COMMON SURGICAL TECHNIQUES FOR DENTAL IMPLANTS
Are you one of the millions of adults who have lost or may lose permanent teeth? Dental implants are an option that can help you to maintain your quality of life.
This page will help you learn about common dental implant surgical options. Be sure to discuss all treatment options with your dental specialist. Your dentist will look at your medical and dental history, and can then recommend a good option for you.
ROBOT-ASSISTED DENTAL IMPLANT SURGERY
Yomi is a new alternative to traditional surgical techniques. Yomi provides dental surgeons with robotic guidance during surgery. The surgeon is in control at all times. Yomi combines your surgeon’s skill with the benefits of robotic surgery.
Yomi provides assistance to the surgeon in planning and placing your implants. This helps your surgeon place your implant precisely for a natural look and feel. Yomi allows your surgeon to quickly make changes to your surgical plan. This helps make treatment easy for you. Yomi may also allow for less invasive dental implant surgery. Yomi is not indicated for patients with no teeth.
WHAT CAN I EXPECT WITH YOMI ROBOT-ASSISTED SURGERY?
If Yomi is right for you, your dental team will create a custom treatment plan. This plan will be made using Yomi software. During surgery, Yomi will assist your surgeon and provide important information that your surgeon can feel, hear, and see. Yomi will guide your surgeon to place your implant precisely to plan.
FREE-HAND DENTAL IMPLANT SURGERY
Free-hand is the most common surgical technique for dental implant surgery. In free-hand surgery, the surgeon uses a handheld instrument to place your implant. The surgeon places the implant after looking closely at your bone, gums, and nearby teeth. Exact implant placement can sometimes be more difficult with free-hand surgery due to human error.
DENTAL IMPLANT SURGERY WITH A SURGICAL GUIDE
Surgical guides fit to your teeth with guide holes for the implant. Guides do not allow the surgeon to make changes to a plan during surgery. This may result in delays to complete your surgery. Sometimes, surgical guides may not work well due to poor fit. This may also result in delays to complete your surgery. Guides may not be a good option for hard-to-reach areas. However, guides may make it easier to place your implants in exactly the right place. Guides may also allow for less invasive surgery. These are some reasons surgeons may recommend guides.
STATE COLLEGE – If you live in Centre County, your next dental assistant may be a robot.
STATE COLLEGE – If you live in Centre County, your next dental assistant may be a robot.
A dentist in State College is in the process of getting a robot that will assist him in dental surgery.
The best way to explain this thing is it is like a Tesla car. It doesn't do all the work, it just gives feedback. When you drive a Tesla over the line, it tells you and gives you a warning when a car in front of you stops. That's exactly what the robot will be doing for Dr. Eddie Kotary.
"I'm super excited to be the first general dentist in the world to utilize Yomi," said Kotary, of Kotary Detar & Associates.
It is the world's first robot-assisted dental surgical system.
The computerized system, better known as "Yomi," will help Kotary with his surgical procedures.
"This is going to allow me to place implants without having to use a scalpel in many cases or sutures in many cases,” Dr. Kotary said. “So, it kind of advances my belief in minimally invasive dentistry."
The navigation works from the planning stages all the way to the implant placement.
During the planning stages, the robot can take scans, then analyze the scan and help plan the procedure.
Yomi provides physical guidance by holding the drill in the present position, orientation, and depth.
This process will make things cheaper and faster for both the dentist and patients.
"A patient comes in. Let’s say they break a tooth, and they need an implant. I can take it out, and I can place the implant in immediately because I don’t need to send for a guide,” Kotary said. “The guide can cost anywhere from $200 – $500 just to fabricate (and it) will allow me to reduce my cost by that much."
Unlike traditional procedures, the system gives feedback and assistance in real time to help guide the surgeon's hand positions to ensure it's in the right place for the plan.
"It gives you a correction so you know exactly where you need to place it based on the program you designed," Kotary said.
Ultimately, the dentist is in control, but Yomi can help alter the surgical plan during the process if needed.
"This is definitely the future of dentistry. This is the first step in robotics in dentistry," Kotary said.
The staff said they're excited about their robot. Yomi is expected to arrive within two weeks.
State College Dentist Pioneers Cutting-Edge Technology
STATE COLLEGE — Whether it’s being the first doctor in town to offer a Starbucks kiosk in the waiting room, or being the first general dentist in the entire world to perform robot-assisted implant surgery, Dr. Eddie Kotary likes to be on the cutting edge.
During his 20 years of practicing dentistry in State College, Kotary has been a pioneer in the use of many different technologies, including pinhole surgery, a minimally invasive procedure for grafting gum tissue; scalpel-free periodontal laser surgery; CT machinery for dental implants; and BOTOX® for dental patients.
“I’m constantly looking for newer technologies, new ways to improve, but one of the things that’s important to me is if I’m going to adapt a new technology or new practice, I have to make sure it’s going to be good for the patient,” Kotary said.
He is particularly excited about the new Yomi robotic system that will be installed in his office in December. He’s been working with developers at Neocis, the company that also developed Mako, a common robotic-arm machine used in joint replacement surgery, to test out the technology. He says it will reduce patients’ costs, discomfort, and healing time of implant surgery.
“Right now when we do implants, we have to take impressions to create a surgical ‘guide’ that has to be drilled into the jaw to stabilize it. It takes time to have that fabricated, and you need to use a scalpel and stitches,” he said. “This (Yomi) is robotically assisted, minimally invasive implant surgery. The robot guides the clinician, and it is extremely accurate. So when I do implants with this, I won’t have to use a surgical guide, create a flap, use a scalpel, or use stitches because I’ll no longer need to place (the implant) by sight.”
To date, there are six Yomi systems in use across the country, all at large implant centers. Kotary said he will be the first general dentist ever to offer the technology, which will reduce his implant fees by $500.
In some ways, Kotary feels that by staying ahead of the curve with new technologies, he is honoring his father, the late Dr. Edmond Kotary, who started practicing dentistry in State College in 1967. The father/son team practiced together from 1998 until shortly before the elder Kotary’s death in 2009.
“My dad said, ‘Graduating from dental school is just your license to learn. You have to continue to stay current,” said Kotary who received his dental degree from the University of Pennsylvania and an MBA from Temple.
Kotary not only stays current on the development of new technology through 100 hours of continuing education each year, but he also has designed several inventions himself.
One of those inventions came as a result of his time as a placekicker for the University of Delaware where he received his undergraduate degree in biology and business.
“My first invention was a field goal net with a logo on it,” he said. “We demo’d it at Beaver Stadium in 2001 with the Nittany Lion logo on it. So, when you see the nets with the ‘All-State’ logo behind the goalpost, that’s my invention.”
Kotary also has spent time working on a new, less invasive dental X-ray machine, and most recently, he’s teamed up with a Penn State biomedical engineering professor, Daniel Hayes, to start a company called Osteosynth, which is developing “bone foam,” a material that can be placed into an extraction socket, eventually hardening into bone tissue.
Kotary sees regeneration and technology, such as bone foam, as the wave of the future in medicine. He also foresees 3D printing technology continuing to grow in prominence and the eventual elimination of radiation in X-ray technology.
Kotary is currently in the process of rebranding his dental practice, located at 2014 Sandy Drive, with a new name: Advanced Dentistry. Now the sole owner and dentist, he has scaled back from the days when his practice included five dentists and 40 employees.
“In some ways, smaller is better. It’s less stress, and you can focus more on the patients you have and on the employees,” he said.
Scaling back a bit is especially important right now to Kotary who suffered a heart attack last year at the age of 46.
“I didn’t even know I had a heart attack. I wasn’t having any symptoms. I was biking to work, and I started getting numbness in my hands,” he said.
Tests revealed that the left anterior descending artery, aka “the widowmaker,” was 100 percent blocked. He received two stents, was put on statins to control his hereditary high cholesterol, and two months later, a follow-up test showed no residual heart damage.
“I feel really lucky, extremely blessed,” Kotary said. “Usually when this kind of heart attack happens to someone my age, it’s fatal.”
Kotary truly appreciates his family time with his wife, Jocelyn, and his two daughters, Hope and Paige, as well as what he calls his “second family”— his practice.
“I have patients as young as 1 year of age, and one patient who is 99, and they’re like my extended family. Whenever I have a patient in the chair, that is the most important person of the day,” he said. “Even though we are very high-tech, first and foremost, I want to be known as a family practice that is patient-driven.”
Kotary is the head of the Special Smiles program for the Pennsylvania Summer Games Special Olympics and offers free oral cancer screenings on Hunter Safety Day every year. He also works to spread his enthusiasm for the profession by teaching a class on business development in dentistry at both Penn and Columbia University every year, and he mentors Penn State students who hope to go to dental school.
“It’s really a cool profession,” he said. “We’re often the first line of defense for a lot of health issues. We do a lot more than fillings, crowns, implants, extractions. We treat the patient as a whole, not just a mouth.”