Tactile Technologies is the first company to offer accurate image-guided navigation relying on low-cost disposable elements, without involving any special equipment.A new Israeli start-up wants to put a robot in your mouth.

The company, Rehovot-based Tactile Technologies, recently obtained US Food and Drug Administration marketing approval for its novel dental implant location software. The software is a three-dimensional surgery planning solution, which will soon be marketed in the U.S.

The company’s flagship product, which is in the final stages of development, is an Implant Location System (ILS) that uses a disposable micro-robot for carrying out dental implant procedures. The company promises that when this product hits the market, the process of getting dental implants will be less painful and less expensive.

A series of animal trials has been successfully completed on the system and clinical trials on humans are slated for July 2005. The company has already signed cooperation agreements with a number of leading medical research centers, including Vienna General Hospital, Boston University Hospital, and New York University.

The bone-sensing technology will enable precision three-dimensional measurement of bone tissue covered by soft tissue, without the need for invasive surgical procedures. The Implant Location System applies tactile sensing technology to offer intra-oral image-guided navigation specifically for dentists. Its computer-guided sensing, navigation and guiding suite for placement of dental implants is designed both for the general practitioner and the expert.

Tactile Technologies’ aim is to help the firms that manufacture implants to find a solution for placing them that minimizes the risks and simplifies the procedure They are doing so using tactile sensing technology, three-dimensional radiological visualization and miniaturized robotic control which is changing the dental landscape.

Tactile Technologies was founded in 2003 by a group of physicists, among them Dr. Zvika Slovin, 39, who serves as CEO of the company.

“We are a group of four entrepreneurs – this is our third start-up,” Slovin told ISRAEL21c. “This time, we wanted to search for a really unique startup that would not only make money but would make a difference – and that was why we chose to look into the medical market. All of our previous ventures were strictly technical.”

Slovin said that when their group looked at the dental implant market, they found a highly lucrative niche “in which not a lot had changed in the past 20-30 years, and high technology has not yet made an impact.”

The problem that they set out to solve was the level of technical sophistication that is necessary for dentists to perform implants, which are increasingly popular in demand.

“Every implant is a titanium screw and they are afraid of perforating a bone or damaging a nerve,” Slovin said

Inserting dental implants in their proper location in the jaw is a surgical procedure that requires a great deal of experience, knowledge and expertise. Wrong placement of implants may cause implant failure and irreversible damage to anatomical structures. Performing implants is not something that is taught in standard dental curriculum.

According to Slovin, current devices still suffer from inaccuracy, high procedural complexity and high prices. 90 percent of all implant procedures are performed by only 4% of dentists, he added.

“To change this you have or provide the means for a safer and easier process,” Slovin said.

The Tactile Technologies concept is a system in which most of the elements are disposable, except for a drill-guided sheath. The sheaths guide the drilling process by constraining drill movement to exactly the right position, angles and depth.

Their technology is the very first to offer accurate image-guided navigation relying on low-cost disposable elements, without involving any special sophisticated or expensive equipment.

“We’re adopting the Hewlett-Packard printing strategy, where the basic equipment is affordable, and the profit is made on the cartridges,” Slovin said.

The company says that the miniaturized disposable Implant Location System will be accurate, simple to use and flexible, and a safe and easy tool for planning and carrying out dental implant placement procedures.
The advantage to the patient is clear: both affordability and lack of pain – imaging of the bone surface is acquired without the need for traumatic gum removal and the protective sheath offers a high degree of fail-safeness by constraining drill movement.

Tactile Technologies’ tactile sensing technology provides a mechanical image of the bone contour without removing any gum tissue. Bone contour measurements are compared to pre-operative radiological information and used for determining the exact location of the system on the patient’s anatomy.

The sensor uses a matrix of micro-needles that are inserted through the gum tissue until contact with bone is attained. The needles used are ultra-thin with specially designed geometry to ensure negligible trauma. Their insertion is measured using miniature position encoders accompanied by digital signal processing electronics, achieving exceptionally high measurement accuracies. Once the optimal implant location is determined it needs to be carried out in a precise and safe manner.

The use of the Implant Location System enables implant placement without the need for painful flap surgery, which is often accompanied by potential marginal bone loss and soft tissue recession, which reduces success rate and may result in bad aesthetic results.

Tactile Technologies hopes to become a world leader in the dental image-guided surgery market by providing safe accurate and easy-to-use devices accessible to the general practitioner. It first drew attention in the world of dentistry in 2002, when Dr. Gerald Niznick invested $4 million in the fledgling company.

Niznick is recognized by many as the father of modern American implant dentistry – he developed and patented his own dental implant design which became the most widely used dental implant system in the world. Niznick accomplished this by personally training over 10,000 dentists in lectures and live surgical demonstrations.

By the end of the 1990s, Niznick held 20 US patents, including the internal connection patent that has become the cornerstone of modern implants and is licensed to nine other dental implant companies. He sold his company in 2001 for more than $100 million.

Niznick’s vote of confidence in Tactile Technologies was a key development for the company, which is located in the Rabin Science Park in Rehovot. The company has 14 employees, including engineers, surgeons, researchers and ergonomic designers.

Slovin notes that there are other Israeli companies involved in bringing robotic technology to dental implants – notably, a company called Robodent – and that some of their competitors are already closer to bringing their products to market.

“Their problem is that while their concept and equipment is good and they do provide a solution, it is extremely expensive, and their systems can cost $100,000 dollars each. A neighborhood dentist in Ohio can’t afford that.”