Time as the most important resource
When entry into computer-assisted implantology is discussed, attention usually falls first on equipment prices. The dentist and oral surgeon Dr Roman d'Olive sets a different accent on the podcast Queens & Sons of Dentistry: dentists are on the whole well situated – the truly scarce resource is time, of which everyone has only a certain amount. The beginning of his digital transition around ten years ago in particular was decidedly time-intensive: a great deal of effort for the planning and a laborious transfer of data between the individual system components, which at that time still took place 'from right to left' by memory stick, because the bridges between the elements were simply missing. Today much of it is cloud-based and considerably better – not perfect, but far better.
The investment in figures
D'Olive also names concrete orders of magnitude. A navigation system such as the Falcon costs around 30,000 to 40,000 euros in Germany – a lot of money, as he concedes, especially as the purchase initially means a loss of time. He himself has attended hardly any formal continuing education, because he was early and there were scarcely any courses on offer at the time; with the Falcon he was supported by the manufacturer's network. With the Navident system, by contrast, the reality was sobering: the device was delivered, and there was not much more instruction than that. At least one good full day has to be invested in order to understand the system – what the markers are for, how the components interact, how updates run. Additional time also has to be planned for the first operation, because it runs noticeably more slowly.
Why the beginning is 'thankless'
D'Olive describes entry into the digital world as 'super thankless and difficult'. After all, the freehand technique works – not perfectly, perhaps a millimetre too far to the right or left, but it works. For the transition, by contrast, the practice has to go into pause mode for a moment: assembling systems, calibrating, solving initial problems, installing updates. In precisely this he also sees an explanation of why many colleagues hesitate and nobody likes to be a first mover. And he warns against the wrong motivation: he never introduced the technology in order to be more productive or to be able to earn more – that must under no circumstances be the goal, because at the beginning such a device is quite simply counterproductive. The money comes anyway when one works.
Step by step instead of everything at once
D'Olive openly names his own biggest mistake: after the impulse from his brother he bought everything at once – a scanner, the first printer, a new camera and further devices. 'A lot of money', and above all too much at the same time, because it then remains unclear how the individual building blocks work. His recommendation is therefore: step by step. Anyone entering the digital world who acquires a camera, a navigation system and planning software such as coDiagnostiX all at the same time has no chance. It makes more sense to begin by working with the planning software oneself and to keep simple things simple. He considers planning oneself indispensable even where good planning service providers exist: anyone who delegates must nevertheless know how it works and how it is done.
What the investment gives back
Why the effort is nevertheless worthwhile in his view, d'Olive sums up in a simple formula: it quite simply makes one a better dentist. The system acts like a feedback and reflection module which, after the procedure, shows incorruptibly how well or how badly the work was done. Added to this is the enjoyment of the work: getting up and looking forward to a demanding operation, planning, operating – and in the end the result looks exactly as it was planned. For practitioners and patients alike this is a gain. As the most important clinical point he names the prosthetics: 'My boss is my dental technician', he says in the conversation. If the technician specifies where the tooth has to stand, the prosthetic plan is to be followed – otherwise the aesthetics or the cleansability of the restoration suffer in the end. The consequence in his own practice is unambiguous: no full-arch case is operated on today without navigation, and navigated in preference to a static guide.