Project ManagementDMAICClient: Save Dent medical clinicEmanuel Grozea, MMA1

The Endodontic Treatment**the treatment of a root infection, also known as a root canal surgery.Emanuel Grozea, MMA1Process:

A - anesthesia - 5 minB - cleaning the cavity - 10-20 minC - reconstructing the missing walls -10-30 minD - insuring the access to the canal/s - 2-10 minE - pulpectomy (extracting the nerve) - 10-15 minDefining the ProcessDMAICEmanuel Grozea, MMA1F - odontometryG - canal treatmentH - canal obturation - 30 minI - crown obturation - 10 minS1-3 - the three stages}90 min

Defining the ProcessS2 - Root Canal SurgeryDMAICEmanuel Grozea, MMA1S1 - Prep WorkS3 - Finish-upS1 - Is performed one single time at the beginning of the treatment, except for the anesthesia, that is performed for each session. Time: an average of 35 min (averaging also C)S2 - Is performed individually for each of the canal along with the anesthesia*.Time: an average of 137.5 min (averaging also E)S3 - Is performed at the end of each session.Time: an average of 10 min* A tooth can have 1 to 4 roots and sometimes 5.Total time: 3-12 hrs

Defining the ProcessDMAICEmanuel Grozea, MMA1Goals:To reduce the Endodontic Treatment (root canal surgery) time from up to 12 hours and 6 session to a max of 6 hours in two sessions.To increase the treatment quality.

F - Odontometry (measuring the canal/s)

MeasuringDMAICEmanuel Grozea, MMA1Description this process is needed so that the dentist would know how deep is the canal and is done with the endo instrument (a spiraled needle)

F - Odontometry (measuring the canal/s)

MeasuringDMAICEmanuel Grozea, MMA1Problems low precision - could give inaccurate measurements due to different root canal anatomieshigh risk - an inaccurate measurement could result in an apex rupture if the measurement is too high, or an insufficient root filling and sealing if the reading is too low.

MeasuringDMAICEmanuel Grozea, MMA1G - Canal treatmentDescription this is the manual cleaning and widening of the root canal, and its done with a series of endo instruments of different sizes in thickness

MeasuringDMAICEmanuel Grozea, MMA1G - Canal treatmentProblems high risk - the endo instruments can easily brake inside the root canal. In such case the patient is in need of microscopic root canal surgery.high costs - a large number of endo instruments are needed, some of one time use and others of some multiple use, resulting in high costs. Also, even as this is not considered to be malpractice and the clinic is not to be held accountable, in case of a endo instrument fracture in a root canal, it is this clinics policy to cover the microscopic root canal surgery.high operation time - a classical procedure takes about 2 hrs/canal. Because of that, if one should work on a 4 canal tooth, the operation would spread over 4-5 sessions.

MeasuringDMAICEmanuel Grozea, MMA1H - canal obturationDescription this is the process of filling and sealing the root canal. The filling is done by cold condensation (fitting and compressing) of odontometrically measured Gutta Percha cones.

MeasuringDMAICEmanuel Grozea, MMA1H - canal obturationProblemslow precision - due to the various canal ramifications, widenings and/or narrowings, the cones may not go all the way down, go further than its supposed, or incompletely fill the canal.high risk - an incomplete fill can result in sealing (vulcanizing) failure. Reaching further than needed can compress the apex and cause pain or even rupture it.

MeasuringDMAICEmanuel Grozea, MMA1J - A clean environmentDescription when performing an endodontic treatment, a clean environment is required, protecting the tooth from saliva, and working chemicals

Problemsrisk of infection - the primary factor of infection when performing an endodontic treatment is the saliva, that is filled with bacteria.

AnalisysDMAICEmanuel Grozea, MMA1

ImproveDMAICPossible solutionsEmanuel Grozea, MMA1

ProcessImprovementActionEffect onTimeQualityEfficiencyCostsOdontometryPain-testingnonenonono0Radiographynonenonono0Apex Locatorpurchaseyesyesyes1,200C. TreatmentOne File Endopurchaseyesyesyes2,500C. ObturationWarm GP systempurchaseyesyesyes1,500Clean Env.Rubber dampurchaseyesyesyes2205,420

ImproveDMAICEmanuel Grozea, MMA1The Odontometry Process can be best improved by purchasing the Morita Apex Locator, a high-end device that electronically measures the root canal length and always gives accurate readings, minimizing all risks to zero and encasing the time and efficiency.Time: 5 minThe Canal Treatment Process can be improved by purchasing the VDW Silver Reciproc One File Endo device. This is an automated head that cleans the root canal by using only one endo instrument chat does not break, thus reducing all risk. The greatest up-side to this is that it can reduce the time by up to 75%, thus cleaning the root canal in under half an hour. This gives the dentist the chance to finish all up in one session.Time: 30 minThe Canal Obturation Process can be improved by purchasing the E&Q +plus Warmed Gutta Percha Obturation System. As the alternative to the cold condensation, this fills all gaps and creates a complete 3D filling and can ensure a good vulcanization of the root canal.Time: 15 min A clean environment can be obtained by purchasing a rubber dam, a dental contraption that wraps around teeth isolating it from the rest of the mouth. This process is added to the diagram.Time: 2 min Time improvement: 70 min (from 120 to 50)

J - Clean Environment F - OdontometryG - Canal TreatmentH - Canal Obturation

ImproveDMAICPriority MatrixDiagramEmanuel Grozea, MMA1from 2h to max 1h / canal

ControlDMAICEmanuel Grozea, MMA1Time improvementIn the classical procedure the time increases dramatically with the number of tooth roots, from about 31/2 hours to over 12 hours, whereas with the new technology the time is brought down to more than a half.

Sesion 1Sesion 2Sesion 3Sesion 4Sesion 5Hours

ControlDMAICEmanuel Grozea, MMA1Quality improvementThere are two axis of control: a negative marker - the returning customers with quality issues, and a positive marker - the encase in customers number for a RC surgery.The positive markeran increase with up to 400%from an average of 3 per month to 12 RC in the last monthThe positive markera decrease from 18.51% (2 faults in 10.8 clients)to 0.96% after (1 fault in 96 clients).

ControlDMAICEmanuel Grozea, MMA1Return Of InvestmentThe total investment is of 5.420.

Out of a total number of 12 clients/day the firm currently performs 4 Root Canal Surgeries for 10 / canal. If we would to average 3 canals / surgery, it would take 45 days to break-even.

The ROI in one year is 5.09 to every 1 invested.

Thank you for your time!