Dr Todd Scheyer: "The most powerful tool we have in this digital world is simulations. And the orthodontists understand this."
By Daniel Ramos
⋅ 4 min read
⋅ 12 Jul 2024
In the latest episode of the new Expand podcast, hosted by Dr Daniel Ramos, Dr Todd Scheyer joined us to talk about two of dentistry’s greatest disciplines: orthodontics and periodontics – and how they can intersect and work together. This in-depth discussion covered, among other topics:
The limits of orthodontics
How SFOT can overcome orthodontic limitations
What is our target, acceleration or periodontal improvement?
Patient-centric care and collective intelligence
Read on for some of the highlights from this episode or listen to the conversation in full on Spotify, Apple Podcasts or YouTube.
The limits of orthodontics
Kickstarting the conversation, Daniel posed a question central to this topic: what are the limits of orthodontics? How can we understand when it’s time to stop with ortho and start a therapy such as SFOT, MARPE or orthognathics?
Dr Scheyer began by explaining the traditional way of treating and its limitations, and that while that’s not necessarily the problem, we can ‘do better’ with digital.
“Digital dentistry allows us to understand the limits of that individual patient risk assessment to the patient. Not to the general population, but to that individual patient. We understand their anatomy, we understand their facial esthetic, we understand their goals – and then we take all that information and we simply run a simulation. I mean, it doesn't get any better than that, right? It doesn't get any better than to be able to do that.
Simulation and then make decisions and then have all this technology available to us and experts from all over the world to come together and execute and deliver.”
SFOT and how it can help us overcome orthodontic limitations
With over 20 years’ experience working on SFOT, Dr Scheyer talked about the importance of customizing surgery for every individual patient as well as digital-first treatment planning.
“SFOT is a tool. It's just like the other things we have in our toolbox to execute. What I want to drive apart today is that everybody can't just go do SFOT; they can't come take a course with me or Rick Roblee or George Mandelaris and go back and implement it tomorrow.
Even a trained periodontist, because it's much more in the thinking, the treatment planning than it is in the execution, the core, the type of bone graft, the type of suturing, the type of soft tissue grafting, that's all what a periodontist can do, or oral surgeon can do quite well. But the treatment planning is critical.
If I'm teaching SFOT today to a resident, I'm saying: ‘You got to get digital first’. Digital first allows you then to use that type of simulation platform, treatment planning, to bring all those tools to the table to help our patients in an optimal way. If you just know how to do SFOT surgery, you're not helping your patient like we can as a team.”
Acceleration or periodontal improvement?
What is the target of SFOT: acceleration or periodontal improvement? Daniel and Dr Scheyer discussed why acceleration is a bonus while the goal is to achieve the final desired position and reduce the chance of issues.
“At least in the US, when this got brought to the table, it was all about speed - cutting the treatment time in half - and that was a mistake. And if you talk to Rick Roblee, for us it's never been about that. It's been about creating the optimal dental alveolar situation to move teeth.
Now, a side effect is it does happen faster. We can accomplish those most challenging movements, intrusion, extrusion, translation, in a significant way. We can accomplish those faster in that window of opportunity post surgery. But if the orthodontist doesn't know how to implement it then, during that window, then it's not any faster. Really, the biggest benefit is the phenotype modification.”
How can dentists upskill in this domain?
Bringing the conversation to a conclusion, Daniel asked for advice for anyone out there who wants to take the next step to make their dentistry better: where do you start?
In Dr Scheyer’s opinion, once you know the digital workflow and want to do interdisciplinary care, it’s all about education. He shared his journey of integrating digital practices in periodontics and discussed the benefits of a platform where specialists from various disciplines can collaborate to achieve the best outcomes:
“We use a team approach in every case. If you don't have that team, it's okay – you can find resources to help you. But if you live in a relatively urban area, trust me: you can seek out those individuals that love what you're telling them. They want to come together as a group of eight to ten practitioners and meet on a monthly basis to learn the digital workflow. And then to learn interdisciplinary care.
Get that textbook. It's all about interdisciplinary care. It's not about SFOT. That's the label on the textbook. It's about interdisciplinary care. There's tons of resources out through Speer education and Kois about interdisciplinary care. There's so much education about pediatric airway and adult airway.”
Listen to the episode in full
To hear more from Daniel Ramos and Dr Todd Scheyer on all the issues discussed in this episode, subscribe now on Spotifyor Apple Podcasts to listen to the full conversation and stay up to date with upcoming episodes.
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