Diagnostics, Treatment Planning, and Guided Surgery
An Interview with Dr. Roland Glauser
THE NEXT DDS
The first patient was treated
using guided surgery more than a decade ago, in 2000. Subsequently, the concept
was cleared by the FDA. An accomplished dentist as well as a respected academician, Dr. Roland Glauser
lectures internationally and runs a successful private clinic in Zürich, Switzerland.
He is also an expert in emerging technologies that help improve patient care,
such as guided surgery and clinician software.
You were one of the first to work with guided surgery systems.
How have they affected the way you have diagnosed and treated patients over the
last eight years?
Glauser: First and foremost using guided surgery
techniques has increased treatment predictability and given me access to more
advanced treatment options—especially in regards to immediate function and the
prefabrication of provisionals. The diagnostics and planning software was always
quite straightforward to use.
With this system, I can reference significant
visual information in a virtual 3D world to test for—and ultimately identify—locations
for the best possible implant placement from both a prosthetic and surgical point
of view. Rather than being forced to compromise between restorative
requirements and surgical imperatives, I like to think that we can optimize
From the patient’s point of view, comfort has
been improved, as a reduction of chair-side time and less invasive procedures
have become possible. The concept allows one to obtain a complete picture
before surgery. This reduces potential surprises and also the stress level on
the day of surgery. With a well-planned treatment already mapped out and
implants installed at ideal prosthetic positions, the restorative process
becomes a smooth, step-by-step procedure.
It should also be noted that communicating the
treatment plan to colleagues—or the patient himself—is made much easier when a digital
diagnostics and planning tool is used.
Have you seen a change in the type of questions posed
by prospective implant patients over the years?
Glauser: Certainly, today’s implant patient is better
informed than his or her counterpart ten years ago. A variety of media—not least
of all the Internet—are full of information and commentary on dentistry in
general and implants in particular. Patients simply know more today about the dental
implant option—and many of the specific procedures, as well.
I find that questions are less general and more
focused on the types of materials, procedures and prognoses today. What’s more,
the sheer volume of questions asked is greater than it used to be
More than ever before, correct and compelling
pre-treatment information that meets the patient’s needs is an essential aspect
of the practice of dentistry.
In which situations do you choose guided surgery
Glauser: In quite a few different situations, actually:
For example, whenever a grafting case has to be transferred figuratively into a
non-grafting case. In medically compromised patients— such as hemophiliacs—or never
minimal invasiveness and reduced working times are preferable, so is guided
surgery. Naturally, I also often use guided surgery when meager hard tissue and
a demanding restorative set-up dictate precise implant positioning. Finally,
whenever a provisional restoration has to be produced in advance of the
surgery— cases calling for immediate function,
for instance—there is no better solution than guided surgery.
Over the last few years, more and more computerized
systems for 3D imaging, diagnostics, treatment planning and even guided surgery
have been introduced to the market, complicating purchasing decisions for
clinicians. If someone were to ask you about introducing these technologies in
their clinic or practice, how would you suggest they get started?
Glauser: I think they should start with a wish list that
includes all the things they would like such a system to be able to do in their
practice. Some people may only want help with diagnostics, while others would prefer
a full range of diagnostic, treatment planning and guided surgery options in
the same package.
Dental and medical technology is one of the
fastest evolving markets in the world. While there are risks involved with
being the first generation to use a new piece of dental technology, the profession
requires pioneers like Dr. Glauser to take these risks and demonstrate the use
of the technology. Guided surgery systems are an important tool for dentists
today, and there will always be something new on the horizon for the new and
hungry dentists of tomorrow to use in their own practice.
*Adapted with Permission from Nobel Biocare News Vol. 13, No. 1, 2011