Latest / Straumann® ProTalk / Straumann® ProTalk with Dr. James Chow (video version)
Transcript
- 0:00You have a very interesting cv.
- 0:01You are an oral maxillofacial surgeon.
- 0:04You also are running very successfully a series of practices
- 0:08in Hong Kong, but also in China.
- 0:10What were some defining moments that actually made you to the
- 0:13person that you are today?
- 0:15I remember more than 30 years ago.
- 0:18I actually attend a course.
- 0:21It was my first encounter of dental implants, and instantly at that moment I
- 0:28knew it was a game changer for dentistry.
- 0:50So welcome to s Straumann ProTalk.
- 0:52Welcome to the pulse of Dentistry.
- 0:54My name is George Raeber, and together with my co-host Andreas Utz, we are
- 0:57very pleased to welcome for this episode, professor Dr. James Chow.
- 1:02So welcome, Andreas.
- 1:03Welcome, James.
- 1:04It's a great pleasure to have you here.
- 1:05I know it's it's very busy times and we appreciate that you are joining
- 1:10us here in the headquarters now.
- 1:13You have a very interesting cv.
- 1:15You are an oral maxillofacial surgeon.
- 1:17You also are running very successfully a series of practices
- 1:21in Hong Kong, but also in China.
- 1:23And at the same time, you're an entrepreneur.
- 1:25You are running your own business when it comes to 3D printing.
- 1:28And then on top of this, you are a technology enthusiast.
- 1:32So I'm very sure that today we are.
- 1:35Covering a lot of interesting topics for our listeners.
- 1:37We will first look at your personal development and have a conversation
- 1:41around that, and then also look into the specificities of the Chinese market a
- 1:46little bit because it's happening a lot there and you can share some insights.
- 1:51Then we'll also look into how you run your business, how you became successful.
- 1:54And last but not least, it's going to be very interesting also to look at.
- 1:58Technological advancements, particularly in digital dentistry.
- 2:02James, thanks again for being here.
- 2:03And maybe on a more personal note could you introduce yourself in just one minute?
- 2:09I think George already make a very comprehensive introduction,
- 2:13so I just make it short.
- 2:16As you mentioned, I am a specialist in all maxillofacial surgery and I'm the
- 2:23managing director of our specialist group practice in Hong Kong and
- 2:29outside the clinic I'm passionate.
- 2:32In teaching, education and providing opportunity to shape the next
- 2:38generation of dentists in Hong Kong, in mainland China and in the region.
- 2:44Whenever I have this opportunity, and although I means I'm very
- 2:49committed in this area, but none of my free grown up children.
- 2:55Have ever pick up a ske or a dental jewel and yeah.
- 3:01Other than walking and teaching the, you may see me rendering the, a museum soaking
- 3:09in a concert or visiting a bookstore.
- 3:12And also the.
- 3:15I like meeting up with new people for a great conversation.
- 3:19I think all this will en enlight me by providing me with a new insight.
- 3:25So this is.
- 3:26Yeah.
- 3:27How about us?
- 3:27How about me?
- 3:28That's a very open personality.
- 3:29Interested in new things.
- 3:31I can imagine.
- 3:32Now when we look at those journeys of successful professionals like you
- 3:37are, then there are often some very defining moments that actually in
- 3:41hindsight, if you would've known, probably you would've been almost
- 3:44scared to take that important decision.
- 3:47How is, how was it for you?
- 3:48What were some defining moments that actually made you to the
- 3:51person that you are today?
- 3:54Okay.
- 3:55If we are talking about the my practice or my career, so I remember more than 30
- 4:04years ago, I actually attend a course.
- 4:08It was my first encounter of dental implants, and instantly
- 4:14at that moment I knew.
- 4:17It was a game changer for dentistry.
- 4:22But of course, at that moment I didn't realize it would become my de destiny.
- 4:29Okay.
- 4:29And, but definitely at that moment already, I think the idea of the,
- 4:37going into the dental implant career.
- 4:40Planned to sit at that time.
- 4:42Yeah.
- 4:43And that defined then also how you took your first steps on education,
- 4:47but then also what made you actually choose to go in private practice?
- 4:51Because you're also very a gifted educator.
- 4:53As you mentioned before, you're interested also to share your knowledge
- 4:57with with more and more people.
- 4:59Did you also consider staying at university?
- 5:01Was that an option?
- 5:03After I graduate from the dental school, I was actually in practice
- 5:08for a short period of time.
- 5:10But very quickly I realized I did not like working alone.
- 5:15In a tiny room.
- 5:18And then I decided I have to.
- 5:22I have to do something for myself, for my future.
- 5:25So I went back to school for my postgraduate training.
- 5:30And when I was a trainee, actually I thought my future
- 5:36would be rooted in academia.
- 5:39So actually I'm interested in I mean doing teaching research in
- 5:43the university, but as time passes.
- 5:47Somehow I decided I to go out to venture into practice.
- 5:53Of course.
- 5:53There are some some background situation because when in your
- 6:00introduction, you know that I also went to medical school, so at.
- 6:04That time there being a maxillofacial surgeon it is not mandatory, but
- 6:09my supervisor he believe, medical background would be very helpful
- 6:16in no maxillofacial surgery.
- 6:18But when I finish my medicine, actually at that time at that moment, there's low
- 6:24position available in the university.
- 6:27So of course I cannot.
- 6:29Keep waiting.
- 6:30So I decide, I open my own practice and, but I to, I told myself if I was
- 6:39doing something for my own, I want I want to keep the same standard as when
- 6:46I was a trainee in the university, I want to do the best for my patients.
- 6:50So this is somehow I start my private practice.
- 6:55How does your medical training influence how you do dental surgery today?
- 7:02Is that, does it still have does it still resonate and influence
- 7:05how you do medicine today?
- 7:08When we talk about dental implants?
- 7:10Okay.
- 7:11Of course, whether we are talking about medical profession or dental
- 7:14professions we are looking after patients.
- 7:17Patients, okay.
- 7:18So the medical knowledge.
- 7:20Certainly help a lot because our perspective is broadened.
- 7:25Because we have more training on patient management compared to just
- 7:31receiving the undergraduate in dentistry.
- 7:34So it, it helped in the total patient management.
- 7:37But whether we are talking about dentist or medical physician or
- 7:42surgeon, the dental implant at that time was lever taught in school.
- 7:49So we learn all this.
- 7:51Actually when we came out to work, in the pyro.
- 7:55But I went to different places to learn dental implants at that time.
- 8:00Yeah.
- 8:02When you decided to do the medical degree, this was not necessary,
- 8:07you took the extra mile when you decided to do this, how much is this
- 8:10typical for you and for your success?
- 8:13Continuously going the extra mile.
- 8:18You are you are right, Andreas, because as I said, it is not mandatory to have the
- 8:23double degree, but my original intention is to pursue some academic career.
- 8:31So I think it was something necessary and coming out in a RO practice, it is, it
- 8:39add value to my practice, but it is not something essential for, performing dental
- 8:46implant procedure, even though nowadays I also conduct a lot of complex procedures.
- 8:51But I continue to learn because I think.
- 8:55Learning is level ending.
- 8:56So there's always new technique.
- 8:58There's always new method new equipment new finding, new knowledge.
- 9:04So I am a, I'm full of curiosity, so I always want to learn something I. I
- 9:12don't really I don't fully comprehend.
- 9:15So I will dive deeper.
- 9:17I will send more time to learn new things to make sure that
- 9:20I do better in my practice.
- 9:23Yeah I fully see this in, in, I. Dental because when we follow your career
- 9:27track and also we see what you have been doing, it really is a learning journey.
- 9:32And you're very curious.
- 9:33Now maybe more on a personal side how does this curiosity translate in your
- 9:37personal life, maybe also your technology interest James Chow at home, maybe.
- 9:44I imagine a lot of gadgets and a lot of technological stuff.
- 9:48How does it.
- 9:48Translate in your personal life, this curiosity.
- 9:52When I look back because.
- 9:53Nowadays I am very dedicated in all this digital workflow.
- 9:59And when I look back, actually I start taking up all this digital technology
- 10:07quite early and, but I agree with you.
- 10:10It is.
- 10:11The first time I think that I want something digital is out of my curiosity.
- 10:16I remember the first times I encounter the digital technology, actually
- 10:23it's 3D printing and I actually come across an article in a journal, a
- 10:31magazine called Popular Science.
- 10:33And there's an article on 3D printing, talking about how to make use of
- 10:383D printing on the medical field.
- 10:41And then immediately I search whether there's a company in
- 10:46Hong Kong selling 3D printer.
- 10:50And then somehow I was able to locate that company.
- 10:54And then I think I was the first customer first.
- 10:57Asking for the company to sell the machine to us.
- 11:02So this is the first time I really, bought the 3D equipment
- 11:08to the 3D printer to the practice.
- 11:10And then I realized as, as far as as long as we, we don't give up research.
- 11:18We try to find something that we want actually, it work out.
- 11:23So constantly pushing,
- 11:24constantly the boundaries.
- 11:25Yeah.
- 11:27I think we come back to this technology topic later focused
- 11:29on, on implant industry.
- 11:31Yeah.
- 11:32Let's speak a little bit about your practices.
- 11:34So soon you will run five significant practices in China and in Hong
- 11:39Kong, China, meaning Shanghai.
- 11:41So tell us a little bit more, what is the focus of these practices
- 11:45and what is your secret to success?
- 11:47As that means I'm in a group practice.
- 11:49So I think the most important thing is as I say I don't like working
- 11:53alone, so I like the team approach.
- 11:55I like working with other colleagues.
- 11:58So that's why we have this group practice.
- 12:01But when you are in a group petti, and the most important thing is to keep.
- 12:08Everyone together and I believe together we can all go.
- 12:15Farther away in our career.
- 12:18So you have to look after the egos of everyone and you have to
- 12:24look after their expectations.
- 12:27So being a leader, sometime you have to think of other people
- 12:30more often than yourself.
- 12:32So this is, I think, a very important point when we are
- 12:36running a group patterns and.
- 12:38The other things we always emphasize is if we want to do something,
- 12:44we want to do it the best way.
- 12:47So we always take the latest technology.
- 12:51We want to create a platform.
- 12:54There's a, not because we don't, or we don't have this technique
- 13:00or technology so that we are not able to deliver our promise.
- 13:05To the patient.
- 13:06Group practice with group partners and then keep keeping
- 13:10everyone staying together to pursue the best for our patient.
- 13:16By taking advantage of all this latest technology, I think is very important.
- 13:22Just recently in China, there was a big change with the value-based pricing policy
- 13:26that was introduced by the government.
- 13:28I think a lot of listeners probably heard about this VVP or
- 13:31value-based pricing in China already.
- 13:34Can you explain a little bit more about it?
- 13:36Yeah.
- 13:37The VVP is a central government policy.
- 13:42To make it simple, the purpose is to make dental implant treatment more affordable.
- 13:48In mainland China, and I think the intention is good, but of course, it
- 13:55is somehow we look at it as a more or less, a disrupt disruptive idea.
- 14:01But we see the good side of it because in China since the implementation of
- 14:07this VPP, the lumbar patients asking for dental implant treatment search.
- 14:14And in fact for most of the stakeholder of all this impact company in China,
- 14:20they actually see the volume of sales.
- 14:24Rise significantly.
- 14:25These are the positive sign.
- 14:28And of course there are other concern too because suddenly, the volume increase and
- 14:35however the number of dentists are capable of doing implants more or less the same.
- 14:40The demand of training is actually also rising significantly.
- 14:44But many colleagues now, they're very engaged.
- 14:47With their busy schedule because there are so many patient.
- 14:50So we see these kind of things happening.
- 14:53Yeah.
- 14:54But yeah, the purpose is to make dental implant treatment more affordable.
- 14:59And I think this is certainly a good thing for the general public.
- 15:03Yeah.
- 15:03If they really have the lead.
- 15:06Do you have the teeth replaced?
- 15:08Did you have to adapt your business model after this policy was introduced?
- 15:12Was it different patients that come, came in or more patients
- 15:15or different indications you saw?
- 15:18This central government policy actually target all this public
- 15:23institution and the government hospital.
- 15:25So it is not a policy mandatory in PY patches.
- 15:30But of course, the China market is quite elite because we see the public and the
- 15:35private, they're running in parallel.
- 15:37Also there something happening in the public side.
- 15:40They also have the effect spill influence on the private over, yeah.
- 15:43To the private.
- 15:44So as I said we see more patient, but the outcome is you may see more patient, but
- 15:50it doesn't means you may earn more, but.
- 15:54As a clinician I have to say patient have a choice.
- 15:58We have a choice.
- 15:59If you feel comfortable and you think it is good for your patients,
- 16:05I don't see it as a problem.
- 16:08Of course, sometimes local colleague ask this kind of questions for our opinion.
- 16:13I think, in every market.
- 16:14Pricing is one thing, but there are also other consideration.
- 16:18We cannot say the pricing is the only parameters.
- 16:24Affecting our, the way we practice.
- 16:27Yeah.
- 16:27Yes.
- 16:28To build a bit, the bridge then to the technology topic in your practice,
- 16:33how important is technology when you educate and convince your patients?
- 16:39I have been working for more than 30 years and we are running a referral based
- 16:45practice, so most of our patients actually come because of word by mouth, because
- 16:51in Hong Kong we live a market ourself.
- 16:54So the I have to say we are lucky because usually we see very good patient.
- 17:01Very well educated and also their expectations is most of the
- 17:05times is very reasonable and they appreciate what we can offer them.
- 17:12I. And when we talk about digital workflow, it is
- 17:15heavily relying on technology.
- 17:18And of course, now we have all the diagnostic.
- 17:21So we have common c oral scanning and also other gadget for face scan, draw checking.
- 17:29And then we have different types of computer assist
- 17:31implant surgery available and.
- 17:35All this help us to keep our promise to our patient because we plan the case.
- 17:39Digitally and then we can actually execute the plan as we aiming at.
- 17:46And usually patient is very happy, especially nowadays because of
- 17:51all this development, we are able to deliver immediate function
- 17:55or immediacy to our patients.
- 17:58And this is very dramatic to our patient because they come.
- 18:02With low teeth and then they left with their teeth or they
- 18:07come with come for extraction.
- 18:09But when they go home already they have implant and they have the restoration.
- 18:13I think patient are basically very happy.
- 18:16Yeah, that's that's life changing I think for many of the patients
- 18:18that you're treating and I, I saw some of your cases there.
- 18:22They're really complex cases that also changed the quality of
- 18:26life for patients significantly.
- 18:27Yeah.
- 18:28And I think that's the perfect segue also to talk about one of your, I would
- 18:32say topics that are close to your heart.
- 18:34Yeah.
- 18:34And we don't want to miss when you're here also the opportunity.
- 18:37So it's computer assisted implant surgery.
- 18:39Yes.
- 18:39And more specifically also dynamic navigation and robot assisted surgery.
- 18:45So maybe for those that are less familiar with those technologies, can you explain
- 18:49a bit what is dynamic navigation and what is robotic assisted surgery?
- 18:54Okay.
- 18:55Actually under the umbrella of guided surgery, we have the static.
- 19:00I think most of us are familiar with it.
- 19:02We are basically talking about surgical guide generated by 3D printing.
- 19:08And other than that, today's we have this dynamic and also the robotic.
- 19:13So whether.
- 19:15Static Dynamic, robotic, we are talking about guided surgery.
- 19:19The purpose of guided surgery, of course, is we have the implant planted
- 19:25digitally, but we lead to find a way to execute the plan and the, all this
- 19:33technology are effective to allow us to transfer the plan from the computer.
- 19:39To the oral cavity of our patient.
- 19:42But when we talk about dynamic the navigation and also the robotics it is a
- 19:47totally different mechanism from static.
- 19:50So we can look at dynamic as we are doing freehand surgery, but it
- 19:55is augmented by computer vision.
- 20:00And the computer visions allow us to see through our patient's jaw anatomy.
- 20:07And at the same time, the digital planning will become a map, which can
- 20:14be shown through this computer vision while we are performing the procedure.
- 20:19And then we'll see the planned route.
- 20:22Of the implant position.
- 20:24And then the convert regions actually guide us to go
- 20:28along the p determine route.
- 20:31So this is a navigation but.
- 20:34How what about robotic?
- 20:36So very similar to navigation, especially most of the robotic system nowadays is
- 20:42also the, an extension from navigation.
- 20:46So we are based, this system are based on the optical tracking using
- 20:51the camera system of the navigation.
- 20:53But there is a fundamental difference between robotic and navigation and.
- 21:01Navigation is you have the GPS, but you are the driver.
- 21:05You know the route, but you drive to your destination.
- 21:08And robotic,
- 21:10self-driving,
- 21:10you have, yeah.
- 21:11You have the robotic arm and the robotic arm actually will assist you.
- 21:17Or some robotics system is able to actually perform
- 21:22the procedure automatically.
- 21:23As you say, it is more like a full self-driving,
- 21:27full self-driving car.
- 21:28Yeah.
- 21:28So that we're still waiting for.
- 21:29So yeah, obviously in dentistry it all always starts to be a reality.
- 21:33Now, besides the technological fascination that it is possible what
- 21:39clinical problems does it solve to do dynamic navigation instead of
- 21:43free hand or in all static guides?
- 21:47I think guided surgery, we are always looking for the accuracy.
- 21:52And from the literature or from the data available up to now we see actually
- 22:00navigation robotic definitely they, in they achieve very high level of accuracy
- 22:07and if we compare robotic to navigation, we see robotic can achieve even higher.
- 22:14In terms of accuracy, that means we see very minimal motivations
- 22:18of the actual position from the planned implant position.
- 22:23And what is the significance of it?
- 22:26Sometime I explain to my patient, okay, when we place an implant, the
- 22:33optimal, the ultimate goal is to.
- 22:37Restore the tube or restore the T.
- 22:40Okay.
- 22:40So the positioning of the implant is critical, the more accurate the implant
- 22:46is, and then we expect to see better outcome in terms of function and aesthetic
- 22:53and how much accuracy is, essential at the moment we don't have this night drawing.
- 23:00We don't have this data to allow us to draw analyzing
- 23:02that we cannot pass this limit.
- 23:05So I think the approach is the more accurate.
- 23:09Should be the better.
- 23:10And yeah.
- 23:12What I hear very often, James, is that accuracy is one thing, but
- 23:16a lot of skilled surgeon would say, look I'm very skilled to do
- 23:20this freehand and much faster.
- 23:22What would you respond to this?
- 23:26I can tell by from my own experience.
- 23:29Okay.
- 23:29So as a human, okay, we improve our technique by learning, by experience.
- 23:36Okay.
- 23:37But we are also have physical limitation.
- 23:41For example, I have been working for 30 years, so can I continue
- 23:44to work for another 30 years?
- 23:46So this is one question because human, we get fatigue.
- 23:50We get aging.
- 23:52But robot, you don't, they will not, you don't have to think about this.
- 23:56And the other thing is, as a human, we try to be.
- 24:02Good every time.
- 24:03But there is always some outlier.
- 24:06That means I perform very well nine days out of 10 days.
- 24:13But last day I just didn't achieve the same level of position as my.
- 24:21Previously, or as my usual performance, it can happen with human, but robot
- 24:28will eliminate all this human error.
- 24:31And also the other thing is okay for machine, okay, by iteration they can
- 24:39only be become better and better, and.
- 24:44I told you earlier, I like to helping the next generation of dentists to
- 24:50help them to develop their career, to provide education to them.
- 24:55No matter how experienced I am, no matter how much case I can show to them.
- 25:01They have to learn from ground zero because they cannot inherit the
- 25:08experience or the skill directly from us.
- 25:11But with machine, again, the robot able to do this in Hong Kong in the
- 25:17future very easily through all this artificial intelligence, another
- 25:22robot of the same model in Basel.
- 25:27Yeah.
- 25:27Capable of doing the same.
- 25:28Same, the same.
- 25:29No, they do
- 25:29The same.
- 25:29Yeah.
- 25:29Yeah.
- 25:30It's and at one point in time, it's this question of superhuman
- 25:32performance with generative ai.
- 25:34I think because these systems can be trained by the best of, of a trade,
- 25:39there is this possibility to actually become much more superior now.
- 25:43We'll talk about it a little bit later what it actually means in
- 25:46terms of, patient acceptance.
- 25:48But before that I wanted to ask you, you're applying dynamic navigation and
- 25:51robotics now in, in your clinic, right?
- 25:54At which state is this technology?
- 25:56When you're talking about this, is it more, in the future it'll
- 25:59be possible to use it like this?
- 26:01Or is it already, usable today for daily clinical practice?
- 26:07It is already here.
- 26:08It is already in daily use.
- 26:11So whether it's navigation, whether it's robotic, whether we are talking
- 26:15about treating patient in Hong Kong, in mainland China or in the United
- 26:19States, we see robotic and navigations.
- 26:23They're working very well.
- 26:25Yeah.
- 26:25But of course, if we are talking about robotic, it is very little.
- 26:30To the profession.
- 26:31We are not seeing it is something already wide widespread, but it is here already.
- 26:36So how many of your patients in your practice do you operate with the robot
- 26:40and how many do you do in a different way?
- 26:44I have to say most of the time I use navigation.
- 26:48So maybe 10% of my patients I use robotic because as I said, patient have a choice.
- 26:55Okay?
- 26:56So whenever we introduce new technique, we will provide very forward
- 27:03explanation and also the sufficient information to the patient to consider.
- 27:09And the other thing is also the, when we are talking about this advanced theology,
- 27:14it add some cause to the patient.
- 27:18And at least at the moment, I won't tell my patients.
- 27:23Navigation is inferior to robotic.
- 27:26They are comparable, so the patient can have a choice and yes, but I will see
- 27:33when robot become more well-known to the profession and also to the patients
- 27:40we will see more and more patients they will consider this kind of technology.
- 27:45Yeah.
- 27:46When we discuss robotics with with dental professionals, then you can get
- 27:49very different feedbacks and opinions.
- 27:51So there is technology enthusiasts like your, that is okay let's try
- 27:55this and let's use it in clinics.
- 27:56And then there is a lot of people that, have outright fusion of
- 28:01actually just trying to do it.
- 28:03In other surgical medical fields, it's already quite standard.
- 28:07So in ophthalmology, for example, in neurosurgery, it has become a
- 28:11standard of care to also use robotics.
- 28:14In many of those interventions, is dental somehow lagging
- 28:18behind h How do you see this?
- 28:20How do you see the future and why is it that there is still quite
- 28:23a debate whether it will have a positive impact in the future?
- 28:28I look at this question from.
- 28:31This angle.
- 28:32For example, if we talk about ophthalmology, I think dentistry
- 28:36and ophthalmology, we are talking about high position.
- 28:40We are the same because when we place in panel when we to restore the teeth, we
- 28:45are talking about micro level of accuracy.
- 28:49And so if we have a way to actually achieve the high level
- 28:55of position, I think, definitely it is something we have to go for.
- 28:59But in reality in dentistry, because the surgical part and the restorative part, it
- 29:08is separate and sometimes, certain level of deviation from the panel position can
- 29:16be compensated by the result of work.
- 29:20Which I don't think is same as in ophthalmology.
- 29:24So if they are doing a ref reflective surgery, there's no, there is no
- 29:28corrective measure to actually, yeah.
- 29:30Yeah.
- 29:30So that's why, in dentistry, maybe there's still room for us to, to
- 29:36play, to see whether it is the time we have to all change to
- 29:43technology, navigation and robotic.
- 29:45It will take a while for this kind of technology.
- 29:48Technology to become the democratize.
- 29:51Yeah.
- 29:53As George already said before, James, you're doing a lot of complex
- 29:56reconstructions full art reconstructions, FP one reconstructions beyond robotics.
- 30:03What was the major technology that changed your total workflow in your practice over
- 30:08the last, let's say three to four years?
- 30:10Yeah,
- 30:11For a long time we are al always looking for technology that can be integrated
- 30:17seamlessly so that we can achieve what we call the food digital workflow.
- 30:23And we spent more than 20 years working on this area and just recently.
- 30:30We are very comfortably to tell our patients we can deliver our promise.
- 30:35That means if we promise the patients we can provide them with the food
- 30:40digital for, we are able to do it's not because I'm getting better than
- 30:45before it is because the technology development is now up to this level and.
- 30:53As Andreas mentioned, the surgical tooth is one important component,
- 30:58but we need good diagnostics and then we need a very good restorative
- 31:04technique so that after the surgery we can really deliver the immediacy
- 31:11within a short period of time with.
- 31:13It's the same level of accuracy as the navigation of robotic surgery.
- 31:18And nowadays because of the advancement is in digital impression, including the intra
- 31:24scanning, including the photogrammetry and also the, with the advancement in 3D
- 31:30printing and also the printing material.
- 31:33Now we are able to, to deliver the immediate restorations within hours
- 31:40within the same day of the procedure.
- 31:42Even when we are talking about the complex cases, if we are dealing
- 31:47with more straightforward cases, for example, a mixing molar in a cyte we
- 31:54can actually fabricate the prosthesis.
- 31:57And then by taking advantage of the guided surgery, whether we are talking
- 32:01about surgical guide, navigation, robotic, or can achieve a high level of
- 32:06positions, then we are able to connect the prefabricated restoration immediately
- 32:12after the implant is being placed.
- 32:14So we feel.
- 32:15Where we comfortable nowadays because we have the confidence, we know I
- 32:20mean to this is what we can achieve, what we can provide to our patient.
- 32:25Yeah.
- 32:26So maybe as a last question of related to that technology,
- 32:30where would you see it go?
- 32:32Five to 10 years?
- 32:33You are already very advanced.
- 32:35In five years, in 10 years is your prediction that every larger practice will
- 32:40have, dynamic organization and robotics?
- 32:42Or maybe is there something that you can imagine beyond?
- 32:45Yeah,
- 32:46so if we are not looking at the development of the technology you can see
- 32:51the technology one thing very rapidly.
- 32:55In some area we can say it is exponentially.
- 32:59And one thing.
- 33:00So we expect to see things keep changing or evolving in a short period of time.
- 33:07But of course, to de democratize all these technologies, there are
- 33:11other question we have to address.
- 33:14For example, the cost of The cost.
- 33:15Yeah.
- 33:16I think this is one thing whether it is from a company perspective or from a
- 33:21clinician perspective, this is something that we also take into consideration.
- 33:26But personally I always look at the efficiency of the workflow and
- 33:32how effective is the technique.
- 33:35Then the last thing I consider is the price.
- 33:38But it is of course something we still have to consider.
- 33:41I think if I tell you I don't consider the cause of setting up all this, I
- 33:47think it is irresponsible because, in real world, this is something that
- 33:51we have to take into consideration.
- 33:53So whether all this technology will democratize at the same pace
- 34:00as the technology being at once.
- 34:03I think there's other factor we have to work together from all the, from
- 34:08the company or from the professions.
- 34:11We have to work together to see how can make it more acceptable to the patient
- 34:16and at the same time to the clinician.
- 34:17Yeah.
- 34:19James, you shared a lot of incredible insights with us.
- 34:22Thanks a lot on the technology.
- 34:24What is the question you brought and you would have to us
- 34:27since we are talking about all this technological advancement?
- 34:32So I'm also curious and Straumann as the industrial leader in implant dentistry.
- 34:40I'm interested to know what.
- 34:43It's the value or what is the significance for the company to actually develop
- 34:48your own navigation system or maybe in the future, the robotic system?
- 34:53What is the significance of this?
- 34:56Maybe I can start and then Andreas, please jump in.
- 34:58Please.
- 34:58Yes, we started this journey already quite some time ago.
- 35:01And you might have seen also with the Falcon, we have a first product
- 35:05on the market that actually, tries to make dynamic navigation,
- 35:09something which is less cumbersome and also accessible for clinicians
- 35:14for all kinds of different cases.
- 35:15So for single cases, but also for larger cases with multiple implants and.
- 35:20We did this because we were strongly believing that there is a benefit of
- 35:25dynamic navigation over static navigation.
- 35:28And we see that the setup time, also the independence of, waiting for a guide.
- 35:33When you plan it with the goal is actually with dynamic navigation
- 35:36that you can do it on the spot.
- 35:37So you can plan your case and then you actually move directly to surgery.
- 35:42And on top of this, I believe it's also giving the surgeon
- 35:45much more flexibility to.
- 35:48React to the individual patient situation on the spot in a guide.
- 35:52You're still quite confined, so you don't have the haptic
- 35:55feedback that you have free hand.
- 35:57At the same time, it gives you also the confidence that you're exactly
- 36:01at the right position in the patient.
- 36:03So you talked before about, the GPS the interval GPS, we were very convinced that
- 36:09this is an important next step and hence also our openness to, take the next step
- 36:15and move further into asking the question, what clinical problems could robotics.
- 36:21Solve in the future and also triangulate this with what are, let's
- 36:27say, the benefits for the patient.
- 36:28What are the benefits for the clinician and what is a affordable.
- 36:33Let's say cost proposal to make this something that doesn't only
- 36:36work for, very large clinics that's on our minds very strongly.
- 36:41And to achieve this, there is different ways to go.
- 36:45So it could be open innovation in a sense that we collaborate with with
- 36:49companies that are already quite advanced.
- 36:51It could also be own development.
- 36:53It could be with the help of OEM manufacturers because.
- 36:57We discussed before there is.
- 37:00A lot already that happened in the general medical field.
- 37:04So there are robots that are maybe too costly for orthopedics.
- 37:09They're robots that are too costly for neurosurgeon neurosurgery.
- 37:12But if we can downscale this, there is a possibility to use this technology also
- 37:17for dental at at an effective level.
- 37:19And hence this is where we're currently at.
- 37:21So understanding what the potential is.
- 37:25What problem it solves.
- 37:27Not, being in love with technology, but actually taking it from the patient
- 37:31and the clinician's perspective, and then try to make or use technology
- 37:36to solve those kind of problems.
- 37:38And we see a lot of potential for this.
- 37:39So it's a very interesting journey that we're currently at.
- 37:42And we learn every day what it could be.
- 37:45And I have to say also looking at.
- 37:47Markets like China, there is a lot more and faster advancements than we
- 37:52see today in Europe and also the us.
- 37:57Looking at those markets in, in, in China that are more, have a higher affinity,
- 38:03I think also for looking at technology on a, with an open mindset can be very
- 38:07instructive for us to draw a way forward.
- 38:12That was a very comprehensive answer.
- 38:13There's not much read, to be honest.
- 38:15I think it's beyond this as usual.
- 38:18It's laying the scientific evidence, for it, positioning it
- 38:22the right way, making sure the right patients are benefiting from it.
- 38:25We put it into the hands of the right clinicians, and I think also together
- 38:29with the idea to to put the education.
- 38:32Behind.
- 38:32So we really want to give this technology into the right hands.
- 38:35And we feel, as George alluded, we feel the responsibility that also in
- 38:40this field we need to lead the thoughts and drive it into the right direction.
- 38:44I think that's a fair summary.
- 38:47So thanks a lot, James.
- 38:49So I think what I. I took away was, first of all, it's worth going the extra mile,
- 38:55like you did it with your medical degree.
- 38:57And I think that's very often in life, the case, the extra mile
- 39:01brings you to, to greater goals.
- 39:03So that, that's something I took away.
- 39:05I took away that.
- 39:07Robotics is really something that is a topic that we need to watch
- 39:11and develop and that we see in some parts of the world, like in China.
- 39:15We see it used very broadly already in in clinical practice.
- 39:20And what I also took away is that, you are very mindful.
- 39:24Bringing your practices to success with caring about a team, providing a great
- 39:29platform for a team that then, can really be a high performing team because you
- 39:35have the mindset of creating a platform for them that where they can excel.
- 39:38I found this an exceptional thought, so thanks a lot, James.
- 39:42Yeah
- 39:42I also I have to thank, George and Andreas, and now we see Straumann
- 39:48is already committed in navigation.
- 39:50So I'm looking forward to see the later engagement in robotic.
- 39:55So thanks a lot James.
- 39:58Also from my side it was a very, thoughtful, interesting conversation
- 40:02that we that we could have.
- 40:03So to all our listeners thanks a lot for being part of this
- 40:06episode of Straumann ProTalk.
- 40:08Please subscribe if you like the content.
- 40:10Please also ask questions on our Instagram account, so we're really
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- 40:20Thanks a lot.