Categories
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
Yeah.
[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
Okay.
[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
Yeah.
[00:17:44.590] – Dr. Ken Serota
Okay.
[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
Right.
[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
Okay.
[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
Okay.
[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
Sure.
[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
Right.
[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
Right.
[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
Okay.
[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
Right.
[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
Right.
[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
Right.
[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.
Categories
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.

Carolina

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

Hello!

Dr. Mathias Sperlich

Hello!

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

Yes.

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!