NK: Which countries are you touring with Nobel? AD: I am involved in a couple of legs of the World Tour – Dublin and Maastricht. NK: What are your thoughts on the new NobelActive? AD: The products are great but what is most invigorating is the way they are constantly looking to the dentists, listening to what we tell them and they’ve done well to go out and tell people. Nobel Biocare is setting the tone for what happens in implant dentistry. NK: How did you get into implantology? AD: When I graduated I very luckily found myself in the conservative dentistry department at Guy’s, working with Professor Rowe and Bernard Smith, and in private practice in the West End [of London]. I saw some fantastic restorative work – great big bridges on very few teeth and when they failed we suddenly found ourselves looking for new solutions. There had to be a way and we turned to implants – and I’m talking 20 years ago. NK: How do you see the future of implant dentistry? AD: Implants have had a big impact here and in the UK but it’s very interesting when you look elsewhere. Looking at what is happening elsewhere in Europe there are probably 10 times more implants placed per capita in Switzerland and Italy than in the UK, which is an extraordinary statistic really. We have similar numbers to Poland, which is an emerging market, so there’s very little uptake over here at the moment. There’s l long way to go and there is huge potential. We have a fantastic opportunity to make a very big difference to the health of our public. It’s probably about getting ideas across, it’s about pricing, which is probably too high, and it’s about the NHS and patients not being used to paying for quality dentistry. It’s all about dentists feeling the burden of the NHS and working within private practice, and patients learning that they don’t get different treatment but rather NHS-like treatment that they are prepared to pay for. In effect, it’s about getting past the bureaucracy. But maybe not all dentists should be placing implants. I rather think that you can’t go from a busy general practice to placing implants in one hit but even if you have been trained up on the surgery, there is still plenty of opportunity to be trained up on the prosthodontic aspect. I think you can really enrich your life by bringing implants into your practice and if you don’t want to get involved in surgery, actually the prosthetics and prosthodontics treatment is really straightforward. I’d go further and say it’s possibly more straightforward than conventional difficult prosthodontics. In other words, a single crown on an implant is actually easier to make than a single crown on a broken down tooth. NK: How do you manage your time, with so much demand on you? AD: I am very nicely supported by a great team. I work with my wife who is a prosthodontist and it couldn’t be an easier working relationship there. And I work with a fantastic group of people who refer to us. Actually one of the most tremendous things about implant dentistry, to me, is that it has brought me into contact with a lot of really wonderful people. NK: Do you spend a lot of time writing and lecturing? AD: I am spending a lot more time writing now; it’s part and parcel of lecturing really. Sitting out there and seeing what people are presenting gives you the opportunity to be reflective about what you’re doing yourself. Actually we’ve realised that we need to spend a lot more time being reflective, looking at what we’ve done. We’re starting to do some retrospective studies on what we’ve done and we’re writing about some of the interesting ways that we’re tackling some problems. We’ve become very interested in the maxillofacial, post-cancer patients. It is a fantastic opportunity to push the boundaries with what’s being done at the moment. I should have more to say and write about that in the future. NK: What do you think will change in the next 10 to 15 years? AD: I think we are going to see a confluence of technologies where imaging technologies in addition to computer-aided design technology and computer-aided manufacturing technology will merge so that you can scan a patient in more than one way, particularly with X-ray scans, cone beam scanning – an area of great interest to me – and take that data and use it not just to plan the implant surgery; not just to do guided implant surgery but actually also just to press a button and manufacture the bridge framework that can sit on the implant so that we can pre-manufacture and provide implant restorations before we’ve treated the patient. That actually will take place with much less involvement from the dental laboratory, so if I was a dental technician right now I would be working hard at developing my CAD/CAM facilities and looking at computer technology. NK: Can you explain more about cone beam volumetric technology? AD: We run Cavendish Imaging in London and we have three CT scanners that take very high-resolution scans. We can take a very high-resolution scan of a very small area for endodontists, for example, or a larger scan at slightly lower resolution for implant purposes. We can take that data and plan implant placement for other dentists. We can manufacture models. We use CAD/CAM processing technology to manufacture models for people so that we can plan both implant and maxillofacial surgeries. NK: Is there a particular case that you are most proud of? AD: What probably gives me the biggest buzz at the moment are zygomatic implants, the long implants that engage the cheek bones for people who have very little bone left in their upper jaw. So at the moment it’s very much that if there isn’t enough bone you have to do a bone graft and I suppose things have changed now. With the zygomatic implants more people can be treated without grafting, using bone from further afield. So zygomatic implants can be used to immediately restore people who previously would have needed years and years of treatment. I suppose these are the things I am most excited about at the moment. NK: What advice would you give to dentists just starting out? AD: Get out and communicate, go on courses, don’t be insular in your approach. Take photographs and make sure you have enough time outside of your work to keep up with the educational experience. Biography Dr Andrew Dawood MRD RCS (Eng), MSc, BDS (Lon) is a registered specialist in prosthodontics and periodontics. Andrew qualified from The Royal London Hospital in 1984. After various hospital appointments, he went on to study for a Master’s degree at Guy’s Hospital. Andrew has worked extensively with Nobel Biocare, and has been involved in several innovations in implant dentistry over the past 20 years. He is also actively involved in developments in computer assisted surgery and rapid manufacturing in dentistry, maxillofacial surgery, and orthopaedics. Andrew is one of the founding partners of the Dawood-Tanner multidisciplinary specialist practice and training centre in central London.