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1327 Guided Implant Technology with Dr. Uri Sonenfeld & Dr. Jeffrey A. Port : Dentistry Uncensored with Howard Farran

1327 Guided Implant Technology with Dr. Uri Sonenfeld & Dr. Jeffrey A. Port : Dentistry Uncensored with Howard Farran

1/7/2020 6:00:00 AM   |   Comments: 0   |   Views: 56
Dr. Uri Sonenfeld is a graduate of the Hadassah School of Dental Medicine. He is an innovator in dental simulation and guided surgery in the field of implant dentistry. Dr. Sonenfeld led the clinical development of the DentSim, the dental computerized simulation system and the IGI, computerized navigation system for placement of dental implants since their early stages in 1996. Dr. Sonenfeld is currently practicing dentistry in a private practice in Jerusalem placing dental implants with the IGI system.
Dr. Jeffrey Port is the R&D Clinical Specialist at Image Navigation.

VIDEO - DUwHF #1327 - Uri Sonenfeld

AUDIO - DUwHF #1327 - Uri Sonenfeld

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Howard: it is just an honor and a privilege to be in Jerusalem Israel with Dr Uri Sonenfeld who's the product manager of image navigation eye product is dead sim specialist it's white okay see you later which is the Dead Sea which comes from see you later and the second product that we have is four implants placements what okay so the other product dental simulation is for the US and okay so here presenting the other product which is what which is the

Dr Uri Sonenfeld:  GPS just like a GPS when we you and me I place it when we play sequencing we need to drill into the bone and it's very crowded environments and when you drill into the boy you don't see what's inside right so you are kind of or this morning you're kind of blind and we need to we need to guess already looks like me in between the roots already closed today forever nerve how far you are from the maxillary sinus and so on and you don't really see not in real time this is where our GI comes in too so now why would they 

Howard: why would they want to use ITI when wouldn't we want to just hire a robot to do the whole thing

Dr Uri Sonenfeld:  these are the next step is some kind of navigation into the human body going to the body you go into the domain you want to find the appendix you need to navigate and just like you know hit within car we have funding application which we call wave which helps you to navigate you know the same exactly technology to help you navigate into the maxillary bone or the globe or in order to do this you need to have first we call a software which you can please plenty locates let me place me you can select all kind of implants plans and position over the patient CT so every patient today needs to move a city that will see it would keep this 3d of that intervention and once you have the CT you can play the case you select invest enjoy to win that way supreme planes and you can select them and for this case we need to stay pretty narrow short implant and then you can move it and position it on the balloon and the right location and right angle to match the perspiration children's and this is a simulation of the prosthetic part we plan from what he calls from the prosthetic to the implant and once you have this planning to configure also on the program if you can read I can get rid of them right here so in proficient also over the panoramic view and once you have the plan now you can go to the surgery and then the technology the system can guide you to three learning plans exactly the way you plan because this is this is mainly the colorful Harbert everybody or almost every dentist can plan it can create a very nice planning but when it comes to the execution of this plan plan this is where the problem starts you want to be you want it to be exactly in between the teeth but actually when you drink you don't know if you're in between the roots so the execution is the hard part and this is where we come into the picture with our technology I said it's like a GPS for a GPS you need to have which have two eyes which created 3d environment and it's really tracking of every object here that is amazing now how long have you have once been in the marketplace 2002 travel to Florida Boca ratone and we school the first system there for him for the name of the clinic friend and he was the first one to use the system in 2003 years in 2002 in school 

Howard:mm that's where he was pretty much the first one to use a GI readers and so what year was that you second so now it's almost 2020 and 2021 clearly in 2020 get it 2020 2020 vision

Howard: so how many systems have you installed cancellation CT scan was pretty rare dentist actually even have had difficulties to read CT years ago navigators imprint placement because 

Dr Uri Sonenfeld: so and you're agnostic to the CB CT x-ray machine you work with all and the same with the implant system from Star Wars puppies for me when I'm doing so the center above is communicating with the Emmys the and this is LEDs connected and can be seen by the camera that is just amazing and if you see when I come close and when I come to the line of sight of this sense of you you can see on screen so every movement here can be tripped by the camera when it moves it through the camera can see me and treatment movement that is amazing when with cars the sunlight in the sky Trek the car but it's only one moving object which is the car let's say you want to go home feeling service on your home is is not mobile it's in the same place all the time just all the cold in those homes here in Texas we have two moving objects the second one the first one is of course agree but the second one is the patient  are one we are not a nested eyes so they move more limits so you need to track the tissues as well and that's why we connected what we call a patient record to the patient job so it's not only tracking what real movement is also tracking the patient so the patients can free people during surgery because we are talking about very high accuracy of reaming less than actually the sweet one never 0.35 so we need to track every movement of the patient so this would be called the patient record infrared lives tracked by the sensor hero above so once you have the ability to track you drag the river to direct the patient and you have your claim here now we can guide the dentist for second plan which is this one and I'm going to make it easier to see the drill inside the boom so I make the implant kind of transference so disease it will reduce the need for an implant surgical guide or complementary to it that's a very good question I would say it's complimentary probably the very let's say cases but everything is all carry the nervous tic inside a body might choose a suitable guide but as soon as it becomes more complex or you are more less digital noticed and you don't want to just rely the guy without thinking more into me you know you don't have a lot of things ways you can you cannot do a lot of changes you just have this claim and you need it we don't want any its ruthlessly here you can play let's say you using it all right and you'll find clinically that you would like to move your implant one we live in to the book with the guys you just can't do it waited by the guy or with a click of the mouse and drag the implants on the screen to the new location once now so the changes in real time very easily in a wait we have nothing in the inside if the guy that bought your vision that might be a problem with the vertical dimension if let's say you walking on Sycamore and mouth open he's really did it's hard to cry over the guy onto the sleeve here the area is kind of free and really we got into the computer so is probably maybe beginning this will benefit from guys others like July and all the tools and freedom many people so and fullest in some cases they use we got the exact in Israel depends the way the technology surgery is with a three-word called indicators if I wanted ID to reopen surgery I need to guide the publication of the drip once you got location that means I need to buy me about the angle of the loop and then we start really learning to value about the test so three parameters location regulation and so these three windows here will show you the three parameters as soon as I get into the lifestyles of the center of the camera and close to the eggplant they start showing now you see how what you have here is actually to cross this is one this is two when I move as long as I'm off my desired location and immigration they wait I need to move my location and change the equation of the wheel to get both of them Center and this is my and here the goal until I get to zero and then it becomes red and all the way inside so

Howard: so is it goal of the game to get the nerve 

Dr Uri Sonenfeld: we actually play some cases very do have one customer that actually is the name I can show you on recipe of this patient and you see other going on with reading plates coming off in the nerve but if you see the city you see the actually  not from what

Howard: who have been your majority early adopters is it more country specific is it more age is

Dr Uri Sonenfeld:  it more oral surgeons or periodontist is it who's been adopting this the fastest yeah what more countries 300 implants they understand just need to take care where the stage respiration is going to be and sees plenty here is based on the restoration top dart learning more oral surgeons are also not interested in so in the policy was somewhere with either his dentist it well felt not safe enough to be free and wanted to have the computer kind of Guardian and help them to do an accurate slave implants and I'm what are the experts one of our experts they are interested in terms of hair more experts the permeabilities is it  colleges with no hair anomalous yeah 

Howard: so I'm you know back in the day when I got us going 87 you got out in 95 the implants that come back 20 any which way in the world surgeon would say well that's for the bone was tough so you know dentists like to believe that its crown down the final restriction we give you the patient back with a rod or a window so in the hands is hit to first and I see it so obviously glue oral surgeons will sit there saying yeah I get it right 99% the time and I always stop and say okay

Dr Uri Sonenfeld:  I agree but one out of every 100 being wrong how many of you place a year and he'll say 1500 and I'll say you really want to send 15 implants non restorable back to your referring dentist that's a showstopper so now this is called dentistry uncensored do you think oral surgeons are getting better at this or our abilities and origins come and show interest in this product so the liquid change and also when I talked to Perry Damas and oral surgeons

Howard: usually they have about 20 referring general dentist but about five of them or 80% of their business so again let's say you place 90 percent correctly you don't want to send and you do 1,500 a year you don't want to send 15 in her back because five referring dentists are 80% of your business and if you lose one of those dentists to a periodontist or someone else oh my goodness so it's say you you said this is a game of point zero three five millimeters yeah well oral surgeons and periodontist their business comes down to five referring dentist so you  can't deliver them a failure one out of a hundred times so the million-dollar question is price what does this system cost  thirty thousand 

Dr Uri Sonenfeld: 30,000 30,000 does that mean of CB CT my CB CT costs two hundred thousand my CAD cam cost 140 there's lasers it cost one hundred thirty so thirty thousand dollars is pretty low low price comparison with you and

Howard: one  lawsuit one lawsuit could easily be $30,000 right well Karl misused to say something very funny and true he said if a patient can't afford to have their implant case done right then you should do it a half Hazzard wrong and then when it fails their lawyer will have it done right somewhere else and you'll get to pay for it and an implant dentistry if you do five pieces and one of them fails and you redo it for free you did all five cases for free so these big cases are big lawsuits I mean when you start doing $25,000 implant cases and they have to be done right and if you're not gonna do it right stick to fillings and cleanings and x-rays not don't go into implantology it's a serious game and  then the other thing that's why I'm here and I'm so insured is when you travel around the world the only two areas in dentistry that are growing at double digit rates are clear aligners and implantology they their routine dentistry cleanings falling exams and x-rays they're pretty much flat growing one and a half two and a half three percent a year but implants and implants and clear liners double-digit growth you're an expert in this for decades why do you think implants is growing around the world I had double-digit rates so yeah so what think in the past 

Dr Uri Sonenfeld: you know I remember my grandfather is with teen dentures their dentures was fine up anymore nobody is not willing to adventurism and change this association totally no you don't need 12 inches connecting plant knowledge to plastic things inside involved and everybody now wants to we're not happy to have beautiful teeth and implants dental implants change the game in this aspect you can avoid the lectures then you can have wonderful teeth sometimes in a day so the more people understand this the more people will go into implant and by the way no this way is number one if you compare from implant to population in the world most of the implants so 

Howard: what is that ratio you have about almost nine million people and 75 million so 10 million people and so does that mean it's difficult to make a living being a dentist in Israel pretty close that's pretty fun do you think that's one reason they like to more likely to get into implants and he was here two weeks ago two weeks ago and I was there and he said it's harder to become a dentist and to act with the same income and more to more than just need to work more and before they retired to get to know to save the money well the other thing about clear aligners implantology

Howard: I mean I saw this in Cambodia Thailand Malaysia where were insurance schemes from the government of right sector they set the prices on in cleanings exams fillings x-rays whatever and usually the prices said to where you'll break even or lose money but they don't do not set the prices on clear aligners or implants so like I was in a several dental offices in Cambodia where they said okay my government fee schedule clinic I break even or lose money but it might mean base of 2,500 patients I pull out one implant and one clear energies per week and that's why I'm a totally successful dentist in Cambodia so it's kind of a the insurance base is just you're almost like a your public health service base but if you can upgrade one person a week to an implant for 1500 or a clear aligner in this line case for 6500 well do that 30 times a year in each and you're  doing very well my mouth sir is telling me real quick look at me while looking on the screen okay

Dr Uri Sonenfeld:  I get an instruction from the screen so I change that to get it Center in green and that's the deeper I go and fuck me one for all anyway they get away from they read all these then several Guinea there so no mistakes no I can't well thank you very much for showing this game it was just an honor to have this demonstration how do dentist wanting more information or running this device this technology in their office what should they do next how would they do that phone calls okay what do you mail what phone call what website were you are is its image navigation okay well thank you very much all right 

Howard: well thank you so much for your time today so now we're back with dr. Jeffrey port on the right and by the way your your Lessing's port the most famous port in dentistry is Ruth port who was married to George support and owns port laboratories and Sydney Australia is that your mom your grandmother or your girlfriend but a shout-out to Ruth port and so your Jeffery Port and you guys might Yuri earlier so you're gonna show us the dead set right and this is a product that is used in dental schools send it for home and I really hope this is the future of dental license exams because in an examination the most important fairness is that it's a standard exam so when you have these poor dentists coming out of school or moving to another state or another country and they don't take their licensing exam and your patient doesn't show up another patient shows up drunk and one open their mouth and then you're then my patient is just perfectly behaved that's not a very standardized test and I think these are these board exams when they have light patients I mean that violates standardization of examination so bad it's almost like it's a racket in fact I think most of these most of these board exams are just ways to extract money out of students and dentists moving and so it shows what you don't send you have

Jeffery Port:  lessons or practices you have assignments you have testing you have different areas of Industry you have operated interest on that prosthetics yeah endo access you have composites you know food preparation a partial denture see different options here we're just going to go into the old and what it does this DVD lesson is it gives you a procedural permission background history you can you see the x-ray and then you go into the clinic and you can actually see what you're supposed to do where you have the tooth this is a preparation in this cage that you're asked to do and remove it by yourself you can do it together with the wrong tooth and you'll see everything here and then it evaluates what happens is when you're drilling when you trilling you're gonna see it the drill and then see the cutting over here real time you'll see any kind of mistakes that you make you have to show up on runtime yield errors and so if we start obviously have to pick the right flow of information see the drill moving and this little arrow if I happen to shoot this is three price points really look as far as where I'm doing it because that's so business specific to a ham piece or a ham piece agnostic or when you when you have condensed them does it have its own specification has away with this is this as you see which has like the camera but if you can look can you see yes if you swing can see if you then compare this to the screen you'll see how accurate

Howard: nice nice nice nice I'm talking about your mani-pedi okay 

Jeffery Port :  there are many different parameters that are checked every type of procedure has its own list of things to check and obviously you look for different things and crowns as you are going to check the fillings 

Howard: what do you think the advantages of this then the way that you and

Jeffery Port:  I did it in school if your student in school check after it's done where it is here to check each other as often as you want is having an instructor sure and it 

Howard: was it just me I mean we call this dentistry and sensory seemed like whenever I raised my hand for a check the instructors would always check the beautiful girls first and the bald guys last you know that was the 

Howard : most stressful thing and also that they that dentists who signed you end for your clinic patient needed to be the one that signed you out because the guy that sign you would say something totally different than the guy that signed you out and you learned in a day that you only want to work with one instructor probation because you were never getting it if you had three different teachers look at the prep you'd hear three different answers personal

Jeffery Port: real-time trainer you always get the same feedback everybody get the same keep it it's in real time its objective as you said before and it's very accurate and in kitchen tools that you cannot see where some losing its cross-sections when I come with a plastic tooth in the teacher you cannot show me cross-section of the income love you cannot show me that you can't show me the dental or they know so there's so much more information that you can get on the screen teacher

Howard: so what are the main procedures fillings crowns into access what is reason they're rich and rest on four percent so I'm sad to report this to you but the largest partial denture lab is in Nogales Arizona they get about eleven hundred partial day and then they put them in a car and they drive him across the Mexico or then they have the foundry that does that and I've been down there several times and I have one thousand incoming cases a day nine hundred just says lower partial they didn't make a single preparation no design and I'm like come on guys they just they're pay me a thousand dollars for a partial and you couldn't get a football burr and make a scene home a single breast seat what do you make of that do you think they don't know they don't understand do you think it's lazy what what  do you think of that come on guys you know you ever watch ESPN football they have that segment come on guys come on guys someone who just sounds a dollar a partial and you can't even look at it long enough for a breast feed why don't you give them a referral to someone who's a little more motivated and ambitious I just and I I find that embarrassing so 

Jeffery Port : so that is one of your features on this scent is cutting receipts now do you think you still need to survey for a lower Percel or when am i giving away my age students how to very accurate precise the excuse that technology will learn faster and be better and we wish them the choice so this change education from all that we talked about objectivity will sign preciseness and so on and so on and the students having trouble with particular moving so quick your aspects of the preparations just on that and we can also work 24 hours a day seven days a week they don't need to trim and they don't need it until they come to the dental lab they open it and they seeked entering and training free you should see our R manager she can make beautiful crowns just by and she's not a dentist just by using the system and played with it she can probably make better perversion that most of the dentist I know just for using it alone it's a independence 

Howard: now this company image navigation we talked earlier about your implant product do you see this merging with atomy will this be implant training to for students someday

Jeffery Port:  absolutely when you see who talked about the evolution of the company the company and this problem this is our first product and we realize that we can give the student real-time feedback so we sit like wait a second if we can give him real-time feedback I can really guide him and show him what to do and why don't we take the technology out of dental school which is a niche into there the market is full market which we go into private practices and go into them implant dentistry so selling me to product gives you feedback into a product that is for everybody that wants to place implant and it can guide you and tell you what you do and you can combine them and make use the technology to train students out into place England so we have plastic models for England industry and they have the same monitoring technology and they can learn how to place implants correctly so we have a product restorative industry from one side they product for implantology on the other side and combine them products for dental student that will do practice implements so when we talked about early adoption for your other product whitney says mostly united states where where is your most adoption for this product around the world today this one so you think it's about four hundred systems are gonna know much more much more we just installed a few years ago 120 simulator in thailand it was bangkok bangkok a university nice so dear isis has 56 tunnel schools or 58 minutes how many dental schools are you in she says how many young dental schools are you in in the United States right now would you guess out of 56 you know we are marketing is not you should a school and what is the price of this system so you don't know what it costs but but it seems like more than one student could use one system right I mean you wouldn't need a system for every student so really almost one system for one school if you and what is the feedbag men from the dental schools that used it what is the clinic instructors and the deans thought after using this technology in the beginning the instructor had kind of a problem with overseas people they said oh 

Jeffery Port :maybe this technology will replace the teacher because this is the personal digital picture so it can maybe replace so the evening they had problem with this but they said this is it switching the 82 or 42 for them they would love it because they can show the students everything before somebody you know you go to the teacher we try to explain you what's your problem and you said it doesn't really understand them with this to make it show me exactly what's tangles the woman in this cross-section I'll give you are with it the depth of the cavity you can see what kind of a geographical not with different colors so you can understand really easily so this is wonderful a helping tool for the future itself and the students love they're really they really love it equally don't need to work in the mine they get asleep more independent raids ravenous student

Howard: so what are your biggest challenge is getting this into a school and why do you think why did the Thailand school get these what are your biggest challenges I think it's such a breakthrough in technology and then she said before I think they are taking the flow being over an old school or what else you know 

Jeffery Port :so it's hard for them to to change from seventy years probably with a plan bring some change to this it's a big shoot so I think this is probably the Dinos these really 

Howard: the next generation is amazing I had my granddaughter on my lap the other day and she saw me on my iPhone so she jumped on my letter says play me Rudolph the red-nosed reindeer so I googled it on the unknown YouTube and I pull up Rudolph the red-nosed reindeer and out of nowhere she takes her finger from the bottom of the screen and flips it up there's a bunch of video spinning through it says no not that one this one and I'm like I didn't even know that was a feature she's not even she's three years old and she just thought a 57 year old grandpa how to use YouTube and I thought how did she know how to do that and it's just so it's the technophobia is a sign of your age right all right well is there anything else she wanted to say probably and what would you say to a dental school Dean who's sitting on the fence about this date technology

Jeffery Port: either way too long other school will purchase this technology and then student will go to learn in the other school because there's they have still the ecology and and is that usually the purchase earning decision made by the Dean is that usually it's the Dean 

Howard: well five five of the 56 dental school deans went to dental school and Jerusalem are Tel Aviv so you should at least get those five okay so which old school did you go to Columbia and so with Israel's better Jerusalem or Tel Aviv technology yeah they use this technology both many years ago a third right they're talking about it you know that seems to be the new trend around the world I remember I was in Malaysia in Cambodia and in Malaysia ten years ago they had one dental school and now they have a eleven and you went to Columbia which is in Manhattan with NYU and they have the SUNY no school in Buffalo and now they're building you know they opened up another dental school so don't dental school expansions on the rice when I get at a school it was the way the closing down dental schools they were closing down Emory Georgetown Farley Dickerson Illinois I mean theythey when I get a school that first ten years he closed down seven schools and now in the last ten years they've reopened up seven dental schools so dentistry is definitely on the expansion the world has two million dentists now and so as these dental schools are expanding and they'll probably go high-tech so congratulations all you do and thank you so much for spending all this time with me my visit to your company all right have a great day thank 

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