Full-Arch Dentistry: How EZ Ref Changed the Digital Workflow | Aaron Gelfand | EODP #27

00:00:00:00 - 00:00:01:56 Aaron I see the matrix now with scanners, 00:00:01:56 - 00:00:07:42 Aaron it fakes the intro oral scanner into thinking it's a tooth and it's that's what the old scanner is designed to pick up. 00:00:07:42 - 00:00:10:31 Aaron And this might sound crazy, but we'll print arches upside down 00:00:10:31 - 00:00:19:28 Aaron You live and die by your scanner. 00:00:19:33 - 00:00:44:14 Rob Welcome back to the Evolution of Dental Podcast, brought to you by Evolution Dental Science, where we tell the stories of the people and the technology shaping the world of ministry. I'm your host, Rob Norton. Today's guest is a clinician who got tired of watching one of the central pieces of the implant workflow fall apart. He's the innovative mind behind the Easy Ref system, and easily one of the most brilliant clinicians that I've talked to. 00:00:44:16 - 00:00:47:52 Rob Captain Aaron, welcome to the podcast. How are you? 00:00:47:57 - 00:01:04:31 Aaron I'm great guys. It's great to be here. Thanks for having me. Very excited to talk about my experience with the easy ref and what we do here at New Set, and how we've kind of perfected the easy ref workflow and what we do on a daily basis. 00:01:04:35 - 00:01:09:43 Rob So I called you captain. Can we can we shine a light on why? Why am I doing that? 00:01:09:47 - 00:01:32:07 Aaron Yeah. Before we hit the on air button, I was telling the guys, Rob and about what I was doing before I did this. And I had a very interesting and diverse background in that I was a tugboat captain, turned into a fishing guide captain for ten years in Venice, Louisiana, and then parlayed that into a barbecue business for ten years. 00:01:32:07 - 00:01:58:06 Aaron And that's about when the time when my brother in law called me and said, Aaron, I have this idea. And what I'm doing is I'm creating these full arch. Doing this, this full arch technique and this full arch procedure and the way to really cap, you know, way to really do this properly and to have full control over this is to do it digitally. 00:01:58:07 - 00:02:04:45 Aaron Can you come on board and help me do that? And I said, of course I can. Nervous because I was about to. 00:02:04:45 - 00:02:09:04 Rob Do you have any experience with digital workflows prior to that. 00:02:09:09 - 00:02:30:23 Aaron Besides taking that? My dad was a dentist for 40 years. Besides taking the debt and trying to go to dental school at one point in my life, I had no dental or digital workflow experience at all. Besides, you know, interning and working at his office on summers and stuff like that and and growing up in a dental office, I had no other experience. 00:02:30:28 - 00:02:53:32 Aaron Actually, this this this actually turns into a funny story about how I met and got into contact with evolve. Because he's my brother said, okay, listen, I'm gonna give you two months, and in two months on the beginning of February, we're going to do a full, large case digitally. So I was scrambled. I had too much to learn every. 00:02:53:38 - 00:02:55:57 Aaron And this is a guy coming from barbecue. 00:02:56:02 - 00:02:57:04 Rob Chair side. 00:02:57:09 - 00:03:13:47 Aaron Did not know where tooth number one was. Finally found somebody who said, you know what, I think there's somebody who's got to use demo unit they want to sell. And that's how I got in touch with Tristan at Evolve. And that turned into Tristan and Josh showing up on February 1st, the day that my deadline to get this done. 00:03:13:47 - 00:03:34:40 Aaron And needless to say, it didn't really go in our favor. It wasn't the smoothest operation, but we got the job done. And, God, how how what we have done is evolved, no pun intended. And we, we meet Johnny and and all the guys that evolve and Alice laugh about it because we say it all the time, and we do it. 00:03:34:43 - 00:03:56:43 Aaron We do. We put it into into real world situation, and we have evolved so much together and we've grown so much together anyway. So I left New Set for a moment to branch out and to do my own thing, and I partnered with a valve to go and become a concierge, help and mentor their doctors and their team of guys out there. 00:03:56:45 - 00:04:30:31 Aaron I start to I start to work with evolve and you'll have a great relationship. We've grown so much together. We've we've I feel like we're one of the industry leaders at this point in converting arches from from surgery to implant position acquisition scans design, print, deliver that day. I feel like we're we're at the point to where we're we got this whole thing nailed down to where we're some of the best in the business at this point, and we could pretty much go around and tell everybody, even the guys who think they're experts at it, how to do it the real way or the right way. 00:04:30:33 - 00:04:50:16 Aaron Anyway. So I go to evolve, and I'm sitting at Amy Jackson's desk and I'm kind of brainstorming with them how I'm going to kick off this AOCs concierge business for for evolve. And I'm kind of just racking my brain. I'm nervous. And I'm also I'm also kind of like, God, how am I going to make this work? I want to make this work. 00:04:50:16 - 00:05:09:45 Aaron And I look down and I see these little scan bodies on his desk. He goes, oh, he is there. This this little scan body that I, that I got from this guy, he they pick it up, they pick up the implant position with it. I don't know, it even works. Well, they make it work. So I go in the other room, I get the library and I go to my guy Johnny. 00:05:09:47 - 00:05:30:14 Aaron Obviously me and Johnny are basically brothers from another mother. And I go, Johnny, let's I'm going to start scanning this. I'm going to do about 15, 20 scans, maybe like 2017, I enter oral scanner technology because I'm like, if I'm going to do this, I'm going to take the crappiest technology, because if I can make it work with this, I can make it work with anything. 00:05:30:19 - 00:05:53:57 Aaron So I start scanning. I started putting them on my little scanning, easy refs taking I cams matching them. I did it about 20 times and Johnny's like errand. This is really accurate. This is, I hate to say it, more accurate than the micro map. And he goes and in one instance, it was actually more accurate than the I came with that game scatter. 00:05:53:57 - 00:06:22:57 Aaron But either way I was like, that's all I need to here. Tell me less. I'm, I'm, I'm putting these in my pocket and I'm going to go on the road with them. So when I started going to these doctor's offices, I started using the, I started scanning the the easy ref. Now, it didn't go without his hiccups. Obviously, the first couple of times you try something, you know, you start learning the little innuendos of how you want them shaped or how you want them moved around, or how you want it, how you want them to, where they're going to get easier scan, and how you're going to roll over with the scanner to get the 00:06:22:57 - 00:06:45:14 Aaron most accurate scanner. What what connects and matches better, you know, feedback back from the designer I did it, you know, on the road the first 30 or 40 times without any ever having an issue ever. Every single time was absolutely perfect. And I was like I was I was just waiting for that. For that. Nope. Doesn't fit. Sorry. 00:06:45:16 - 00:06:49:21 Aaron You know, it never happened. 00:06:49:26 - 00:07:07:04 Rob Oh, I didn't see you there. Hey, y'all, it's Robert with the Evolution of Dental podcast. If you love these stories and you want to see more guests, more content and help the show, please remember to share it. Like it? Subscribe to our channel and hit that little notification bell if you're watching on YouTube so you can get notified of our new episodes. 00:07:07:07 - 00:07:15:16 Rob New episodes drop every Friday. Follow us on all the socials. You'll see all the latest content. Looking forward to seeing you there. 00:07:15:21 - 00:07:40:28 Aaron So two years ago, I went back to new set with a new with a new, role. And I decided to, you know, at the time we were building that new set back up because we, we left our other, our Colorado location. We're building up our other offices around the country. And I decided I'm like, we're going full easy ref on this, you know? 00:07:40:31 - 00:07:48:50 Aaron And it might have been it might have been looked out upon by other, other operations. But guess what we are. 00:07:48:55 - 00:08:14:35 Aaron 15, 1200 arches into it. Same day surgery without a hiccup. Maybe. Maybe 1 or 2. I mean, I can count on one hand how many times we had non passivity issues and you know, other than maybe a bite being open here or there, everything's been been spot on. And and you know I've talked to other leaders of the industry, let's call them. 00:08:14:35 - 00:08:34:02 Aaron And I'm like, you know, how about, you know, kind of going, wanting to battle with them about the easy ref. And they're like, data shows that the easy ref or scanning with the scanner is not as accurate as the micron Mapper. And I'm like, I have I'm like, hey buddy, I got a thousand case studies saying real world situation. 00:08:34:04 - 00:09:00:38 Aaron I got a real world case studies that says a different story than what you're telling me. As a matter of fact, I've corrected and fixed multiple 20 to 30 to 40 micron mapper like scrap discrepancy non passivity scans with the with the easy ref and made them work. So it's a proven proven product and it works very well. 00:09:00:38 - 00:09:24:38 Aaron And you know we're going to talk about the future and where we're heading over here at New set. And it's funny that we're having the this meeting today because I've actually started just started messing with the T marker and really like it a lot. And and not that I'm eliminating the easy ref. We're going to use the easy ref in our same day surgery workflow. 00:09:24:43 - 00:10:00:14 Aaron And we're going to as we go into finals, we'll, we'll incorporate when the patients come back with the with the integrated implants, we'll come back for start final appointments and t marker them and go forward with our esthetics and and better bite occlusion contacts and or whatever else kind of design changes we need to do going forward. But, yeah, our surgeons, we're, we're knocking out 100 plus arches a month now at News8, and every single one of those gets an easy ref and that's, you know, you can imagine how many we're doing now. 00:10:00:14 - 00:10:03:11 Aaron So. So what would you say the case study. 00:10:03:21 - 00:10:20:59 Rob So people know like it's it's this time. This is the this is the scan body we're talking about. I don't know how well the camera is focusing on. What would you say. What would you say. The secret is the secret sauce that makes these so much more accurate and so much more friendly and usable to clinics? 00:10:21:04 - 00:10:43:28 Aaron I think it's the I think it's the built in CAD library that they have with it. It just the match to it. It's just it's the geometry of it. And you know, and we see a lot of imitations out there and we see a lot of other systems that are very similar to it. But I just love that white scan body. 00:10:43:31 - 00:10:44:47 Aaron It just this 00:10:44:54 - 00:10:50:50 Aaron it fakes the intro oral scanner into thinking it's a tooth and it's that's what the old scanner is designed to pick up. 00:10:50:55 - 00:11:06:55 Aaron If for whatever reason, the triangular mesh that the that the intro scanner uses to pick up shape, it works seamlessly with the easy ref and and the tissue loves it that it's just it's just a really easy scan body to pick up. 00:11:06:57 - 00:11:28:16 Aaron Do I have to ever have to redo them? Sometimes. Or sometimes. Is there a little bit scattered? Yes. And that just comes with experience and understanding how to how to scan. And and the lower is obviously harder to scan and get more accurate than the upper. But you know, there are different scanning techniques. I sometimes I forget when I'm training other technicians in our practices how to scan properly. 00:11:28:16 - 00:11:36:00 Aaron And I'm, I'm scanning and I'm just like, I'm not even looking up, just looking at the screen. And I'm scanning away and and I just forget. I'm like, I feel like I'm. 00:11:36:09 - 00:11:38:03 Aaron I see the matrix now with scanners, 00:11:38:03 - 00:11:50:31 Aaron you know, when I'm scanning, I just, I just, I just, I just, I and I realized and I tell all my technicians I do the same exact motion and scan and I follow through the same exact way every single time. 00:11:50:31 - 00:12:09:26 Aaron Looked at my scans. And I don't know if I figure something out. But that's just how I scan and how I do everything. I, I do everything the same way every time I figure I found that to be a great systematic approach to full arch. The way I screw arches in everything, I follow the same pattern. Anterior front. 00:12:09:28 - 00:12:19:35 Aaron Right posterior. Back left. Anterior front. Left. Posterior back right. I just do the same. That way I know where I'm every single time I kind of scan the same way as well. 00:12:19:40 - 00:12:28:43 Rob So you're spreading out your your initial data acquisition as you're spreading out your, your landmarks essentially, and then. 00:12:28:43 - 00:12:53:26 Aaron Bring it about. I'm always and people think that you just kind of go over the edge and you follow everything. I always, I always do a little bit and then come back to the palette. If I'm doing the upper, let's, let's call it the upper. The lowest different lowers more difficult obviously, but upper is always palette back to the front right palette front left palette back left palette back right. 00:12:53:28 - 00:13:15:04 Aaron You know it's just it's just all I just I kind of always come back to a certain point and I always tell people, you know, they feel like the scanners glitching or messing up, go back to go back to that one spot where you know it's going to pick up immediately and you kind of know when you're scanning patients that that the scanner loves that one spot, you know, it picks it up immediately. 00:13:15:04 - 00:13:23:56 Aaron Go back there if you're having trouble and then branch back out again. I think a lot of the success with the easy ref has to do with scanning accurately. Scanning accurately. 00:13:24:01 - 00:13:25:43 Aaron You live and die by your scanner. 00:13:25:47 - 00:13:45:11 Aaron I have a little think tank of doctors I always talk with, and we think that the latest and greatest technology of scanning is actually holding us back, because the latest scanners mesh everything together and make it look beautiful and perfect when it's really not so, it's actually holding us back from what the scan actually really is. 00:13:45:14 - 00:14:04:09 Aaron These scanners now are like, you know, AI or putting things back together where they're not supposed to be there. They're automatically putting the bite together where it's not supposed to be. I always take all that AI stuff out and just and figure out how to really get the patient into the most, you know, centric, perfect bite that they are in. 00:14:04:09 - 00:14:25:02 Aaron And I try to figure out the best way to mimic that in the software, because the software does want to move it around a little bit, always. And I always told my technicians, I'm like, when you're done scanning, watch the screen. Ready? Do you see it move a little bit. You saw that move a little bit that sometimes I'll redo a scan if it moves in a way that I don't like. 00:14:25:07 - 00:14:27:33 Aaron You know, when I like, adjust whatever. 00:14:27:47 - 00:14:30:45 Rob Just does like the little things. It's fixing it. 00:14:30:50 - 00:14:38:19 Aaron It thinks it's. Yeah, things just trying to fix it. That's the problem with the the newest scanners that that it fix it sit too much. 00:14:38:23 - 00:14:55:35 Rob I think that's I mean these little armature, these little arms that stick off the side of the, of the scan body. Right. Which I don't know, I hope I hope that the camera is picking this up properly. Yeah, I think that does that have a lot to do with the way it's able to acquire the data accurately across the arch. 00:14:55:40 - 00:15:24:04 Aaron So the way that the, the, the, the scan body is matched, it's not the full on it matches the cylindrical piece that, that the screw channel sits inside of and about two thirds of the arm. So on the double arm it's, it picks up to about two thirds away from the cylindrical piece of the double arm. And on the single arms, it picks up two thirds of that one single arm. 00:15:24:09 - 00:15:48:02 Aaron We prefer the single arms because we like to kind of also show as much tissue as well as the scan body at the same time. But sometimes a double arm. It does come in handy, but what we found is that we like the single arms the best. And sometimes you need to have a, we call it the ref, which is just a cylindrical piece. 00:15:48:04 - 00:15:52:45 Aaron Sometimes you need those. There's always a solution to everything. 00:15:52:50 - 00:15:56:52 Rob Absolutely. You sound like a solution oriented kind of guy. 00:15:56:57 - 00:16:04:35 Aaron Yeah. Solutions rather than problems guys. Always right. That's our tried tell people. 00:16:04:40 - 00:16:13:35 Rob For the doctors that are just stepping into all on X work, what do you think one of the bigger separations is between that success and failure there? 00:16:13:40 - 00:16:45:43 Aaron I think it's understanding what it takes to get these patients into a final. It's not just because because just step one is consult and and be like, oh, I can do this. And then surgery day and they got em. They got them flapped open and they're reducing bone and they're sinking implants. And that's a whole nother thing. And then they're skirting multi-unit abutments and suturing them, and then they're putting on whatever scan bodies they have to get their implant location. 00:16:45:45 - 00:17:08:09 Aaron That's that's the easiest part of the whole procedure. That's the that's the easiest part. Right. And even the surgeons will tell you that. Or doctors or whoever's doing it, they'll where the real work begins is when that patient comes back for their second scans and for their try ins, and to get him into that final prosthesis that's going to work really well. 00:17:08:11 - 00:17:35:47 Aaron Locked in by perfect smile, perfect speech pattern, happy patient. That's the that's where that's where the real work is. So it's not it's not the surgery day. It's not it's not that first day, same day surgery design that's going to make or break them. It's what happens after that. And then and then as they go forward and they rack up, you know, ten, 12, 20 surgeries, it's managing all this patients. 00:17:35:52 - 00:17:55:02 Aaron It's the patient that goes in their finals after four months. Great. Easy. Well guess what. Now they got their patient. They got their problem patient that nothing goes right. And their in their in month eight and 910. And they're still not in finals you know is how do we how do we how do we manage those patients. How do we get those patients into a happy place. 00:17:55:04 - 00:17:58:16 Aaron You know, it's there's a lot of variables that go on with this. 00:17:58:21 - 00:18:05:38 Rob What was that like the first time you encountered a situation like that and how did it feel to overcome it? 00:18:05:43 - 00:18:17:40 Aaron I wanted to, you know, get balloons and champagne bottles and I wanted to, you know, have a big reveal moment, you know, when they finally came in for their finals and, and, you know. 00:18:17:45 - 00:18:21:59 Aaron After the first time it happened, I was like, oh, my God, I hope that never happens again. Well, guess what? 00:18:22:04 - 00:18:22:26 Rob It's going. 00:18:22:26 - 00:18:37:07 Aaron To happen. It happens again and again and again and now and now it's we've gotten better at at dealing with those kind of patients or dealing with sometimes it's the patient, sometimes it's it's just a hard design. It's a hard. 00:18:37:11 - 00:18:54:23 Rob How do you how do you deal with how do you deal with those kind of patients in those sort of situations? I mean, obviously every situation is different, every patient different, every complications different. But how do you frame it in your own mind? How do you how do you bring the team on board so they don't just get exhausted and say, I quit, I'm going home for the day. 00:18:54:23 - 00:18:56:04 Rob There's a martini calling my name. 00:18:56:07 - 00:19:24:07 Aaron I think first of all, they give the patient to me. Usually that's the that the first. The first way to solving the problem is give it to Aaron. Captain Aaron gets that patient. No, but really I would say what I do, the first thing I do is because I'm a solution oriented guy. We talked about that before is I look at the patient and I figure out what our major problem is, and I make it real simple because there might be eight problems. 00:19:24:07 - 00:19:44:04 Aaron And I was telling my team earlier today, I asked the patient what their major issue is, and they might rattle off a bunch of I say no. What's your number one problem? And they tell it to me and I write it down. And I said, what's number two? I write it down, what's number three? And I take those three things. 00:19:44:16 - 00:20:00:23 Aaron I make this really simple. I take their first, their biggest three problems and I solve them. And a lot of times when you do that and you make it simple and you make it a goal and you talk to the patient about that and you're like, we're going to fix these three things. Usually after that they're they're happy again. 00:20:00:33 - 00:20:25:45 Aaron But sometimes you might have to stop after you fix those first three problems and you might have to do three more. But once you start doing that and you show the patient, hey, we're going to fix these, we can. Not only are we going to fix them, we can fix them. It makes that patient happy. It makes that patient believe that that that that you know what you're doing that that they believe in you and you believe in them and they feel heard and you're getting their heard, and they're we're getting into a better place every time. 00:20:25:45 - 00:20:41:52 Aaron We're getting better and better. And once you show that progression, you're in a good place. And I feel like as long as you're going into that progression of getting better and better, you're doing the right thing and you're going to get there. Don't get caught up in the little things. Don't get caught up in the big picture. You realize that you're going to get there eventually. 00:20:41:55 - 00:20:42:07 Aaron You know. 00:20:42:09 - 00:20:48:21 Rob It's like a whole cloud of possible problems and you just eliminate it down to a few. So variables. 00:20:48:26 - 00:21:07:14 Aaron Yeah, exactly. Let's, let's, let's and that's, that's the way that I got my team from getting stressed out and overcome with like a lot of anxiety is I'm like, hey guys, listen, we're just going to fix three problems and that's it. We're going to keep it simple. And then once you show your team that it's that simple, nobody gets stressed out. 00:21:07:14 - 00:21:15:55 Aaron Everybody it's attainable. Right. And once it becomes attainable and then the patient gets happy, once the patient's happy, you're happy. Everybody's happy. And that's the goal. 00:21:16:00 - 00:21:24:09 Rob Have you have you started to delegate some of these tasks off to the team? Like as a captain I'm sure you got to delegate some things. You can't run the whole book by yourself. 00:21:24:11 - 00:21:45:28 Aaron Of course. Of course. And they've they've I mean, I've put my team up against anybody. I mean, I have my I feel like with our system that we've created here and what we're doing. I mean, we have our assistants, our are now they're not just these days that are coming out our RDA school. They're they're many prosthodontics. 00:21:45:33 - 00:22:09:19 Aaron They're they're they're qualified to get a patient and scan a patient and understand what a patient needs to get from their surgery teeth to their finals. And they're doing it. They're doing it at a high level, and they're printing and they're characterizing and they're scanning. I mean, I don't want to talk too great about them. People are going to start trying to steal all my, my, my text over here, my, my days. 00:22:09:19 - 00:22:19:40 Aaron But, you know, we have a really solid team here. It's about doing everybody, doing a little bit of everything, you know. 00:22:19:45 - 00:22:33:38 Rob That sure sounds like you definitely built a good team. Some people you can rely on. How what do you think went into what do you feel really went into building a team like that? Because people don't walk off the street and just become team members? 00:22:33:40 - 00:22:54:23 Aaron No, it takes time. It takes it takes a lot of time. I mean, when I first started back here at New Set two years ago, if I wasn't there, we weren't converting an arch. So every time we did, every time we wanted to convert it arch into a same day surgery prosthetic, I had to be there and we were doing about 2030. 00:22:54:26 - 00:22:57:09 Aaron I found all of the country I was. 00:22:57:14 - 00:22:58:33 Rob You can't be the only bottleneck. 00:22:58:35 - 00:23:15:52 Aaron No, I was I was on three four. I was on 3 or 4 airplanes every week. I was in Saint Louis and Nashville. I was in Maryland, back to Nashville. Some days we would do surgery in Saint Louis in the morning and fly to Nashville and doing in Nashville the afternoon. You know, we were cooking, but still, it was stressful because I was like, girls, are you scanned? 00:23:15:52 - 00:23:21:47 Aaron And they're like, what? You know? And I was like, oh my God, I'm going to be on the road my whole life, you know? 00:23:21:47 - 00:23:26:04 Rob But what's your private jet? 00:23:26:09 - 00:23:48:04 Aaron Be nice. That's nice. Maybe I don't know, that's nice. Maybe. Maybe after location, you know, ten maybe. But, so, you know, it took about, I'd say about six months of, of training and, and and showing them how to do it over and over again for them to just kind of figure it out, you know. 00:23:48:09 - 00:23:50:33 Rob Show them how to do it. What were you showing them? 00:23:50:38 - 00:24:14:55 Aaron How to scan properly. Okay. How to organize the scans. How to how to how to communicate with the design team, how to get communication back from the design team and then and then turn that into better data acquisition and vice versa. And so that took some time, you know, they didn't even know what they didn't even know what to evolve was. 00:24:14:59 - 00:24:32:50 Aaron They're just scanning and putting things in a share file. And, and you know, then they knew who Johnny was and they knew Tessa and they knew Luke and they knew all the people there. And Sidney and you know, and now now we're family. We know everybody knows everybody, and everybody talks to everybody every day. They probably talk to you. 00:24:32:55 - 00:24:56:14 Aaron Our team probably talks to evolve team more than they talk to their own family. You know at this point evolves family. And and that's a big part of it. Communication is a huge part of going from just data acquisition to really nailing it down and getting a really awesome locked in design on on day one. 00:24:56:19 - 00:25:08:28 Rob What are some of those communication strategies you've taught them to employ speaking to the lab and things that maybe other doctors or other clinics listening to this might can take away and apply within their own situations? 00:25:08:33 - 00:25:38:31 Aaron A lot of it is just listening to just listening to what everybody needs and, and, and doing things differently, adapting and changing, maybe the way they, they acquire data a little bit, or maybe going a little extra mile, maybe stopping and realizing what they did because nobody wants to be told they did something wrong, and sometimes they did do something wrong and just listen, hearing it out and be like, okay, I'm going to go back and do it again and, and nail it down. 00:25:38:31 - 00:25:58:40 Aaron And sometimes that's what it takes to to to get to the finish line faster. It's listening. It's like anything it's like with the patients. It's like with the design team, with the days, with the text. It's just listening and and figuring out how to get better. And everybody gets better every day. And you learn something new every day. 00:25:58:40 - 00:26:09:31 Aaron I learned something new every day. I still learn. I'm like, wait, it's better if I do it this way. I mean, I change the way I do things. Just in the last month, I changed the way I scan arches. Now. 00:26:09:43 - 00:26:13:09 Rob What's one thing you think you've changed in the last month or six months or year? 00:26:13:11 - 00:26:31:21 Aaron I'll tell you one thing. I feel like the one of the biggest changes I've done in the last six months is 360, doing a 360 on every single large before I scan it in the mouth without a I don't care what it is, I 360 it put it in the mouth and then and then gather a great occlusion with it. 00:26:31:21 - 00:26:35:26 Aaron And that's changed a lot of of how we move forward. It's made. 00:26:35:26 - 00:26:37:26 Rob Matching scan of the try and. 00:26:37:31 - 00:26:57:45 Aaron Yeah it makes, it makes matching so much better. It makes going to the next step better. It's eliminated. I'm going to say this right now in the last month or two. It's eliminated 20 to 30 patient visits across the board. Of all the patients I've seen in 360 scanned. 00:26:57:50 - 00:27:16:50 Rob Absolutely. Yeah. It makes a lot of sense. I mean, the when it comes to matching up for, you know, for those who don't know when it comes to matching up the scans, the mirrored surface area is the key. There's no no substitute for having matching data that you've acquired. You know, where it's 1 to 1 from one thing to the next. 00:27:16:52 - 00:27:21:16 Rob Having a 360 scan, huge leg up on having it in place. 00:27:21:23 - 00:27:28:23 Aaron Huge. And for everybody listening out there, if if you want to nail it down 360, scan it. 00:27:28:28 - 00:27:47:23 Rob And speaking of like what are some other what are some other hot tips you'd have for doctors or clinics or even labs looking to step in to, say, a full arch workflow like this like to go from, oh, well, we kind of do some CAD cam or we, we do some in clinic scanning. But what would you say their first couple steps might be? 00:27:47:33 - 00:27:54:26 Rob Whether that's buying something, learning something, observing something, praying to God. What would you say? 00:27:54:31 - 00:27:58:23 Aaron I would say. 00:27:58:28 - 00:28:24:28 Aaron Understanding your interval scanner at at its fullest at you live and die by the oral scanner if you can't, if you can't have an accurate, incredible internal scan and then you're not going to do, you're going to not be very successful in this industry. And I know that might sound basic, but I mean, you could take two different scans. 00:28:24:33 - 00:28:29:59 Aaron Two people can scan the same patient and get two different outcomes. Yeah. 00:28:30:04 - 00:28:33:19 Rob I've I've seen it myself. It's 100% right. 00:28:33:21 - 00:29:01:09 Aaron Yeah. And that's, that's a, that's a big one. And then I mean and then going from there it's it's it's understanding I think from a printed there's little little tiny things like post-processing 3D printed arches in your trying phase because, you know, just burning down too much of that support in the back changes that bite a little bit. 00:29:01:11 - 00:29:06:29 Aaron You know, and we've done things like when we're when we're having some trouble with that, we'll print. 00:29:06:29 - 00:29:11:28 Aaron And this might sound crazy, but we'll print arches upside down 00:29:11:33 - 00:29:21:52 Aaron it clues, we'll print it and tackle the side down to just just to get that. Yeah. Yeah. Just to get that occlusal side nailed down. And that causes other issues too. 00:29:21:55 - 00:29:29:07 Aaron But, we'll do that sometimes just to, you know, when we're messing around trying to really figure out the seclusion thing. 00:29:29:11 - 00:29:35:31 Rob Yeah, it comes down to the conversation of, well, what's more expensive, more chair time or a little bit more printed resin. 00:29:35:43 - 00:29:56:33 Aaron Exactly, exactly. We do have a PMMa mill that we mill some PMMa onto, and we'll do that as well. That's a great verification. Some of us, I think building some PMMa might be as cheap as, as, you know, some cheap PLM pucks might be as cheap as as printing onyx. Tough to arch. You know, it's about the same. 00:29:56:35 - 00:30:00:43 Rob It's comparable. I mean, good PMMa costs almost as much as they're going to. 00:30:00:57 - 00:30:21:33 Aaron Yeah. Yeah. No, we're when we when we're verifying we just use you know right. Little cheap in the to verify it. And it works really well. It's a great verification I think experienced time obviously I, I thought I knew everything a year ago and here I am a year later and I'm like, oh my God, I didn't know anything. 00:30:21:33 - 00:30:28:45 Aaron It's like anything, you know, you're not you don't you don't really master until you're not a 10,000 times. 00:30:28:50 - 00:30:43:11 Rob The. Yeah, that sounds I mean that sounds as accurate as anything because like, you really you really learn the more you put into it. And like you said, what you learned in 20 cases versus 200 or 2000 totally different levels of perspective. 00:30:43:16 - 00:30:48:14 Aaron And here I am just now just starting the 360 scan everything. I probably should have been doing that two years ago, you know. 00:30:48:26 - 00:30:49:33 Rob Well, better now than never. 00:30:49:33 - 00:30:51:35 Aaron Write better now than ever. 00:30:51:40 - 00:31:15:02 Rob Yeah. And it's. And now now that you have that experience, you can share it with others and we can all reflect on that which again, having seen both sides of it lab tech wise, like it makes a massive difference. What are what are some things that you're looking forward to with this? Like are there new technologies or techniques that you've either heard about or considering adopting in the future? 00:31:15:07 - 00:31:38:57 Aaron Yeah. Well I think that there is there's going to be a in the future. There's definitely going to be some materials that come out that are going to revolutionize the way we, we do things. I think you know breaking breaking of temps is something that that has reduced a lot with Onyx. Tough to but I think going forward, I think some residents are going to change the way we do things. 00:31:38:57 - 00:31:53:02 Aaron I think there's going to be an AI system that nails down implant position and tissue scan and design in one swoop. Motion. There's going to be, you know, 00:31:53:02 - 00:32:06:04 Aaron we're probably 4 or 5 years from from taking your cell phone, scanning the patient's mouth and your computer, spitting out a perfect occluded upper lower arch. You know, 00:32:06:09 - 00:32:09:50 Aaron that that's kind of light years ahead, but I think. 00:32:09:55 - 00:32:11:07 Rob On notice of it here. 00:32:11:09 - 00:32:35:52 Aaron Yeah, I think I think data acquisition is going to be a huge we're going to have a huge leap shortly in data acquisition. And I think that's that's the main portion. As fast as, you know, being accurate and repeatable is is the key here. And, and however we can do that is is going to drive this industry. 00:32:35:57 - 00:32:53:57 Rob Outside of that. Just it's kind of gets my gears turning outside of say, the specifics of on X, right. And the specifics of creating the easy ref system. What do you think one of the biggest things you've learned from this journey has been so far? 00:32:54:02 - 00:32:57:19 Aaron You. 00:32:57:23 - 00:33:01:28 Aaron What do you mean like outside of just just well. 00:33:01:31 - 00:33:25:31 Rob So you you travel around all these different clinics, right? You're on airplanes, you know, 40 times a week and you've come up with this incredible system. And it's clearly revolutionized how a lot of this data is acquired. Right. What's that experience been like? Like what is it? Have you learned or applied anything differently in your life outside of your professional life? 00:33:25:33 - 00:33:31:14 Rob Like has there been other things that have kind of clicked with you or takeaways? 00:33:31:19 - 00:33:55:59 Aaron Perhaps? I thought about this actually recently. You know, I think because of of my role, as you know, dealing with some of the patients that are more difficult or cases that are more difficult, I get brought into that, that place, I'll fly around the country dealing with cases that are kind of not going as planned, maybe, I think. 00:33:56:04 - 00:34:14:23 Aaron Assessing the problem and addressing it and in a way of just listening and trying to figure out what the problem is, is, is, is something that's changed a lot for me. I've, I used to think that I could just I was like, oh, I know what I'm doing. I know how to do this. Whatever. I got this, you know? 00:34:14:26 - 00:34:55:07 Aaron And instead of being listening and actually seeing what the real problem is, I think sometimes that's that's a big part of this is, is sometimes a problem is not what you think it is, you know, and, and I've learned that to be a better listener and to understand the patient better and understanding really what the problem is. And I feel like that's kind of also a, overflowed in my life outside the practice to and just kind of being a better communicator with, with everybody and, and and learning how to listen better and problem solved better outside of the practice. 00:34:55:11 - 00:35:16:40 Rob That's powerful. It really is. I mean, it's it's the things like that to just go overlooked. We get buried deep in the technology, the techniques and the buzzwords. And don't get me wrong, I love the easy ref system. I've used it quite a bit myself. It's like the way it's able to bridge the gap literally, with integral scanning and the way the arms can connect and unite all the data. 00:35:16:43 - 00:35:22:47 Rob That's awesome. But if you don't know what problem you're solving, what good is any tool? 00:35:22:55 - 00:35:23:52 Aaron Exactly. 00:35:23:55 - 00:35:41:59 Rob If you're not listening to the other people, what you said earlier, again, I keep resonating with with talking to the patients and all right, name three things and we'll just write those down and take those one at a time. I think that that's something anybody can take away and not just apply to a practice, but apply just to their lives. 00:35:42:02 - 00:35:43:16 Rob So yeah. 00:35:43:21 - 00:36:09:23 Aaron And and the other I really want to say that another great technique I use with patients is when I can see that they're frustrated and they're like, where is this going? When am I going to get this? And when am I the finals coming? I'll draw out a timeline of when their next trying is going to be, and I'll even say, hey, listen, if that one doesn't work, I'm going to give you one more after that. 00:36:09:23 - 00:36:25:04 Aaron And that one's if that one's not perfect, we'll do one more. So two weeks after that, we'll do the next try. And and then two weeks after that you're going to get your final. So that's going to be on July 19th. So let's just mark that down in our books. Let's make that a goal July 19th. You're going to have your finals. 00:36:25:04 - 00:36:40:45 Aaron And that means all the that means the world to these patients. And even if you don't hit that goal but you're trying to you're you're you're we all know we're all on the same page. And we have we have a goal, and we're going to try to get there. 00:36:40:50 - 00:36:42:26 Rob And brings them into the light. 00:36:42:30 - 00:36:44:31 Aaron Yeah. 00:36:44:35 - 00:36:48:19 Rob It's a collaborative effort. It's not happening to them. It's happening with them. 00:36:48:21 - 00:36:54:59 Aaron And they feel and they just feel so much better knowing that, that they can kind of see the end of that light tunnel. You know. 00:36:55:04 - 00:36:59:55 Rob I think we've all been in that position one way or another and the dental chair or otherwise. 00:36:59:57 - 00:37:01:09 Aaron Yeah. 00:37:01:14 - 00:37:03:59 Rob Erin, this has been awesome. Thank you so much for being a part of this, man. 00:37:04:02 - 00:37:05:16 Aaron Yeah. Loved it. 00:37:05:19 - 00:37:09:23 Rob Love it. Where can people find. Do you do you have socials? Where? Where do people. 00:37:09:23 - 00:37:27:04 Aaron Find you? I don't I don't do social media. But if they want to get Ahold of me or they want to talk, they can just. They can email me. I'd love to respond if they have any kind of questions. Aaron at news set dental implants. Com, I love to reach out and talk to to my peers. 00:37:27:04 - 00:37:37:31 Aaron And I love to think tank and I love to just talk about and mentor, teach or whatever it is. Questions. I'm here for everybody. 00:37:37:35 - 00:37:41:14 Rob Thanks, Aaron. And this was an awesome conversation. Thank you so much for being a part of this. 00:37:41:14 - 00:37:43:26 Aaron Great Tom. It's great meeting you guys. 00:37:43:31 - 00:38:01:55 Rob And thank you everyone for joining us for this episode of the Evolution of Dental Podcast. Remember to look for us on all the social medias like, subscribe, share the show with your friends. We're available on all the major podcast platforms, release new episodes every Friday and remember, never stop evolving.