As an implant surgeon, I feel there is an intuitive component to surgery that cannot be denied. Robots seem much better suited for an assembly line manufacturing process than for treating a human being.
There is a lot of focus lately, online and in dental journals, on surgical guides and the digital workflow paradigm in implant dentistry. It is amazing to see technologies come together to assist patients in achieving improved dental health and, in many cases, a better life with dental implants.
Recently, there was even a story in the news about a robot in China that performed the first robotic implant surgery on a patient. Behind every digital plan created must be a human component to design and plan a case. I feel this human component must go hand in hand with digital technology. When I hear that a robot is performing surgery, my first question is, “How is that possible?” As an implant surgeon, I feel there is an intuitive component to surgery that cannot be denied. Robots seem much better suited for an assembly line manufacturing process than for treating a human being. Whether it be a robot or a human being utilizing a surgical guide, due to variations and subtleties of anatomy, intuition of the clinician should, and must, dictate the final verification of implant placement. After surgically placing thousands of dental implants, I know there are nuances to each clinical situation that mandates human verification at the time of surgery to ensure a successful outcome. Artificial intelligence would have to be at an incredibly high level for implant treatments to be successful, in my opinion.
This is the same for a surgical guide. While an ideal plan can be made, in the end, the clinician must verify the correct positions and stability of every implant placed. Whether it is a tooth-borne guide, soft-tissue guide, or bone-supported guide, the clinician is responsible for the final implant placement and must verify it. The fact that a planned-guide case even has the potential to be clinically incorrect mandates verification at the time of surgery. I have seen clinicians falsely believe that guides are training wheels to surgical success. While there is some truth to that, every clinician using a guide must be ready to perform the surgery without one in case, for some reason, the guide does not work out as planned. This becomes more of an issue with full-arch bone-borne guides than tooth-borne guides, as there is more potential for error, in general, without tooth support.
This month’s Implants Today section has a great article that addresses the digital aspects of dental implant treatment. Implants Today Advisory Board member Dr. Tim Kosinski continues his article series highlighting the relationship between digital planning and prosthetic success. As a practicing dentist, he brings real-world clinical insights into all of the topics that he covers. We appreciate his willingness to share his clinical experiences, and we hope that the content of his article serves to assist our GP readers who may be interested in learning more about modern concepts and clinical techniques in implant dentistry.
If you have any questions or comments about this topic, or any other subject presented in Implants Today, feel free to contact Dr. Tischler at firstname.lastname@example.org.