Bianca Castillo doesn’t like being at the dentist. In fact, when she learned that she needed to have a tooth extracted and then implanted, she decided to wait a while until she could have the implant placed with Neocis’ YOMI Robotic Dental System under the supervision of Austin dentist Dr. Frederick Shaw.
“Getting an implant is generally scary,” Castillo said. “It seems a lot less scary knowing the accuracy of the system.”
The only thing Castillo, 24, should feel during the procedure is the blow from the numb shots and maybe a little pressure.
Since July, Shaw, of the Austin-based Shoal Creek Prosthodontics Group, has performed more than 40 robotic implants. It’s part of the increasing use of robotic technology in everything from diagnostic procedures to non-invasive surgeries.
Traditionally, Shaw would need to see a patient once to plan surgery and take an impression of the teeth. Then the patient goes home. He will have a surgical guide to place the implant. This guide may take up to two weeks. Then the patient returns to place the implant.
With the robot, he does not need a surgical guide and can perform the entire procedure in one visit.
Once the area around the implant has healed, after about three to six months, the implant is fitted with a crown, if it is a single tooth, or permanent dentures or partial dentures if it is more than one tooth.
Using the robot, Shaw planned and implanted Castillo’s implant on the same day. When I arrived at Shaw’s office, she did a full mouth examination using a dental conical beam CT machine (this is the machine where you stand and bite a piece of plastic while the machine moves around your head).
The scan is sent from the CBCT machine to the YOMI robot, which resembles a computer system with a giant arm with a drill at one end.
The robot then uses the scan to help Shaw plan where to dig and how deep to dig in a matter of minutes. Shaw also decides what size of the implant to use in that space.
Castillo’s mouth is numbed in the area where the implant will be placed. Xu then directs the robot’s arm to where the implant will go. Puts the first drill on the robotic arm. Using a CBCT scan, the YOMI monitor can show where the drill is in relation to the Castillo’s mouth.
Shaw will drill five times, with each drill bit being slightly larger. Each time, the machine will notice that it is ‘locked’ in the right place, then ‘Drill’, then it will say ‘in depth’ when you reach maximum depth, then ‘Free’ when you stop digging and out of the hole. YOMI is designed to stop drilling when it reaches the planned depth and will not allow you to drill too deep.
After drilling, the implant is placed, which is a screw into the bone.
Shaw said he loves being able to do everything in one day, and the system also takes into account what human patients do: breathing, movement, nervous vibration. He watches the YOMI screen to tell him where his exercises are in real time, in a picture of that patient’s mouth. His technician also watches a monitor and calls out the dig depth numbers and repeats if it is ‘caged’, ‘pit’, ‘deep’ and ‘free’.
At first, Shaw was apprehensive about the robot, but once he saw it in action, he said, “This hold is totally over. It’s for the benefit of the patient.”
It reduces the chance of errors and reduces the amount of time each implant takes even during the drilling and placement process. Shaw estimates that one implant takes about six minutes to fit into the robot. With two cases in which they implanted fixed dentures, it took about 45 minutes, compared to two hours earlier.
“It’s exciting when technology helps us pay more attention,” Shaw said.
This makes it worth Shaw’s $250,000 investment. It doesn’t charge more for robotic implants than the standard. There will still be some cases where current health conditions make the use of a traditional surgical plan necessary, but most people will be able to have robotic implants.
The advantage, Xu said, is accuracy. YOMI will not allow him to search somewhere he did not plan on in the computer based on the scan.
“It’s easier on patients,” he also said.
Sponsorship donation:The Capital Region Dental Foundation provides seasonal care for sponsoring families
TJ Jordan, Shaw’s patient, performed five regular implants and two with a YOMI robot to secure his full set of dentures.
Jordan said he felt in the traditional way as if there was a dig, could smell his bone being dug into it, and felt a sensation of bleeding. “I just taste blood all the time,” he said.
He said he left with blood on his lip, and it took hours.
With YOMI implants, she was calm, and he didn’t have a mouth full of blood. It was faster. It was also not painful or swollen.
“It was half the recovery time,” he said.
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