Dr Pelekanos, how have implantology workflows changed since you began in dentistry?
Implantology in the 1990s, when I started, was mostly bone-driven. Implants were placed by surgeons who had little to no knowledge about prosthetics. In recent years, implants have been placed more regularly in accordance with a prosthetic plan. This means that guides are manufactured prior to implant surgery, leading to a more favourable implant position and thus helping the restorative dentist to finalise the reconstruction.

In other words, in the past, implantology was 80% execution and 20% planning, whereas today it is 80% planning and 20% execution.

What are some of the factors that have led to these changes?
This shift has been accelerated in recent years, in large part owing to technological advancements. Computer-guided implant surgery has become an everyday clinical workflow in my hands, despite the fact that I have placed thousands of implants without computer guidance over the course of my career. I always say that conducting guided implant surgery is like using Google Maps—everybody uses it to avoid traffic, even though most of the time we know how to get somewhere.

When and how did you become a practitioner of digital dentistry?
I was lucky enough to finish my postgraduate studies in Freiburg in Germany under the supervision of my mentor, Prof. Jörg Strub, to whom I owe my career. In Freiburg, I learned to be critical and to work to the highest standards and to the highest level of accuracy; therefore, entering the digital world was a crucial step in my dental journey. There was a time when I did everything both digitally and non-digitally to prove to myself that the digital approach was reliable and worth following. Now, this has changed, and for the past six years, I have worked almost exclusively using digital tools and technologies.

What benefits does digitalisation bring to scanning, designing and treatment workflows in modern implantology?
First of all, the single most important factor in becoming a better dentist is that you need to plan more when using digital resources. Of course, nowadays, the use of intra-oral and facial scanners, combined with DICOM files from CBCT imaging, gives us the opportunity to effectively have the digital patient in front of us, even though he or she is not there in person.

Finally, what we gain by using digital technology is time and quality. This means that we can accelerate treatments by milling or printing immediate or final restorations before we even touch the patients. Digital technology is also able to power everyday workflows. This means that we can provide same-day teeth to our patients using monolithic restorations with materials that have excellent physical and aesthetic properties.

“What we gain by using digital technology is time and quality”

What advice do you have for dentists who are planning to transition from more traditional workflows to digital workflows?
The young generation of dentists will grow up digitally anyway but, nevertheless, my advice to the majority of dentists who are still working with traditional workflows is simple: Go for it. Once you start, you will realise that there is no turning back, and for good reasons—simplicity, versatility and quality of life being the most important ones.

What role does 3Shape and its suite of solutions play in your everyday implantology workflows?
The 3Shape TRIOS was the first intra-oral scanner that I used in my dental office. Since then, I have used almost all of the available scanners on the market, but I still prefer working with the TRIOS as I find it user-friendly and it fits well in my hands. In addition, my in-house dental laboratory is using 3Shape software that really makes our lives easier by simplifying procedures, saving time and delivering an extremely high level of precision and quality in our workflow for the benefit of our patients.

What will you be highlighting in your presentation at the upcoming 3Shape Global Symposium?
In my presentation, I will show, step by step, the digital workflow that we are using in our daily practice. I will analyse the implant abutment design and the digital workflow in the aesthetic zone through scientific evidence and daily experience as well as the indications and the limitations of the digital process depending on existing materials and known procedures. Chairside intra-oral scanning, the handling of digital impressions, the usual mistakes, and the full process from digitisation to manufacture and final delivery will also be clarified. Clinical cases will be presented discussing different clinical approaches, showing the synergy of older and newer biological concepts in the treatment workflow.

What would you like participants to take away from your presentation?
After the presentation, I would like the participants to be able to:

• understand the indications and limitations of intra-oral scanners;
• design the implant position properly according to the implant design and prosthetic set-up;
• become acquainted with the different materials that are used for monolithic restorations in implantology; and
• recognise weak links in the digital workflow.

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