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Opening the eyes of the patient

by: Jim Mack

Using NobelClinician® Communicator, Dr. Luc Vrielinck walks his patients through the treatment process step-by-step.

Treatment planning with NobelClinician

NobelClinician Communicator makes it possible to consult with the patient in a relaxed setting. “It works like a natural—and non-intimidating—introduction to treatment planning, after which the clinician can easily start discussing success rates, potential complications and treatment alternatives,” says Dr. Vrielinck.

We recently posed a few questions to Dr.Luc Vrie-linck, who has extensive experience using the NobelClinician Communicator iPad® app to walk prospective implant patients through the entire treatment sequence step-by-step.

Oral and maxillofacial surgeon Dr. Luc Vrielinck is in private practice at Ziekenhuis Oost Limburg in Genk, Belgium. He works extensively with computer- and model-based implant planning systems. His special field of interest is the atrophic maxilla and treatment with zygomatic and pterygoid implants, and he teaches NobelGuide training courses on a regular basis. In this interview, he provides some valuable insight into the use of the NobelClinician Communicator.

How long have you been using NobelClinician Software? Why do you use it?

Dr. Luc Vrielinck: I have been using the NobelClinician Software since the beginning. The 3D analysis of underlying bone structures and the computer simulation of implant planning add a new dimension to the practice of implant dentistry. 

Having a view in all directions on the bone anatomy adds to one’s clinical knowledge and augments the experience of the clinician. While classic radiology allows us to “see” the bone, (CB)CT analysis and 3D computer planning allow us to define and understand treatment planning. 

Knowing and seeing, after all, are two different things. 

What has your experience been using NobelClinician as a patient communication tool?

Vrielinck: It has always worked very well, but today I prefer to start discussions using an iPad® rather than a computer screen. Although using the NobelClinician Communicator app requires a few extra steps of preparation before the NobelClinician planning is ready for viewing on the iPad®, it is well worth the effort. The patients are always impressed with the beautiful images and rarely hesitate to point to these images when asking specific questions.

The Communicator app makes it possible for me to explain the general treatment plan to the patient and allows me to visually show the need for additional procedures, such as a bone grafting and the use of membranes for augmenting the thickness of the dentoalveolar border. It can also help me to illustrate the need for a sinus lift, or simply depict the patient’s own bone anatomy clearly, which always facilitates a treatment planning conversation.

What changed when you began using the NobelClinician Communicator iPad® app?

Vrielinck: It works like a natural—and non-intimidating—introduction to treatment planning, after which the clinician can easily start discussing success rates, potential complications and treatment alternatives in order to obtain the informed consent of the patient.

The Communicator app provides an open invitation to discuss the treatment ahead, including treatment choices that need to be made, and makes it possible to discuss much more than which type of implant will be placed.

Explain how you use the Communicator app to discuss the treatment plan with your patients.

Vrielinck: Mostly I start in a cross-sectional view (radiographic cross-sectional image) to explain the bone structure and bone volume. 

Next I show a planned implant at its intended location. The virtual implant is depicted in blue, and around the implant is a yellow outline (the safety zone). I describe the importance of this “safety” zone and use it to explain that an actual treatment never can be as precise as depicted on a screen. 

I also explain—if appropriate—the relation of the implant to the inferior alveolar nerve or the maxillary sinus. If the yellow zones are larger than the thickness of the bone, this can be viewed easily and provides an opening for me to explain the necessity of grafting procedures in such situations to the patient. 

When the different individual implant positions are explained, I often show a 3D bone model of the jaw to the patient, but certainly not in every case. Sometimes the 3D (CB)CT images are difficult for the patients to see, especially in partially edentulous cases. 

NobelClinician can shorten treatment time and increase safety. Can you imagine working without it today?

Vrielinck: To me there is no doubt about whether or not I will use Nobel-Clinician. It is simply a part of the pathway leading to the treatment plan. 

To my patients, the use of NobelClinician is very straightforward, and they tend to understand it intuitively: Its purpose is to assess the bone volume of the patient, to see if implant treatment is possible or not, to evaluate whether or not there is a need for bone augmentation, and to determine which type of implants can be used. 

This assessment results in the formulation of the treatment plan. In the practice of implant dentistry, conscientious planning is a necessity for me, like food and water.

How do your patients perceive the use of such sophisticated technology in their treatment?

Vrielinck: I don’t think our patients are surprised to see the team using an iPad® these days. The iPad® is used by the implantologist for explaining the treatment plan to the patient, it is used by the dental nurse in rehearsing the treatment plan before the surgery actually starts, and is used by the administrative treatment coordinator to check which implants and components have to be available and eventually ordered. 

If a practice is up to date, well organized and professional, a patient should not be surprised to see us using this technology. Rather, I think they ought to be surprised if they were to meet somebody who is not using it!

Explain why using the Nobel-Clinician Communicator app helps you gain patient acceptance of your proposed treatment plans.

Vrielinck: The communicator app is a basic tool used to present an agglomerate of knowledge to the patient. The process may have started with a prosthetic set-up, and continued with the (CB)CT scan and the subsequent treatment planning, but it will always end up with a final presentation of a solution to the patient, and that’s where this app excels. 

The communicator app is not fancy imaging software; it is a tool used to present the solution for the patient. 

If patients feel that one step logically follows the other to a good solution, they will be inclined to accept the treatment plans proposed via the app in front of them. 

But it doesn’t stop there. The NobelClinician Communicator app for the iPad® can also be used to explain alternative treatment modalities, paving the way for informed patient consent.

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