'Easier for the patients': Robotic advances finding their way into Austin dental offices

Bianca Castillo doesn't love being at the dentist. In fact, when she knew she needed to have a tooth pulled and then an implant, she decided to wait awhile until she could have the implant placed by the Neocis' YOMI Robotic Dental System under the guidance of Austin dentist Dr. Fredrick Shaw.

"Getting an implant is scary in general," 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 pinch from the numbing shots and maybe a little pressure.

Since July, Shaw, of Austin-based Shoal Creek Prosthodontic Group, has done more than 40 implants using the robot. It's part of the growing use of robotic technology in everything from diagnostic procedures to noninvasive surgeries.

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Traditionally, Shaw would need to see a patient once to plan the surgery and take an impression of the teeth. Then the patient would go home. He would have a surgical guide made to place the implant. That guide could take two weeks. Then the patient would return to have the implant placed.

With the robot, he doesn't need a surgical guide and can do the whole process in one visit.

Once the area around the implant has healed, about three to six months later, the implant is fitted with a crown, if it is one tooth, or permanent dentures or a partial denture if it is more than one tooth.

Using the robot, Shaw planned and placed Castillo's implant the same day. When she arrived at Shaw's office, she got a full mouth scan using the dental cone-beam computer tomography machine (that's the one with which you stand and bite down on a plastic piece while the machine moves around your head).

The scan is sent from the CBCT machine to the YOMI robot, which looks like a computer system with a giant arm that has a drill at one end.

The robot then uses the scan to help Shaw plan where to drill and the depth of the drilling in a matter of minutes. Shaw also decides what size implant to use in that space.

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Castillo's mouth is numbed in the area where the implant is going to be placed. Then Shaw guides the robot's arm to where the implant is going to go. He puts the first drill bit on the robotic arm. Using the CBCT scan, the YOMI screen is able to show Shaw where the drill is in relation to Castillo's mouth.

Shaw will drill five times, with each drill bit being slightly larger. Each time, the machine will note that it is "locked in" the right space, then "drilling," then it will say "at depth" when it has reached the maximum depth, and then "free" when it has stopped drilling and is out of the hole. YOMI is designed to stop drilling when it reaches the planned depth and will not allow you to drill too deeply.

After the drilling, the implant, which is a screw into the bone, is placed.

Shaw said he likes that he can do everything in one day and the system also accounts for what human patients do: breathing, moving, nervous shaking. He's watching the YOMI screen to tell him where his drill is in real time, in an image of that patient's mouth. His technician is also watching a screen and calling out numbers of the depth of the drill and reiterating when it is "locked in," "drilling," "at depth" and "free."

At first, Shaw was apprehensive about the robot, but once he saw it in action, he said, "That reservation is completely gone. It's for the benefit of the patient."

It decreases the chance of mistakes being made and reduces the amount of time each implant takes even during the drilling and placing process. Shaw estimates one implant takes about six minutes to place with the robot. With a couple of cases in which they have done implants for fixed dentures, it's taken about 45 minutes, compared with two hours previously.

"It's exciting when technology helps us do more care," Shaw said.

That makes it worth the $250,000 investment for Shaw. He does not charge more for robotic implants vs. standard. There will still be some cases in which existing health conditions make using a traditional surgical plan necessary, but most people will be able to have implants done robotically.

The advantage is the precision, Shaw said. YOMI won't let him drill in a spot that it had not planned out in the computer based on the scan.

Also "it's easier for the patients," he said.

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Shaw's patient TJ Jordan has had five regular implants and two with the YOMI robot to secure his full set of dentures.

With the traditional method, Jordan said, he felt as if there was drilling, he could smell his bone being drilled into, and he felt the sensation of bleeding. "I just tasted blood the whole time," he said.

He left with blood on his lip, and it took hours, he said.

With the YOMI implants, it was quiet, and he didn't have a mouth full of blood. It was faster. He also was not as sore or as swollen.

"It was half the recovery time," he said.

This article originally appeared on Austin American-Statesman: Robotic advances finding their way into Austin dental offices