Episode Transcript
[00:00:06 - 00:00:26] Rob: Hey everyone, I want to take a moment to share how honored our Team is to have received the Top Customer Service Award from exocad this year at Lab Day, Chicago. It truly means the world to our entire team at Evolve. Every day we work to push the standard higher and guide our clients to success. A Special Thank you to exocad for the acknowledgment, and thank you to the dental community for your continued support as workflows evolve.
[00:00:32 - 00:00:49] Rob: Welcome back to the Evolution of Dental Podcast, brought to you by Evolution Dental Science, where we share the stories of the people and the technology shaping the world of dentistry. Today's guest is the president of ID Dental, and an expert exocad trainer, Dora Rodrigues. Welcome to the podcast. How are you?
[00:00:49 - 00:00:51] Dora: Hi! I'm good. How are you?
[00:00:51 - 00:00:52] Rob: Doing well. Thank you for being here!
[00:00:53 - 00:00:55] Dora: Of course! Thank you for the invitation!
[00:00:56 - 00:01:01] Rob: So, how did you get into this? Did you wake up one morning and go, “I'm going to teach the world exocad!”?
[00:01:02 - 00:02:27] Dora: Haha, I wish! I don't know, I, you know, I started very analog. And once I saw the transition to digital dentistry, exocad was my choice. I mean, it took me a couple of years. I remember going to Chicago, I don't know, 2018, 2019, and I would go between exocad and 3shape attending both lectures, both sides to figure out: what am I going to pick? And I picked exocad just because I'm a full arch lab. So I do full arch all day, every day. And, I went that route, and after a couple of years, I just got certified last year, I decided to teach just because I saw… I don't know, I saw it was so hard- not that it was hard. It took a long time for me to actually figure out and be in a comfortable place. And I feel that there's different ways to approach the teaching side, and I felt that I could give that side of my perspective, why it took me so long to understand and learn and how to transition and teach others. So I was like, let me give it a try. Let's see where that can take me. And I just got certified last year. And it's great because I was the first woman here in the US. Well, the whole continent, but who’s counting? Haha!
[00:02:27-00:02:28] Rob: Who’s counting? Haha!
[00:02:28-00:02:36] Dora: So I was the first woman here in the US. So it kind of gave me like, oh, I was the first one, so it's pretty cool! So, here we are!
[00:02:36 - 00:02:50] Rob: That's awesome. And so what were some of the difficulties that you ran into learning? What kind of resources were you not seeing in the environment? And what do you bring to the table now that you feel really changes the environment?
[00:02:50 - 00:04:46] Dora: So I feel that with exocad or any digital technology or route that you pick, you really need the support and training, right? And, I was lucky. I actually went with evolve, and they were my resellers for exocad. I got really good training out of it. So I focused on the full arch because that's where I wanted to go. Although I dive into the full arch right away, it still took a long time to fully understand the software completely. There's just so much and so metimes I'll say, it's just full arch. There's so many things that you can do with full arch that it's really hard to figure out everything that you can do with the software. So, because I was so into that field of the full arch and there was so much to learn. It took me so long to understand. I decided, you know, there's an easier way I've been in this for so long. I figure out the workflows. I figured out an easier way to get to the beginning, middle and end. Let me see if I can use my personality and my knowledge and teach others the way that I would like to learn back, you know, in the day, or at least from my perspective, what I can do. For other people. So I decided to get certified, and that was last year. So, it's been great. It's still, you know, I was the first woman in the US. Not that it is a big deal. It is a big deal for me. Just because when I did it, I was the first one that went through that route. But it's great. The guys from exocad and everyone from exocad, it's amazing. All the trainers. You know, all the- there's such a good bond with the trainers in exocad too, that I feel, at least from my perspective, the ones that I bond with. It's like there's no competition. It's like everyone helps each other. It's pretty cool. It's pretty cool to be within the trainers of exocad.
[00:04:48 - 00:04:58] Rob: They're an awesome crew. And so you're the first, certified, you said, woman in the field, right? First in the continent, in the country? Here, in the US. That’s incredible!
[00:04:58 - 00:05:13] Dora: Here in the U.S. Yes. I think there are two others? Yeah. So from my understanding, when I was, last year, there were two other women that were certified, I think one in India, one in Portugal. I don't know if they still are, but here on this side of the continent, I was the first one! Haha!
[00:05:14 - 00:05:18] Rob: The first one! So what did you start with? Well, you opened up courses directly into full arch design?
[00:05:18 - 00:06:02] Dora: That's all I do. That's all I know. And, you know, funny story: when I went to my certification, my trainer, he was like, okay, let's start with the easy stuff. We'll start with crowns and bridges, like, sorry, I’ve never designed a crown or a bridge in my life! Haha, because I went into full arch from the beginning. So that's what I did my entire life before. So that's what I wanted to get certified in. I mean, I could go through the entire certification, but even now teaching, I want to focus on the full arch only because that's where I'm comfortable. That's where I know all the little nuances, all the workflows, the shortcuts. And that's what I'm trying to, you know, teach other people.
[00:06:02 - 00:06:05] Rob: Yeah. Full arch is kind of the “Wild West” if you don't have somebody to guide you.
[00:06:05 - 00:06:37] Dora: Yes. And I feel that nowadays everyone wants to go to full arch. And there's a lot. It’s not just knowing, and I do have a background. I've been doing this for almost 20 years in the full arch field. and I feel that it's not just knowing how to design. There's just so much more that you have to take into consideration that I see sometimes , some people might not take. And you know, we’re working with patients-
[00:06:37 - 00:06:41] Rob: What, for example, would you say is a common thing that people don't take into consideration?
[00:06:42 - 00:7:58] Dora: When you're planning for a full arch, you can't just extract the teeth from your scans and place them in there. You have to consider bone reduction. You have to consider the muscles, the anatomy of the patient. If they lost vertical, if the vertical is too open, there's just so much planning that has to go into the all-on-x on the full arch that a lot of people are not doing. And I see I have some cases from doctors that we didn't start the case, patient already has a temporary and they want me to do a final and it's completely… It's bad. There's not much room for you to make it better because the standards, or like the protocols that you had to start with, they were not followed. So after the implants are placed and heal like there's not much to do if the planning was done incorrectly just because full-arch it has to be, all the planning has to be prosthetic driven and it's not. A lot of times they don't take that planning into consideration at the beginning. And that's where it fails. Once you start going to temporary to the final. And you see some not so great cases that you might be able to help somehow, but it's not the perfect outcome at the end.
[00:07:59 - 00:08:08] Rob: Sounds like you're saying that, if you don't plan, you're going to plan to fail, and you really have to coordinate between the lab and the doctor as to what the final outcome and expectations are. Is that right?
[00:08:08 - 00:09:06] Dora: Yes, that is correct. And I feel that a lot of times, “oh, don't worry, it's just a temporary” I put a lot of time into planning. Even my lab, we're a small lab and focused on the, you know, the planning, focused on the outcome more than being fast and having a lot of surgeries still to do or a lot of cases. If you do not go through the planning the right way, your temporary space on the planning. So once you go to the final, there's not much more that you can do. You can change the tooth position and shapes and sort of those details. But in terms of the bigger picture of vertical dimension, bite, occlusion, the bone reduction, and I feel that is the most important thing, transitional lining, things like that, they might not be, you know. If they're not evaluated at the time of surgery and not done properly, the temporary, it's a temporary. But at the final, there's not much more room for you to do to make things better.
[00:09:07 - 00:09:18] Rob: So in your experience, what's the first step for doctors who are just getting into full arch, who saw it online and they're like, wow, that's a great idea. And that's a lot of money. And maybe we should do that in my practice. But where do I get started?
00:09:20 - 00:10:19] Dora: They need to get some training, because there are a lot of doctors that they figure, you know, I can place some implants and make it work. It's not just placing some implants. And if you're going that route, you know, at least team up with an oral surgeon or a lab that knows what they're doing, or at least that they could help them understand better. And I know from experience, because I work with some oral surgeons that will bring their referrals. They're first timers, they’ve never done an all-four, and they have no idea what to do. But it's okay because I know the oral surgeon knows. So we can walk through the process with the restorative doctor, and then they understand what needs to be done. If you go in blind and you're trying to do the surgery on your own, and you're trying to figure out and do everything in-house or send it somewhere just because, you know the patient is going to suffer. And it's just not good, right.
[00:10:19 - 00:10:25] Rob: Yeah no. Ultimately, you need the patient to get the best possible outcome for everybody involved.
[00:10:25 - 00:10:26] Dora: Yes.
[00:10:27 - 00:10:34] Rob: And so how's, teaching exocad influenced the way that you approach these cases, and how has that changed how you look at your own lab?
[00:10:34 - 00:11:12] Dora: So I don't- I'm not using exocad courses to help me in the lab. Like most of our- because we're just full arch. We work with our oral surgeons and our referrals, so we don't advertise more than that. I only work with the doctors around my area just because I want to make sure I am there on the day of the surgery. I want to do the planning. I want to work with them at the surgery and then the final. So, I can design for doctors out of state. But, I prefer to keep everything close by. Small environment kind of thing.
[00:11:12 - 00:11:15] Rob: Yeah. Like you were saying earlier, good planning leads to good results.
[00:11:15 - 00:13:20] Dora: Yes. And I do use exocad. Not so much to get doctors. It's more to teach other people, other labs, how to utilize it, the software, and how they can be efficient. I don't believe in- I don't feel like there's a competitor. I teached labs around me, or I did some lectures and labs around me and I'll have some people saying, why are you teaching the lab down the street? Because they're your competition. I don't think they're my competition. I know what I know. Doctors work with me because of how I am, the relationship that we have and what we can bring to the table. So teaching other people at the end is going to help not just exocad, but the full arch in general. You will help the patient down the road. There's so many doctors to work with. There's so many patients that need this service. Why not be able to provide, you know, a better understanding of the software and the workflow in general so other people can utilize it and other patients can, you know, benefit from it. And I do talk a lot to patients a lot because I did work on my dad. My dad had an all-on-four double, last year. And it completely changed- not a complete change because I already, you know, I deal with patients for so many years, and I see the before and the after. I see what they suffer and what they don't. But I never had such a close experience of what the patient goes through after the procedure, before the nerves and the excitement, the “I don't know what's going to happen”. And then the “after”, the recovery and everything. I went through that with my dad and everything was great, but he gave me a different perspective. I knew where to take him. I knew who was good to work on him. There's some other patients that don't know, and I wouldn't, you know, it's just hard to think that patients can go through that phase of, I spent all this money and the outcome was not.
[00:13:20 - 00:13:28] Rob: We don't know where it's going and hopefully it ends up well. How's that influenced how you approach these cases? Have you changed anything since going through that process with your dad?
[00:13:28 - 00:14:30] Dora: No, I did not change much. But there are other things, like little details that I looked into, my designs and my conversions and the process, just because I got that perspective. I remember one time, he was on the temporary and he would say like, “This hurts. Something hurts here”. I was like, “There's nothing there. Everything is smooth, there's nothing”. And at the time of impressions I just smoothed the area down slightly and it's like, “oh my God, it doesn't hurt anymore”. There was nothing there, but just a little bit of extra support on the lip. He felt it and he was complaining about it. So little things like that, that it doesn't make a big difference. But it made me understand. You know what? Maybe when I'm planning the case next time, I won't incline the canine so much, I won't do so much thickness around this area or that area. So just those little things that- the complaints of the patient that I didn't get to hear because, you know, they complain to the doctor, not me. In this case, I got the complaints.
[00:14:31 - 00:14:43] Rob: Absolutely. And the doctor may take those complaints and not necessarily share it with the lab, which is always another, I mean, pardon the pun, pain point between the two. So and like you said, it's a small detail, but it mattered to him.
[00:14:43 - 00:14:43] Dora: Yeah.
[00:14:45 - 00:15:04] Rob: Which means it ultimately matters in the final results. So teaching your exocad classes, how has that influenced how you reach out to other labs? Where do you think labs should get started? If a technician is wanting to first step into full-arch in themselves, like their doctor just sent them a case and they're like, I don't know what to do with this. Where do they start learning?
[00:15:05 - 00:16:52] Dora: So, for others I mean, I know their labs want to get better at designing and production. I don't prefer- I have a very small presence on social media. I'm horrible at social media. I just started out like, okay, let me put more out there, but, more is like people that know me, they know their full-arch and referrals through other colleagues, and small practices that they want to train someone. They have 1 or 2 people in-house that they want to train them on exocad so they can do… start designing in-house. So I don't promote. I just have my presence, social media. and that's how my courses go for now. I do have some lectures that dive into more. Like last year, I was invited to go to Mexico to a big conference, Digital Days. And they tied to a course, a two day course. They had 30 plus people, people that were on waiting lists, and we’re planning on going back this year, maybe to two different locations in Mexico to do it again just because of the promotion that they did. Me, I'm horrible at doing my own, haha! But yes. Now this year, I have three lectures and, one is going to be overall full arch, with GC America. And the other one will be with Zahn [Dental], it’s going to be actually a live design, and all the versatility of exocad details. And like those foundations that you should have to be more efficient with your design. And then the other one is going to be with exocad also for the new Split-Bar workflow that just became available with version 3.3.
[00:16:53 - 00:17:00] Rob: Yeah, that split-bar, that is an awesome feature. How has that changed how you work with exocad? Is that something you've incorporated into your classes?
[00:17:01 - 00:18:09] Dora: Yes, and in my workflow as well. So, we were using Blender. We still use Blender, but any PMMA titanium bar that we do, we do exocad now because efficiency is just so streamlined. And that's the thing. If you know exactly how to set up your case properly, you can go from the scans to design for a try-in and then split the bar to a final. If you're not sure how to set up the case, you might end up doing it, redoing it, redesigning 2-3 times. And that's what I try to bring to the teaching side, is that you don't have to redesign three times, because that's what I did back then. Like you learn one way, this is how you design a temporary. This is how you design a bar. This is how you design a final. But there's a way to combine them all and just design once and just go back and forth and, you know, going around the software to make it work so you don't have to spend so much time. So that's what I'm trying to focus on. It’s not being fast, setting teeth, it's knowing the software enough to only design once because you know what to do back and forth.
[00:18:09 - 00:18:42] Rob: Yeah. No, it makes perfect- well, it makes perfect sense to me. I fluently speak exocad. Full disclosure. But for those who don't like, what are some of the things that you've seen change in the last couple of versions, like what's come out with the new 3.3 that launched this past November that you're super excited about? You mentioned the split bar. And, people who don't do full arch or who are not very familiar with the newer versions of exocad may not be familiar with the idea of what even is a split bar. Can you speak to that a little bit?
[00:18:42 - 00:21:00] Dora: Yeah. So my favorite, favorite, favorite feature is not from 3.3. The best feature that I think exocad came up with that is amazing is being able to save your tooth positions, because it's just that. You can design a denture for conversion, you can design the prototype, you can design a final and your setup is done. You don't have to change a thing unless you have to. And that gives you the opportunity also- not saving those tooth positions for that case, but for any case that you want down the road, if it's pretty much a similar mode. So you can with exocad libraries, you can design a couple of cases, design 5-10 cases, spend some time really nice setting up occlusion, double upper and lower and save them. In any case that you have you need to be very quick. You can just grab them somewhere that you saved, import them and away you go. That is the favorite of the favorite features.that is amazing. It’s the speed of efficiency with full-arch is there, saving the tooth molds. The split bar workflow is the new feature on 3.3. And it's great because again, you can start designing your try-in, stop there, print or mill your try-in to have the patient wear that try-in or prototype 2-3 or 4 weeks. And then if everything is good, you go back to the same scene, to the same project and you just split the file and move along to your final restoration. So it's efficient. Again, because before, if you needed to design a bar, you had to go through other softwares or you had to go again to exocad but open a new file, redesign and import all the scans, design a bar, save it, bring it back to the other scan to the other project. So now it's efficient. Everything is in the same scene, the same project. And you can just go straight from beginning-to-end to a bar or just stop halfway, print a try-in or whatever prototype, and then come back to the same, to the same step and then proceed. So I feel that is great because of the efficiency. We were able to do bars before, it’s just you had to go back and forth and go through different workflows that now you don't have to.
[00:21:01 - 00:21:40] Rob: Yeah, it was more of a workaround, like you could do a bar, you could do a full arch, but doing them together was not not quite so easy. Now it's almost unbelievably easy because yeah, it's made bar design so simple and you don't have to worry about where your bar construction is going to be because it's incorporated directly into and related directly to your final, which is so cool. One of the things I really like about the new features with the 3.3 is the symmetrical tooth positioning that they have as well. And the additional free forming in tooth positioning where you can 1 to 1 match, has that influenced the way you, the way you do full arch at all?
[00:21:40 - 00:22:28] Dora: Not really. Because the full-arch is the full-arch, you're working with all the teeth, right? I see, like the symmetry and the mirroring teeth is good for crown and bridge and like short spans of designing, For the full arches we're working on all the teeth at the same time. And a lot of times we don't- nothing is symmetrical in the face. Right. So you might go from symmetry, try to position the right, the same. You might try to position all the same arch, of occlusion. But we're not symmetrical. So there's always some changes that you did. So I don't use much of the symmetry. It’s great. It is cool. What I like about the new features is actually the bridge gap, because before-
[00:22:28-00:22:30] Rob: Oh, yeah!
[00:22:30 - 00:22:34] Dora: Before it was really hard to bridge-
[00:22:34 - 00:22:45] Rob: The bridge gap is something that even a lot of non-dental CAD softwares can't do, which is pretty good. Yeah. Go ahead, please, tell us about the Bridge Gap because that is an awesome feature.
[00:22:45 - 00:23:12] Dora: The bridge gap before was like you can open holes, you can close holes. But every time there's something open that you wanted to extend, you would not be able to. So you would have to go to a third party, to another software and bridge, extend the borders if you want to, and then bring the imported scans back again. So now with the Bridge Gap, you just select the area and it closes it on its own. So it's pretty cool because you don't have to go back and forth between different softwares.
[00:23:12 - 00:23:15] Rob: It’s so helpful for all sorts of things.
[00:23:15 - 00:23:22] Dora: And we all know we don't get great scans all the time. So we do need that function.
[00:23:23 - 00:24:01] Rob: Absolutely. And for those who are totally clear on that, like it means that if you have a hole that has an opening on one end and so more like a U-shape than a perfect circle, you can still close that hole with the bridge gap as well as extend the scan data, because especially things like full-arch or even dentures, where it's very difficult to scan, toward the edge of where you would have a border, and sometimes you just need that extra wiggle room. I mean, in the past, what we would do at Evolve is we would actually save a 3D printed model. Exactly. And then try to bring that back in as your scan. And now we don't have to jump through that hoop as well again. Yeah. It’s incorporated into the work.
[00:24:02 - 00:24:26] Dora: Yeah. We were doing that too, just bringing it through the model, design, extending the borders and then save, resave, readapt, reposition. It's less clicks. It is not that it's very difficult to do again once you know the workarounds but it's just less clicks. It makes you more efficient because instead of doing 4 or 5 different steps, you can just now go to that option and bridge the gap and proceed.
[00:24:27 - 00:24:38] Rob: It's so cool. So how's that, you've incorporated that in your lab, obviously, with the full arch design. You've incorporated, I'm guessing based on some of the things you said, a lot of 3D printing, is that right?
[00:24:39 - 00:27:40] Dora: Yes. I am fully digital now. I mean we still do for the full arch. We still do convergence, immediate loads in the patients in the office the same day. We have all the technology. We have photogrammetry. I got my photogrammetry scanner back in 2020. So, now, well, you know, nowadays there's so many systems that you can use. Back then five years ago, there were, like, two cameras in the market. So at the beginning, I kind of thought a little bit of digital because I was afraid that it was going to take my business away. I was fully analog for so many years, and I was working for a lab before I decided to venture on my own. And when I left, I thought, I'm amazing. I'm really good at what I do. Completely analog. I'm super fast, I'm going to do great. And then I see all this technology… There's scanners. Doctors are designing dentures. Like, oh my God, what did I do? Why did I quit my job? But you know, I fought it for a couple of months, but then was like, okay, let me see. Technology's here. Right? Everyone is looking for the latest phone. Everyone is looking for the latest technology device. So let me see how it can help me since I'm on my own. Maybe technology is going to help me grow this way because I'm on my own. Maybe I don't have to work so much. And that's where I start. I started by getting a scanner, I got an intraorall scanner, I got photogrammetry, and I started a little by little incorporating additional technology into the lab. Just for the sake of, you know, I want to go. I want to be in the front. I don't want to be behind and waiting while everyone is advancing. And then I had to run to them because I waited too long. So I decided to dive into digital technology, exocad, and everything by 2020, and I started incorporating all that. So I'm able to offer digital services not only for design to accounts out of state, but also when I go to surgeries, we can either do the conversion the same day or we can do the digital workflow that we deliver, which is to take all the scans with all the technology that we provide, that we bring to the office and deliver for the next day. And the really big difference is if I work with accounts for like an hour, an hour and a half away from the lab, and they don't have a 3D printer or anything in the office, it makes it really hard to, you know, get all the scans back to the office, do everything, redesign, print here, and then send it back. The patient waits a long time. And it's not only that. It’s anesthesia, the time of the surgeon and the staff and everything else. So if they're not okay with delivering the next day because of a lot of accounts, it's like, no, the patient wants to leave with teeth the same day, so we'll do it in the office. But we do offer both options, for that purpose. So I have had 3D printers for a couple of years now and only now, actually, at the end of last year, we added two mills. So now I am fully capable of doing everything in-house. So exciting!
[00:27:40 - 00:27:48] Rob: It is so exciting! And in light of that and all the new tech that you have, where do you see your lab in maybe another 5 or 10 years?
[00:27:49 - 00:29:50] Dora: I see it growing, growing more- But that's the thing. I'm very picky. I don't work with everyone. I try my best because, you know, even sometimes when I have bad accounts that they don't pay attention to details like we want them to. Again, I think about the patient. And if I can do something, even if I don't like this dentist or the way that- not that I don't like the dentist, but if I don't like the way that they work, I try my best to help them change that, because ultimately, I'm thinking about the patient. But if that doesn't work, you know, I’m ok firing accounts because I don't want to deal with this. You know, I keep telling you what to do, and this is the right way. And I'm very detailed in explaining why. And then I'll have someone they say, no, no, no no no no no, don't explain it to me. Just tell me what to do. Like that is not a good sign because you need to understand. And the reason that I'm always being so picky in detail about what needs to be done is like, if you understand the purpose, then you don't need to- I don't need to tell you again what to do. So, I am okay with- I’m getting accounts through referrals because I don't do marketing outside. Everything that I get is through my oral surgeons or restorative doctors, and I don't like it. I kind of don’t like to work with doctors that I don't know, like, it's three parties right? It’s me (the technician), the oral surgeon, and then the restorative doctor. And if I know one of the other two sides, I'm okay. If I'm going to work with two people that I never worked with before, let's see how it goes. And depending on that first interaction, I will dictate, okay, we can try again, we can work again, or no. It’s just not going to work. And it happened before and I'm okay with it. I don't need- I want to grow, but I don't want to grow crazy because I want to keep it very, you know, detail oriented.
[00:29:50 - 00:30:12] Rob: And it sounds like it goes back to what you said originally about having a good plan put together both with the oral surgeon and the practicing doctor. Yeah. If you can't coordinate with them and you can't work with them, and they're not willing to listen to your input, then you're not going to have a good plan going in. And that's not going to be a good result for the patient either. Right?
[00:30:12 - 00:31:07] Dora: Yeah. Yeah-yeah. And that's the thing is it's like going back to bone reduction. Right. And this might be for people that are not aware even what the full arch entails and all the, you know, all the planning that we have to do, if I ask them that I need X amount of space for my restoration and they simply don't give it to me, there's just so much I can do with that space that they left me to work with. So at the end, if I have a very minimal restorative space and I know for a fact that's not going to work and something breaks… and something breaks, then it's like, well, whatever you did didn't work. Your materials are not good, or whatever you did is bad. Like it's not. I know I told you from the beginning, you know, restorative space is the important thing that we don't have right now. So there's just so much we can do. So little things like that is what you know, I'm picky about when I choose my accounts.
[00:31:08 - 00:31:27] Rob: Yeah, they're basically planning to fail because they don't have a plan and they don't want to listen to your input. And I like how you're talking about stressing the small details, because the small details may be small details, but they become big details. They become big problems if they're not addressed. And if it's not incorporated into the plan.
[00:31:27 - 00:32:42] Dora: Yes. Because that's the thing. The full arch, like if you are involved in it from the beginning to end we're looking at six, eight, ten months, maybe a year worth of work, right? So you need to plan initially and then you go to the surgery, conversion and sort the space, all those little details that have to be followed, those planning considerations that you have to be really good at. And then the patient stays another three, four, six months in a temporary, and then goes to the final. So it's not something that you can do today, something's not happening, something's wrong tomorrow, and you can fix it. Once the temporary goes into the mouth. Those implants are not to be touched within 3 to 4 months. So even if you see something wrong then, like, okay, it's just a temporary, we will fix the final. But once the inputs are integrated, there's just so much you can do. In some cases, there's just so much you can do to fix it. And what is fixing really? Because if it's just to position color, it's okay. But if we're talking about planning how the transition line shows and restorative space is not enough, the multi-unit abutments are coming through the buccal. Those are things that sometimes you cannot change.
[00:32:42 - 00:33:04] Rob: Yeah, it's no longer a fix so much as a Band-Aid. At that point. So, that makes me curious. What are some of the things that were maybe considered standard practice or essential, say, 5 or 10 years ago, that you don't really see as much anymore? And what do you think that we're doing now that's considered standard that might kind of fade in the next, say, 5 or 10 years?
[00:33:04 - 00:33:08] Dora: Umm. Hold on, repeat the question. What do you want?
[00:33:08 - 00:33:29] Rob: Hahaha! I threw a lot at you. So it just makes me think, what are some of the things that you saw 5 or 10 years ago that were considered essential or standard practice then, that have kind of faded out of relevance now? And what are some of the things that we're doing now that you think might fade out of relevance in the, say, the next 5 or 10 years going forward?
[00:33:30 - 00:35:16] Dora: I don't know if fading relevance- I feel that now with the show, we're able to pinpoint exactly what goes wrong or what's being done wrong, and how to fix it, because before, it's almost like taking a final impression. You know, the dentist will go through the jig, open-tray impression, and give you a tray for you to pour a model. That is it. That's it. Right. That model’s your master cast, it is perfect, it’s great. That's what you follow. That's what you use for your final. Now with digital technology, you can see if that implant position is wrong. You can see- you can align the tissue and photogrammetry impression and see if something matches or not. You can take two scans and see that both scans are different. So now, or like a bite from a patient's bite relation right. I had cases in the past that if we take four bites, all four bites are different. So how do we fix it? Before you would get one bite and like that's how it is. Now we can take four because technology allows us to. And you can see they're all different. Now what do you do? Just pick one? No. There's more advancement for that purpose. Like you need to figure out how to do things correctly. So in terms of the full arch overall, I don't see things that were done before and now they're not being done, per se. But technology does help planning a lot better with CBCT, and guided surgery. So there's more things now available because of the technology that makes us more efficient overall in the workflow.
[00:35:17 - 00:35:44] Rob: I think that anybody, especially those who're looking into this or even people who do this already, probably hear what you're saying and are already taking away a lot from it. And, so I guess it'd be a good segway to go back to your courses. So you teach these full arch techniques that you've learned all the new technology and how to incorporate that into your practice. So where do you teach your courses? How do people sign up for them, where do people find you?
[00:35:44 - 00:38:10] Dora: So, yeah. I have my lab, so we have a separate room for courses. [They] can go 8-10 people, very small. And then I have some courses that I can go to an office, I get some requests to go, either to teach other labs where they have like two, three, five technicians, just to streamline the workflow or in-house technicians for, like, a specific doctor or full-arch clinic. And, then I'll have the other companies that I deal with that want to organize courses on a bigger scale like the one in Mexico, 30 plus people, for their technicians who are there, you know, customers. So there's different ways. It's just a matter of planning it. Normally I make it two days, just because it really depends on the audience, too, because if you're a beginner, it's going to take some time. And again, I learned from experience. My very first course, I spent like a half or three hours like half morning trying to figure out the hotkeys. And while they were going through the course, I was trying to figure out what’s Shift, what’s CTRL, why something disappeared from my screen. So it really depends on the attendance. Also, if they're beginners or already advanced into the workflows, because if you're just starting with exocad, there's a lot more detail. But I don't think full arch is that complicated. And of course I say it's not complicated for me because I've been on it for a long time. But once you know exactly what the software does, you don't really need it. And there's a slide that I use on my presentations, courses and everything that you can get to just starting your order form. You can pick like eight different ways. You can do a full arch in eight different order forms when you start designing. Do you really need to go through all those eight? What's the difference? You can only pick two: one if you have implants, the other one if you don't have implants, but you will. So once you know those, okay, there's only two ways. I mean there's a lot, but just focus on those two and then streamline it from there. It makes it a lot easier to understand. Instead of trying to follow, you know, YouTube and, this social media and that doctor, and that practice. So it's just easier if you get trained on the full arch entirely, you know, from a trainer.
[00:38:11 - 00:39:00] Rob: It sounds like it's a lot more approachable if you have one sort of funneled path to success as opposed to grabbing pieces from different sources on YouTube. Yeah, I think that's one of the things that's very confusing about exocad is that, as you said, one of the things I like to say with my courses and training is that there's usually at least 2 or 3 ways to do any one thing with exocad. And there's not just one right way either. There's several ways. And just because there's several ways to be considered “right” that doesn’t necessarily mean that that's a good course. You can't take every direction at once. You can't go left and right at the same time. And it's helpful to have a training course with an experienced teacher like yourself that can show here's a solid, proven workflow path to success. That’s excellent.
[00:39:01 - 00:39:54] Dora: Like I normally say: You want to know how to design a full arch? This is the way one, two, three, four. And you're done. Now what if you want to design a denture for conversion, before? What if you want to design halfway a prototype? What if you need to do a bar and a prototype and then redesign? Those are the little things you might know exactly how to design a denture, a prototype of zirconia. But how do you incorporate them all together without having to spend time designing them all? And that's where the majority of you know, you don't see that on YouTube. You don't find that unless you have a specific course and a specific workflow for the full arch, you know, when you're doing those cases for so long and every day you find those workflows, you find the efficiency on the workflow to make it work so you don't have to do things over and over again.
[00:39:55 - 00:39:59] Rob: That's beautiful. Where can people sign up for your courses and where can people find you online?
[00:40:00 - 00:40:27] Dora: Okay, I am on Instagram and Facebook. I know, “old things, old people” as my kids say. @dora.v.rodrigues, that's my name on Instagram. And the website is iddentallab.com/events. That's where the courses are posted. And I promote more on social media. The website is just for signing up and getting all the details and exactly what the course entails.
[00:40:27 - 00:40:34] Rob: Perfect. Thank you so much for being a part of this, Dora. I really appreciate your time. Thanks for the conversation.
[00:40:34 - 00:40:47] Dora: Oh, of course! I had such a great time! Thank you guys, this is great. Thank you for the invitation. It really is cool to be able to, you know, spread the knowledge. And I saw you guys did a couple great podcasts already. So I'm excited, thank you.
[00:40:47 - 00:41:00] Rob: Thank you very much. And thank you everyone else for listening to the Evolution of Dental podcast. Please look for us on all your major podcast platforms. Remember to like, subscribe and share this show with your friends. And remember, never stop evolving.
