transcript/or_transcript_deid.srt

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Now we're going to start making incisions in the mouth here.

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Okay, so now we're going to start making incisions in the mouth here.

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We're going to take a retractor and give some traction on the muscle here.

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We are going to try to split that.

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tissue. Evenly, so we don't have water with that gingiva, but we want some niche style.

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And we're going to make a little release right there. So the reason why we do those releases

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is we don't want to have tears, so that's the main thing, not to have tears. We want

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I have a good release. Now I'm gonna do on this side. Again the goal is here to do

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four or five implants in between the mental foramina.

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4/4" All-on-4.

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There's another release incision there.

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So we're going to do a subperiosteal dissection with the subperiosteal elevator.

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I like to do the lingual flap first.

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all the way to that little hockey stick incision on the lingual wall you can see

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a little bit right there so it doesn't tear and then pick up that one here and bring this one

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This one anteriorly.

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You can see this is anterior.

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So we can identify the mental foramina.

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I'm going to stretch the periosteum a couple of times.

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Now we're going to come from here.

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This is another mental nerve on the right side and now I'm going to pick up that periosteum

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Okay, so good, so this other section here, I'm going to use a gauze to get rid of the

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dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.

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Now we're going to do this, so ideally what you want to have is something from here, you

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know?

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Down.

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You can easily have more than one camera doing that.

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No, it's fine.

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Huh?

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No, no, it's fine.

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I think that will be better, you know, if you do one, you know, maybe a little higher

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if you can, you know, put some on the way, I don't know, like this, but, I don't know,

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We're going to continue with the alveolar reduction here.

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Come here.

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That's why I'm going to use this, you know, one more view, for my own.

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Okay, well done.

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So let's do it.

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Okay?

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Mm-hmm.

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Okay, what else? So let's do it. Okay.

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Open your mouth wide.

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Open wide and close the lid.

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so

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So with this first drill now, this first drill is going to give it a little bit of volume,

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ability to guide so you can see this is the nerve and we're doing our first and

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this is a second drill I'm sure it's for that mental parameter

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I want to stay parallel to this bone right there

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to this cortical bone and we're going to drill to 16 and intention is to place

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implant number 13 on there

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Here, same thing with the drill.

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Here you see, we are repairing the sides of the filing point.

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Open, open, open.

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I'm going to go ahead and put this in.

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You need three bites on this one. Okay. Mm-hmm.

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So, let's go.

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*sizzling*

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Ok, so everything is prepped to about 16mm and I'm going to put a little antibiotic.

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And now we're going to put 13mm implant.

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Alright, I'm going to start from here.

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So this is an implant.

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4.3 by 13.

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Mm-hmm.

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Another implant, 4.3 by 13.

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4.3 by 13.

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As you see we did the mechanical installment on the hand piece and now we're doing torquing.

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You can see how it's getting dense.

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Now we're reversing to release the bone a little bit.

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Now we're going to change retractors and change this side here to this and we're going to

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Another implant, same. Implant 4.3 mm, about 13 mm, here, so it stops at 40 mm, right?

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pork

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Okay.

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One more. We should have five.

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No, we put four.

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Yeah.

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We bring these four.

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I brought four, always?

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Mm-hmm.

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Thanks.

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Thanks.

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Look what I did for you.

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I'll see you next time.

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All right.

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so

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It is closed, so we are going to put a multi unit abutment so all implants are installed.

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Add the chopped green chillies and fry for a minute. Then add the chopped green chillies and fry for another minute.

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replacing the implants so making sure that rotation is in a good spot

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so when we replace this abutment it goes into the central fossa which it does

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Okay.

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Thank you.

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So, let's go.

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*blows air*

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I'll give you a good check.

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Close, look right there, that's how, teeth are right there so we're gonna do, open, and

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the bone is back so we're gonna do, okay, so all gonna be this, 3/5's.

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Okay.

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Ready for you?

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Yep.

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Okay, open wide, wide, wide.

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so

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So we're doing profiling now, and everything is going to be here, because this is 30 degrees

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reverse, because we want to match it to the occlusion value, so we have to have a, yeah,

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If we do 17 degree, it might be not as...

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17 is pretty good as well.

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Thank you.

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Thank you.

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*whistling*

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Torquing those multi-unit abutments to 25, all of them.

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We need to put the screw in itself. It's better.

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All right.

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Thank you.

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Now we are going to tighten this one again, just to check.

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centimeter. All of them.

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Okay, so we'll do white caps.

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Thank you.

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You need to tell them. So, these are white caps, two comfort caps and also the scanning caps.

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So, let's do the summary before we close. We're going to rinse and close, but this is the nerve.

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We bypass the nerve, the implant like this, this implant like that, here, here, same thing there, away from those nerves.

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And that will give us the ability to get about 10 teeth in here for him, so they're all going to hold about 10 teeth or more.

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I'm going to put some antibiotic under the flap.

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So those are Nobel Biocare white caps, and we like them because everything is new then except for those caps.

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They're just very good for scanning. They're white, so the scan picks them up real nice, and we have a matching software for those components.

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So now, since we did this incision here, which is a vertical releasing incision in the midline,

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we're going to fold that first, do this, we're going to do a little horizontal mattress here,

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So this is a very powerful suture, it aligns everything, and it's a natural suture so it

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reverse the tissue a little bit

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The patient is under sedation.

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Mm-hmm.

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I'll have this used right here.

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Thank you.

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So we're doing interrupted sutures. You can see five white caps and we're gonna

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take a PIC scan. So we're gonna record the PIC scan and [STAFF] can do

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annotation for the PIC scan.

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I'm going to do the suture as you see it pulled through.

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I think it will be amazing when the robot starts suturing like humans.

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So even if you enjoy doing some surgery, but usually people are not enjoying suturing as

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much so it might be done so it's a very repetitive task so so this can be

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delegated to robotics

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Did you call?

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I like this chair, it's nice.

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So the goal of this operation obviously is everything we did with the

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IRB studies is to train AI the virtual model and then the robots to suture

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and then do some manipulations in the mouth maybe even cut the suture so

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and then when they become really good they can learn the surgeon skill

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from hopefully only good surgeons and

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can operate under supervision of the

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humans especially things like this this is very repetitive task very boring it's suturing

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i mean it's fun in the beginning but after a while it becomes very boring so

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it'll be a good thing for the robot to do after big surgery like this go ahead and suture

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So this whole operation, how long did it take us to do this forge?

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recording time? 39 minutes. 39? So this is 39 minutes operation.

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Incision to suturing.

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It takes about 10-15 minutes to suture that big incision. So if they're

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robot gonna suture it then your surgery time is 15 minutes in 30 minutes and

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then robotics will take 10-15 minutes to suture maybe faster who knows that's an

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interesting skill for the robot to learn suturing that requires a lot of haptic

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function and a lot of vector data, spatial analysis. You don't want to suture the tongue

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to the gum. Can you imagine if you suture it like this and the patient cannot move a

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We have a doctor in New York who did that, sutured the tongue to the patient's wisdom

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tooth incision. I'm going to say his name.

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*snoring*

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So we're using vicryl suture and so this, everything we talked about pretty much defies the operation.

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So the only thing I can add is that our rotary speed was 1200 for the drilling of implants.

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did the cooling irrigation of the saline and we use the antibiotic for the topical

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antibiotic including this vancomycin irrigation. So we placed five implants and we can deliver

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the up report from this recording.

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Mm-hmm.

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So, okay, now we're ready for PIC scan.

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Yes, don't move, stay, just remove the white covers and put a special plaque, a special

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So we'll scan the body for the scanning process.

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Stay open and done.

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Open, open, open.

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*sad music*

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Stampin', stampin'. That's number three.

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1-9-6.

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Stay open, stay open...

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Open, open.

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Open, open, removing flags and put white covers again, white caps.

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I'm going to open up a little bit here.

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It's just me, though.

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Mm-hmm.

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So, now I am going to make some impressions and vertical dimensions, bite registration

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and everything for producing digital design and then printing the lower arch.

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Dentures.

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Dentures.

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So, let's see the size, like that, should be good.

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Relax your jaw and bite. Smaller sides, open. Relax your jaw. Open please. Open, open, open.

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Open, open, open, open.

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I'm going to take a picture of you.

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Thank you.

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Thank you.

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I'm going to put it in the oven.

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*phone ringing*

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Just relax your jaw and close it, close it.

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Wait, stop, that's it, don't open it.

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Stay close.

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Is it suction?

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Yeah, that's it.

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Okay, open, bite, open, bite again, bite, open, bite, bite, bite, bite, bite, bite, bite.

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There we go, there we go, very good.

200
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Okay, bait again, bait, bait, bait, bait, bait, sure, sure, bait, bait, bait, bait, see?

201
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Thank you.

202
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Okay, open.

203
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Thank you.

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Thank you.