 30:03
  And I think so too.
• 30:05
  But the thing is, we know that something happens as the patient,
• 30:10
  patient ages the immune system ages.
• 30:13
  So we have not fully understand this effect yet.
• 30:16
  But this is the thing that I'm saying, we need to collaborate with
• 30:19
  the other fields to understand that.
• 30:21
  'cause it is really something that we see.
• 30:25
  The implants, the intraoral condition looks worse in elderly patients.
• 30:30
  But actually the impact on the bone stability, the occurrence
• 30:33
  of periimplantitis, we have mucositis, we have bleeding, but
• 30:36
  we have no effect on the bone.
• 30:38
  And we have to understand it.
• 30:39
  'cause maybe it's not only a finding, maybe this could also be a
• 30:45
  therapeutic thing that we can follow.
• 30:47
  If we understand it, why it is like that, maybe we can modulate the
• 30:52
  immune system in a way that it's also working in younger patient.
• 30:55
  I don't know.
• 30:56
  But first we have to understand it.
• 30:58
  big dreams for the future.
• 30:59
  but a very interesting observation and, going back, the, Swiss cohort
• 31:05
  that you mentioned in burn, every second patient is an elderly patient.
• 31:08
  Yeah.
• 31:08
  65 plus.
• 31:10
  I think listening to Danny, it's also a lot of single tooth patients there.
• 31:13
  Sure.
• 31:15
  Which is probably based on a very specific way in Switzerland.
• 31:18
  People since a long time I educated on hygiene, oral hygiene.
• 31:22
  But let's, look into, let's say full large treatments, specific implant
• 31:27
  born removal over the end of patients.
• 31:30
  because I saw you do some work on this and it's a field that is interesting me a lot.
• 31:35
  And my feeling is a bit, I'm, in this industry since 20 years plus,
• 31:40
  not a lot has happened in, advancing treatments of removal over of patients.
• 31:46
  Yeah.
• 31:47
  It didn't receive a lot of attention in research and also in
• 31:50
  innovation, product development.
• 31:52
  Product development as well.
• 31:53
  We have to admit, how do you look at this field, remove lower denture
• 31:56
  and what is it that we should fundamentally do different there?
• 32:00
  So I think the future for Overdentures is actually very bright.
• 32:07
  'cause the thing is what we have to see, first of all.
• 32:11
  It's not only that we place implants in elderly patients, we have patients that
• 32:17
  are growing older with their implants.
• 32:19
  So we will come at the point to the patients maybe when they're ous,
• 32:25
  but they have already some implants.
• 32:27
  So then the question will be, what is, so where is the
• 32:32
  implant position within the jaw?
• 32:33
  Can we go fixed at all or should we just do a removable over denture?
• 32:39
  So I think we will have the patient population coming from there.
• 32:42
  We will have a patient population that is wearing fixed arch,
• 32:46
  fixed fage prothesis already.
• 32:49
  That may be transition to implant over dentures.
• 32:53
  And I think what the consensus conference showed us brilliantly
• 32:57
  that the patient reported outcomes as well as the oral function is so
• 33:05
  much superior with implant supported or implant retained overdentures.
• 33:11
  Compared to complete dentures that I believe in the
• 33:14
  future that we will not see.
• 33:17
  So the, general complete denture, the removable complete denture.
• 33:21
  The standard denture
• 33:22
  We will
• 33:23
  not see anymore.
• 33:24
  I think we will have a transition from standard complete denture
• 33:27
  to implant over dentures.
• 33:29
  'cause the price for an implant overdenture will also decrease.
• 33:33
  So we, we will need the implants for sure.
• 33:36
  But the thing is, with all the new materials that we have, with the
• 33:40
  digital designing processes, the digital manufacturing processes, the costs for
• 33:46
  an overdenture, maybe even without a framework, we can mill it monolithically
• 33:52
  from PMMA highly polymerized, from a pok, we can mill it from zirconia.
• 33:58
  We can even maybe in the future, print it, print, if the material
• 34:02
  properties are well, no.
• 34:04
  So the costs are not higher than for a complete den.
• 34:09
  The only costs that the patient has to cover is the implants and the
• 34:13
  surgery, which may be, and this is also some, something which may need a
• 34:19
  shift of mind, maybe will be covered by health insurances in the future.
• 34:25
  'cause when we have so many benefits, the health insurance should cover that
• 34:30
  when the treatment costs are not higher.
• 34:33
  And maybe we have the health insurance covering it, but we have to say, I don't
• 34:37
  know if the health, insurances want that the patient to live longer, but because
• 34:41
  then it's getting, expensive for them.
• 34:43
  Let's hope and assume yes.
• 34:45
  but again, it's going back to what you said, it's, impact of this
• 34:48
  implant treatment on general health.
• 34:49
  Yeah.
• 34:51
  And it's interesting what you, do, and I think I wanna underline, is you're not
• 34:54
  comparing a removal overdenture treatment to, is it better or worse than, let's
• 34:59
  say a fixed, full, large treatment?
• 35:00
  No.
• 35:01
  But you compare it to a general overdenture treatment, which
• 35:04
  clearly, is, not a great,
• 35:06
  is inferior
• 35:07
  place to be for, for a patient.
• 35:10
  exactly.
• 35:11
  And let's frame it for a little bit differently.
• 35:14
  So you have the patients developing the, evolution in the patient.
• 35:19
  So a patient who is wearing a fixed, complete denture on implants in
• 35:23
  the beginning, maybe at some point.
• 35:28
  For cleaning issues, it may be easier for them to clean and overdenture.
• 35:35
  So we, transform the restoration.
• 35:37
  And with the digital tools, we can easily do that 'cause we had to do a
• 35:41
  design for the fixed restoration already.
• 35:44
  Maybe we can just copy design.
• 35:47
  That we had before, put a denture base below, giving it the denture design,
• 35:51
  and then use the same tooth set up, same tooth position, the same, jaw
• 35:57
  relation, which will also make the adaption for the patients much easier.
• 36:02
  And we know that this is an issue, especially in elderly patients.
• 36:05
  So when this transition comes from fixed to removable.
• 36:10
  thanks to the digital tools that we have nowadays, we can
• 36:13
  even ease the adaption for them.
• 36:15
  and I think when we can ease the adaption, it might not be that big of
• 36:19
  a step also for the clinician to switch from a fixed concept to removable.
• 36:25
  So therefore, I think when this mindset is coming to the people's minds, I
• 36:30
  think that we will clearly see the indication for overdentures rising.
• 36:35
  Yes.
• 36:35
  Perfect segue to, digital.
• 36:39
  let's talk a bit about digital dentistry and, I know you work very digital,
• 36:44
  you're very much interested in, new technologies, in, digital dentistry.
• 36:49
  Lemme start by asking, is there one digital technology that stands
• 36:54
  out for you that really not only changed your workflow on, let's say
• 36:58
  small bits and pieces, but changed.
• 37:02
  Your way, how you think and how you treat patients.
• 37:05
  Completely.
• 37:07
  For me, clearly intraoral scanner was game.
• 37:11
  This was so much a game changer.
• 37:13
  When you think where, it was coming from.
• 37:15
  It was in the mid eighties.
• 37:17
  Yeah.
• 37:18
  When we, see the, two directions like re and France and, Merman here in Zurich.
• 37:26
  Yeah.
• 37:27
  With the idea of intraoral scanning in a, time when I think back to my
• 37:32
  Commodore 64 and they were thinking of an intraoral scanner, it's amazing.
• 37:39
  This was science fiction and nowadays you cannot, I cannot think of a
• 37:46
  world without intraoral scanner.
• 37:48
  So we are doing nearly everything with.
• 37:52
  Intraoral scans, and it's not only a benefit for me as a clinician,
• 37:57
  it's a benefit for the patient.
• 37:59
  yeah.
• 37:59
  Did you know that there is, there's a study looking in why do patients
• 38:05
  hate the dentist going to the dentist?
• 38:07
  There's the fear two things.
• 38:09
  The f the biggest fear is the injection.
• 38:13
  The second one is the impression.
• 38:15
  Wow.
• 38:16
  Yeah.
• 38:17
  The second one is the impression I'm surpris.
• 38:18
  Yeah.
• 38:19
  It's all, it's very uncomfortable.
• 38:21
  So
• 38:21
  it's very uncomfortable.
• 38:22
  And I think we all know this, all the material going back there, we hate it.
• 38:27
  and the intro, all scanner has become a real game changer.
• 38:31
  And now I think it's evolving even across the fields of dentistry.
• 38:35
  So when we look, I have a senior in my team who is very strong in forensics.
• 38:42
  And when we look into forensics, it's crazy, per Interpol standard.
• 38:48
  You have Moon.
• 38:49
  Yeah, moon, yeah.
• 38:51
  you have three ways to identify a person, DNA, fingerprint, dental status.
• 38:57
  So these are the only things that are allowed to identify a person.
• 39:02
  A hundred percent.
• 39:04
  So the thing is, the intraoral scanner can give us so much information here.
• 39:10
  And something that I learned from her is we have a, unique intraoral fingerprint.
• 39:18
  The papilla, I are as individual as the fingerprint.
• 39:22
  And we are collecting these data in every treatment now.
• 39:28
  For forensics, intraoral scanners are getting more and more important.
• 39:32
  So there, there are even like, police departments asking us, which
• 39:37
  intraoral scanner we should buy.
• 39:39
  And so it's crossing borders and so intraoral scanners
• 39:43
  have really changed a lot.
• 39:46
  So for some people this might not be the biggest motivation
• 39:48
  now to get, interval scan.
• 39:50
  But true that, no, that, that's interesting.
• 39:54
  But there's
• 39:54
  data protection
• 39:55
  still.
• 39:55
  There's, data protection.
• 39:56
  Exactly.
• 39:58
  you, published already quite early on about workflow innovation.
• 40:02
  So what we call workflow innovation is basically how do you connect
• 40:07
  digital tools, digital workflows with also hardware that you modify.
• 40:11
  And in this re in this case, I think it was, polished 2019.
• 40:16
  It was about, combining heating abutments with, internal scanning capabilities.
• 40:24
  what prompted you to be interested in this, in, let's say this part
• 40:28
  of innovation and, did it really change the game as you, expected it?
• 40:33
  Not yet, I have to admit, but I think it will.
• 40:40
  the thing is what I never understood.
• 40:44
  So when the patient came to me and I had to take my impression independent of, if
• 40:48
  it was like digital intraoral scanning or conventional implant impression, you have
• 40:54
  to dismount the healing abutment and then you screw your impression post whatever
• 40:59
  in your compressing the soft tissues.
• 41:01
  You trying somehow, maybe you had a provisional, you're trying to
• 41:05
  somehow copy the emergence profile.
• 41:08
  There's so many techniques out there, how to copy the emergence profile.
• 41:12
  And when I read those techniques, I'm thinking, okay, it's very analog idea.
• 41:16
  Analog.
• 41:16
  No, it's either analog or it takes me an hour.
• 41:20
  I think digital tools should ease our lives, so make our workflows efficient.
• 41:25
  And the idea of having a scannable, healing abutment that is already
• 41:31
  conditioning the soft tissues in a way that I want them to be, and I don't
• 41:36
  have the need to disrupt the connection between the soft tissues and the
• 41:40
  healing abutment by taking something out, putting something in, taking
• 41:43
  something out, putting something in.
• 41:46
  Amazing.
• 41:47
  And we, now, in, minds, we have created the workflow after surgery, the surgeons
• 41:55
  do the intraoral scanning of the, healing abutment, sent the patient home,
• 42:00
  sent me the files, we do the design.
• 42:02
  And the first time that I see the patient is really.
• 42:06
  When they're coming to insert the crown.
• 42:08
  So it's I'm, like a magician for them.
• 42:12
  So I come in, I have a crown for you.
• 42:14
  Beautiful.
• 42:15
  Before it fits.
• 42:15
  And it perfectly fits.
• 42:17
  Yeah.
• 42:18
  they did you do that?
• 42:19
  Exactly.
• 42:20
  So
• 42:21
  excellent.
• 42:22
  Is taking the pain and you are the hero.
• 42:24
  That's, I love it.
• 42:25
  I, love this work share.
• 42:29
  But you spoke about your, the, impression, the, inal scanners left
• 42:34
  on you, but still Samir, we have to admit, penetration of digital tools
• 42:40
  in the industry goes very slow.
• 42:42
  And at the end, I mean if we speak about workflow innovations, be it for removal
• 42:48
  of a single tooth patients, you can only benefit from future innovations
• 42:52
  if you have an intraoral scanner.
• 42:54
  otherwise you're just locked out of innovation for the future.
• 42:58
  from your perspective now, talking to the teacher in you, what is it
• 43:03
  that all involved parties have to do to really, let's say, accelerate
• 43:07
  the adoption of intra or scanners and digital tools in the industry?
• 43:12
  That's a good question.
• 43:13
  The question is if we really want to accelerate, and I'm
• 43:17
  saying that, and I'm saying that because of a very important thing.
• 43:22
  the, whenever I see there are so many brilliant.
• 43:26
  Inventions in the field of digital dentistry, but in the end, it's sometimes
• 43:32
  hard to get them in the process chain.
• 43:35
  So a workflow that works nicely for a very small part can be very
• 43:40
  frustrating when it is not connected to, like a perfect treatment chain.
• 43:47
  And so like after this step, you do this digital step.
• 43:50
  When you have to go back in the, real world, it is not the,
• 43:56
  thing that you want to have.
• 43:57
  And I see this when, things are thrown on the market very fast, they have
• 44:01
  nicely thought about one problem, but not the problem or the next step that
• 44:06
  comes after solving this problem.
• 44:07
  This is very frustrating for the people 'cause they buy,
• 44:11
  let's say an expensive tool.
• 44:14
  And then they just solve a mini step.
• 44:18
  In the treatment.
• 44:20
  and therefore I'm saying, I don't know if you want to accelerate it, that I would
• 44:24
  love, when we have more digital tools on the market, the penetration through the
• 44:28
  market would be bigger, would be amazing.
• 44:31
  But the thing is, it is very important to, to be very thoughtful how you launch your
• 44:37
  products in the markets and to make sure that you don't have this frustrational
• 44:42
  moment for the practitioners.
• 44:43
  'cause when you have this frustrational moment, it'll take more time if
• 44:48
  you, or for the practitioner to do again, a step in that direction.
• 44:52
  So maybe by throwing things too early on the market, we
• 44:56
  even decelerate this process.
• 44:58
  Because the people are aware that something may go wrong.
• 45:03
  Things that we don't have asked yet is even if we come with brilliant
• 45:07
  ideas, with complete workflows.
• 45:10
  Is the infrastructure already there?
• 45:12
  That we can apply all these beautiful things that are very
• 45:17
  well thought of by the industry.
• 45:19
  So sometimes it's not even.
• 45:21
  Let's say the prices that hold the people back or the integration
• 45:26
  in the complete workflow.
• 45:27
  Sometimes it's just the infrastructure and the, speed of the wifi,
• 45:35
  let's say the cloud server.
• 45:38
  Now the cloud servers that are somewhere in the world, people are, some
• 45:43
  people are very concerned about that.
• 45:45
  Yeah.
• 45:45
  They don't know where the data are.
• 45:47
  So there are companies that are really going on a cloud-based workflow only.
• 45:53
  and the idea, I think it has to come like that.
• 45:58
  I, think that we will see this shift, but the thing is, I understand people
• 46:03
  that are a little bit reluctant to these things 'cause they're
• 46:06
  questioning, okay, where are those data?
• 46:08
  I don't see those data and.
• 46:10
  No, this is something where we have to convince the people to tell
• 46:16
  the people to give them security.
• 46:18
  And I think this is very important when we really want to accelerate the penetration
• 46:22
  of digital tools in the, in our field.
• 46:25
  I think that's a fair objection.
• 46:28
  you know that we created a lot of digital islands and then, people
• 46:31
  have to jump islands, but in between they have to go enter all again.
• 46:34
  Exactly.
• 46:35
  Which is very cumbersome.
• 46:37
  And I think this is where all this, ecosystem and platform.
• 46:41
  developments go to Yeah.
• 46:42
  To create an infrastructure that, you have a digital tool and then
• 46:46
  you stay digital and you continue.
• 46:48
  yeah.
• 46:48
  Exactly.
• 46:49
  As I said, the treatment chain, the, continue, the treatment chains continues
• 46:52
  digital and goes digital from one step to the other in a flawless way.
• 46:56
  And I agree, there's, a way to go.
• 46:58
  But I think, the platforms developed like trauma access and others.
• 47:02
  I think that this, is the step that was, much needed.
• 47:05
  Huh.
• 47:06
  And we need that without, the industry.
• 47:08
  Yeah,
• 47:08
  exactly.
• 47:08
  Without giving us the opportunity to go those ways.
• 47:12
  Nothing will move forward.
• 47:14
  So I love it that you, guys doing it on a great level.
• 47:17
  Thank you for that.
• 47:19
  But I, see the, I see the point for some of the practitioners to
• 47:24
  why, the adaption is not as fast as I think we all wish it to be.
• 47:28
  It takes a lot, I think just this compartmentalized data,
• 47:31
  it's just not impactful.
• 47:34
  So if, you have your data locally on your machine and you can't share it with,
• 47:37
  your lab or let's say with the next step.
• 47:40
  Yeah.
• 47:40
  So it, it actually, I think it takes much more than, initially thought to
• 47:44
  connect those islands and, it, maybe it doesn't meet the eye immediately how
• 47:49
  much is needed in the background Yeah.
• 47:51
  To make those connections actually work reliably.
• 47:54
  I think these are things you are thinking about.
• 47:56
  These are things we are thinking about.
• 47:58
  Yeah.
• 47:59
  But, I think we all have imagined in the beginning it's gonna easier, faster.
• 48:03
  Yeah.
• 48:03
  It's much easier.
• 48:05
  And you compare also to consumer, let's say data handling that is
• 48:08
  like already at the very high level.
• 48:11
  Yeah.
• 48:11
  But we, see already some technologies, in our hands on the mobile is already
• 48:15
  available for us since 10 years plus, some of the things we just now
• 48:20
  have to transfer to also, implant industry, cloud-based systems that,
• 48:26
  we haven't had for a long time.
• 48:27
  And I think it's about time.
• 48:29
  And it also, it's not having it, it's also limiting for us,
• 48:32
  a lot in the innovation space.
• 48:35
  Samir, I know you also, from being very engaged in, associations like in
• 48:41
  the, German Association for Implants, dentistry in the ITI and in the German
• 48:47
  Association for Implant Industry.
• 48:48
  You've been, let's say, representing the young generation for quite a while.
• 48:52
  And, so, you're active in this space of associations and then foundations,
• 48:59
  what is it that from your perspective, these associations have to do
• 49:04
  differently in the future and bring to the table to, to really help the young
• 49:08
  generation to, to do the next steps?
• 49:10
  How do you look at this?
• 49:12
  That's an interesting topic because
• 49:16
  some of the, institutions, some of the, let's say the, faculties and
• 49:23
  so on, they're pretending that.
• 49:26
  The young generation, they're difficult.
• 49:28
  They don't want to engage.
• 49:30
  So the thing is they want to engage, but maybe the people are not
• 49:34
  understanding that they want to engage.
• 49:37
  when you want people to engage, you have to give the people some trust, to
• 49:43
  give the people also space to engage.
• 49:47
  So some of the, let's say the German Association of Implantology, the
• 49:54
  ITI and so on, they have understood that they have to create paths, to
• 50:01
  create ways and to also include young role models that go the way like.
• 50:08
  Starting as a young fellow, whatever, and moving up in the hierarchy.
• 50:14
  But there are also, now let's say the German Association of
• 50:17
  Prosthodontics, which is, I have to admit, a retirements club, or they
• 50:25
  pre behave like a retirements club.
• 50:28
  They, it's, there are so many people, there are so many brilliant minds.
• 50:32
  They have all deserve to be there 'cause they have done so much for
• 50:35
  prosthodontics, but they don't leave enough space for the people to engage.
• 50:42
  So maybe because of fear, maybe because they do not understand
• 50:46
  the, ambitions of the young people that come with disruptive ideas.
• 50:51
  Now.
• 50:51
  Like when you, when you show them like a.
• 50:56
  TikTok style videos, YouTube, shorts, whatever you showed it today.
• 51:00
  They were, what is that?
• 51:02
  What
• 51:02
  is this?
• 51:02
  And, but this is how education Has to be nowadays if you don't do that.
• 51:08
  And I think this is a task that, that some major companies, some major,
• 51:16
  educational sites have understood.
• 51:18
  If you don't take this out, you leave the space for rubbish social media education
• 51:25
  where you can see things like me.
• 51:28
  I'm sitting there.
• 51:29
  How did that work?
• 51:30
  This cannot work.
• 51:31
  This can work.
• 51:33
  I don't know.
• 51:34
  and if I am asking that myself, go deeper.
• 51:36
  So yeah.
• 51:37
  Yeah.
• 51:37
  That's it.
• 51:38
  But if I'm asking that myself, a young clinician sees that
• 51:41
  and says, oh, that's cool.
• 51:42
  I'm gonna do that in my tomorrow practice on Monday.
• 51:44
  Yeah, that's cool idea.
• 51:46
  but that's not the way of education that we want to have.
• 51:49
  So we have to take up the responsibility to see what the young
• 51:52
  generation wants and to implement that in our, current approaches.
• 51:58
  Otherwise, others will do, and I don't know if you like the result.
• 52:02
  Yeah.
• 52:02
  on, on the flip side, so basically on the receiving end, what would you
• 52:06
  recommend to, young clinicians how to actually deal with those associations?
• 52:13
  The thing is, what I have always seen
• 52:16
  when young people really wanted to engage or to get engaged, they got engaged.
• 52:23
  So when they went to the institutions saying Hey, I have a concept
• 52:30
  for a young clinician program or maybe a young study club series.
• 52:38
  The people are happy that the pe that, the people in the leadership
• 52:42
  positions are happy that the young people are coming to them.
• 52:44
  Maybe they do not understand it, but when they're coming with a
• 52:47
  concept, they try to pick it up.
• 52:50
  But what is unluckily not happening?
• 52:54
  Especially when we have institutions that have, let's say a certain age level.
• 53:05
  They don't come out to the idea to ask the young people themselves.
• 53:09
  So I, think that is weakness that the people cannot ask the
• 53:13
  young people themselves, that the young people have to come.
• 53:16
  But if you want me to give an advice to the young people, I'm saying don't wait
• 53:21
  for the older people to come to you.
• 53:24
  Go there,
• 53:25
  proactively, go there.
• 53:26
  Proactively go there.
• 53:28
  And don't be the elephant who's destroying everything.
• 53:31
  Just go there and, be polite.
• 53:34
  And the tone is still very important, especially when dealing with the,
• 53:40
  retirements club
• 53:43
  that has a, lot of expertise and knowledge through many years.
• 53:47
  Yeah.
• 53:47
  And it's worth tapping into this, samya there, there's also a habit that we have
• 53:52
  a question from the audience for you, which is actually a quite interesting one.
• 53:57
  The question is, do you have a non-dental routine that,
• 54:01
  secretly makes you a pet dentist?
• 54:04
  I, think it's my life beyond dentistry, so actually that I
• 54:08
  have a life beyond dentistry.
• 54:09
  So when I go home, no, it truly is.
• 54:12
  Yeah.
• 54:13
  It, when I go home with my, family, so I can, skip dentistry.
• 54:20
  Out of my mind completely.
• 54:21
  So when I'm, with my friends, we can, we even can talk about non-dental topics.
• 54:26
  Can you imagine?
• 54:27
  So I, think there are people
• 54:30
  no.
• 54:31
  The thing is, there are, so many people in dentistry that are just focusing on
• 54:35
  dentistry and everything is dentistry.
• 54:37
  And dentistry is very important for me.
• 54:39
  Yeah.
• 54:40
  But, still, I think you, you need to have a life beyond dentistry too.
• 54:46
  Become a better dentist to understand the needs of people who are not in your field.
• 54:52
  And if you ask me about my, let's say, secret, this is it, and to have a focus
• 55:00
  that is pretty much out of the industry,
• 55:03
  that's something to do with balance, right?
• 55:05
  And,
• 55:05
  exactly.
• 55:06
  Yeah.
• 55:07
  Sometimes, the distance to your topic brings the best ideas at the end anyway.
• 55:11
  So this is the thing, when the best ideas always come to me when I'm
• 55:15
  running and listening to music.
• 55:17
  So when I'm completely away and then I, there's something in the musing now.
• 55:21
  Oh, wow.
• 55:22
  Oh.
• 55:24
  so I know you also brought a question, to us that you always wanted to ask.
• 55:30
  Yeah.
• 55:30
  It's, I told you before, I am.
• 55:35
  Really focusing on or trying to focus on the bigger good in dentistry.
• 55:39
  So you are here in Basel, let's say in the Napa Valley
• 55:42
  of the pharmaceutical industry.
• 55:45
  So what is, what are your approaches like, not only with the pharmaceutical
• 55:51
  industry, but maybe also to cross the border in the industrial field to
• 55:59
  make dentistry more dental medicine?
• 56:03
  Again,
• 56:04
  I, really like the question, Samir.
• 56:06
  It's, it's something that also, keeps me quite, awake because I
• 56:11
  strongly believe as well in the power of, let's say, oral health.
• 56:17
  In the real realm of general health.
• 56:18
  So it has a much bigger impact than just, the, general or the, oral health.
• 56:23
  If, we do, implant dentistry, and the question is of course, how can we be
• 56:28
  part of this and how can it become one of our strategic pillars to, as,
• 56:33
  you have also strived for, be there for the greater good of the patients.
• 56:37
  Because one thing is to restore a missing tooth.
• 56:40
  It's great and I think it has an impact and we, know, what it does,
• 56:44
  but then the questions that we touched on before, what's the comparison
• 56:49
  to, doing no treatment and why is implant treatment a good option and
• 56:55
  a better option than doing nothing?
• 56:56
  I think this is something that for us is really important now to put
• 57:00
  this in a, broader perspective.
• 57:04
  Our medical devices.
• 57:05
  They're also in a, very special place in the body, which, the,
• 57:10
  prosthesis, the implants, all these medical devices, they have contact
• 57:14
  with bloods, they have contact with tissues, they have contact with saliva.
• 57:18
  They are still quite accessible in, Contrast to many other medical devices
• 57:23
  like, exchange a battery on a knee, will, there are, knee prosthesis, they
• 57:28
  have batteries in there, but they, run out after one and a half years.
• 57:32
  So in, in a prosthesis, if miniaturization goes, further, improves further.
• 57:38
  We believe that we can make smart devices, which actually allow us to measure
• 57:43
  continuously health related parameters that go beyond just oral health.
• 57:49
  And I think this is something that drives this a lot.
• 57:52
  it's not directly related to, pharmaceuticals, but then you
• 57:57
  can think about how these data can actually help to further.
• 58:01
  Personalized treatment that go beyond again, the, the
• 58:05
  oral treatment with implants.
• 58:06
  So for example, if you can monitor food intake, if you can monitor exactly,
• 58:12
  specific parameters of, disease, and you could actually give indicative, directions
• 58:18
  on how to, for example, administer a drug.
• 58:22
  So does it need to be more or less?
• 58:25
  Is it, saturated or do you need to actually, decrease the, the intake?
• 58:30
  These are all things that today we feel that medicine is, still
• 58:35
  early stage, non-personalized.
• 58:38
  And potentially with these medical devices, we can further increase
• 58:42
  the personalized, treatment options.
• 58:48
  Amazing.
• 58:50
  Yeah.
• 58:51
  And I think, beyond the impact that you had on, food intake and then
• 58:55
  gen, the link to general health, I believe there's a big impact on,
• 59:00
  psychological wellbeing as well.
• 59:01
  But it's hard to measure.
• 59:03
  But, there are means to measure.
• 59:04
  But if I see what you guys are doing to the patients and how life
• 59:08
  changing this is very often, I'm, pretty sure there's a very strong
• 59:11
  link to, general health as well.
• 59:14
  But we can't measure this with pharma
• 59:16
  and mental health.
• 59:17
  Mental health is a big topic.
• 59:19
  Yes.
• 59:20
  So this brings us to the end, George of, very exciting 55 minutes.
• 59:26
  How to summarize, what are your three key takeaways, George?
• 59:29
  Yeah, first of all, thanks a lot Samir.
• 59:31
  It, has been a great conversation and, a lot of also personal remarks.
• 59:34
  So it shows this duality of a very, I would say successful professional
• 59:41
  person, but also grounded in your, I would say non-dental life.
• 59:46
  And to me, let's say that, the highlights or common themes, it's like a red
• 59:50
  threat, through everything that we had, discussed now in the last hour.
• 59:54
  first of all, I felt that you really want to create an impact for the patient.
• 59:58
  And we discussed about the selection of your.
• 1:00:01
  Publication, areas of your scientific work, et cetera.
• 1:00:04
  All you want to create impact for, the patient.
• 1:00:07
  And to bring this to the next level.
• 1:00:09
  You're not only thinking about dental, health, but you're
• 1:00:12
  thinking about general health.
• 1:00:14
  And that brings us to the, third level, which is basically your, desire
• 1:00:18
  to connect better, the different.
• 1:00:22
  Medical fields because we can't solve it on our own.
• 1:00:26
  So dentistry alone is a bit, as you discussed it, also isolated and your, I
• 1:00:32
  would say aspiration is to bring it closer to, to general health, general medicine.
• 1:00:36
  And I think this is, it's a very nice thread that, stood out to me prominently.
• 1:00:40
  Very nice wrap up.
• 1:00:42
  Yes.
• 1:00:43
  Thank you.
• 1:00:43
  So thanks for being here, Samir.
• 1:00:45
  I also, I have to congratulate you.
• 1:00:48
  I, really observe you being someone also that would like to push out
• 1:00:51
  the front of dentistry and implant dentistry further to, to, let's say a
• 1:00:57
  bigger connection to general health, which, which I think is, a beautiful.
• 1:01:02
  Objective that, you have.
• 1:01:04
  And I'm sure you are, we're going to hear and read about
• 1:01:07
  your research work in the future.
• 1:01:08
  So thanks for being here.
• 1:01:09
  We'll try.
• 1:01:09
  Thank you.
• 1:01:09
  Thank you.
• 1:01:10
  So this was it with Samir today and I hope you enjoyed this episode.
• 1:01:14
  If you liked it, if it provoked some thoughts and changed your mind and made
• 1:01:20
  you think, then please share it and recommend it to your colleagues as well.
• 1:01:23
  And other than that, we always appreciate if you connect to us on
• 1:01:28
  the usual podcast players and on Instagram, we are always happy to
• 1:01:31
  receive a note and to respond to it.
• 1:01:33
  And thanks a lot for being with us and looking out for the next episode.
• 1:01:37
  Thanks a lot.