My First Dynamic Surgery with the Falcon System - clinical report

My First Dynamic Surgery with the Falcon System

by André Chen, DDS, MSc, PhD – IAD Lisbon

Introduction

Dynamic navigation represents one of the latest frontiers in digital implantology.

Unlike static guides, which depend on pre-fabricated templates, dynamic systems combine real-time optical tracking, AI-assisted calibration, and software-guided drilling to allow intraoperative adjustments with sub-millimetric precision.

At IAD Lisbon, our commitment to innovation naturally led us to adopt the Falcon System, a new-generation platform that integrates optical sensors, reference markers, and a user-friendly interface compatible with our CBCT-based and intraoral-scanning workflow.

This clinical entry documents our first live case with the Falcon System — a milestone that combined curiosity, learning, and humility in equal parts.

As with any clinical skill, the first step is always the hardest one.

Like Sun Tzu wrote in The Art of War:

“Every great journey begins with the first step.”

And this was mine — into the world of dynamic navigation.

In implant dentistry, there are two moments where a surgeon can get into trouble:

in the beginning of a technique, when he knows little,

and when he thinks he knows everything and turns into God mode.

The first is always better — by default, you go more cautious.

In this dinamic journey, there was a period of model training that went fairly well — smooth, realistic, and genuinely exciting for everyone involved.

The Falcon simulator made sense from the very first interaction, creating a sense of joy and curiosity among the entire team.

(Figure 1) – Model-based training session at IAD Lisbon using the Falcon dynamic navigation simulator.

Calibration and the First Drill

We started calibration by placing the tracker on a posterior tooth — the position that made the most sense to us at first. ( but after this first surgery probably was a mistake....)

However, this resulted in less light entering the oral cavity, and although the system completed calibration successfully, it took longer than expected.

The first drill should have been the spear, but somehow (maybe the euphoric phase of the beginning took control of my rational at this point ...) I went directly to the 2.2 mm drill, which created difficulty maintaining the crest.

As a result, I started drilling slightly off position — more toward number 25 than 24, which was the intended site.

I analyzed the osteotomy and corrected it using the 2.0 mm drill.

After that adjustment, the drill found its way and we prepared the first osteotomy correctly.

Next came the 2.8 mm Velodrill (the yealoow....) — a bur I honestly dislike due to its wobbling — but somehow it stayed on track.

We prepared for a 3.5 × 12 mm BLX implant, and although I struggled with the length selection between the short, medium, and long 2.2 drills, the ISQ value reached 65, confirming that we were right on track.

(Figure 2) – Falcon calibration and live tracking during the first osteotomy. Posterior tracker placement shown.

(Figure 3) – Real-time trajectory correction from 25 to 24 displayed on the Falcon interface.

Finger Position and Ergonomics

One of the unexpected challenges was the low-speed drilling technique required by the navigation system.

Finger positioning must adapt — primarily to avoid blocking the sensor’s view of the intraoral marker. Also the weight is something new that we have to adapt and correct ( i guess the climbig fists go handy in here ...)

This minor but crucial adjustment affects comfort and precision, especially during posterior cases.

(Figure 4) – Falcon tracking field showing optimal finger and handpiece positioning for unobstructed sensor view.

Second Site – Tooth 26: The Island of Bone

We moved to tooth 26, an island of bone between the sinus wall and the nasal cavity with 8mm of vertical height.....

Inversly to the complexity, at this point, I was more relaxed.

This time I used the spear bur to mark, followed by the 2.8 mm bur from the BLT kit (my favourite) to reach full depth.

Here we could see the versatility of the dynamic system — you can adapt the bur sequence during surgery without losing control.

For this site, a 3.75 × 8 mm implant was placed, achieving an ISQ of 75 — excellent stability.

The implant was inserted without Falcon guidance — not because it wasn’t possible, but because we hadn’t yet practiced that stage.

And honestly, with 14 people in the room watching, we decided not to complicate it further.

(Figure 5) – Osteotomy at 26 showing island of bone and adjusted trajectory.

(Figure 6) – Implant placement at 26 with excellent primary stability (ISQ 75).

Observations and Conclusions

The deviation was not ideal on the first implant, but much better on the second — I was more calibrated and comfortable by then.

This first surgery was not easy: the posterior position, limited bone, and lack of prior experience were negative factors, but even so, the Falcon behaved well.

Dynamic navigation is not just about technology — it’s about team synchronization.

The surgeon, assistant, and technician must move together, each perfectly tuned.

Only then does the technology perform at its best.

(Figure 7) – Team setup during dynamic surgery: synchronized workflow between surgeon, assistant, and technician.

(Figure 8) – Postoperative CBCT overlay comparing planned vs achieved implant position (deviation < 1 mm).

Dynamic systems don’t replace expertise — they amplify it.

And this first surgery wasn’t just a case.

It was the beginning of a new chapter in how we think, plan, and execute implant dentistry at IAD Lisbon.