A PODCAST BY SDS Dr. Karl Ulrich Volz

Episode 7 – Talk with Dr. Karl Ulrich Volz and Dr. Ken Serota

Mind and brain nerves

This time we have a relatively spontaneous recorded episode for you!

Dr. Karl Ulrich Volz spoke during his tour through the USA with Dr. Ken Serota, representative of the CleanImplant Foundation in New York City, who visited one of his lectures in Las Vegas.

They had a very interesting conversation which led from the topic of the mind and brain nerves to ceramic implants and oral surgery.

Let us take you on this exciting journey!

Today‘s Guest

Dr. Ken Serota

New York City (USA)

Ken Serota, DDS, MMSc, graduated from the University of Toronto Faculty of Dentistry in 1973 and was awarded the George W. Switzer Memorial Award for excellence in prosthodontics. In  1981, he received his Certificate in Endodontics and Master of Medical Sciences in Nuclear Medicine from the Harvard-Forsyth Dental Center in Boston, Massachusetts. For this research he was awarded the American Association of Endodontics Memorial Award. In 1987, he received the Ontario Dental Association Award of Merit for his contributions to continuing education.

In 2000, he founded ROOTS, the first online Endodontic forum and coordinated the first of ten ROOTS Summits. In 2004, in concert with Oemus Media, he founded the ROOTS Journal. In 2015 he founded the Facebook forum NEXUS, to integrate all the dental disciplines. Contributing editor to Endodontic Practice, he has published over 70 articles and has lectured internationally on endodontics and implants.

Dr. Serota is a member of the:

Ontario Dental Association

Canadian Dental Association

Ontario Society of Endodontists

American Association of Endodontists

Digital Dental Society

[00:00:00.160] – Dr. Ken Serota
I had an opportunity today, actually I had an opportunity yesterday to meet Uli Volz and the conversation was supposed to be about SDS, you know, SWISS DENTAL SOLUTIONS. But it has turned into this incredible discussion about the mind. We’re not talking about teeth anymore, we’re talking about the mind. So I’m going to ask you to start the trigeminal nerve, that’s crazy beginning. We’re going to talk about the trigeminal nerve and everything that it relates to. So how do we begin with the trigeminal nerve and your perspective on how that part of the brain affects everything we are as a human.
[00:00:39.010] – Dr. Karl Ulrich Volz
Yeah, the super interesting thing is for us, as dentists that I think we all, or the most of us, we underestimate how important our work is. There was one dentist, maybe the most famous of all times, Weston Price who used to be the president of the education and science of the American Dental Association about 100 years ago. He was already aware of the importance of the work of the oral system, oral cavity. But there are some more things we have to take into account. It’s the brain nerves, twelve brain nerves. And one of those is the trigeminus number five. And we dentists, we are working in this area of the number five. So, we should expect that each of the twelve would request the same space in the brain, but just the trigeminus is the equivalent of 50% of the space. So that shows this single nerve we are working in, the dentists, represents 50% of the space in the brain, what is preserved for the brain nerves and as well, it’s in the head. It’s So very close to the brain. The brain is the only organ we can’t transplant.
[00:02:14.730] – Dr. Ken Serota
Yes, exactly.
[00:02:15.520] – Dr. Karl Ulrich Volz
So maybe in 20 years.
[00:02:17.070] – Dr. Ken Serota
There are few people that need one transplanted, but not yet.
[00:02:20.660] – Dr. Karl Ulrich Volz
It would not be so bad for some politicians. And so the point is that most of the senses are very close, like the smelling sense, the vision, the taste, all the senses are super close to the oral system. And so this shows how important is the oral cavity. And at the same time there is no other part of your body where so many, let’s say, strange materials placed into the teeth. Like I mean Amalgam. My doctor sees about amalgam, but it contains more than 50% of mercury. What is the most poisoning non-radioactive element on the planet.
[00:03:10.200] – Dr. Ken Serota
Your study was amazing. That was your master’s thesis, your PhD thesis on Amalgam?
[00:03:15.370] – Dr. Karl Ulrich Volz
Yeah, actually my doctor thesis 35 years ago.
[00:03:18.970] – Dr. Ken Serota
35 years ago. You look like you’re 25. We’ll talk about how you stay healthy in a minute and you regress your age. But your doctoral thesis was done on Amalgam and you did it on soldiers, you said, right?
[00:03:30.250] – Dr. Karl Ulrich Volz
Yes, actually I placed amalgam fillings into the wisdom teas of soldiers. They were due for extraction.
[00:03:36.750] – Dr. Ken Serota
Captive audience, of course.
[00:03:38.190] – Dr. Karl Ulrich Volz
And I extracted the teeth. I was still a student. I extracted the teeth after 24 hours, two days, one week, one month. And then we analyzed the quantity and the quality. So that like with a microscope. So size was very close to my university, so I was able to use the at the time most modern microscope REM. And on the other side, you did a neutron activation analyzes. So to see how much mercury moved from the filling into the tubes, and already within 24 hours, we could prove that the mercury was not just inside the tooth. It was not just inside the pulp. It was not just inside the shells. It was already inside the core of the shell.
[00:04:35.510] – Dr. Ken Serota
You know, when you think about it initially with Amalgam, the argument initially was, well, there’s one study on a lamb that one man wrote that’s substantial. And meantime, now Amalgam separators is gone. It’s eliminated from dentistry. You mentioned Dr. Price. I’m an endodontist. So most endodontists wanted to shoot Dr. Price. They would have liked to have done away with it. It’s okay. He was quite valid in what he did. I know Germany was very focused on endodontics being a source of sepsis in the body. But what was intriguing in talking to you is at various times in your life, on several different areas, you’ve embarked upon a path that diverged completely from the norm. So when you started to change, you brought a CEREC. You had one of the first CEREC machines in your practice. So somewhere along the line, you had to suddenly – there was an inflection point. You realized what danger there was and your whole perspective on health, how to achieve health, sustain youth balance, which we’ll talk about Dr. Norbekov in a moment. But the thing is sort of where it starts that you said to me, you said you weren’t uncomfortable, you had a stutter.
[00:05:48.400] – Dr. Ken Serota
Okay. You’re one of the most articulate, spectacular presenters. I watched you yesterday. The words flow. Your presentation flows. There’s such logic in your presentation, and yet you said you stuttered for a long time. You got it under control.
[00:06:04.150] – Dr. Karl Ulrich Volz
[00:06:05.140] – Dr. Ken Serota
That’s awesome.
[00:06:06.450] – Dr. Karl Ulrich Volz
Yes. I believe we should always – so if we face our biggest challenges and if you overcome those, that’s definitely the ones who will change our lives most. And so for me, that was my big issue, to talk in public. So it was like I was super afraid, super nervous, and I started to study, and I was super lucky, actually. It was in the US. So I took all the courses of Andy Robbins.
[00:06:40.390] – Dr. Ken Serota
Anthony Robbins, right.
[00:06:42.040] – Dr. Karl Ulrich Volz
Quiet famous in the US.
[00:06:42.682] – Dr. Ken Serota
Yes, for sure.
[00:06:42.790] – Dr. Karl Ulrich Volz
I did all the courses. I even became on the level of master trainer. But I never worked for him because I did it for myself. So to overcome the stuttering
[00:06:53.890] – Dr. Ken Serota
How did that get perceived in Europe? I mean, Tony Robbins in America is a guru, and he has his I won’t say it’s cultish, but he’s a guru. Everybody sees him as leadership, empowerment, self actualization. Does that work in Europe? Is that kind of a concept, a culture that they understand or respect.
[00:07:12.630] – Dr. Karl Ulrich Volz
To be honest the first course I attended was about 25 years ago. And at the beginning it was a little bit hard for me to get used to his style. So this is for us Europeans, a little bit hard to digest.
[00:07:38.400] – Dr. Ken Serota
[00:07:38.860] – Dr. Karl Ulrich Volz
It’s super straightforward and super strong marketing. So he forced us to go into the next level, next courses and so on. But actually I saw that he’s super honest and I mean, I’m following him now since 25 years. So every ten years I do some refreshment courses whatsoever and I see it really works.
[00:08:06.510] – Dr. Ken Serota
You know why he became who he is. He had a stutter. That’s how it started. It’s a little known fact Tony Robbins actually stuttered when he began. This is how he controlled it. That’s why I thought it was so fascinating, the discussion about the trigeminal nerve, the discussion about the stutter and the ability to control it. It’s the mind, it’s mind over matter. You can’t control the physiology and you’ve done that with every part of your life. Starting with the Amalgam, the switch to using CEREC, to using Zirconia. So when you switch to CEREC, it was probably the first unit, right? It was like the one that kind of it was hardly ergonomic at that point in time. How did you integrate it? How did it become part of the fabric of your practice?
[00:08:51.260] – Dr. Karl Ulrich Volz
Yeah, actually when I started I wanted to not to be dependent from southern Germany. We have quite strong insurance system. So it’s a government insurance and about 97% of the population, they are inside this government insurance and everything is super restrictive. So they would just pay this time for Amalgam fillings. And I decided to start a private practice. What means I would be outside this system and I would have to focus on the 3% of the population which are outside of the government insurance. And on the other hand, I was the youngest dentist who ever started in Germany, a private practice I was 25 years old. And so I had to do something different. And I learned that and it was never in the past 32 years a matter of money or costs. It’s a matter of quality and service and commitment. So I decided not to do any Amalgam fillings because of the findings of my research. I started in a very, very small practice, just with one treatment room. Even the panoramic was inside the treatment room. So when we had to take a panoramic, the other patient had to leave the room. It was really strange.
[00:10:25.230] – Dr. Karl Ulrich Volz
But I received so many new patients because I wanted to treat the patients like I want to be treated. And that is, I think is the trick and the base for any success. Because I mean, in many places where you go, even in practices or hospitals, you get treated like you not feel that you are a customer you’re something that is disturbing – you’re a product. A few years later, we already had 10/11 treatment rooms, 15 dentists. So it was my first clinic. And so we are growing extremely fast because there was a huge demand for this kind of treatment and always full of the metal free path beside the implants.
[00:11:25.840] – Dr. Ken Serota
Well, you did 12,000 titanium implants. It was interesting in assembling the research. You did your research on Amalgam. You proved the point. Dr. Price was your, I would say well, not your avatar. He was your point person, I guess, and all of the things that you’re talking about. The move to CEREC initially was dismissed. The use of Amalgam, the need to avoid the use of was dismissed. The thing that you did with Tony Robbins in the early days, he was viewed as cultish, right. The people that followed him were outside the norm. But you followed your path through all of this and assembled this into who you’ve become. You’ve walked your own path. You’re not concerned about what anybody else thinks. It’s your choice. And ultimately, even it all comes down to being very centered. At least that’s what I see. But you are actually doing that. You have a philosophy of selfcare, physical self care, obviously, mental selfcare as well. But can you talk about what you do to center yourself, to bring yourself into your core with Dr. Norbekov?
[00:12:34.930] – Dr. Karl Ulrich Volz
Yes, I think in general, there’s a lot of things you could do. And I believe that any person on the planet should become his own health advocate, because at the end, when you’re going to die and you knock on heaven’s door, so there’s nobody you could blame. It was my doctor – my doctors fault – or the Minister of health. You have to become your own guide, your own professional. The really good thing and nice thing about our profession is that if we study all those techniques and ideas and knowledge and science about health, it’s at the same time our profession.
[00:13:31.180] – Dr. Ken Serota
Yes, it is.
[00:13:31.860] – Dr. Karl Ulrich Volz
Other people, they would have to do it at the end of the day after their daily work. If they are, for example, a banker in their free time, they have to study and to understand how health works. But every person has to understand because they’re responsible for their own health. So I think it’s important, especially for me, it’s the morning. So the first few hours, that is mine. So I think what is super important not to switch on the iPhone or whatever or the mobile or the computer before you have done all your routine, because then everything starts and goes into your brain. And from this point on, you are not more or less not the master of your time anymore, because you get so many notifications and requests and calls and whatsoever. So for me, for example, this morning, I woke up at 3:30 in the morning because of the time difference, and I started to work and it was beautiful because it was quiet and I could really go ahead with my mind – my mind was clear. And I think it’s super important sometimes to shut down and to just to think and to do nothing.
[00:14:59.890] – Dr. Karl Ulrich Volz
And for that we need to find certain places because at the end of the day, thinking is actually the metabolism. If you think, yes, you need the most energy even more than doing work out. And that shows how interesting, how hard it is. But it’s the most important to think.
[00:15:20.890] – Dr. Ken Serota
It’s the most important exercise to use our brain. We will get to implants, by the way. It’s coming, but your dad is very interesting, we will get to ceramics in a moment. So what was interesting in piecing all of this together. You just mentioned iPhones. Your clinic is literally there’s a barrier from electronics, right? Nobody can use iPhones. There’s no WiFi. There’s nothing. It’s all part of your sense of biology and immunology as it pertains to the health of your patient in your facility. They can’t get outside unless it’s hardwired. So there’s nothing coming. Can you talk about that for a second? I found that fascinating. You’ve created this sort of immuno bubble to do your work. It’s spectacular.
[00:16:05.920] – Dr. Karl Ulrich Volz
Yeah, I can see you’ve really done a good research.
[00:16:08.620] – Dr. Ken Serota
I checked you out.
[00:16:12.120] – Dr. Karl Ulrich Volz
So the idea was I saw other clinics and in 2016 we decided to build another clinic in Switzerland, the SWISS BIOHEALTH CLINIC. And the idea was to kinda it should be a role model for other clinics. And I can see that a lot of other dentists started to copy us what is good, so it’s nothing bad. So we support them. All the materials are from Switzerland, so it’s Swiss oak. And even the pictures are from the photographer of this Ricola. Yeah. And the stone is from the Valsa Valley where the mineral water comes from. And we protected it so you would not have any mobile connection when you’re sitting inside. But we have a lot of cable connections. Just very few people know that you could go into the Internet with your iPhone while in the flight mode. That is something as a special plug what you need. And because there are even some peer reviewed published studies, they show and proof that the ostheo integration and the bone implant contact is compromised if the patient is exposed to WiFi and to mobile network.
[00:17:42.000] – Dr. Ken Serota
Okay, and this is peer reviewed?
[00:17:43.960] – Dr. Karl Ulrich Volz
[00:17:44.590] – Dr. Ken Serota
[00:17:45.330] – Dr. Karl Ulrich Volz
I could give you the link on it’s, on PubMed. It’s really super interesting.
[00:17:48.430] – Dr. Ken Serota
I have to spend the rest of my life just trying to figure out what you’ve done. Because the research, the effort that you put into so much of what you’ve done, the thing that was most entrancing in all of this wasn’t just that SWISS DENTAL SOLUTIONS, these zirconium implants and what you do and we’ll talk about the business in a minute. But it’s this foundation that you’ve laid of sense of self, physical self, mental self, the assemblage of all of these things that you’ve put together. What was fascinating yesterday, for example, was again, we are going to get to the implants, I promise. But your whole sense of how to create a – and I was going to use the word holistic – it’s so wrong. It’s sort of a bioimmuneologically idealized state of being. And so vitamin D 3 and K 2. I’d like to talk about that if I could, for a minute. I think I mentioned to you yesterday, my daughter is an osteoporotic specialist in New York, so she works on the Upper East Side of New York. And every second person walking down Madison Avenue is osteoporotic. That’s just the reality of being too rich and too thin.
[00:18:51.400] – Dr. Ken Serota
But you basically have taken this, you’ve created products for your patients, you’ve done phenomenal research on the biochemistry. Can you talk about that as well?
[00:19:00.190] – Dr. Karl Ulrich Volz
Yes, I was always thinking if there would be kind of a magic bullet for health, I would say today is vitamin D 3.
[00:19:12.150] – Dr. Ken Serota
Vitamin D 3.
[00:19:13.030] – Dr. Karl Ulrich Volz
Yeah, because it’s produced from the sun. So there would be no life on the planet without the sun. One vitamin, what is produced by the sun, and then it’s processed into an hormone. And if you talk about testosterone, estrogen, melatonin or whatever, but the most important hormone in our body is vitamin D 3 or it’s a Calcitriol. And it’s responsible for some say 2000, others say 20,000 gene expressions. It’s responsible for all the immune system. And for us, dentists it’s super important. It takes care about the bone metabolism. And we dentist researchers, we focused on all the cells in the bone metabolism, most opportunities on our cells and whatsoever. But we completely forgot to have a look at something totally normal. What is the Calcitriol and the Calcitriol is so super important because it activates the osteoblast and it inhibits the osteoclasts. So if Geistlich would sell us a product, what would be able to do that? We would pay a lot of money for it, sure. And we get it for free, at least in nice places. You could live in Las Vegas, but if you supplement in 20,000 units per day, it might cost maybe one dollars or something like that.
[00:20:45.060] – Dr. Karl Ulrich Volz
So that’s nothing.
[00:20:46.620] – Dr. Ken Serota
But you made an interesting point. I thought the thing that you said yesterday was amazing. People do implants and they put a cow into a patient biowise they put a cow into the patient and 20 years later there’s still a cow inside that bone. Nothing’s changed. You, on the other hand, are looking at preparing a patient biologically and immunologically by addressing vitamins, Janitor cells, you’re a PRF advocate. So let’s look at that for a moment because you were very adamant that when you do implants, and again, we’re getting there, I promise. When you do the implants, you set your patient up for perfection. You leave no risk factor in place within your control. Could you talk about PRF and why you view it – you see it as such an integral part of your success. 350.000 implants or 400.000 implants later, it’s integral to what you do.
[00:21:38.670] – Dr. Karl Ulrich Volz
Yeah, actually, I think what helps a lot that I’m already for so many years a surgeon. Now it’s 32 years. And when I started, there was no bone graft material available. So at this time, we used autologous bone and we used the memphic system, so like the tent pole system, and we created bone. And then came this period where we were told we should put everywhere bone grafting material. I mean, I use bone grafting material, but we should never forget what is the reason for bone grafting is to create a space and to kind of push away the periost or the endiost what is called Schneider’s membrane. But the more you condense, the more you put, the less space is for vascularisation. And any bone grafting material, if it’s not autologous bone, will need osteoclast to be resolved, but definitely do not want to have osteoclast in a new augmentation site.
[00:22:47.220] – Dr. Ken Serota
[00:22:47.580] – Dr. Karl Ulrich Volz
So actually, in my opinion, it’s not bone. A guided bone regeneration is guided bone augmentation.
[00:22:56.860] – Dr. Ken Serota
[00:22:57.250] – Dr. Karl Ulrich Volz
Guided bone regeneration is what we do. We create a space not by bone grafting materials, but like we did 25 years ago with the umbrella screws or with our bone implant stabilization system, those cages, or just by the white tulip of the implants or by the disc on top of the sinus implants. And then, of course, we need to take care about the bone metabolism that the system is able to create new bone, like with vitamin D 3, K 2, magnesium, vitamin C, omega 3, all those things. And then we know that the blood and the stem cells in the blood, they tell the system where to build new bones. So, for example, if you extract the twos and the socket will always be filled with bone, and the top will be new keratinized gingiva produced by free apikalisation. And so that is open healing. We all do open healing every single day. But Professor Ghanaati, one of my dear friends, he created a concept where we do huge bone grafts. We do open healing all over the bone graft. And with that, the patient would not have any swelling, any pain. We do not compromise the vestibulum, and everything is going to create new soft tissue due to free apikalisation, will be keratinized gingiva and so this is something that we did much more free apikalisation 30 years before when I started as a young surgeon.
[00:24:42.000] – Dr. Karl Ulrich Volz
And then we started to do those crazy fancy techniques with deepitalization and split, and just like crazy, and it never worked. And today we’re kind of coming back to this. The interesting thing is, when I was a young immunologist, they told us the cavity for the implants should be perfectly congruent and the implants should be perfectly fitting into the cavity because the epithelium is growing so quick, and it would grow in between. So today we know that this is not true because no socket would be filled by bone. But there is one situation where the socket is not filled by bone, and it will be filled by epithelium. It’s a dry, socket because the blood is missing and the information is missing. So as soon as you have got blood information, stem cells in the socket, in the cavity, in the chamber, it’s going to create bone. There’s something what is even better than blood, that is blood concentrates, because it’s about 9 to 18 times. So if you draw blood, it’s about 9 ml, it will be half to one CCM of membrane or matrix. This is not a spacer.
[00:26:05.940] – Dr. Karl Ulrich Volz
It’s not a spacer because it could be compressed to zero. But it’s information matrix, right. And it just delivers growth factors. And I started already 25 to go with PRP. Then I did PRGF and all those systems, and I think the development of Professor Choukroun regarding the PRF was incredible and changed the world. Because the PRF is a material which contains leukocyte, lymphocytes, monocytes, macrophages, and therefore it’s creating acute inflammation.
[00:26:43.090] – Dr. Ken Serota
[00:26:43.470] – Dr. Karl Ulrich Volz
And we think inflammation is something bad, right? Yes, there is a bad inflammation. The chronic inflammation based on giant cells, but the inflammation based on leukocytes, lymphocytes, macrophages is a good inflammation. If you get hard or you scratch your skin or whatsoever, there’s always three stages of healing. It’s acute inflammation and the proliferation and the new formation of tissue, the growth of tissue, what takes 21 days if you use it’s, like a catalyst. The PRF is condensitude. Ten days you have a cause, if something heals in ten days instead of one day. It’s much safer.
[00:27:34.500] – Dr. Ken Serota
[00:27:34.960] – Dr. Karl Ulrich Volz
And so we should not think that inflammation is something bad. We need acute inflammation. But the dangerous thing is, the chronic information, I mean, it’s actually the cause of all aging, of all chronic disease is chronic inflammation, and chronic inflammation equals chronic stress. So it actually is not so difficult to avoid chronic disease and aging. We just we have to take care about the chronic inflammation.
[00:28:03.420] – Dr. Ken Serota
But you’re doing that you do that with your sense of balance, with this. You call it Russian yoga, I think you said it was. You find the center of your body, you’ve centered your brain, you’ve centered your biochemistry. You’re conveying that to your patients. So all in all, do people look at you and go, well, you know, do you get a lot of pushback? Do people challenge this as if it’s esoterica, it’s not real? Do you get a sense that people are confrontational about it? Certainly no, people accept it. They’re understanding, they’re clear on it. Because that’s the draw that your patients have.
[00:28:41.530] – Dr. Karl Ulrich Volz
Yeah, I mean, the point is, if you are – my situation. I’m now 58 and my energy is better than when I was 25. And when I do my courses, I’m on stage for two days in a row. And I could do that for three, four, five in a row. I would not get tired. And so they start to understand that there must be something, what I’m doing, what is working. So this Norbekov Russian Yoga is nothing special. I do a lot of things. I mean, at the end we have to take care about everything. What causes stress and chronic inflammation. And this actually starts in the mouth.
[00:29:33.960] – Dr. Karl Ulrich Volz
There are infections, right?
[00:29:36.560] – Dr. Karl Ulrich Volz
So actually I’m totally against root canal treated teeth, sorry.
[00:29:41.140] – Dr. Ken Serota
It’s okay, I retired. No problem. I’m not practicing. It’s good.
[00:29:46.460] – Dr. Karl Ulrich Volz
But a dead tooth is a dead tooth. There are tons of studies, they are not performed by dentists. They are performed by cardiologists, by immuneologists and by biologists. That organ always is going to release toxins. Yes. Mercaptan, thiolethanol and so on. And it’s impossible to do a root canal treatment. What will be not poisoning the patient. It’s impossible.
[00:30:21.460] – Dr. Ken Serota
There’s residue, without question. You’ll never get rid of the quality from units. I know, it’s true.
[00:30:26.740] – Dr. Karl Ulrich Volz
And I can tell you, I’ve treated so many from my clinic in Switzerland. We are receiving about 80% of chronically ill patients. Like Lyme disease is a very big group. Neutral degenerative disease, cancer, alzheimer’s.
[00:30:48.270] – Dr. Ken Serota
This is the focus of this is what your practice sort of centers itself around.
[00:30:52.910] – Dr. Karl Ulrich Volz
It is. I would like to have more like healthier patients, it would make it easier, make life easier.
[00:31:00.150] – Dr. Karl Ulrich Volz
We have about 10% of athletes. So at our clinic we have the equivalent of more than 20 Olympic gold medals. So we have a lot of very famous athletes. And I can tell you, none of them would have root canal treated teeth or some leftover, some metal based grounds or inlays. None of them would have a titanium implant.
[00:31:25.010] – Dr. Ken Serota
How did you come to Zirconium implants? How did that happen?
[00:31:28.600] – Dr. Karl Ulrich Volz
Actually, because of my doctor’s thesis. What was about Amalgam. And it ended up against Amalgam.
[00:31:38.580] – Dr. Ken Serota
[00:31:39.370] – Dr. Karl Ulrich Volz
It’s obvious now, 30 years later.
[00:31:41.980] – Dr. Ken Serota
Three years, they knew you were right.
[00:31:44.520] – Dr. Karl Ulrich Volz
But I mean, stock the Noble Prize winner in 1923 he, at this time, he said It will be proven. And it took another, let’s say almost 100 years. It was really a bad thing for humanity.
[00:32:00.460] – Dr. Ken Serota
[00:32:01.270] – Dr. Karl Ulrich Volz
And so I think I had the second or third CEREC machine, then the second DCS machine in the world. We started 97 to –
[00:32:15.780] – Dr. Ken Serota
DCS, I’m sorry, what is DCS.
[00:32:18.130] – Dr. Karl Ulrich Volz
This was the first machine where you could mill a framework, but at this time it was a HIP. So just for one tooth, it took 5 hours, so it was really super tough. And I still placed titanium implants. And the patient asked me if I could not provide ceramic implants. And there’s nothing on the market. And I was super lucky that one day a new patient turned out to be the owner of that time world market leader in Zirconia hips. And I asked him if it would be possible to produce Zirconia implants. And he said, easy. Nothing. And I said, do you believe they are going to osteo integrate? He said, of course, we know. I said, okay, interesting. And so we started a study and approved by the ethics committee for implants. And I did the first cases in 2000, and I still am showing a case, eight implants. And so when the patient came back and said, oh, my God. When I saw the soft tissue, it was totally different than I was used to in Titanium. That’s cool. And I saw that the implant was super stable. It sounded perfect. I can tell you. All those implants are still in place.
[00:33:33.460] – Dr. Karl Ulrich Volz
And I just saw this lady with the first big case eight implants one year ago. Absolutely perfect, still. So that was when I started the beginning. Everybody was super interested into ceramic implants.
[00:33:48.040] – Dr. Karl Ulrich Volz
“Wow – That’s super interesting.” I was invited doing lectures, and then it became suddenly kind of as a feeling, a little bit like a threat for some big business.
[00:34:00.710] – Dr. Ken Serota
Yeah, big business.
[00:34:01.690] – Dr. Karl Ulrich Volz
But it was not from the industry, actually, to be honest, I would even say I’m friends with all titanium implant companies. And even one of my dear friends, Marco Gadola, is the former CEO of Straumann. And they all understood that the future will be Zirconia. And Straumann went into ceramic implants in 2012, right around ten years ago. And if you are the worldmarket leader in titanium, there is no need to go into a risky new technology. You would never do that, it’s against all books. But Marco Gadola is 100% convinced, and he was a speaker at our last JCCI JOINT CONGRESS for CERAMIC IMPLANTOLOGY in Switzerland last year. And he estimated that in the coming five years, the number of ceramic implants is going to multiply by 40.
[00:35:05.380] – Dr. Ken Serota
[00:35:06.640] – Dr. Karl Ulrich Volz
To be honest, I’m not so optimistic because it took now 22 years, and we are growing about 20-25, sometimes 50% per year. But still it’s a very little percentage. But the patients there but if you ask the patient as a survey, Straumann did 80% of the patients, and that’s already many years ago, they would go for the ceramic implant.
[00:35:33.910] – Dr. Ken Serota
[00:35:34.360] – Dr. Karl Ulrich Volz
And of course, at the beginning, we had to understand that the way is not to copy just a titanium implant.
[00:35:41.190] – Dr. Ken Serota
No, you can’t replicate it exactly.
[00:35:43.240] – Dr. Karl Ulrich Volz
Because it’s different in physics, immunology, biology, everything is different. So the zirconia implant has to just to give you one example, so if you grew an implant into the bone, you create friction. Friction means friction heat. In a metal based implant, the heat will be dissolved into the core of the titanium, so there is less risk for overheating the bone. But in Zirconia, it would stay on the surface. So it makes no sense to create an implant. A Zirconia implant will create a lot of friction heat. Because the risk to burn the bone is much higher. And this is why our implant looks totally different than all other implants. Because we are working with a lot of healing chambers. So we created, high stability with the tip of –
[00:36:35.590] – Dr. Ken Serota
Primary stability.
[00:36:37.540] – Dr. Karl Ulrich Volz
Yes, We are creating a lot of healing chambers, we are creating new and denovo bone, what is highly vascularized and so on. So we had to understand and find out anything. What is the big advantage of our implant system? That I was the guy who placed the most implants. So I placed more than 25,000 ceramic implants.
[00:37:01.710] – Dr. Ken Serota
[00:37:02.050] – Dr. Karl Ulrich Volz
So I was my best customer.
[00:37:03.810] – Dr. Ken Serota
Good deal.
[00:37:04.590] – Dr. Karl Ulrich Volz
And without me, –
[00:37:05.700] – Dr. Ken Serota
You got a discount 25,000 good discount.
[00:37:08.020] – Dr. Karl Ulrich Volz
Actually, I never got a discount and that was how I financed the company. And today I’m very happy. We’re the world market leader and we –
[00:37:18.060] – Dr. Ken Serota
You are the world market leader. Fantastic.
[00:37:19.920] – Dr. Karl Ulrich Volz
We’re selling more than all the other companies together. And I think it is because I’m still in the surgery very often and I see and understand how it works, what doesn’t work. And then we are changing. And the nice thing is it’s all in one place. In Switzerland, there is the clinic education center. There. The research is SDS. It’s all in one big building. So it’s not something that was designed on the desk. And let’s see if it works. We know what works because we are working with it every single day. And I think that was the big advantage of SDS, that it was created by surgeons for surgeons. We understand the needs. I mean, I’m a surgeon for 32 years, so I know exactly the needs of the surgeons and of the patients, of course, as well.
[00:38:17.880] – Dr. Ken Serota
Well, you’ve done some amazing things. Like it was interesting, some of the only implant system that’s ceramic that I’m aware of in Canada was CeraRoot. And CeraRoot is I think the smallest is four, one at the neck or something. But you’ve actually brought it down. You have a three, three implant, so you can do lower in sizers. Basically, your implants are set up and again, single and two piece. Right. It was interesting the questions that were asked yesterday of you. We’ll address that in a minute. But it’s a mental shift to move away from screwing abutments and screw in prostheses. You could see the reaction like people are going, Wait a minute. So to go back, you basically are you’re biomimetic in contrast to titanium. From what my understanding of what it was yesterday, the integrations are different in a sense because of these chambers that you’re creating, the way the tissue, the platform is different. And in theory, you can prep the tooth. It doesn’t matter. You don’t need to melt the abutment to angle. You can do literally anything you want because your implants have that shape. You’ve now got the balcony implant to prevent trapping and as the tissue regenerates.
[00:39:24.570] – Dr. Ken Serota
And what was most impressive was the tissue growth. Okay, everybody, they’re worried about the emergence profile, the abutment, and this that. That doesn’t seem to be a factor in your case. The way your implant is designed, it doesn’t seem to be a complication for you. You don’t see the bone moving away. You have the foundation for the tissue, for the papilla, because you essentially, you’re almost like prepping teeth is what it came across in watching you yesterday. You’re prepping teeth. They may be made out of zirconium, not enamel and dentin, but you’re prepping teeth. So how did this all come about for you? How did you visualize this? Conceptualize it?
[00:40:02.080] – Dr. Karl Ulrich Volz
Yeah, actually I started my career with bonefit Straumann tissue level. And this is still the best titanium implant of all time.
[00:40:13.920] – Dr. Ken Serota
The Straumann, yes.
[00:40:15.430] – Dr. Karl Ulrich Volz
Still in all studies, but of course not the most prettiest.
[00:40:19.780] – Dr. Ken Serota
Yeah, totally aesthetic.
[00:40:22.200] – Dr. Karl Ulrich Volz
So they started to push it down to the bone level and then to come out of the gum with a nice white post. But the interesting thing is, if you look at the latest developments of the worldmarket leaders, Straumann so the BLX is a quite aggressive thread in the lower part of the implants, a micro thread in the upper part. So it looks very similar to what we created now 14 years ago.
[00:40:53.200] – Dr. Ken Serota
14 years ago.
[00:40:54.860] – Dr. Karl Ulrich Volz
So that is since I’m using this shape. And just our implant, to be honest, is much more elegant. So it looks much nicer I believe. But what is super new about this BLX implant and now there is a TLX implant, tissue level. Tissue level implant for immediate implant in titanium. I mean this is the worldmarket leader. And so they’re coming back.
[00:41:24.280] – Dr. Ken Serota
They’re waking up,
[00:41:25.450] – Dr. Karl Ulrich Volz
They’re coming back to tissue level.
[00:41:27.220] – Dr. Ken Serota
[00:41:27.870] – Dr. Karl Ulrich Volz
It’s interesting because tissue level always is better than bone level. Because bone level, you always you will have a second gap. And there’s some better connections, some are not so good. But if you take off the abutment, it stinks. That means there is there’s micro gapping always, that’s for sure. The only disadvantage was in tissue level titanium that the margin could be exposed. Then it was quite ugly because black and you were not officially not allowed to shape it. I know some dentists shape Straumann tissue level many years ago. I know that. Even I did it sometimes. But now we’ve got the material what we are allowed to shape. So the zirconia we use is the pure zirconia. We are not adding nothing like other metal oxide to make it like yellow, a 2, a 3, or even pink, what would be a nice color, but it would change the physics of the material. So we’re using the pure so called TCP Zirconia. So we are allowed to shape it if it’s FDA or if it’s the European authorities. And it would not lose any stability. And it’s wide. So now it would make no sense to push it down because a bone level implant in zirconia is even worse because it’s worse, a lot worse because there is no cold welding.
[00:43:09.420] – Dr. Karl Ulrich Volz
So if you put zirconia on top of zirconia, it would be always a huge welding. In titanium, it’s a very flexible material. There’s a cold welding. Some systems, like Bicone, they don’t even use the screws.
[00:43:25.900] – Dr. Ken Serota
Just tap it.
[00:43:27.520] – Dr. Karl Ulrich Volz
Tap it inside and it works. It will never work like this in zirconia. It would either break or create a huge gap. And even I’ve already removed, just two weeks ago at my live surgery at my course in Switzerland, I had to remove a bone level because the smell was so bad that the husband of – She’s a dentist herself –
[00:43:50.500] – Dr. Ken Serota
Divorce was imminent. Is that what that meant? He’s leaving. Oh my goodness.
[00:43:59.850] – Dr. Karl Ulrich Volz
The smell was so bad, for sure. And so in 22 years, never anybody questioned when I was saying the one piece implant tissue level with the margin exactly on the gum line and the crown cemented on the implant, not on the abutment on the implant is the best what you could place into your patient. There is nothing better. I always am asking my audience, do you have an idea if there could be something better? Never ever anybody was telling me what could be better than this.
[00:44:39.790] – Dr. Ken Serota
The woman yesterday was interesting. There was a lovely young lady who was very into what you were doing. And she kept saying, well, prosthodontists, they screw in the abutments, they screw in the crowns. And she couldn’t understand, like, what’s the difference between prepping on zirconium? As if you were prepping a tooth and cementing the zirconium crowned surface at tissue level with cement. So her point was, well, cement, it’s going to get caught on. But your point was perfect. You’re prepping a tooth. It’s not an implant you’re prepping yes, it’s an implant, but you’re prepping a tooth. So given that we’re going to run out, I want to talk about Clean Implant for a second, if that’s okay. You are one of the strongest advocates of the Clean Implant Foundation. Why?
[00:45:23.590] – Dr. Karl Ulrich Volz
I designed or I went into ceramic implants because of immuneology. And so we have a responsibility to our patients. And I never thought about surfaces could be contaminated or not clean. Then I met a guy, Dirk Duddeck, ten years ago and I said, it is completely changed my world. And I said, okay, that is something I have to focus on. And it took many, many years and cost a fortune to make the implants clean. But actually today we are the Cleanest implant company. We are the only company in the world with two navigation systems accredited by Clean Implant.
[00:46:12.840] – Dr. Ken Serota
That’s AIM.
[00:46:14.140] – Dr. Karl Ulrich Volz
AIM and SDS BOX are the only two. There are no more in the world and they’re both owned by SDS. And because there is another thing we should think, what we transport when we drill with a metal through the sleeve into the bone well, –
[00:46:30.750] – Dr. Ken Serota
This is yes – This is what Dirk’s whole thing is about. It’s just why it’s so fascinating. Yeah, you’ve embraced it like you’ve committed wholly to this. You see the vision of it, which is fantastic.
[00:46:43.010] – Dr. Karl Ulrich Volz
Always when I do something, I do it –
[00:46:45.580] – Dr. Ken Serota
a 110%, if that’s possible.
[00:46:48.250] – Dr. Karl Ulrich Volz
120% –
[00:46:49.910] – Dr. Karl Ulrich Volz
Because there was not even before we started. So Dirk said, okay, we could even do a double certification on the production level and on the manufacturing level. So we are the first company. And then so we actually did more than 100% because we went into areas like the navigation system where there was not even already like a certificate for that. But I can see and feel my patients. I mean, today all knowledge is available. So you just Google it and you get all the information, right? And before that, you had to go and to read a book and whatsoever to get information was super hard. Today, all information is available. The patients, they’re getting more and more concerned about what they want in their food, in their drugs, in their implants.
[00:47:48.660] – Dr. Ken Serota
It’s a polluted world.
[00:47:49.630] – Dr. Karl Ulrich Volz
It’s a polluted world. And anyway, it’s a beautiful world.
[00:47:54.250] – Dr. Ken Serota
No, you’re the avatar for living it beautifully.
[00:47:58.590] – Dr. Karl Ulrich Volz
I would never like to go 100 years back, but this is our situation. We have to make the best out of it, and we have to understand that. We have to avoid some of the pollution and we have to detox. That is a part of our life, of our lifestyle. And I see there’s a huge interest in the patients and in the dentists. And so I strongly believe that the Clean Implant Foundation is something that is going to change the world. It’s still hard.
[00:48:31.610] – Dr. Ken Serota
There’s still going to be pushback. However, it’s the first time that there is a peer review of our corporate partners. It’s one thing to publish a paper and have other colleagues evaluated, but now colleagues are evaluated. Peer review of the corporate people, it’s becoming a true profession. It’s integrated. I know we’re going to run out of juice. Sorry. This was fun. We should do it again. I really had a lot of absolute, very much pleasure to meet you.
A PODCAST BY SDS Dr. Karl Ulrich Volz

Episode 5 – Guided Surgery with Dr. Markus Sperlich and Dr. Mathias Sperlich

Immediate implantology and the future of guided surgery

Today, Dr. Karl Ulrich Volz talks to Dr. Markus Sperlich and Dr. Mathias Sperlich, who have a dental practice together in Freiburg.

Guided surgery has been an integral part of the working practice of Drs. Sperlich since the joint practice was founded in 2013, as has all-ceramic implantology.

The brothers talk about their entry into ceramic implantology, its advantages and the benefits of Guided Surgery.
They also discuss the clear advantages and future of immediate implant placement, especially with regard to ceramic implants, which are ideally suited for immediate implant placement.

Todays Guests

Dr. Markus Sperlich

Freiburg im Breisgau (DE)

Dr. Markus Sperlich studied dentistry at the Albert Ludwigs University in Freiburg. Following his studies, Dr. Sperlich completed his doctorate at the Clinic for Oral and Maxillofacial Surgery at the Albert Ludwigs University of Freiburg. He spent his residency at the University Hospital in the Clinic for Dental Prosthetics with Prof. Dr. Dr. hc. Jörg Strub.

Dr. Mathias Sperlich

Freiburg im Breisgau (DE)

Dr. Mathias Sperlich studied human and dental medicine at the Universities of Freiburg and Würzburg. During his training, Dr. Sperlich worked in the field of oral and maxillofacial surgery at the University Hospital in Zurich and at the Chhatrapati Shahuji Maharaj Medical University Lucknow (India). He completed his doctorate at the Clinic and Polyclinic for Trauma, Hand, Plastic and Reconstructive Surgery at the Julius Maximillians University of Würzburg under Prof. Dr. Meffert.


Hello and welcome to the fifth episode of the SDS Podcast. Today, Dr. Ulrich Volz talks with Dr. Markus Sperlich and Dr. Mathias Sperlich, who together have a dental practice in Freiburg, Germany. The brothers talk about their entry into ceramic implant dentistry, its advantages and the benefits of Guided Surgery, which is in development. They also address the distinct advantages and future of immediate implant placement, especially in relation to ceramic implants, which are ideal for this implant placement. Biological dentistry and micronutrients was new territory for both of them and they talk about what convinced them to use them and the clear difference they experienced in their treatments.

Dr. Ulrich Volz

Dear colleagues, welcome to our new edition of the SDS Podcast. And we are here in Kreuzlingen and we have quite exciting guests for you today, namely the two brothers Sperlich and Sperlich, Markus and Mathias. Welcome here to our podcast in Kreuzlingen.

Dr. Mathias Sperlich


Dr. Mathias Sperlich


Dr. Ulrich Volz

Nice to have you guys here. Thank you very much. I think we can look forward to an exciting conversation. Maybe you’ll give ours again. Well, many people know you, of course. You’re on the road so much. I see it all the time on Instagram, but my daughters point out to me where we just again you guys are drifting around in the world, in Copenhagen or wherever. And, um, but maybe again very briefly two, three sentences each from you to introduce yourselves again briefly to the audience.

Dr. Mathias Sperlich

Yes, hello, I’m Mathias Sperlich and I studied medicine and dentistry at the universities of Freiburg, Würzburg and Zurich. Then I spent some time abroad in India. Half a year, then I was a sub-assistant in the clinic in Zurich, completed further training as an oral surgeon and then in 2013, together with my brother, the best decision of my life, opened a practice in Freiburg and there we have our location to this day, will now expand from next year and are super happy with our work. And above all, the collaboration is excellent, isn’t it Markus?

Dr. Markus Sperlich
Yes, perfect. So it’s great when you form such a great team with your own brother, and when your ideas cross-fertilize each other and your everyday life is greatly enriched, and above all, there’s a great basis of trust. My name is Markus Sperlich. I completed my studies in Freiburg, but after a short practice and then a long time in the prosthetic department of the University of Freiburg and there I have the great good fortune that I was allowed to get to know ceramic implantology relatively from the beginning and there, above all, the way of the scientific side, as far as all-ceramic implantology is concerned, in preoperative as well as operative side well mapped. And in addition to all-ceramics, my other focus there was already digital implantology with the current systems that were available at that time with 3D Nobel Guide, Simplant, and I also gained a lot of experience there. And as Mathias has already said, in 2013 we founded our practice in Freiburg and focused on guided surgery right from the start. And as a second hobbyhorse, we brought in all-ceramic implantology. So ceramic implants have been our focus of interest from the very beginning. In 2018, there was what I would call a decisive turning point in our work. I had a stay in Brazil in December and in Curitiba in the south of Brazil. Have also worked there clinically and just got to know there the immediate implantation and immediate treatment in extenso.
Dr. Mathias Sperlich
Not a great experience for us.
Dr. Ulrich Volz
Yes, I would say that you are definitely in line with the trend that we are observing and that others are also observing in the market. It goes towards Guided Surgery. For the beginners I think it has great advantages and simply more safety has advantages for the advanced, if you simply get to the goal faster and with ceramic implants anyway. In that respect I think it’s great. Can this be combined particularly well? Do you see a good symbiosis in these two topics in particular? Ceramic implants and guided surgery.
Dr. Mathias Sperlich
Yes, absolutely. It’s true that ceramic implants are still in development, but our experience, which we have simply made over ten years of experience in guided surgery with ceramic implants, can be transferred one-to-one, i.e. in many points to ceramic implants.
Dr. Markus Sperlich
A major advantage of guided surgery is that, especially in the area of immediate implant placement, it is possible to work very well in pre-operative computer planning with congruent shape between the implant and the tooth socket, and it is also a goal, an important goal for us, to preserve the biological structures. In this respect, the ceramic material offers a clear advantage over titanium. And if you symbiosize the two with each other in everyday clinical practice, i.e. digital planning with ceramic implants in an immediate implantation surgery, then you have a super outcome.
Dr. Ulrich Volz

Yes, actually what the patient wants. And the second thing is also that of course we have tremendous advantages in terms of atrophy. I did a ceramic implantology, the largest immediate implant study and was able to show that the bone loss was as high as with a late implantation. So in that sense we can take it out because we always have a certain bone loss of 0.4 0.6. In other words that actually means we don’t have bone loss with immediate implantation because you have the same with late implantation. What else fascinates you so much about immediate implants? Because I have noticed that immediate implantation is your big topic at the moment. How do you see the future for implantation? Why do many people still have reservations about immediate implants? What is your opinion?

Dr. Mathias Sperlich

Yes, in any case we can absolutely share the data you said. We used the corona time, 2020 and we evaluated all our cases. And what you said about maintaining the structures, we can absolutely prove that with our numbers. We have gone one step further, we have not only studied the tissue, but we have also studied with the help of the SF-36 health questionnaire, we have evaluated, what benefit does the patient really get from the immediate care? We compared it. So we took our patients that we implanted immediately and treated immediately. Everything in one session and then we took our normal implant patients. So late restoration or early restoration and also late implant and early implant have compared that. And then you still compared to the normal population and that found a significantly higher standard of quality of life in all two comparisons. When patients received immediate implants and were treated immediately and not only in the period of 2 to 3 months after immediate implantation, but also two or three years later, it remained in the patient’s mind that he was absolutely socially fit again due to this immediate rehabilitation. In everyday life, at work, in the family, everywhere. And of course he had much less pain, because I’m sure you’ll agree with that. You did a lot more immediate implants than we did because you’ve been doing it forever. Is also less significantly less trauma. And we both absolutely see the future in this type of treatment. And that is also in line with what the WHO says. They commissioned a Delphi study and the renowned professors in implantology gave a comment on how they see implantology in 2030. And everyone said that it is moving towards immediacy, i.e. immediate treatment.

Dr. Markus Sperlich

In addition, it is of course also an economic aspect, because this evaluation of the PROMs is of course also reflected in the number of patients – satisfied patients are the best advertising that you can have for a company. And since we’ve been doing this, we’ve had an increasing number of implant cases in our practice, and on the other hand you’re also working more economically, because of course in a surgical procedure, if you look at the classic procedure, you make three appointments, which of course also means more patient time, which you can use for other new patients, which then also pays off in terms of profitability.

Dr. Ulrich Volz

I also believe, which is an important factor that we have to consider from the economic side, that the highest willingness for implantation in patients at the time of extraction is about 95% according to relevant surveys and studies. If I send the patient home to “let heal” in quotation marks, because actually the behavior is nothing but left to atrophy, with loss of volume with loss of aesthetics. I have a smaller diameter, I have a smaller length, which in turn brings a higher risk that then 50 to 70% will not return because other priorities, higher gas prices, whatever personal issues come to the fore. Or they even go to a colleague, then get implanted there. This means that, as an immediate implant planner, there is no question that the number of implants will be higher. And I see it also in such a way that the patients also in the clearing-up, if one says, we make the tooth out, us should I the anyway already existing hole in the gum a new root is inserted from ceramic. I wouldn’t call it that figuratively with drilling screws and talking about it in a big way. And I call it so a little bit the “arthroscopy of the surgeon” or the or the oral surgeon, is actually an arthroscopic procedure. And where do you see the advantages of ceramic as a material with regard to immediate implant placement? Do you see advantages purely from the implant material compared to titanium, that it has no free electrons, no particle abrasion and so on due to its super hardness, that it perhaps offers advantages and that I can possibly go a bit further out on a limb and bring a higher level of safety into ceramic implantology.

Dr. Mathias Sperlich

Just in the case one that Markus operated on two months ago. It was a case Markus where we have absolutely reduced bone, operated together and the tooth came out. Here we had a very thin buccal lamella. We would never have put a titanium implant in there again. But we thought about the properties of the ceramic implant. It is totally stiff and we thought that the ceramic implant would have the buccal lamella, for example. It just occurs to me now, and then of course with immediate implantation the issue, even when we look at our cases. The soft tissue loves the ceramic. Tissue in general, loves the ceramic and you just, if you put in the ceramic implant right away and right away you have the crown on it, which is what we do in a high percentage of our cases. So with us the crown is the wound closure, then we see there already clear – temporary crown – exactly, it is with us the mouth closure. We try to implement this in 80% of all our immediate implants. And the one case Markus, that was, you probably wouldn’t have done that with titanium.

Dr. Markus Sperlich

I absolutely agree with you there. I mean, with you immediate implantation I have one. Our basic goal is to preserve the biological structure. Of course, you also have to see that the biological structure that I have there needs surgical handling, which is very, very careful. This starts with the extraction. I must not destroy this structure and, of course, ceramics also cause less irritation to these very sensitive structures than when I use titanium, for example. And thereby I have from my point of view with the immediate implant so with those, you really also have to say, with the modern ceramic implants has the older generation ceramic implants, offers due to the design disadvantages compared to titanium implants. But just for example your implants, the SDS2.2 is a super implant for immediate implantation and with the new geometries new threads, I have clear advantages over titanium in immediate implantation, because I can simply support these fragile structures in their healing by ceramic better than if I take titanium. And what – especially when someone is starting out and doesn’t have a lot of experience in immediate implant placement, if there is a recession, of course I still have the advantage of the white color. That’s very clear.

Dr. Ulrich Volz

The or in our case of the load-bearing capacity, so that I can also there of course again corrective intervention. In my experience, it is also so that just the, the non-existent particle abrasion just also not like titanium, but activation of tissue macrophages thus cytokine release can lead. That is, I also have a whole series. I also have 12,000 titanium implants placed from my ceramic career. Of course, some immediate implants as well. If something didn’t work out there, I often had a disastrous defect. This was worse than the initial situation, which is of course unpleasant for the patient’s dentist. With ceramics, I have never experienced in the worst case that I fell lower than zero. As initial condition, then it was hal Socket Preservation 2.0 and did not become solid. I think it also certainly a good advantage. Now where do you see another advantage in immediate implant placement in relation to Guided because that’s really the crown of creation, the tip of the iceberg. Immediate implant placement is what patients want. I don’t think we need to talk about it at all, and many dentists have already understood it, have developed concepts that it works well, reproducibly, reliably. But how is the combination of guided and immediate implant placement with ceramic implants another step into the future.

Dr. Mathias Sperlich

Our goal is to use the possibility of computer planning to plan the prosthetics at the same time. We’ve already done that very successfully in Titan, we’ve already tested it, and the results are excellent. That we go here and the fixed implant position that we have in the Guided Program, whether it’s SMOP or Coda Implant, it doesn’t matter which one. First of all, we use this fixed position and export this data to ExoCut or 3shape via a transfer tool, such as a scanner, and design the crown for our immediate restoration right there pre-operatively. In other words, this is how it works for us: the patient comes in, the tooth comes out. Only an alveolar management is done, because we also – you will agree with us – do not shy away from inflammations. So chronic inflammation, acute inflammation, pools, of course we don’t implant in there, but chronic apical inflammation is not an exclusion criterion from our point of view after proper alveolar management for immediate implant placement. So we use these data that we generate and then we can of course have a setup of splint, implant and the crown right at the start of surgery – we screw it all on and the patient is rehabilitated within a very short time and can participate in everyday life again. And that has been the absolute game changer for us, and it works the same way in ceramics. And we are convinced that just putting the crown on post-operatively brings even more gain in esthetics and well-being for the patient, because ceramic is simply the inherent material.

Dr. Ulrich Volz

We are now working on a project together with our dentists or some dentists from the SWISS BIOHEALTH CLINIC together with the oral designer Joachim Meier, dental technician, we are developing or have developed together and are now fine-tuning it, you could say it already works, but we are fine-tuning the SDS Box Service fully guided navigated with SDS implants of both implant series Value and Bright. Um, you were a bit skeptical at the beginning, because you have an infinite amount of experience. What are your first experiences and impressions of the SDS Box, where you see advantages and say that or in which direction do you think we will get there? Are we going to, um what are the advantages? Will we be superior in certain areas, even common conventional systems? What are the big advantages of this this joint activity? In the field is the SDS box.

Dr. Mathias Sperlich

You first of all a huge advantage. Still what I still want to follow up on the previous question, I am of course guided working with ceramic implants as well as with titanium implants I can of course in the immediate implantation the existing structures better protect against trauma. Maybe not quite the super difficult anterior case to restore immediately. There the alveolus is mostly congruent in shape to the implant, but if is already going on. If I’m talking about a molar where I have several roots, especially in the maxilla, where I might have to make optimal use of the bone in the septa to get the implant stable. Of course, with exact planning and guide treatment, i.e. exact preparation of the implant and insertion of the ceramic implant, I can absolutely protect the existing substances, so that I always achieve success if I can see in the preclinical planning that it is possible to drill once with the free hand and the bone is gone. Now to your question about the 2INGIS system or SDS box, a very big advantage is that I have very, very precise guidance via these bidirectional guides, these guide pins, so that I can see right into the operating field. I actually have a clear view of the surgical field, which is sometimes very limited with conventional systems, and I don’t want to mention any names here. Without a view, I tend to work blindly and have to rely blindly on the system. I have a great deal of variability when it comes to implant designs. When I work like this, I don’t need a special guided set. But I can take the existing OP set and can then the appropriate tools here from you super prepared along sent. In the SDS box package, since in the conventional implant form practically apply and can then bring it there to use. A big advantage that I see in SDS Box is that in the future I will also have the possibility, from my point of view, to insert the prosthetics navigated with it. This means that I will be able to plan here in the future and will be able to use this SDS Box template as a guide for the prosthetics at the same time, which will certainly be a great help in full-arch cases, for example, and will also save a considerable amount of time.

Dr. Ulrich Volz

What was your experience regarding the accuracy of the system, precision, which is a very important topic. And perhaps the second topic, which leads to the topic of CleanImplant: Particle abrasion.

Dr. Mathias Sperlich

Yes, in terms of accuracy, the system is outstanding. Just like the studies say. These studies indicate that the average deviation here is almost twice as good as with the sleeve-scoop system. And the things that we have operated bomb accuracy, super fit of the splint really well. And getting to your question: Particle abrasion always zero. So that’s a tip-top clean thing. And if you also compare it to titanium drill in titanium sleeve, we always have a slight abrasion. You can’t deny it, it’s like that, and of course we’re absolutely clean here.

Dr. Ulrich Volz

Yes, that was also the reason for me to go into this system. And I’m glad, because we were a bit skeptical at the beginning, because it approaches the situation quite differently, the system. But for me it was for the reason that we come from immunology. It was decisive. And it is the first and only one. There is a second system, but it is also based at SDS. The SDS AIM, theAd hoc Navigation System, because the only two systems that are accredited by CleanImplant Foundation, which I think will already play a bigger role in the future. I was at the AO Summit in Chicago two weeks ago, where also the highest FDA inspector spoke as a guest speaker, with whom we have been in contact since then and exchange some information. The FDA is looking very closely at the whole issues of particles, release, particle release etc, we know it from other areas orthopedics? That’s a huge issue. With breast implants, it was a huge issue. That’s also kind of where the MDR came from, which is looking very closely, which I think is also good. And in this respect, we think that this is a great concept that we are developing together here. And I’m glad that we’re doing this together and that you’re contributing your expertise. And I am particularly pleased that you are now slowly becoming enthusiastic about this, despite your initial skepticism.

Dr. Mathias Sperlich
We have already changed some things now that we are now also on the program, which is just as fast, just as precise and above all just as simple. And that was the point at the beginning, that we had a very complex system, we had now once created a system. Yes, that can be said in advance, which works at least as easily as the current systems on the market.
Dr. Markus Sperlich
And we still have further potential and it will become even better, if it is now at the moment and even more grazieler, even clearer, even more descriptive and therefore also for the first user a very simple thing.
Dr. Ulrich Volz
Yes actually a great proof for teamwork and cooperation, because then you sit together and several intelligent brains think in the same direction. And in the beginning, that was also for us. How do we get the complexity out? And actually one of you two, I don’t remember who it was. In the Zoom meeting, we suddenly had the brilliant idea. Actually, it was quite simple. We just leave something out and it works, a little bit.
Dr. Mathias Sperlich
The beauty of the system is that the dentist who has been using SDS up to now will be able to continue working completely as before. He simply has two small particles, plus the template, and then he is fully guided, and not just the preparation, but also fully guided insertion.
Dr. Ulrich Volz
As the last point in our podcast, we would like to come to a completely different topic, which actually then also plays a role here again somewhere. It was for you so in our contact, so certainly not the first, but intensive of course, because we see yes, let’s say so the lion’s den. As far as biological dentistry is concerned, the whole micronutrients, that is such a first hardcore encounter for you. Of course, you’ve already heard a lot about it. You yourself are interested in health and performance. What were your first experiences with biological dentistry in the form of micronutrients, where we are actually in such a middle we have the cellular level, osteoprogenitor cells and then we have the bone metabolism and that actually no one has taken care of the last 40 years. And there we have the macroscopic situation, over-extended preparation, healing chambers and so on. And the micronutrients are sitting in the middle, activating the bone metabolism. How did you guys feel about that? Because you guys are already coming from a very scientific corner. This, this concept? Were there any surprises? Was there anything exciting, interesting for you?
Dr. Mathias Sperlich

So surprised me with my background from human medicine the fact that the concept what you have, with the micronutrients BASELINE BOOST is absolutely physiologically explainable. Absolutely medically comprehensible, is top scientifically backed. And it has simply also convinced us completely. And with us it is in the meantime in such a way and we know us now a good year more closely and within that year with us that established itself absolutely that we add better BASELINE and BOOST to our treatments and with fabulous results. The patients have consistently received this very, very positively. Before they gave it to the patients, we also tried it ourselves. And we have also received it absolutely positively and in the whole circle of friends. So you can really say that what is physiologically explained there…

Dr. Ulrich Volz

So you don’t have to believe in it, but you have a feeling that it is…

Dr. Mathias Sperlich

You don’t have to believe in it, deifintivly.

Dr. Ulrich Volz

Outside of a placebo effect, noticeable, visible also for you on the gingiva, how the patient comes back.

Dr. Mathias Sperlich

Is it once so that just this point in time, where we have the contact to biological dentistry, which I have now come to know more closely, which has just coincided with that, where you also much on social media, vitamin D3 for example and osseointegration, are shared quite a lot of studies now. And if you take a closer look with your expertise, you can also see in clinical everyday life, really a clear improvement in the classification, especially with regard to complications. They are reduced. If I prepare the patient pre-operatively accordingly, then it works wonderfully. From my point of view, from the patients’ feedback, it also gives the patients a sense of security if they are treated immediately. And after this clinical phase, after the operation pre- and post-operatively, we now also have quite a few patients who simply come to us, like in the drugstore and say: “can we have a little BASELINE again?”. They also feel an improvement in their well-being in their private everyday life as a result.

Dr. Markus Sperlich

And we use it, it has to be said, not only in implantology, but also very, very successfully in periodontology. Adjuvant to the periodontal treatment. And there we actually got extreme results. That patients…

Dr. Ulrich Volz

So visible really for you?

Dr. Markus Sperlich

Yes visible. None. No more bleeding, nothing within a very short time. That is also the proof for us. Besides knowing that what you all are saying is true, that it is absolutely not a placebo effect. Definitely not.

Dr. Mathias Sperlich

And I think, if you also go further and look, how do we live nowadays in comparison, how did we live in the past? That means sunlight, nutrition, and so on and so forth. Then you almost can’t avoid taking supplements. You have to see that quite clearly.

Dr. Ulrich Volz

So another proof that we have to think from the inside to the outside and not always the attack from the outside. But what is actually happening physiologically, where can we intervene? Last question to you Do you think that at some point we will implant and immediately put the final crown on it?

Dr. Mathias Sperlich


Dr. Mathias Sperlich

Yes. Very briefly and succinctly.

Dr. Ulrich Volz

So let’s be surprised. I also believe in it. I have also developed the thread to this end and am also involved in the topic. To insert the first implants with final restoration, where I think that ceramic has advantages, that our thread has advantages, that Dynamic Thread builds up the immense force. But just where I can’t do any damage, not in the marginal bone. And in that sense what is your prognosis? When will we stop using titanium and only use ceramic? How many years would you say until then?

Dr. Mathias Sperlich

Well, I’m very, very optimistic, because very, very many people are looking at ceramics right now. And I’ll put it this way, we’ve already talked about it. Very briefly the forecast I want to correct a little bit upwards, but I think what she also said, 2030 I could definitely imagine that ceramics will dominate.

Dr. Markus Sperlich

So I would put ten years in any case. Okay.

Dr. Ulrich Volz

Good. Marco Gardola said last year at our JCCI congress, in the next five years times 40, multiplier 40, I’m not completely optimistic, because I’m waiting now for 22 years for the dam to break. But I think also, in the next 5 to 8 years, we will certainly get there. In that sense, I thank you for your commitment, for your friendship, for the great things we do together. That a lot of what I was allowed to learn from you, also in terms of Guided Surgery for me new topic actually because I was always freestyler, I actually came through you to the topic and I’m looking forward to the further cooperation, what we will still develop together there. And yes, it’s great that you were here and thank you both very much.

Dr. Mathias Sperlich

You’re welcome and thank you,

Dr. Markus Sperlich

Thank you!

A PODCAST BY SDS Dr. Rebekka Hueber

Episode 4 – Future Talks with Prof. Dr. Florian Beuer, President of the DGI

Future Talks with Prof. Dr. Florian Beuer, President of the DGI

Dr. Rebekka Hueber interviews Univ.-Prof. Dr. med. dent. Florian Beuer, President of the German Society of Implantology (DGI) and Board Member of the CleanImplant Foundation.

Prof. Dr. Beuer is Professor at Charité – Universitätsmedizin Berlin, Dental Prosthetics, Geriatric Medicine and Functional Science, his main areas of work are digital dental technology, all-ceramic restorative forms, implant prosthetic restorations (surgery and prosthetics), CAD/CAM technology and esthetic dentistry.

In this episode, Prof. Dr. Beuer talks about what his goals are as president of DGI, including restorative and restorative dentistry, more integration of dental technicians, knowing more about ceramics in the dental world, using his international contacts to strengthen global partnerships, and the digital future of dentistry.

Scientific knowledge is very important to him and, of course, it is also important that dentistry continues to develop and be researched, especially in the direction of ceramics and digital dentistry. In the latter, there are already great applications, such as artificial intelligence that analyzes X-rays and more.

Another topic is his important work with the CleanImplant Foundation, which works to make dentists aware that sterile does not equal clean.

You can hear about this and more in the fourth episode with Dr. Rebekka Hueber and Univ.-Prof. Dr. med. dent. Florian Beuer.

Today‘s Guest

Prof. Dr. Florian Beuer MME

Charité Universitätsmedizin Berlin

Prof. Florian Beuer has been Director of the Department of Dental Prosthetics, Gerontology and Functional Dentistry at Charité Universitätsmedizin Berlin since 2015, and President of the German Society of Implantology (DGI) since November 2021. He was awarded the Förderpreis der Bayerischen Landeszahnärztekammer in 2007, the Robert Frank Award of the International Association for Dental Research in 2009, and the Research Award of the Camlog Foundation in 2012/2013.

Experience Prof. Dr. Florian Beuer live!

At the 2nd JOINT CONGRESS for CERAMIC IMPLANTOLOGY you will have the chance to do so: As one of 12 world-class speakers, he will present the latest findings of his research at this unique congress, as will other top innovators in the field of ceramic implantology.

Hello and welcome to the fourth episode of the SDS podcast. Today, Dr. Rebekka Hueber, who is an oral surgeon and specialist in biological dentistry and ceramic implants, as well as the head of the dental department at the SWISS BIOHEALTH CLINIC, will guide you through this episode. As her guest. She welcomes Prof. Dr. Florian Beuer, who is the director of the Department of Prosthodontics, Gerontology and Functional Dentistry at Charité Universitätsmedizin Berlin. In this episode, Professor Dr. Beuer talks about his goals as president of the DGI, including restorative and maintenance dentistry, more integration of dental technicians, more knowledge about ceramics in the dental world, using his international context to strengthen global partnerships and the digital future of dentistry. Another topic is his important work with the CleanImplant Foundation, which is committed to making dentists aware that sterile is not the same as clean. I will now give over to Dr. Rebekka Hueber.

Dr. Rebekka Hueber
Welcome and thank you very much, Prof. Florian Beuer, that you are our today’s guest at this podcast. It is really an honor for me to welcome you here since I know you since my studies at the Ludwigs-Maximilians University of Munich, where you were chief physician of the polyclinic for dental prosthetics. And I was able to learn a lot from you, so especially about ceramics, of course, and prosthetics during my studies. And now you are head of the chair of dental Prosthodontics at the Charité University in Berlin and also the editor in chief of the International Journal of Computerized Dentistry. And not only that, you’re also the president of the DGI (german Society for Implantology). And this is one of the biggest societies in the Germanspeaking region. The DGI plays a very important role in the education and training of dentists, especially in the field of implantology, but of course also prosthetics and offers comprehensive programs. My first question to you would be what is your goal as the president for the society in the next years, and do you already see achievements that occurred during your presidency?

Prof. Florian Beuer
Wow. Welcome, everybody. Rebekka, thank you so much for inviting me and for having me. It’s my first experience, to be honest, in a podcast. But let’s come back to your question. In general, I have three main goals I would like to achieve with a DGI. And DGI is the largest society for implant dentistry in the Germanspeaking region, and I think it’s also the biggest in Europe. And I think we are number three or so in the world. So we have more than 8500 members. And all the presidents before, with just one exception, one exception Hubertus Spiekermann. He was also prosthodontist, but all the other presidents were surgeons, either maxillofacial surgeons or oral surgeons. And my perspective, of course, I also like surgery. I like the surgery and placing the implants. But my strength is definitely a restorative part of implant dentistry. And this is one of my major goals, or perhaps the biggest goal. I would like to strengthen the restorative part of implant dentistry. And really something that is very important for me is also to integrate our lab technicians, because I think they are very important when it comes to successful implantsupported restorations. So really get more knowledge of implant prosthodontics into the general dentistry offices. This is one of my major objectives because the surgeons and also the specially trained prosthodontists, they are pretty much into implant prosthodontics. But the general dentist who is also doing implant prosthetics, the knowledge sometimes is very, very little. And I would like really to enlarge the knowledge in the general dentist office and to integrate the lab technicians more into the DGI. The second the second object is this. I would like to use the context, the international contexts I have and really get the DGI a little bit more internationally based. Tomorrow in the morning, I will fly to Malaga to meet with the SEPA (Student Professionalism & Ethics Association in Dentistry) guys, with the Spanish colleagues. And we have quite successfully made a consensus workshop together with the Osteology, the SEPA and the DGI in March in Madrid. And I would like to strengthen these partnerships to the partners in Europe, but also to partners in America, in the US. In two weeks, I’m going to the American Academy of Prosthodontics and I would like to see the DGI as a hub for knowledge concerning implant dentistry and with a lot of connections all around the world. And my third objective is, and this is perhaps something which is rather unusual, I would like to develop an app for our patients, a patient based implant app, like a passport, where you have all the information about your implant on your smartphone. Because I think you know this problem. Patients come to our offices with implants in their mouth for 20 years or so. And it’s really hard to identify the implant system. It’s hard to identify what parts we need when we want to do a new restoration. And it’s really hard to get knowledge about the maintenance that has been taking place, about the recall appointments. And all this should be integrated in such an app. The patient should be in the driver’s seat. He should have the full access to all the data on his smartphone. And if he likes to, he can share the data with his dentist or perhaps with a DGI or with the scientific organization. And then I think we can get real numbers about implants success and implant survival outside of our controlled clinical studies we have on our universities or special training centers.

Dr. Rebekka Hueber
Wow. So thank you very much. I really like your goals. Yeah, especially to incorporate more prosthodontics and the lab technicians, I see that at our clinic, where our lab technicians are there every day, we work very closely with them and they are young and they love to involve into digital dentistry. So I think it’s also a profession that should be promoted more so that we don’t lose the dental technicians or make it more attractive to young people again, because it has changed over the years and it is really a value to work closely together with them. So that’s wonderful. And also that you want to strengthen the international context, since I’m also a lot in the US. And join a lot of congresses and see how much we can also or how much value we get out of the international context and the knowledge that is all around the world. Wonderful. And also the implant app, I had the same problem in the past. So it is really something that needs to be done so that we have all the information or the patient has the information and we can help them better. So, yeah, I’m really excited to see what you do in the next years. And the consensus conference in Spain, what is it about or what topics will you have there?

Prof. Florian Beuer
Basically, it was about soft tissue. It was about soft tissue dehistences and the coverage of soft tissue dehistences, because when you come together with the SEPA, which is originally a periodontics association, and the osteology, which has a strong focus on regeneration, and the DGI, which has strong focus on implants, perhaps the soft tissue is the common goal of all the three organizations.

Dr. Rebekka Hueber
Yeah, very interesting. Thank you very much.

Prof. Florian Beuer
Like a lot of these consens meetings are organized. First of all, we made up the three different topics, and then we did a scientific review, and the scientific review was published in the clinical implant research. And then we made the consensus. And the consensus of all the three groups will also be published in the clinical or implant research.

Dr. Rebekka Hueber
Okay, wonderful. Thank you. We will definitely have a look. Yeah. As you may know, I’m an oral surgeon, and I changed from placing titanium implants to ceramic implants a few years ago. So that is, of course, something I’m very naturally very interested in our audience. So also in how the DGI is positioning itself in the field of ceramic implants. Is the growing field of ceramic implants already being trained at the DGI, or will this be implemented in training programs in the future? Yeah. And how important do you see ceramic implants in the educational programs?

Prof. Florian Beuer
That’s really a tough question. You know that the DGI is promoting a lot of these scientific guidelines. And last year at our guideline, I don’t know if guideline is really the correct English word for “Leitlinie” this guideline process is pretty much comparable to the consensus, but it’s really just based on scientific facts. So first of all, you make up your scientific question, which was because we did a guideline about ceramic implants. What is the difference in survival and success of ceramic and titanium implants? And then you make a review, scientific review with the meta analysis, and then you write this guideline. And I think the guideline will be published by the end of the year. And I hope when we see each other on the Congress in October, I can present you some of the results or the content of the guidelines. And we had some years ago, there is one one-piece implant system that is really very well scientifically evaluated. We had this implant system at the DGI and we had several courses about ceramic implants with this implant system. However, the implant system is not in the market anymore. There’s a lot of scientific data there are a lot of clinical data on this implant system, but it’s not on the market anymore.

Prof. Florian Beuer
But we definitely have the ceramic implants I would say not in the focus, but it’s one topic that is important for us. Yes, in particular for myself. You’ve met me 20 years ago or 15 years ago at the Munich Dental School and I was always a ceramic guy. So I love ceramics, I love implants. So why don’t do a ceramic implant? From my perspective, I have done several ceramic implants but my standard implant still is the titanium one of various reasons. But when I have a ceramic implant with a hard scientifically, hard proven advantage towards titanium implants, then I think there’s no reason to use a titanium implant anymore. However, from the prosthetic perspective, to be honest, we have more opportunities when we have two-piece titanium implants. But I think there’s a lot of exciting work for the future to work with ceramic implants and to bring them further.

Dr. Rebekka Hueber
Yeah, that’s really interesting. Yeah, I also think that there is already signs out there, but as I can see, it needs more we need to do more scientific research, especially in this field, and see where are the board of like work can we have, where are the indications where we may be better used titanium or ceramic or see the advantages of either the one or the other one material? And yes, I’m very excited because that would have been my next question. Are there any guidelines or is the DGI working on guidelines in the field of ceramic implants? Because I know and I follow the guidelines or always learned from the guidelines of the DGI, they have a high reputation, especially of all the people that work there on these guidelines. And I’m excited to hear about the results in October at the JCCI conference here in Kreuzlingen at our education center. And I’m really happy that you come and grateful that you contribute because your experience in ceramic or zirconia is outstanding. I know that and I always followed your path and it was back then and I can only imagine how much knowledge or how much more knowledge you gained over the years. So, yeah, I’m really excited to hear about this. Wonderful. So something where you’re also very interested in is computerized dentistry. And you already told us about the app, so that’s just one part. But what can you tell us where are we in digital dentistry? And what can we expect for the future?

Prof. Florian Beuer
Wow, this is a very, very interesting topic because yes, but perhaps you also remember when we started in the Munich Dental School 20 years ago, we started with the digitalization in the dental laboratory. So we needed the digitalization in the laboratory to fabricate zirconia restorations. So this was really this was the pacemaker and this was the trigger to get all this digital stuff because we wanted to have the white material. And today, I would really say that also the COVID crisis perhaps has increased the numbers of scanning units in the dental offices. From my perspective, I’m working with intraoral scanners, I think for 15 or 17 years. But in the last four to five years, we have scanners that we can use for almost every case. So we don’t really need the analog impression for or we need it perhaps for 5% of our cases, but not more. And I think that perhaps somewhere around 15% to 30% of our colleagues now have access to the scanning units in the offices. However, if we just scan instead of taking a regular impression, this is not what I think that digitalization is about. Let me give you an example. In the past, when you had high blood pressure, when you went to the doctor, the doctor measured the blood pressure with a stethoscope, wrote down the numbers, and then you came back after some days and you came back a third and a fourth time. And then you got a medication that should work against your high blood pressure or increase your blood pressure. If you have low one, but you just had four or five measurements, and then you got a medication. And perhaps if you have high blood pressure today, you still go to the doctor. And the doctor now has an electronic blood pressure measuring machine which has an LCD screen. And you can read your numbers on the LCD screen, but you still do the same. You go three or four times and then you get the medication. And if you have a smart watch, and if you have the latest model of the Apple Watch, for example, then you have 24/7, your blood pressure monitored. And this is what digitalization is about, not changing from the stethoscope to the LCD screen. And when we compare this to dentistry, I think we are on the shift from the status quo to the LCD screen. We are not on the level of the Apple Watch right now, but I think in the future, what can we expect? For example, when we scan our patients, when we take intraoral scans on a routine basis, every appointment, when we do a checkup, and then if we have artificial intelligence software that can analyze the changes that happen over the years, then I think we are able to learn a lot more about teeth, about our oral environment, things we cannot even imagine today. And this is what digitalization is about, not replacing an impression with a scan. This is just the first step.

Dr. Rebekka Hueber
Okay, interesting. Very good. So, yeah, artificial intelligence and also maybe the evaluation of X rays with artificial intelligence. Do you see that coming, or is it already happening?

Prof. Florian Beuer
Yes, it’s already happening. One of my colleagues here in Berlin is a Prof. Falk Schwendicke, and he’s really a very, very bright guy. And he developed a software where you have a Panoramic Xray. Then you get the dental record by artificial intelligence from the X ray, and you get also some analysis of the Xray. And you just have to double check this. So this is already on the market. You can buy that. And I think that there is also a software and implant planning software from DensplySirona. They also used artificial intelligence to plan the implant position, which is absolutely smart because there is so much knowledge or so much scientific literature about the implant position. But, yeah, usually you don’t know all these factors when you plan the implant. Or this makes it very easy for the artificial intelligence to place your, or to give you a suggestion of the probably best implant position. So there is already the artificial intelligence working for us, and I think in the future, there will be a lot of new applications also come down the road.

Dr. Rebekka Hueber
Sounds exciting. Very good. And what I’m interested, you have a lot of international contacts. You travel around the world. Where would you rank the German speaking in Central or European region in regards of digital dentistry? So do you think Germany or also Central Europe is ahead, or are we in the middle field or are we behind? But what do you feel in that area?

Prof. Florian Beuer
So when we define digital dentistry as CAD/CAM dentistry, and then I think we are pretty much ahead because we have really developed dental laboratories. We have a lot of dental labs with a lot of dental lab technicians. And so the working chain of the dentist and the dental lab is working pretty well in the Germanspeaking countries. So when it comes just to CAT/CAM restorations, I think the Germans are Germans, Austrians, Swiss, they are pretty much ahead. Or when it comes to things like planning, like digital smile design or something like that, where you don’t need so many or so much expensive equipment, there are other countries I think are a little bit ahead of us. So digital smile design was developed by a Brazilian guy, by Christian Coachman. Floridian Kofar from Romania is one of I think he’s one of the one of the keynote leaders when it comes to this digital planning. And I think when you’re just talking about the use of the computer for dentistry outside of CAD/CAM, then perhaps some other countries a little bit more ahead than we are.

Dr. Rebekka Hueber
Okay, which countries do you have in mind?

Prof. Florian Beuer
Not the traditional Western European or North American countries, but countries where we don’t have more ideas to get a solution, where we don’t have the perfect laboratory or the perfect equipment, where we have to find our own solutions. And this is perhaps in countries like Brazil or Romania or Bulgaria, eastern Europe might be a little bit might be a little bit easier because they are not so captured in the in this professional environment of dentistry. So they’re really outside the box thinkers.

Dr. Rebekka Hueber
Okay, okay, that’s interesting. I didn’t know that interesting. Okay. What are the current topics in research in regards to zirconium dioxide or which topics in your mind, do we need to do more research and gain more knowledge and experience when it comes to prosthetics? Maybe also implantology?

Prof. Florian Beuer
From my perspective, when we are talking about Zirconia material and when we are talking about Zirconia based restorations and let’s talk about two supported restorations. I think the chance with Zirconia now is to make minimally invasive dentistry and not to grind down the teeth, but to have a high strength material that allows us to fabricate reservations that are very thin and allows us to save tooth, tooth tissues. And I think we should much more focus on that topic. How thin can our restoration be to have enough stability and not to sacrifice too much too structure. The second thing is when we are talking about 3D printing of Zirconia. I think this is something very, very interesting. We have the technique to do the 3D printing and now we can print restoration layered like the natural tooth with a dentin and a nanostructure and print it from Zirconia. I think this is really something we should also put more effort in. In combination with minimum thickness to have really thin and minimally invasive enamel bonded restoration. Yeah, I would say perhaps this is the most interesting part of Zirconia right now. On the other hand, when it comes to implantology or implant prosthetics, when we print Zirconia, we could also use the printing procedure to get some particles into our Zirconia restoration or into our Zirconia abutment that prevents the inflammation of the soft tissue. And I think this is also very interesting and perhaps in the future customized for every patient. So if we know the distribution of germs of the patient, we can perhaps print the restoration or the implant or the implant abutment for the patient customized really with some contents that prevent in his or her specific situation the inflammation of the soft tissue.

Dr. Rebekka Hueber
That’s really interesting. Okay, very good. Is there already research in this field?

Prof. Florian Beuer
Yes. So in my clinic we are doing some research on the printing of zirconia abutments with this idea to prevent the growth of bacteria around this zirconia.

Dr. Rebekka Hueber
Okay, wow, that’s very interesting. I’m really excited about the results and to hear more about it. Very good. And when we talk about gems, maybe this is also something very interesting. You are a board member of the CleanImplant Foundation. Can you tell us more about that and why this topic is so important to you?

Prof. Florian Beuer
When I first met Dirk Dudek I think it must have been 15 years ago or something like that, I was really yeah, I was surprised by this very, very simple idea of just having a look at the surfaces of implants because I always expected the surface of a sterile implant is completely clean. I just thought this because an implant is a medical device, it’s quite expensive, it goes through a lot of cleaning processes. So I expected this to be clean. And I was completely surprised by his result that there are clean implants and there are implants that have a lot of particles on the surface. And of course, we don’t know yet what those particles are causing in the patient’s mouth or in the bone or in the oral environment. But from my perspective, I think, yes, we have to make sure and this is really the responsibility also of the manufacturers. We have to make sure that we get implants that are really clean into our patient’s mouth. Our patients deserve that and we deserve that. And so, yeah, when I was talking to Dirk and he asked me if I would like to join his group and I said, yes, of course. I really like your idea and I really like the initiative to draw the attention on the cleanness of our implants we are using because I think most of our colleagues are in the same situation I was when I first met Dirk. I always thought a sterile implant sterile means clean, but that’s not the case.

Dr. Rebekka Hueber
Yeah, you’re right. The same happened to me. I also expected that and couldn’t believe that even on zirconia implants you can find titanium particles or steel particles or PTFE, plastic, whatever, and organic particles. So I’m very grateful that you are at the board because you have an impact and to make the dentist aware of that problem. Because, as you say, we have a very high responsibility when we place implants to have absolutely clean implants. And of course, it should be natural that we can rely on that they are clean, but obviously, or unfortunately, it’s not the case. So, yeah, thank you very much that you do this work on top of all your other work and yeah. That you contribute to that foundation. Well, that was really interesting. Thank you very much. I learned a lot and I’m really looking forward to what is coming in the future. And yes, thank you for all your research and your work. And do you like to add something? Because I think we heard a lot about the topics that will come in the future.

Prof. Florian Beuer
I think that we don’t have to be afraid of the future. We can relax because the future will always be better than the past. And I’m really looking forward and I’m looking forward for the next. I hope that I will be around the next 20 years in dentistry, and I’m really looking forward to work more with perhaps ceramic implants, to have different opportunities of digitalization to I really like your point. I haven’t mentioned that yet. I really like your point about the dental lab technicians. We have also to give them a perspective to be a serious partner, an important partner in our business. And I’m completely with you that a lot of young people really have lost or the dental lab technician work has lost the attraction to young people. And this is our responsibility to get this back, because we have talked about digitalization and the German speaking region in the world when it comes to dental laboratory work, the German speaking region is absolutely Champions League. But if we lose this competence, if we don’t attract enough young people taking over this very, very interesting profession, then we will not have this position in the next or in the near future. Yeah, it would also be great perhaps at your congress, if we have some lab technicians there and also exchange our ideas.

Dr. Rebekka Hueber
Definitely there will be some. And it’s so important what you say. Maybe one idea is to implement the digital dentistry lab work into the education already, the first education, so that they are really trained from the beginning, because I think it’s really exciting and it has changed so much. It’s so different than when I started dentistry, how they work there, and there’s so much more development, and that’s very interesting for young people. So maybe we need to make the people or the young people aware that this is now much more digital work than sitting on plastic. I don’t know. And making teas are just prosthetics just with your hands, but also do it digital. And yeah, I hope that this is really supported and this profession will be exciting or interesting again for the young people, because I think it’s really important. We, as dentists, we cannot do this like a trained technician. And for me, it’s such a such a contribution to work directly with the technician, directly at the patient. The results are much more better. So, yeah, we have CAT/CAM and we can do a lot on our own in the dental office, but I think when it comes to full restoration and crowns and everything, it just needs a dental technician. We cannot do everything on our own. I don’t know how you see it, but yeah,

Prof. Florian Beuer
Definitely. I’m a dentist. I don’t like to do dental lab work, so I don’t like chairside dentistry. Just from my personal perspective, I’d like to do the dental work. This is something that really I love that, but I don’t want to make rounds. I don’t want to be a lab technician. I want to be a dentist.

Dr. Rebekka Hueber
Yeah, that’s true. Wonderful. Yeah. I’m really looking forward to meeting you in October here in Switzerland, in Kreuzlingen we are really honored that you come and excited about your lecture and presentation. Our lab technicians will be there and a lot others from the US. Dentists from all over Europe. So it will be a very exciting event. And until then, I wish you a wonderful summer and safe travels to the US. And also to Spain. And thank you very much that you took the time and told us about all these exciting news about the next years of the future in dentistry. Thank you very much.

Prof. Florian Beuer
Okay, so it was my pleasure. Thank you so much. And I’m also very much looking forward to coming to Switzerland in October. And thank you so much for my first podcast experience.

Dr. Rebekka Hueber
Yeah, you did great. Perfect. Thank you.

A PODCAST BY SDS Carolina Volz

Episode 3 – Dr. Rebekka Hueber on the advantages of ceramic implants, in particular SDS implants

Dr. Rebekka Hueber on the advantages of ceramic implants, in particular SDS implants

Which aspects convinced the experienced oral surgeon of the SDS system?

Dr. Rebekka Hueber is a specialist in oral surgery and successfully completed the curriculum “biological dentistry and ceramic implants”. She is also head of the dental department at the SWISS BIOHEALTH CLINIC and will in this episode of SDS PODCASTS tells us how she came to ceramic implants and why she uses SDS implants exclusively.

Although Dr. Hueber came to the world of implant dentistry via titanium implants, as a practitioner she sees tremendous benefits from ceramic implants, especially SDS implants.

Dr. Hueber followed the classical path of dentistry and accordingly had to deal with various problems, such as peri-implantitis. Therefore, early in her professional career, she dealt with alternative materials such as ceramics, but had to realize that most implant forms, just like titanium, are still awkward and inconvenient to handle, as well as unsatisfactory in terms of results.

With the SDS ceramic implants she achieved immediate success. The handling, the biological drilling protocol, the easy possibility of immediate implant placement and the extremely good soft tissue behavior convinced her and her patients.

In the third episode, Dr. Rebekka Hueber and Coco Volz talk about the many advantages of ceramics and especially the SDS implants.

Today‘s Guest

Dr. Rebekka Hueber

Oral surgeon and specialist in “biological dentistry and ceramic implants”

Specialist in oral surgery and head of the dental department in the SWISS BIOHEALTH CLINIC, personally trained and educated by Dr. Ulrich Volz. Among other things, she is a member of the SWISS BIOHEALTH ACADEMY, where she is involved in current research with great commitment.

Dr. Rebekka Hueber: oral surgeon, specialist in biological dentistry and ceramic implants

Dr. Rebekka Hueber – Specialist for Oral Surgery in the SWISS BIOHEALTH CLINIC

Dr. Rebekka Hueber – international Speaker

Hello and welcome to the third episode of the SDS podcast. Today we will talk to Dr. Rebekka Hueber, who is a specialist in oral surgery as well as the head of the dental department at the SWISS BIOHEALTH CLINIC and who successfully completed the curriculum biological dentistry and ceramic implants. Dr. Hueber followed the classical path of dentistry and accordingly had to deal with various problems such as periimplantitis. Therefore, early in her professional career, she dealt with alternative materials such as ceramics, but had to realize that most implant forms, just like titanium, are still awkward and inconvenient to handle as well as unsatisfactory in terms of results. Dr. Hueber will tell us how she came to ceramic implants and why she uses SDS implants exclusively. Hello, Rebekka.

Hi Coco.

Dr. Rebekka Hueber
I’m very glad to have you on our podcast.

Yes, and thank you for the invitation.

Dr. Rebekka Hueber
So let’s get right into it. My first question for you is how did you get into ceramics?

Well, that’s kind of a little bit of story. I did the classical path. I did my studies in Munich, and in a very early stage I realized that I love doing surgery. So I did the specialization for oral surgery in different dental offices, also in a referral practice where we got a lot of patients referred from other dentists. So I saw a lot and I also got referred many problems, especially also with titanium implants or infected teeth. And I had to deal a lot with periimplantitis. And that was kind of the start where I wondered if titanium implants are really the right therapy or why some patients with some patients it’s no problem and some patients really have problems with it. And afterwards I became the head of the surgical department of a dental clinic in Germany and the patients there were treated in very modern ways. The titanium implants were premium manufacturer. We did everything on the highest level, also the technicians. However, after some years with some patients we started to see the same problems, although everything was done on a very high level. In addition, I also always didn’t like the handling very much of titanium.

Dr. Rebekka Hueber
I thought it was a little bit complicated. It includes many steps. So you have a gingiva former gingiva former you have to do the exposure of the implant after some time impression, you have abutment parts, so there are many steps and until you can place the final crown. So that’s something that also I didn’t really like. And I took a lot of trainings in how to treat periimplantitis. But I also realized that there’s no real solution for this problem. And on congresses you often can also hear from leaders of periodontitis or prosthetic departments that we are facing a tsunami of periimplantitis in the next years due to the corrosion process that is happening in the mouth. And that can cause a loss of bone and infection. And that’s what made me search in the end for an alternative material. And I found ceramics. I tried different manufacturers, but what I didn’t know back then, but what I know now, is that often the shape of ceramic implants is the same like titanium. And that’s still a problem because the handling was complicated. I also had losses and I found the handling of these implants not very satisfactory. I didn’t have that much success in the beginning and also immediate implant placement. What I had started with titanium did not really work with these implants. But yeah, I didn’t want to give up. And the ceramic itself is really an interesting material. So yeah, that’s how I found to it. And then I found the SDS ceramic implants and that changed a lot.

But how did you specifically get interested in the SDS ceramic implants?

Dr. Rebekka Hueber
Basically, I learned about SDS through a hint from a colleague. He told me you should go to Switzerland and have an educational course there. So I traveled to the education center and I was hooked right away. So not only by the people I met there, but I could really feel that they had understood how ceramic works and also how you should respect the biology of the bone. And it was very impressive that there was a high practical experience with ceramic implants over 20 years. So I learned that this company had placed ceramic implants over 25,000 ceramic implants in the last 20 years, and that they learned by doing that. That was really interesting. And I was also very enthusiastic about the training I got there because the material was explained in detail. And you get a combination with the SWISS BIOHEALTH CONCEPT where the thing is unique because everything that is explained there also matched my own clinical experience. For example, that different metals in the mouth can trigger symptoms or chronic inflammation, the jawbone even. And even if an inflammation doesn’t hurt, it can affect the immune system via the blood system of the patient and so much more. I learned a lot about medical staff and medical therapies, the physiology of the bone. And these were things I had never learned like this at the university or at my specialization for an oral surgeon. And I also learned how to better prepare my patients for procedures, avoid complications and support them in healing. And that was the first really, education where I understood what is important about ceramics. How can I treat my patients that they don’t have a lot of swelling, that they have a better healing? How can I prepare them for their surgical interventions? And that’s how I got hooked by SDS.

You are now head of the dental department of the SWISS BIOHEALTH CLINIC. How did that come about?

Dr. Rebekka Hueber
Yeah, after I did the educational program, which I can really recommend, because you really have to think different when it comes to ceramics. So you get a lot of support and you will have faced a lot less failures once you start. So I started to place ses influence in the clinic where I worked. And the success came quickly. The handling was much easier. I had happy patients because they had less interventions, and the soft tissue results were amazing. So I did not have any infected tissue around the implants. And I also like the drilling, according to bone classes, very much so, yeah. Actually, I started to have fun in my surgical experiences with the SDS implants and in my clinic, unfortunately, the implant system could not be changed easily. They had their own manufacturers they worked with. And I just wanted these successes. I just wanted to see these successes going on and work completely with SDS implants. And that’s why I applied to the clinic. And it was basically it was the best decision of my life. Because here I can specialize in ceramic implants, bone graft in combination with ceramic implants. And I have also improved my surgical skills very fast because I can work with a specially, really highly skilled team that works here. And yeah, that’s unique. And also the combination with the medical department where the patients are really treated after their surgical interventions. They don’t have any swelling, no pain. You know, they’re in good hands. And that makes me feel relaxed about what I do, because we do huge interventions. We do ALL IN ONE treatments here, and that needs a special care afterwards.

Yes, for sure. Yeah. So today you place ceramic implants every day, but you came into the world of implant dentistry via titanium. Where do you see the advantages of ceramic implants as a practitioner and in particular of SDS implants?

Dr. Rebekka Hueber
First of all, for me, it’s the biocompatibility, because you don’t have any free electrons on Zirconia implants. You don’t see any allergies in the patients, no periimplantitis. If you see bone resorbing around ceramic implants, there was probably too much pressure on the cervical part during the insertion, but not due to particles of the ceramic or anything. You don’t have any corrosion with them. And second, the amazing soft tissue behavior. Also, from histolocigal pictures, we know that we have an epithelial gingival connection between the zirconia and the gingiva. So the gingiva directly grows and connects on the zirconia and closes the door into our body, into our neurological system. So you could say periodontitis and periimplantitis are comparable with leaky gut. The only difference is that we have a leaky gum. That means toxins from bacteria in our environment can entrance the body through our blood system. But that doesn’t happen with ceramic implants because it directly connects. And if you look at patients after surgery, the patient may have old restorations and then next to it, the ceramic implant. The gingiva looks perfect on the ceramic implant. And sometimes it’s a little bit inflamed on old restorations or metal restorations. So that’s really impressive. And SDS in particular, there are many points. First of all, it’s the intelligent drilling protocol, you only work with zirconia drills, which I could consider very important with other systems. I could just take the old drills, the steel drills. But from studies we know we still have a metal debris when we drill into the bone. And when patients ask for ceramics, they want to have pure ceramics. They don’t want to have a contact of seal or metal with the bone, of course. So it’s very important that you drill or prepare the implant bed with a zirconia drill. And then the drilling protocol, it’s not just divided into diameters. It really respects the bone class. So when you do the drilling, you have to feel the bone and decide. And that’s actually it makes so much more sense because the bone has different layers in the deep and the epical part, you have the spongeous bone that has more blood support, that is a little bit softer. On the upper part, you have cervical bone and cortical bone, that’s really hard bone, and it does not have so much blood support. So you have to treat that part of the bone different than the lower part. You can apply much more pressure on the soft bone than on the upper bone because the blood flow would just decrease if you put too much pressure on it. And so the drilling protocol exactly matches the implants and the bone physiology. The handling is amazing for me. They are really easy to place because they have a macro thread and a cutting thread on the epical part. So even in 1 millimeter bone, you get an absolute primary stability of 35 Newton centimeter and have very high strength values. And the cutting thread allows you to position the implants precisely, maybe even if you have drilled in another direction a lot. But you can still correct the direction with your implant with this macro thread. And I don’t know any similar system with which immediate implant placement is as easy. So therefore the patients also save money and time because they don’t need several surgical interventions. And that’s why I love immediate implant placement. But you really have to have a special implant implant shape. In addition, it’s a tapered implant, which makes absolutely sense when you look at the different layers of the bone, because you need the most stability in the epical part, in the region of the spongeous bone, and absolutely no pressure on the upper part, the cortical bone, because you have less blood vessels there. So it does not make sense to have a cylindrical implant that puts pressure, the same pressure on the cervical and on the apical part. But it’s important that you have a tapered implant with zirconia. And the micro thread also provides hollow spaces on the tip in which the blood clot can form and then transform into lamellar bone “de novo bone” is how we call it, and that’s the high quality bone.

Does the shape also reduce the friction? Because I could imagine if it’s like a cylindrical shape.

Dr. Rebekka Hueber
Exactly. Yeah. What you need to know is that when you place zirconia, it’s not a good conductor of heat. So if you have a cylindrical implant, you have a high or when you insert it, there’s high heat on the whole bone. So it’s more important that the implant half falls in and only the last turns. You really get it stable and you apply a little bit of heat. As you say, you have pressure on the whole implant from first drilling in on the whole length of your implant bed and preparation. If you have a cylindrical and not with a tapered, the tapered just applies forces in the apical part. Yeah, that’s absolutely true. And in addition, the implants are available in one piece and two piece, but both are tissue level. That means you never have a gap on the bone. Bone level and ceramic implants, for me, actually doesn’t make any sense. And you have a high or a very high diameter tulip that supports the soft tissue so that it can really grow on the zirconia. And what I also like is that you can prep it like a tooth because it’s pure zirconia. There are no added or there’s nothing added in the material. Also, the surface is not changed. Some ceramic implants have biovirt coating or something like this in order to change the color. But then you cannot prep them because you change as soon as the materials change, you cannot prep it anymore. And it’s really easy to restore with a temporary because you just prep it like a normal tooth with a diamond bur, and then you place a temporary. And what I also like is that the implants are available with different prosthetic platforms. So when you place the implants, you have oval forms, you have balcony forms, you have wider oval shapes so that you can match them with the alveolar ridge or with the width of the alveolar ridge or the alveolas where you extracted the tooth. And that’s unique. I don’t know any systems. And what I love also had to work or what I really don’t miss is to work with removables, with prosthesis or something like that, because patients always had pain with them or pressure somewhere in soft tissue. So you have to correct them so often. So we don’t work with any removables. We just work with fixed prosthetics. On zirconia implants, you don’t have any dentures or anything. And that makes it for the patients much easier to handle their teeth. They are easy to brush and they don’t miss any tasting. Like when you have dentures often, you don’t taste that much. You cannot bite that well, and you don’t have any plaque adhesion on the implants and zirconia crowns. So that’s what I really love about these implants.

Do you also see advantages in areas where the bone is already resorbed or patients have large inflammations in the jawbone.

Dr. Rebekka Hueber
Yeah, definitely what I told in the beginning. When it comes to ceramic, you really you can really think different. You can do more than with titanium. Titanium needs at least 1 millimeter of circular bone around. So usually you cut the alveolar ridge when it’s very thin, or you have first to do a bone graft, and then you can place the implant. With ceramics, it’s much easier. Bone augmentation possibilities are higher. We can combine techniques with the implant placement, for example, with a split bone technique where you screw bone shells on the alveolar ridge when you have a horizontal resorbtion. And, yeah, if you miss bone on the back of heart, you can just augment it, bone graft it directly. With the implant, you can do a bone split on the alveolar ridge very easily and still get a high primary stability. And you don’t need to cut down the allveolar ridge if it’s thin, you have to do that with titanium because it has a high elasticity module. That means it moves like the wings of a plane in the bone. It also moves a little bit in itself with every tooth contact. And if you don’t have enough bone around, the bone will absorb and zirconia is completely firm. You could not fly with zirconia wings, so they don’t move. And therefore, you can also have a thin alveolar ridge. You don’t have to worry that much about it. The upper part of the implant has a micro thread, small thread, because we don’t want to apply any forces on the upper bone. And even if the bone is very thin there on the micro thread and you see it a little bit, it’s no problem. You can grind it, and you don’t have any resorption or loss of bone over the time. And when it comes to the SDS system, there are also some additions. So SDS also offers three dimensional techniques for bone augmentation in vertical and horizontal dimensions. For example, the BISS or the Bone Implant Stabilization System. So if you, for example, don’t get the primary stability with an implant right away, you can fix it with that system on the bone. With Cortical screws, you can individualize this. It’s an osteosynthesis plate with a connection to the bone, but also to the implants. You can also use them without the implants and just augment your bone. It’s like the mesh technique, but you don’t close the tissue over it. You just keep it open and work with PRF, the rich fibrin and the blood concentrate and the OPEN HEALING technique of Professor Ghanaati. He’s the inventor of it. And we actually grow tissue and bone underneath. And, yeah, the possibilities are huge. And since I changed to ceramics, I just have a lot more fun during my surgeries and see better results, and I have greater patience and yeah, that’s really an advantage.

That was very interesting for me as well. It was a very good learning lesson. And, yes, thank you so much for taking part

Dr. Rebekka Hueber
Thank you, too. It was very nice to be here, and yeah. I hope I could share a little bit my enthusiasm for ceramics.

For sure. I definitely felt it, and now I’m enthusiastic as well. I might go back to Uni and study medicine.

Dr. Rebekka Hueber
It’s fun. Yeah. It’s really changed my life a little bit because I was not that with titanium. I just didn’t have that much fun. And when you see how healthy the patients become and how happy they are with the results, and that’s just amazing. And you start to like your profession again.

Very nice. Thank you so much for being here, Rebekka, and see you soon.

Dr. Rebekka Hueber
Yeah. Bye. Bye.

A PODCAST BY SDS Carolina Volz

Episode 2 – Dr. Dirk Duddeck talks about Implant Contamination

The "Trusted Quality Mark"

What made a dentist acquire a scanning electron microscope, and—a few years later— establish one of the world’s most recognized “Trusted Quality Marks” for dental implants, whilst continuously running many research projects? In the second episode, Coco Volz will be talking to Dr. Dirk Duddeck, CleanImplant Foundation’s Executive Director and Head of Research.

Dr. Dirk Duddeck will be explaining what type of contaminants are found on implants (titanium and ceramics), describing their clinical relevance and providing implant manufacturers with quality management solutions.

He will also be telling us about the enormous benefit the CleanImplant Certificate for dentists, as it boosts patient confidence and guarantees better implant healing and osseointegration.

Today‘s Guest

Dr. Dirk Duddeck - Clean implant Foundation, Verunreinigung von Implantaten

Dr. Dirk Duddeck

Executive Director of the Clean Implant Foundation

A dentist and biologist who has been researching the consequences and clinical relevance of avoidable contamination and quality defects in dental implants for more than ten years. He wants to equip colleagues with the necessary expertise, and to protect all patients from avoidable risks that often have serious consequences.

Presentation of the Clean Implant Certificate

Awarding of the CleanImplant certificate to SDS SWISS DENTAL SOLUTIONS in October 2021

Hello, and welcome to the second episode of the SDS podcast.
My name is Coco and today it’s my great pleasure to welcome to you, Dr. Dick Dudeck, who is the executive director and head of research of the CleanImplant Foundation. Dr. Dudek will explain what kind of contaminants are found on implants, titanium, and ceramics, what clinical relevance they have, and what you can do as an implant manufacturer in the area of quality management.
He will also explain how the clean implants seal is a great benefit to dentists as it inspires confidence in patients and guarantees better healing and osseointegration of implants. Hello, Dr. Duddeck.

Dr. Duddeck
Thank you. Thanks for having me on this new podcast.

Yes, it’s great to have you.
Before we talk about the importance of the project, the impact on the market, and the benefits for dentists in private practice, but also the concerns and resistance of some manufacturers. When and how did this all start? Why did you decide to buy a scanning electron microscope? It’s not conventional for a dentist. Was there any initial spark for the project?

Dr. Duddeck
Oh, these are some good questions. Good start. Yeah. Where should I start to answer? Um, I think it was about 15 years ago. I was working at the University of Cologne in the dental department. When I first saw the problem by doing implants that they are not all on the same. You see as a dentist that some implants work quite well and others cause more or fewer problems by the handling or the outcome. This was the beginning when I started to, work with a scanning electron microscope. And to be honest at these at this time, I had very, very, let’s say small experience on, this highly sophisticated electron-microscope. I saw something that I didn’t understand. To that date sterile meant clean to me. If you buy a medical device, like a dental implant as a dentist, you assume whatever incorrectly that these implants are not only sterile but clean, if they are delivered from the manufacturer. Bit I saw so many particles and the high magnification of the scanning electron microscope that I wondered: “Where did they come from? Is there a reason, did I make a mistake, by doing the unpacking.”
This was the beginning. Um, more questions than answers to me. And at that time, the, um, I remember quite well, the European Association of Dental Implantology, EADI, um, was supporting this project. And, um, we made some publications that caused a lot of rumors, the data from some companies. They were angry and, wrote us emails through the association saying, oh, “how can you dare to publish this kind of images?” Because this is not the truth and so on and so on. Um, well later, a few years later I, uh, started to do the, uh, the third study, and I was asking for support from the association and God knows why. They didn’t support it because I had always to wait so long and the long queue of doctoral students on the scanning electron microscope in the clinic.So I thought it was a clever idea to have an, an access full access to our 20 SCM because we had so many implants to check. And well, this was the decision: to invest one hundred, even 120,000 euros in this scanning electron microscope.
Some friends of mine at these days invested in a fancy car and new boats or other hobbies. Um, I decided to buy a scanning electron microscope. In hindsight, this was the best idea ever had, because this offered not only answers to the questions I have, it was kind of Pandora’s box opening and. So, this is kind of the initial spark: driven by curiosity, I wanted to know what are these particles are made of? Why do you find so many particles these days?
We had 23 implants in my first research and even in my doctoral thesis. And, uh, more than 10 showed some interesting particles that were not supposed to be on a sterile, clean dental implant. So this was the beginning of everything.

Okay. Wow. This is very interesting. So, um, let’s talk about the CleanImplant Foundation. What is the goal of the CleanImplant Foundation? As a nonprofit foundation, you have to do something for the benefit of all patients and not just one. Your colleagues about inferior medical.

Dr. Dirk Duddeck
Yeah, the Foundation of the CleanImplant Foundation was the logical consequence of all data we achieved, in the years before. As we needed a space, something like, like a, like a project. The idea to develop this as a nonprofit organization, is important because no one can buy a good result. If you do some research in a university environment, it is not okay if companies give you some money, awaiting good results. So we always try to, to produce non-biased data and. So this was the initial goal of the foundation: to give it a framework for this, let’s say the delicate topic of inferior quality dental implants. This is a huge market. A multi-billion dollar market. And if someone comes around from Germany, looking through the eyes of a scanning electron microscope, and see something that is not okay. And no one expected this kind of contaminants on a factory side reason.
So, wedecided, it was in San Diego, actually, I just tried to remember. I gave a lecture, for around 1,200 American dentists. And, um, I showed them some images and complained about the failure of the EU device regulation, because all implants I see under the microscope and not just from the lab or some kind of research and development, uh, department, they are ready to use for the patient. These are the products that my colleagues see on their sterile table, when they start the operation. I showed these images at this conference. And I could see that some people took out their mobile phones. They say “European implants who care for Europe?” You get a good feeling as a lecturer, if you kind of loses the audience, the attraction. And then I said, okay, give me one more minute. And then you guys can take your mobile phone, whatever, you can speak, you can even leave my lecture. I don’t care. But give me one more minute and I’ll show you some more images. And the next images were the SEM images from US-made implants.
And that’s the moment – I can still recall it – It was total silence in these huge room. You could hear a needle fall. And from far, far back, you could see people shocked, just kicking their buddies sitting to them and saying “look at this”. And I said, sorry guys, they are not safe under US law. These are implants with an FDA clearance and they look like this. So some bad apples, even in Europe. And your basket here. And this was the moment after the lecture. I was surrounded by around 20 people. I’m complaining to start the next lecture because it looks like a big fan club and asking me for my business card, no one wants to see my business card.
They’ve all shouting names, like brand names. I said, okay, what about this A-B-C? And they just dropping names. And I thought, Jesus Christ. If I start to do some thumbs up, thumbs down here. I will. I’m on, I cannot leave the US I mean, maybe in handcuffs. I don’t know. So this was a threatening situation later on, by the way, I, um, a colleague came to me and said, okay, lucky, you, you had no brand names on all the dirty images or images of dirty implants. Because, um, maybe you, you will have some legal problems as well here. I guess that from thousand people in the audience, at least one lawyer must be there. He was laughing at what, I know, seven lawyers, I saw the room. So all the big companies sent their legal advisors to see if there was something wrong with my lecture.
10:36 min Spotify
At the beginning of this moment, I thought, we needed protection for this nonprofit project. Telling the truth, even in dentistry is something that is not as easy as it sounds. And then we decided to ask more and more people, renowned professors, to help us, to join the scientific advisory board, give us some rules and then, by finding out a threshold, we came together. People like Tomas Albrektsson and Vanderburgh from Sweden, what does our grand scheme university, uh, even Michael Norton, the former president of the American Academy of Osseointegration, the AAO. So we asked them and all of them said, yes, we’re gonna help you.
This is an interesting topic. We, we see that you need protection. We give you a framework of what is a clean implant meant to be. So is there some other, thresholds and finding? In the end, some, uh, kind of, um, consensus paper, uh, you can download this and on the internet on
There’s a paper 20 pages long that shows bad and good examples. In the last two pages, we found a consensus about what is clean implant and how many particles can still be accepted. So this was the thing, the question was the goal. And as a nonprofit, we do have to do something that benefits the patients. Yes. Making a, let’s say giving some pressure to the market that, um, beyond every FDA, um, um, uh, clearance is even in the European CE marking process. Some guys are looking at the end product and is this promise of a manufacturer always fulfilled with something real, a real clean implant. So – sorry for the long answer to the short questions.

It’s very interesting, but, um, let’s talk a bit more about the contamination. In the meantime, you have examined well over 300 different implants in the SCM for contamination at the factory. What did you find on the sterile packaged implants? Is it only plastics or also foreign matters?

Dr. Drik Duddeck
Yeah, this is the shocking experience I made over the years. Um, it’s not getting better. We informed always the manufacturers about the results, every company that sends us an implant, uh, receives an answer, at least a short information. And total it’s more than 300 different implants from, I think about 200 different manufacturers.
So I think we cover more than 90, 95% of the market. And what we find on the dental implants is, um, You see some organic contaminants in the material contrast image of a backscattered electron imaging. That is a very specific technical detail. You see when something is not made of the core material, if it’s either titanium or zirconia. So we can see quite well if there’s something that is not declared on the, on the paperwork for the implant. So is there a foreign material? And we find very easily organic materials, it’s hard to differentiate what it is. Sometimes we see from the shape of the particles and the elemental signals in the EDS, and out of this we see that there’s a certain combination of elements.
If we want to go deeper and we now have an additional tool. It’s the time of flight, secondary EMS spectrometry, tough SEMS, uh, even how to pronounce in German, by the way. Um, it’s we know not only is made of carbon or something, organic material, but we can also actually now see that this is a plastic material. And what kind of plastic it is. So good example we found Polyacetal, um, Polyoxymethylen “POM” is the technical class of material. We found Polysiloxans. We found remnants from the cleaning process. Uh, this was, for example, this, If I have an implant and my doctor gives me an implant and he has no clue that this implant may contain on the surface Dolyphon Benozo Sulfonic Acid “DBSA”. This is a very aggressive cleaning solvent. They used to use to have it, this get rid of all the oil and all the, um, contribute nation during the process. And if we find even the remnants of the cleaning material, this is an aggressive surfactant. And according to the American environmental protection agency, EPA, it’s a hazardous substance.
This is a toxic hazardous substance remaining on a sterile package implant. While we pay for this implant between 60 and 400 Dollars or Euro. Um, in addition, you ask about foreign metals. Yeah. Interesting. We find particles and not only one, on one implant, we found more than a hundred particles with elements of iron, nickel, chromium. We found remnants of the tank stand from, the turning machine. We find, um, metals, even small particles. We have to speak about, the amount of the size and the clinical relevance, but I find corporate tin, a hundred percent clear signal of a metal particle, small enough for Phagocytosis containing corporate tin, and God knows what tin bronze does to the body. I don’t think it’s good for osseointegration, to say it a little bit sarcastic. So we found many different metals, from an either contaminated blasting material or from touching the implant during the process, even the tungsten remnants of, from the blasting nozzle, this, tin bronze is a very soft metal, most likely, uh, originating from the blasting ozone.
So we have plastics, we have metals and we have even hazardous substances. This is the bad news. The good news, by the way, is there’ll be still have under 300 different implants, at least two-thirds of the implants are not that bad. So we see a lot of implants that, um, really deserve our trust, that are produced on a very high level. I have to speak about this later… The general quality of a dental implant nowadays, it varies from I won’t give my cat to beautiful super-clean implants. Okay. So you see a very high, uh, range of, of different, um, contaminants in these, let’s say total 300 implants.

Okay. But I have a question for you. How big are these particles usually? Does the size of the particle play a role in the possible foreign body reaction?

D. Dirk Duddeck
Of course, of course, as fast as I remember from my basic study, and you can read this in many, in many publications, the size of a bit of a, of a particle that is okay for phagocytosis. So macrophages come to. No, let us start it another way around. If, if a body sees a foreign body, it always leads to a foreign body reaction. Even an implant is a foreign body by definition, but this is a controlled foreign body reaction. Osseointegration is nothing else than a controlled foreign body reaction. We see some smaller particles with more or less. They are not so bio-inert like implant materials are. The body is reacting by getting rid of these materials. It’s a foreign body. So we have a foreign body reaction, we see the foreign body giant cells. We can detect and see macrophages. And in macrophages, uh, have a, have a nice appetite for these particles and the size of the limitation is about eight to 10 micron. So if people tell me “these particles you find, are so small, the biologic reaction is not worth to mention because they are so small.” My answer is they are so dangerous because if they are smaller than 10 microns, they most likely they will be, um, intake by these, uh, macrophages by phagocytosis.
The follow-up leads to an increase of osteoclast and osteocluster janitors. In other words, by trying to do a sort of cleaning of the contaminated implant by the biology of the patient. We have a follow-up reaction with an increase of osteoclasts taking away the bone in the moment and in the area we wanted to have the best bone seal. So usually we have an accumulation of these particles in the shoulder area. If you drill, if you take an implant inside the bone with forces up to 17 Newton centimeters, um, there might some particles detache from the surface and they might all accumulate in the shoulder. And this is the place where you want to have a, uh, from a clinical point of view, see a lack of, uh, osseointegration.
But you are forcing the contaminated, implant is forcing the body to, um, increase there, the osteoclast cells. And not only take away these particles by macrophages and phagocytosis, but also by taking away the bone as well. So this is the start of, some cases, I guess, a lot of cases of peri-implantitis induced by an avoidable factory-related contamination. I’d say very slowly, because this is the core message of this complete interview, I guess.

Okay. Yes. So what would you say is the general feedback by, um, toxicologists about your results? Do they say that the particles play any role at all in the healing phase? Meaning do they have any clinical relevance?

Dr. Dirk Duddek
I had this question for years. Um, all my friends say, what are you doing for kind of crazy research? Nobody cares. Um, you have to keep in mind that we have, uh, You have to see the the most recent FDA numbers of failed implants. There are some statistics that see an incline and in failed implants, but there must be some reason. And I want you to know this. Exactly the question. Thank you for giving me the question here. Um, I took a flight to Brisbane. In Australia, uh, and visited, uh, one of the most renowned toxicologists Prof. Jack Ng. I don’t know how to pronounce this. However, he’s on the board of American toxicology and I asked him the same question.
We see a very local area, that we are not contaminating the whole body because he’s a specialist in, in an environmental, um, uh, intoxication. So some from water, uh, lead in water and something like this. So I ask him is how can these particles have an effect? And he agreed on this, this might be only with a question mark, uh, a local effect. There is, um, always a reaction. He confirmed that there will be some, maybe some local effects and we, as dentists take care of local effects. I don’t want to have an implant where the body has to do the cleaning work, uh, um, by doing a 50% osseointegration less good than it could be with a clean implant.
Well, the answer is quite easy. Um, there is a kind of foreign body equilibrium. That means there is no technical threshold for how big can the size of a contamination be. How big is the particle? Um, do we have a specific amount of specific toxicity of these particles? It is not, um, uh, the particle amount. We always see the reaction in the body. And even if it’s a local reaction, um, we, we, we have to deal with, um, peri-implantitis parabola. Again, induced most likely by, uh, these avoidable particles. And no patient is the same. And this is why there’s a very nice publication entering the same question.
The answer is there is an individual foreign body equilibrium. That means a 20-year-old basketball player. Um, super healthy and just losing a tooth, a central incisor by an accident might have a wonderful osseointegration, even with a contaminated implant. No doubt about it, could happen. It might even take a rusty nail. I don’t know if it’s sterile.
We have to deal always an hour threshold is the weakest patients we can, can, uh, that is visiting our practice. I have to, I, I was working about 14 years in a university. I have to deal with compromised patients and I speak about pre-radiated, um, um, patients. Patients with heart diseases, and so on. So we, we went to the, to the limit, to the limits of, of, of indication for implant therapy and the last thing you want to have if you have these weak and, and suffering patients are extra contamination on the implant. If it’s technically avoidable. So the far about equilibrium, it gives us the answer that, um, the one patient can deal with it. The other one, not.
And our bar or threshold should be always as we are a medical person, we should always take care of the weakest patients. This is what he confirmed, the toxicologist.

In environmental medicine, there is the concept of “precautionary principle”. One assumes a burden on health in this case of contamination until the polluter proves otherwise. Does this also apply to dentistry or implants?

Dr. Dirk Duddeck
The precautionary principle is a German invention, by the way. In the environmental medicine and this was something, that was brought up by Prof. Ng in Brisbane. And he said, um, if this the same rule as in the, environmental topic. If we don’t know how a specific material is good or not good for the bone or the health of our patient. We should always see this as a toxic or let’s say, not having positive effects on health or osseointegration. Unless we have proved that they are healthy and there are no reason for concerns.
The reverse of the burden of proof is something I have to deal with. People always sell, some manufacturers would try to reduce the cost of production by a lack of quality management. This is the only reason why we can see these implants even as a CE mark. They say, well, Dr. Duddeck, please send us any information that the things you find have a negative, um, effect on osseointegration. I said, no, you have to show me if you can’t avoid Dolyphon Benozo Sulfonic Acid, if you cannot avoid massive milligrams of plastic from the packaging remaining on the implant surface, if you can’t avoid this, you have to give me as a dentist proof that these materials are safe.
So this is. I think we have to admit that even dentistry is playing by the same rules and it should be for the sake of our patients, that the precautionary principle is something we follow, even in dentistry.

Okay. So you have been observing the problem for several years now. And when you report in your lectures and write in articles that one in three implants examined is significantly contaminated, which by the way, as a patient, I find hard to believe. Is there a tendency over the years towards improvement? Don’t all companies improve their quality management when they learn about contamination in their medical devices?

Dr. Dirk Duddeck
Oh, good question. I hope we have some time to answer this. This would be quite a long podcast here. Yeah, one in three that is still the remaining, um, proportion of, uh, contaminated, significantly contaminated implants. And when I speak significantly, I mean more than 20-30 particles, obviously avoidable on the implant, mainly organic particles, but even some we spoke about before this, even some foreign metals, not by the core material. So, is there a tendency towards improvement? Um, we have very, very positive and we have very, very negative experiences with dealing with the information.
If we give this information to manufacturers. Um, not all companies start to improve their manufacturing, unfortunately. Maybe because they don’t feel the pressure. They don’t see any reaction from their customers at all. And the complaints, um, of failing implants is always easy, to address this to a patient with some diseases or with a lack of hygiene or at least even a lack of education from the dentist. I think it’s too easy. Uh, as long as we see this one-in-three ratio of significantly contaminated implants, there should be some reaction. I would love to see. We are now starting the fifth study, following the same protocol. We do have a very good database, we can compare data from even from 2011, 2012, a study in 2015 a study in 2017.
And now we do study the years 21/22, collecting more than a hundred implants. So we have a huge database. And the problem is, um, two examples I’ve met a CEO in the, in the most recent IDS at the International Dental Show in Cologne. And he told me, well I know your work, Dr. Duddeck. I know what a CleanImplant is doing, giving a lot of pressure on the market, but you know what? I sell a million implants. I don’t care what you do. As long as I sell a million implants, we don’t even stop the research on implant services. That is what a CEO of, one of the major companies told me right into my face. I said, I said, and this is the story behind the story is that I addressed a problem to him, where I found an implant from his factory site, contaminated with hundreds and hundreds of stainless steel particles, mixed with aluminium oxide as blasting material. Iron, chromium and nickel metal are’nt good for osseointegration. I would love to see this, um, this study. Um, he couldn’t give it to me because it’s just a contaminated plastic material. So I found this one example and it was two implants from the same batch. Um, but, um, I don’t want to see the 1 million implants, maybe, as far as I know, he has a lot of sales in India and not in Europe, but, um, I doubt that all these implants, uh, lead to osseointegration. I, for sure I have respect for his success, for his business’ success. But it’s not all about money. It’s not about 1 million sold implants in about 1 million treated patients with inferior quality implants.
Another company told me in 2014, I showed them the results of, uh, two implants that they offered for the study. Um, they have a lot of room for improvement and the answer was very politely asking me, uh, to avoid, publishing any negative data on the company or the implant type.
I checked the same implant three years later. And I found the same or even more contamination, organic material, uh, on the implant. And I received a standard form, I received nearly the same mail, the same information from the company. But in addition, he warned me and he threatened me with legal actions in case of any publication of this.
So this is, let’s say, the dark side of the moon. Uh, on the other hand, we have a lot of positive reactions, and some companies trying to get better. It’s not because of the pressure that CleanImplant gives to the market. Um, control is a very good thing. As long as we have this amount of contaminations, avoidable contaminants on implants, and, um, most likely clinically effects on this contamination, someone has to look at them and there are some companies taking care and asking us, how can we get rid of the problem? We want to sleep better.
We want to sell a good implant, please help us in get better. And this is what we do as well. So even companies that see the room for improvement, we give them a helping hand and whatever we know about this topic, we, uh, we give them a stage and we have candidates in our group of supporting companies who really show a huge improvement in the quality of the dental implants. And I’m very proud that these companies, um, are now better on the market.

No. It was very interesting. Yeah, it’s good that there are, um, companies who want to improve their quality. Um, so what would also interest me is how do manufacturers react to this initiative and the CleanImplant foundation? It has become something like the “Stiftung Warentest” for implants. I hope this word also exists in English.

Dr. Dirk Duddeck
I think that’s a comparable institution, and doing the same as the Stiftung Warentest in Germany. It’s the “UL” in the United States, there is an underwriter’s laboratory. They check everything from a toaster to a washing machine. They check every technical issue. So the same as the Germans’ Stiftung Warentest is doing.
Yeah. Um, how do they react? I told you some already spoke about two, two examples. Um, again, we have friends and foes in the market, and, uh, I would like to emphasize that our glass is half full. I would love to give those, who really improved their quality – I show from the first moment on an implant with cleanliness that is promised by, by the packaging that is promised by the name of the company – that we give them a stage. I have no fun in dealing with legal threats and some guys told me “Oh you are the Robin hood of dentistry implantology”. I’m not sure if this is a right, um, a precise description of what we do, however. Sometimes I feel like this, I received a call from a, from a manufacturer I remember quite well, two years ago, he was so angry about the results and about, um, the way we publish this data that he told me. He was driving his car back home from his factory. And he was so angry, shouting into the microphone, saying, Dr. Duddeck, I know that you live in Berlin the next time you will walk in the evening in the streets of Berlin. We have many, many friends there. “Take a look at your back!”
So this was the first time I have received this kind of threat. I have this on tape. This was the first time I ever received, a personal threat. Again, on the other hand, we are so proud and we are so happy that we have, uh, companies that help us. I would love to mention one more thing. It’s not a question, but it’s important to understand.
Implants are not good, just because the company is a big one.
We still find implants with significant contaminants on implants from major manufacturers. And I mean, number one to number five. This is not that they have sometimes, they don’t want to recognize that they maybe even they know that some implants have a lack of quality.
However, the reaction from some major companies differ a lot from the smaller companies. Because they think they are too big to fail. And it’s kind of- the German word is “Majestätsbeleidigung” – It’s uh, if you accused the king that he’s doing something wrong, then you, again, you go into jail.
So, um, It’s kind of, um, uh, we, it is what it is. We open an implant. We don’t care about the size or the name or the reputation of a company. We see the implant as it is. And unfortunately, there is no pattern of, uh, let’s say, market share or price of the implant we have even. Costs implants with significant contaminants.
So there is no safety in the market, and this is why I think the complete, the project the CleanImplant project is so important for the market.

Absolutely. Yes. So I understand that there is encouragement and at the same time resistance coming from the industry, but, um, let’s move to the topic of ceramic implants. I’m sure you’ve seen a variety of ceramic implant systems. What about clinically relevant impurities? Shouldn’t the zirconium oxide implants be cleaner since the manufacturing process is fundamentally different from implants made of titanium or titanium allies.

Dr. Dirk Duddeck
True. Um, the process of manufacturing is different. However, um, you can, um, contaminate an implant, even after it’s leaving the oven. The ceramic implants are produced with a high-temperature process and, usually you have a clean implant after this. So at least the organic particles are gone, but if you then take an implant and squeeze it in plastic packaging by using the first the shoulder and the first threat of an implant where the implant packaging is touching the implant. But the surface, as you take the implant out of the packaging, you see, the remnants of the packaging itself. So this is something we found in a, uh, um, major research project performed with the, not only with the Charité University here in Berlin, but also with the University in Gothenburg and the Malmö University in Sweden. Where we collected 25 implants, ceramic implants, to answer your question, from five ceramic implant manufacturers and we, uh, all of these five samples had to follow-up the same protocol of analysis. We measured the roughness. We checked the literature of the implant system. Uh, is there clinical proof of success?
And, um, my job was to check these implants, um, for cleanliness and this scan electron microscope again, using backscattered electron imaging. And what we found unfortunately is the same ratio from these five types. Two types, um, just played significant contaminants, the one with the packaging process problem, having massive milligrams of polyacetal, POM polyoxyethylene on the implant.
So there’s no proof, that simply because they are white, they are not clean. You have to do the same quality management as a titanium implant. This is very important.

Okay. As an experienced implantologist, what would you look for when selecting an implant system for your patients or your practice.

Dr. Dirk Duddeck
Let me just add some additional information.
The publication from the JOMI journal, the Journal of Oral Maxillofacial Implants, can be downloaded, it’s on our website. Uh, if you want, uh, they can, people can send me an email and I will send them, uh, a, a print of this publication. It’s important to, to understand. What would I look for when selecting implant for my patients in my practice? When at least I would, for sure don’t buy this in the gray market, I would love to have an, an improvement from a CE mark on FDA clearance, the minimum, but. As I know, and maybe I know too much about this topic. I would love to see additional information about this implant. I want to be on the safe side. I don’t want to have the problem of, uh, legal threats or, um, seeing that. Uh, the patient can, can Sue me for four and have claims of damages. If they get the information I use, an implant showed in a publication significant contamination.
So this is a huge problem in the United States, by the way, where it’s kind of standard that so many patients are suing their dentist and not only their dentists, even the medical clinics for any kind of mistreatment or misbehavior. So there, I would love to have safety and the safety of that, uh, I know from my microscope is then when we give – there’s a process that leads to a, um, the trusted quality mark. The trusted quality mark is awarded to implants that give proof not based on one implant that on five implants. Um, and they show in the microscope in accredited laboratories, by the way, that’s not a kind of backyard SEM it’s an accredited laboratory where they produce data on a very high standard of science.
And I would love to have this quality seal on a dental implant, the trusted quality mark. I think this is where at least the surface is clean. There are more reasons for a good implant, but I would love to have safety on this topic.

So as a dentist, you can become a member of CleanImplant and sign up as a certified dentist. And aside from supporting a good cause, what is the benefit, for the dentists?

Dr. Dirk Duddeck
Um, supporting us is one good thing is that we need support from dentists worldwide. And we get them by the way, this is one reason why we have to date. I think, uh, there is a number is 110,000 followers on the internet. It’s even more than the Nobel Biocare by the way. So there’s an impact on the market and people who are supporting the CleanImplant as a clean implant certified dentist, they will be shown on a website that is a “CleanImplant4you” with a four, a numeric four “cleanimplants4”, uh, German it’s “”, people should check this. They will be mentioned, they will be shown in the map. A certified dentist for himself, he has a safety that he’s on the safe side. And his implants are not contaminated. And he can show it to his patients and we support the practices with marketing material. For the waiting room, um, and for the referral practices. So some dentists don’t do implants on their own, but they have, they, uh, our surgeons, our maxillofacial surgeons doing the, uh, the surgical part of, of implantology.
And this information is even good for these people who can support their practices, showing them that, uh, implants in use are double-checked. They don’t only have the official CE or FDA mark. They have additional tests, uh, and they underwent additional tests in the CleanImplant foundation and a very high level of scientific evidence. So we can see that these implants are finally clean. So it’s a mixture of marketing and material for the practice. They can convince patients that they are using only good implants. And I can see more and more patients are aware of the problem.
Any patient to date knows the difference between a, uh, vaccination, of the vaccines. They want to have either this, uh, standard vaccine or they want to have the MRA. Patients are informed and if they take care of so much of explanation, why don’t they, I think they will, sooner or later they will take care for their implants as well. I can promise this.

For sure. Yes. So I did some research on the internet before our conversation. And if I see it correctly, the CleanImplant Foundation has more subscribers on Facebook than, for example, a global market leader like Nobel Biocare, which you just mentioned. But how would you explain the high number of followers in such a short time on social media?

Dr. Dirk Duddeck
Yeah, we are on social media since 2018. I mean, this is not, this is not full four years. And we reached more than a hundred thousand followers. We were surprised by the feedback from colleagues. This topic is something, people, my colleagues don’t want to have in their practice. If they are aware of the problem, they might have a solution.
And, uh, this is why they, um, want to be informed by our emails, by our newsletter. So, um, I think, to kind of put it short: If there wouldn’t be a problem of avoidable contaminants on sterile dental implants, there would be no CleanImplant Foundation. Then I wouldn’t have bought a scanning electron microscope. Maybe I haven’t fancied Cano instead. And, um, we wouldn’t have this discussion for the last 40 minutes. So, um, I think it’s momentum what we see. People, my colleagues, and even patients, although we address only professional colleagues on social media, um, I think there’s a small percentage of patients as well. However, it is something my colleagues are concerned about.

So, um, this was very interesting and sadly, we have already reached the end, but I have one final question for you: Where do you see yourself in five or 10 years? What would you like to have achieved with your initiative by then?
Dr. Dirk Duddeck
Oh, good question. I would love to see a higher percentage of implants with no reason to be concerned of. So I would love to see in a, uh, average less than two out of 10 implants, um, being, being contaminated, um, or being, uh, showing something. Giving fulfilling the promise that they, that the companies do with their advertisement.
And I see myself in five or 10 years. Well, I think we just opened the first box of Pandora. I think we should have a look at us your orthopedic screws as well. We would take care of for, um, bone substitution, bone substitutes for, um, we will take care of, for. Um, other medical devices. I think we are, we’re at the beginning of a very, very interesting and a success story here. CleanImplant is something, although some companies don’t like us, I think it’s hard to ignore that there is power of users, of customers that we support. And I think in five or 10 years, we will have, um, and even better standing in the market.

This is a very good outlook for the future. And it was, for me, it was a very interesting lecture. So thank you very much. And I’m sure that our users appreciate this episode and all the information you gave us today. So thank you for this.

Dr. Dirk Duddeck
It was my pleasure. Thank you for having me now.

Thank you for participating. Bye Mr. Duddeck

A PODCAST BY SDS Carolina Volz

Episode 1 – The Ceramic Implant Market with Dr. Karl Ulrich Volz

Welcome to the very first episode of the new SDS PODCAST!

In the first episode, Coco Volz will be talking to her father, Dr. Karl Ulrich Volz, who will give a brief introduction to the SDS PODCAST, and explain how this new medium will enrich the lives of the SDS customers on many different levels. He will also give a brief recap of the past year, and explain SDS’s plans for the current year—among others, he will be providing a peek preview of SDS’s new concept, which is comprised of several levels/steps with different levels of difficulty, even though some details are still top secret. 

Todays Guest

Dr. Ulrich Volz

Dr. Karl Ulrich Volz


As a ceramic pioneer and leader of his guild, Dr. Ulrich Volz has his own view of the ceramic implant market and its shareholders. With his holistic treatment concept, he has succeeded in bridging the gap between biological dentistry and surgery, thus combining the best of both worlds.


Hello and welcome to the very first episode of the SDS Podcast. The SDS podcast is designed to provide our customers with exciting and informative conversations between members of the SDS family and specialists in the industry. The podcast will broadcast one episode every two weeks, which will then immediately be uploaded to the SDS Media Library. Today. It’s my pleasure to welcome Dr. Ulrich Volz. We will talk about what are the key pillars in the implant industry and how can these pillars be built? Dr. Volz will share some insights from his long professional experience in the industry and give an insight into SDS future plans. Hello.

Dr. Ulrich Volz

Hello Coco.


Hi dad. So my first question for you is what is the idea of this podcast that we are starting today?

Dr. Ulrich Volz

We know in those times that the physical meeting or event, of course, always is the best, but it’s a lot more time consuming and you have to go to a certain place at a certain time. So the next level, in my opinion, is the webinar where you have so you have to be there at a certain time, but you don’t have to travel. And the online course, you can do any time, but you can’t do something else at the same time, like traveling or walking or sitting in the train whatsoever. So I think it’s a great idea. And I mean in general, the idea of all what we do if it’s webinar or courses or online courses or congress or whatsoever, is to forward a lot of precious information from the big SDS and SWISS BIOHEALTH family and their friends to the user to make his or her life as a dentist better and more successful. That’s at the end is the idea of any area like webinar courses or this new podcast.


So let’s dive right into our next question. Why was SDS so successful last year?

Dr. Ulrich Volz

OK, actually it was a super successful year with a growth of almost 30%. But it was not something special last year because we had given in 2020 we had a growth of more than 15% the year before, 25%. So at the end I would say it’s like the Japanese, they say “cani” constant and neverending improvement. And it’s kind of the payoff of a really every day, step by step, millions of steps. And it’s now 21 years since I’m in this field of ceramic implants, producing ceramic implants, doing education, placing ceramic implants. And so it’s always a matter of time and we always totally overestimate what we can do in one year, or maybe with 1 million or with 50 employees, but we totally underestimate what we’re able to do within ten years or 20 years. And at the end, what I saw a lot of new ceramic companies coming up and being sold or being closed, whatever, in the past ten years. It’s not that easy. And at the moment we are still the world market leader with SDS. And I think it’s a consistency over 21 years now. And because after such a long time, we have even some team members and employees, they are now for those long period and maybe even longer in the team.

So 100% trustful, great persons with amazing knowledge. And we are always talking about the SDS and SWISS BIOHEALTH family, because it’s like a family. I mean, you Coco, you have grown up. You were more or less a little bit born before I went to the first ceramic implants. And so you grew up in this kind of family. That is why we call it the family. And we are a family because our family members are working in SDS. So my wife Nicole, and your sister Ann-Sophie. And of course, after such a long time, you know a lot of good people in the field. And so with some, you become friends. This is something that you can’t build up in two or five years. This is something that needs to grow over decades. Or some other people, they came from other areas or from other infant companies where I was a customer maybe 25 years ago, and now they’re working with SDS. So this is something that takes a long time. I mean, nobody likes to become older and getting gray hairs. The huge benefit of getting older is getting more experience, getting more knowledge, getting more people to know and to know what is dangerous or difficult, or whether possibilities for failures and so on, and how to move around obstacles, things like that.

And I believe that a big strength of SDS is that with my person as the founder, the inventor, the developer, and the 100% owner of the company of SDS and SWISS BIOHEALTH, it’s all in one person. And at the same time, I’m the one who has placed the most ceramic implants in the world. It’s no more than 25000, actually. I do not believe that there will be another person in the future who is going to place more implants than I. Because when I started, there was already a huge demand in the population, in the patient, but there was no experience, no offer. So the demand was much higher than what was offered by the dentist. And so I was invited in many big clinics to place implants. And I remember I had one year where I played with my own right hand, two and a half thousand ceramic implants. It was an incredible year, super tiring, but at the end, that made the experience. And so this is, I think, another important thing, that’s now more and more paying off, because SDS is 100% super based on experience, on practicing dentistry on a super high level.

And of course, like in the SDS company, for a clinic, it takes a lot of time and years to build trust and to get the best dentist, surgeons and prosthodontist.


In your clinic, would you say that the physical closeness between SDS and the clinic is another advantage for the company.

Dr. Ulrich Volz

I think there is another huge strength of our SDS SWISS BIOHEALTH family, that it’s not just that we are super close, but we are actually physically super close. It’s all in 200 meters in the same building the SWISS BIOHEALTH CLINIC, with ten dentists working there in the meanwhile. And the nice thing is that we have five medical doctors as well. So it’s not just a biological dental clinic. It’s as well as biological medical clinic with some of the best people in the field. Like Dr. Klinghardt is several times voted as one of the best biological or the best biological medical doctor in the world. So it’s in the same place like SDS, where all the employees of SDS are working. It’s the same place where the education center is located, where we are training the last two years, around 4000 dentists a year. And even the German company SDS Deutschland GmbH is just 2 km away. So we’re all super close, even physically. And I think that makes us super strong and quick and fast and we can put everything together. And at the same time, like this complexity. We have a huge complexity regarding the concept, because we are not selling an implant, because I didn’t develop implants and had the idea it’s a good business concept, I’m going to make a lot of money out of it.

There is the concept I’ve followed since 91 and for this concept I needed a ceramic implant. And that is because nothing was in the market. I invented it. And I was lucky that at that time, the market leader for ceramic hips, the owner of the treatment chair, and he helped me on that. So we started in 2000. But at the end, what we sell or teach is a concept, a treatment concept on a super high level, always outcome focused. That means we want the patient to improve and to make the patient healthier. I mean, this is why we created the slogan MAKING THE WORLD A HEALTHIER PLACE. And at the end we are kind of maybe even we are kind of consultants, because all our users, they tell us after some years they are so much more successful. They have mostly just got one problem left, that is finding and then hiring good dentists and nurses and employees and technicians whatsoever. And this is why they get all the information.

Firsthand and I was the youngest dentist who started a private practice 32 years ago. And I was the first dentist who started with a private practice based on the government insurance. So I have proven that I was able able to found and to run super successful practices and clinics over the past 32 years. And so I would say there’s always two ways you listen to a consultant who is in the first place, a consultant, but he never proved that he’s able to run the marathon under 2 hours, or you listen to somebody who run the marathon under 2 hours. And that is in my case, it’s the case that I think is another very important thing. So I think that is as well the reason why I was voted again as the president for the ISMI (International Society of Metalfree Implantology), which was founded about, I think eight years ago. And since I’m so long in the field and so well known, I was able to get different implant companies, bring different implant companies and very good speakers and organizations together to create the JCCI this year. What is the JOINT CONGRESS for CERAMIC IMPLANTOLOGY. Because my idea was there is on one side and SDS, but on the other side we have to move forward with ceramic implants and we have to join forces.

And there are a lot of ways that lead to Rome, and we all want to Rome, but there are different ways and paths to go to Rome. So actually I was able to bring several influence companies and organizations and amazing speakers together. And we had from zero to 100, we had more than 300 participants. It was super successful and it became the first year the biggest congress of its kind for ceramic implants. And so we are super happy and super proud about that. And I think that is as well kind of one of the pieces in the mosaic or in the jigsaw. What makes SDS so successful. I think all ceramic implant companies are becoming more and more successful in the coming years because we have now joined forces with other companies in the JCCI congress. And so ceramic is more and more getting into the brains of the patients and the needs, the demand becomes bigger and bigger by the year. Of course we know that titanium is getting a little bit under pressure in the past years because titanium oxide was banned by the European Union and many other things. And a lot of people are talking about bio, corrosion and so on.

But on the other side, in the past 21 years, the ceramic implant industry has managed to make their homework. And now today, if you choose the same diameter, our ceramic implants are more stable than any titanium implant with the same diameter. But this was not the case 20 years ago. And we have super well working shapes like our dynamic threads, so we can do even in upper Molars in 95% of the cases, immediate implants. So I don’t know any titanium implants that would be able to do so.


Did you discover a trend towards health and aesthetics within the last years?

Dr. Ulrich Volz

In the past year, more and more people started to care about their aesthetics and to care about their health. Because we have seen that this is the most important thing, like health, family longevity and so on. So this is that while the patient who could afford it is more and more asking for ceramic implants and we are more stable, we have the better shapes, we have the biology integrated as well, kind of like according to the Zeitgeist that the people are going for healthy, beautiful, nice aesthetic treatments.


Recently, SDS received the CleanImplant label. Can you tell us about that?

Dr. Ulrich Volz

We are super happy that we some time ago at the JCCI Congress received an implant label with SDS. And on one hand that there is no other company yet where this label two times, one is on the production side and one is on the manufacturer side. We’re the first company who has these two labels and we are going to certify a lot of our users for the user label. And at the same time we’re at the moment working on a navigation system which is going to receive the CleanImplant label as well. So we are going super clean. And because I think this is going to become a huge issue in the future, we know that from the silicon breast implants that this is going to be a really big thing. I strongly believe in that. And so my idea ten years ago when I first heard of it, I said you can’t beat him, meet him. And so we worked super hard and invested a lot of money, spent a lot of time and money to be able to be according to the really strict rules of the CleanImplant label and Foundation. This is something that is, in my opinion, really important as well.

And of course, there is no other material. Let’s say if you compare titanium and zirconia in titanium, I personally believe in zirconia. It’s much easier to be super clean on the surface. Why? Because the last process is a process with 1500 degrees, for example, this is going to burn off everything, what was there. And you just have to create a kind of interface how you get it out of the oven straight into the clean room. And then not to make it dirty again. But we’ve worked on that now for 20 years and we’re able to offer a super clean implant. And so I would say today at least, the SDS ceramic implant is on a much higher level in any aspects than any titanium implant. So I think that is the reason why we’ve been super successful in 21. And I believe it’s going to be the same, maybe even more in 22.


This is really exciting. And actually this brings me directly to my next question, which is what are the plans for this year? What are SDS’ plans for the year 2022?

Dr. Ulrich Volz

We are now working super hard, the whole  team. We’re using, let’s say, the time of Lockdown, what we always perfectly anticipated and forecasted, so we knew when it’s going to open again the last two years. And we have not planned any physical event at our education center. Actually, we’re using the time and we are making it at the moment again, investing money, making it again bigger and nicer and better education center. So we won’t have any physical event until end of April and we’re using the time to kind of build a structure into our huge concept. I mean, there is no other implant company definitely has got such four dimensional concepts, how to treat and how to make the surgeon’s life better and to improve the health of the patient. But to be honest, when you start it’s a little bit difficult. You have to be really dedicated to get into the “ALL IN ONE CONCEPT”, how we call it, what is on the medical side based on the biologically immunological side, based on the physicals concept, what are you approving in the clinic day by day. But it is, to be honest, a little bit like I would offer you a yoga course and we’ll ask you in the very first course to bend your foot behind your neck, for example.

So if you’re able to do so, it’s exciting and it’s great. And it proves that your flexibility is really great, but it’s too much and not attainable for many dentists out there because I still remember when I started dentistry 32 years ago. It is you improve year by year by year by year. Some are more talented, some are less talented, but at the end it is year by year you become better and better, definitely, if you stay healthy and energized. This is not their good dentist and not so good dentist. It’s like it has something to do with the experience, what you could collect by the years. But we do not want those dentists to have to wait for another ten years and collecting more experience before they would start with SDS ceramic implants. So we have built a lot of structure. I would say 22 will be the year of structure and support. So we have started to build a structure and have built three levels. So the first of those three levels will be generally we call it SDS Light, let’s say the beginner level, the basic level, the starter level. So to get the feet wet and to have successful, easy, quick access to ceramic implantology by SDS.

So this will be based on healed and delayed implantation sites. So with easy to reach goal, you would focus on the six basic shapes. What is the 3.8 and 4.6, 8, 11 and 14 millimeter. By the way, we are going to launch a new implant around April/May. What will be the 2.1 value implant. It will be a really nice implant, the same shape, but much easier and cheaper and already altogether with the post. So you just buy the implant and everything you have in the first place, so you don’t have to have a second order. What would be as well easier for us. And this will be just in the shape of 3.8 and 4.6, 8, 11 and 14 mm. But of course you can use the regular implant.


Will the regular implant also receive an upgrade?

Dr. Ulrich Volz

The regular implant will get an upgrade as well. Let’s say we already have the new upgrades in US now for two years. It’s SDS1.2 and SDS2.2. It’s exactly the same then the implants we have sold in the past year. But it’s beautiful packaging, it’s gamma sterilized and the package has a little window where you can see the implants of what you see, what you get. It’s even a little bit more stable and a little bit more precise in the thread. And it’s the one who has received the CleanImplant Lable. So it’s the cleanest implant ever. And we have already started to do kind of a silent or soft launch in the second half of the last year because we were not able to produce enough implants because of the huge demand of the SDS2.0 and SDS1.1. But the official launch will be around April and May. So stay tuned, we will inform you about that. What I wanted to say is that in this basic level you could start with the basic shapes of the, let’s say, premium implant and those six shapes but you could use as a one-piece or as a two-piece implant at the same time of the new 2.1 Value implant.

Then the next level is, let’s say, an advanced level where we are focusing on the immediate implants. I mean, in general, ceramic implants are way better than titanium implants if it comes to immediate implantation. Why? Because there are no free electrons on the surface. So there will never ever be an inflammation around a ceramic implant. Just if you take care about the biology and the immunology, that means that you take care about the vitamin D3 & K2 and some others. So in this level, we are taking care of D3 & K2, Omega 3, magnesium and vitamin C for example, with supplements. But in titanium it quite often works. But if something goes wrong, you’re going to face a huge defect because titanium has got free electrons on the surface. So there could be an infection, inflammation, but you will never see that on ceramic implants. The second thing is the shape plays a big role in immediate implantation because you need root shaped implant. One should be not tapered. So our implant is not a tapered implant. So we call it step implant because when it starts at the gum line it’s vertically, then it’s angled, then it’s vertically and it’s angled as well in the core adjust the outer shape.

That is what we call the dynamic thread is like parable whatsoever curve and that means that any place of the thread there is a different depth of the thread. So it starts with a very thin epical part. So you could easily get into the drilling hole even if it’s the angled side. Like when you drill for an incisor you always are going to drill palatinal into the socket. And if you would have a parallel implant or cylindrical implant it’s impossible to cut the thread into angled drilling side. So this is why the SDS implant works so well in any sites. And even we are able to do lower and upper molars as immediate implants. We have done thousands of those and they work perfectly. And with the development of the balcony implants we have a perfect emergence profile. So this second level. What is let’s say the advanced level for immediate implantation is able to place implants in all sites and to create even if you would not go in the middle. Like if you would use the palatinal socket or the distal socket in the lower through the balcony implant you would have a perfect symmetrical emergence profile which is quite wide because it’s 6 to 8 millimeters. Highest level like it was is let’s say the all in one concept where the SWISS BIOHEALTH CONCEPT comes to play.

And this is why this ALL IN ONE CONCEPT we are not anymore going to teach outside of the education center because we need the CLINIC right beside the EDUCATION CENTER. So it will be always part of the CERAMIC IMPLANTOLOGY WEEK. So that means the first day at the same time we are going to have a huge ALL IN ONE surgery and several times during the day we are going to connect to the surgery and have live hospitation at the same time. And especially on a Saturday we’re going to do a lot of practical education in the CLINIC. So it will be based on the first two levels. That is something those participants should have been educated before already. And then we will focus just on the ALL IN ONE CONCEPT if I come back to the yoga course. So the first step is like you would get with your fingertips. So the basic level if you get with your fingertips to the floor and the immediate implant level is maybe with the flat hand and then in the ALL IN ONE CONCEPT you would bend your foot behind your neck something like this. Another thing is that we are working very hard on the concept of navigation.

We have already last year launched the AIM system. What is system where what is an ad hoc navigation system where you don’t have to plan anything. You could just start with it but this is more for the experienced user and it’s more based into the ALL IN ONE CONCEPT but we are going to very soon we are going to provide very nice. Beautiful and especially super healthy and clean that is why we are going to go for the CleanImplant Lable for the navigation concept as well where you would receive where you would support the user there with the position of the implant and the shape and the position of the temporary and like other companies like Straumann “Smile in the Box” we’re going to support the user with everything you would need to do a guided surgery and to follow the completely digital workflow. That is something that is definitely new and will be another, let’s say vertical level, which of course you could use if it’s in the basic level, if it’s in the immediate implant level or if it’s the ALL IN ONE CONCEPT and as well we already have improved our prosthodontics concept where we are not just have integrated a method to test the perfect position for the bite with the method of Dr. Klinghardt, the Autonomic Response Testing but as well we’ve integrated Dr. Mosetter used to be the sports doctor of the US soccer team and he’s taking care of many Olympic gold medal winners and he is the founder and inventor of the Myoreflextherapy and this is something he’s training our participants on the jaw and neck muscles. So this is instantly within two or three minutes you will be able to relax all the muscles around the bite so if it’s the chewing muscles or the muscles in the neck and so that is what you need to test and install the perfect bite. So of course you could send your patient to a physician to relax the muscles but just when they come back and on the road being in a hurry whatsoever. Waiting too long at the traffic light they will be tense again and it will be impossible to find a perfect bite and as well we have started to address not just the upper chain but the lower chain as well that means it’s all connected and we are taking care now of the posture of the patient so we joined forces with a company with the world market leader of the inserts what you put into shoes so to make that even better so this is a really top top professional and outcome focused prosthodontics concept. And as last year we’re going to still have the weeks, like the CERAMIC IMPLANTOLOGY WEEK where at the end I’m going to teach in two days the ALL IN ONE CONCEPT. We will have the BONE AUGMENTATION WEEK, where we created very good structure for bone augmentation and a very nice system with our BISS-System “BONE IMPLANT STABILIZATION SYSTEM” where you could even place implants without

any contact to the bone and it works. We have proven that in many cases and we will have the ART FAST TRACK WEEK, we will have the PERFORMANCE WEEK, with some of the best doctors and speakers from the Sports medicine. You know, last year we had the annual Sports Medicine congress at our education center and it will be the same this year. So we have learned a lot from this area, what we have half implemented into our concepts as well. We are going to have some roadshows where I’m going to teach the concept about immediate implantation and we’re going to have a lot of micro events where we’re going to teach the first level. And so, as I said, everything will be perfectly structured and based on different levels. And as well, the education will be based on those levels as well. And inside those levels, as you know, we have every week one or two virtual shadowings. We will have from February on every week a webinar, what will be at 06:00 p.m., European Time Zone and in English at night, European Time Zone. So it will be perfectly accessible for our US community.

And we are taking a lot of tutorials. We have now these podcast. So I think education and staying and transport of information and support of our customers will be a very big focus this year. And of course, to finish with that, the most important event again will be the JCCI. And based on the huge success of the first year, we were able to now to have five ceramic implant companies. So beside SDS there will be Straumann, there will be Ceramex, there will be BreDent and there will be Patent. So it’s amazing that we’ll have five ceramic implant companies at the JCCI congress. We will have several organizations besides the ISMI, the Society for Blood Concentrates and biomaterials, which was founded by Professor Ghanaati, and we will have the DGOI, possibly one or two more and they’re going to bring the most amazing speakers to this venue, which is very hard to get in contact to in other places. So just to give you one example, we will have Professor Albrektsson, I mean, he’s one of the biggest pioneers in dentistry or especially in implantology, and he’s going to come to our place and many others on this level.

So this is really going to be a huge congress regarding the companies presented there, regarding the organizations presented there, regarding the speakers, and of course regarding the quantity, because we have already sold 96% of the physical seatings that you will have interactive Zoom and of course unlimited number of online participation reconstructing our education center. So to have another more 40 physical places and we’re expecting way more than 500 participants. So this will be a huge congress this year. And yeah, I think that should be all. And let’s say the most important thing, of course we’re working on a thousand things at the same time, but I would say this is the most important part of improvement on changes and benefits, what the SDS used and the community for income could expect from SDS in 22.


Yes, I myself feel a great sense of excitement for what is to come. And I’m even familiar with the concepts which are being developed currently. And I can tell you that great things are coming up. And, yes, I think we can close this episode. And it was very informative and it was great to talk to you. See you at dinner.

Dr. Ulrich Volz

Thanks a lot. It was a lot of fun and I think it’s a great format. It was your idea. And I think it’s a huge benefit for our users, for our community out there, to get more information in a special form where they can listen to it while driving. Always happily engagement.


Exactly. Thank you so much and bye.

Dr. Ulrich Volz

Thank you, Coco. Bye bye. See you.