Dr. Franck Renouard - "Threats and Errors Management in Edentulous Maxillary Surgery: The Example of Zygomatic Implants"
Episode summary
Dr. Franck Renouard, a Paris oral and implant surgeon and past president of the European Academy of Osseointegration, discusses human factors and error management in edentulous maxillary and zygomatic implant surgery ahead of his Edentulism 2025 session in Barcelona. He argues that most complications arise not from deficits in knowledge or technical skill but from non-technical factors such as fatigue, interruptions, cognitive overload and team communication. He notes that the human brain receives about 11 million bits of information per second but can consciously process only around 2,000, making error inevitable at roughly five to seven mistakes per hour. Renouard advocates checklists, cognitive aids and a reduced authority gradient so team members report errors early. He stresses that low-probability, high-severity risks, such as orbital infection in zygomatic surgery, must be actively considered rather than dismissed because they are rare.
Key takeaways
- Surgical outcomes depend heavily on non-technical skills, distinct from clinical knowledge or manual skill.
- The human brain receives roughly 11 million bits of information per second but the prefrontal cortex can consciously manage only about 2,000, so selective attention and error are unavoidable.
- People make on average five to seven errors per hour, a figure derived from aviation flight and simulation analysis.
- Surgeons operating on the day of their birthday show an elevated mortality rate in one general-surgery study, illustrating how personal distraction affects performance.
- Going without sleep for 24 hours impairs performance comparably to a blood alcohol level of about one gram per litre.
- A German study by Christian Schmidt comparing 40 surgeries with a checklist to 40 without, using the same team, recorded 10 incidents with the checklist versus 43 without.
- Low-probability but high-severity risks, such as orbital infection in zygomatic implant surgery, should be actively managed rather than ignored because they are rare.
What you'll learn
- Why non-technical skills, not knowledge or surgical skill, drive many complications
- Using surgical checklists and cognitive aids to catch errors before they reach the patient
- Flattening the authority gradient so team members report mistakes early
- Weighing low-probability, high-severity risks such as orbital infection in zygomatic surgery
- Managing fatigue, interruptions and cognitive overload in the operatory
About the guest
Dr. Franck Renouard
Dr. Franck Renouard is a dental surgeon (DDS) in private practice in Paris limited to oral and implant surgery. Early in his career he spent several years in the craniofacial surgery team of Paul Tessier and Jean-François Tulasne, and he trained in implant surgery in Göteborg under Professor Per-Ingvar Brånemark, becoming one of the early adopters of implants in France. He authored the internationally successful book on risk factors in implant dentistry, translated into ten languages, and for more than two decades has researched and lectured on human factors and error management across medicine and high-risk industries.
Credentials: DDS, oral and implant surgeon, Paris; past president of the European Academy of Osseointegration
