Technology panel: Part II

Q: Flucke: Can a wi-fi SD card (eye-fi) be used for digital dental imaging?

A: Absolutely! The Eye-Fi can even be used with a CF adapter and placed into cameras that only take CF (Compact Flash). The best thing about the Eye-Fi is that it can be set up to download all of your pictures automatically as they are taken. This means more efficiency when showing patients photos as there is no downtime while you load the memory card into a reader and then download them.

I have a blog post detailing how one doctor is doing this. You can read the post by going to: dentaltechnologyblog.blogspot.com

Q: Flucke: I am concerned about the high cost of dental care. Technology is very cool and makes dentistry more interesting and helpful. However, I don’t see the end product justifying the great expense of the equipment. Can you see a way that going “high tech” will reduce costs to the consumer?

A: Cost can be a relative thing in a lot of regards and isn’t always definitely defined by the fee the practice charges. Let’s use lasers as an example. If a patient has been diagnosed with 2 needed restorations per quadrant and has this need in all 4 quadrants, this would frequently mean 2 office visits. Most doctors don’t’ like to give bilateral inferior alveolar blocks preferring instead to treat the upper and lower on the same side at one visit and then upper and lower on the opposite side at the next visit. In this scenario of 2 appointments, the patient has one extra time off work, one extra baby sitter, one extra gasoline consumption, etc in addition to the cost of the treatment. Many employees that I see must take time off in ∏ day increments. Needless to say these hourly wage patients are paying a lot of money for that extra appointment. In this scenario, the laser actually saves the patient money.

The same scenario applies to CAD/CAM. If you can reduce the number of patient visits, then you have actually saved the patient money. Technology and the efficiency it brings can help streamline the treatment and allow the patient more time to earn a living instead of sitting in a dental office.

Q: Flucke: Though the technodontics revolution is amazing, doesn’t it make basic dental care less accessible for the 120 million Americans that cannot even afford minimal services?

A: If the office is more efficient and profitable due to technology, they now have the time and financial resources to be able to donate care to those who cannot afford it.

Remembering that efficiency helps cut costs means you have more time in your schedule to help others. If, through the use of digital radiography, I can cut 30 minutes from an endo appointment, I can now earn the same money with 30 minutes to spare. That extra half hour can be used, if the dentist chooses, to provide care to those who cannot afford it. Working slowly with antiquated materials is not the way to help more people who desperately need us.

Current statistics indicate that more dentists are retiring than graduating. That means that for the foreseeable future practices will actually get busier. We will need the efficiency technology brings to allow us to help more patients. Many people see the dollar signs accompanying technology and assume that it will drive costs up. Frequently this type of efficiency means more treatment for more individuals.

It also means that once you begin to treat one of those 120 million you can do more treatment, with high quality, in less time and therefore require fewer appointments.

DPRWorld isn’t just about innovative technology, but innovative solutions. Take a look at this video for TeamSmile, an organization finding creative ways to provide access to care for underserved children.

And, check back next week for a clip of TeamSmile founder Dr. Bill Busch, talking about his organization’s PGA Golf and NFL events slated for 2008 while working at the Henry Schein booth at DPRWorld.

Many of the key points raised by keynote speaker Gordon Christensen are right in step with what’s new at Discus Dental. Here, Dr. Marilyn Ward, Director of Global Education for Discus, highlights some of the company’s signature products in categories raised by Dr. Christensen.

J. Morita USA came to DPRWorld ready to embrace the event’s focus on dynamic new technologies. Known for its dedicated research and development team—more than 172 employees focus only on the development of new products—the company was eager to talk innovation.

In the Innovation Centers, Steve White, Senior VP of Sales & Marketing, highlighted Morita’s revolutionary new 3D imaging system as well as the TwinPower Turbine highspeed handpiece.

Our DPRWorld team then followed White back to the Morita booth where Walid Wardaki, Vice President of Merchandise Sales, gave us a more in-depth look at the TwinPower Turbine.

Highlights from the Innovation Centers included Dr. Bob Lowe discussing his experience with Heraeus Kulzer’s Venus restorative material, J. Morita’s Steven White talking about Twin Turbines: A Revolution in Handpiece Design, Dr. Gary Severance of D4D Technologies highlighting the company’s contribution to dental office CAD/CAM technology, and Dr. Bill Busch with Henry Schein Dentrix explaining the features of G3 practice management software with a dentist who had just purchased G3 on the DPRWorld show floor.

Dr. Lowe, also a panelist at the show, used case studies from his own office to demonstrate Venus—a unique microhybrid composite for restorations—in action. Venus Color Adaptive Matrix and 2Layer shade guide help ensure that optimal esthetics are no longer a matter of chance or trial and error, but can be produced easily, quickly and reliably.

White, Senior Vice President of Sales and Marketing at J. Morita USA, explained how TwinPower turbines provide increased power and reduced torque ripple.

Dr. Severance, Vice President of Marketing and Clinical Affairs at D4D, took the audience through the system’s highlights, including intuitive DentaLogic software and SOS (Support on Sight) tech support.

Dr. Busch, meanwhile, explained how G3 “closes the loop for going paperless.”

In attendance for his presentation was Dr. Diana Racean, a Skokie, Ill. general practitioner who just purchased the latest Dentrix software.

Videos of the Innovation Center presentations can be found online at DPRWorld.com.

During each CE session, runners collected questions from the audience for our esteemed panelists to answer. Due to the outstanding influx of questions, we didn’t have time to answer them all on stage. Rather than toss those valuable questions, our experts will offer answers here on the e-show daily.

(Don’t see yours? Don’t worry! We’ll continue to post as we get answers back from the panelists.)

Technology panel: Part I

Q: Drs. Lowe or Flucke: I am a PPO dentist. All the ideas you present excite me. But what can I do to make all these expensive toys a part of my practice when I don’t get paid so much.

A: The initial investment for a hard tissue laser is about $80,000, a significant investment. Being in a PPO practice, I don’t see how you can continue to work without one…you can work so much faster, prepping for composites often without anesthesia. Multiple small occlusals in multiple quadrants are done much faster and efficiently with the laser…you will produce more, therefore make more. Once your investment is paid off, even more dollars will go to your bottom line. You need to go for it!

Q: Dr. Lowe: as a practicing periodontist utilizing lasers for almost four year now, I can honestly say that lasers are mandatory for the future of dentistry. Why are our colleagues so slow in incorporating this into their practices? Patients love this!

A: This question puzzles me as well. I am glad to see a practicing periodontist recognize this. I have been doing soft tissue and osseous procedures for over 26 years and there is no better instrument! I don’t need to see 20 years of research on how lasers cut bone. They cause less collateral damage than burs…healing and post op discomfort are less as a result…and yes, closed flap osseous crown lengthening for minimal osseous correction works and works well!

Q: Dr. Lowe: How can lasers be used to improve soft tissue management for immediate load cases?

A: I don’t know exactly, because I haven’t restored an immediate load case. But, for implants in general, again, I restore quite a few. Lasers are safe around titanium, therefore, very useful to contour soft tissue around implants and clear implant platforms of tissue when seating abutments, and for uncovering (second stage) as well.

Q: Dr. Lowe: how do you get reimbursed from insurance when you do crown lengthening when you do the prep for the crown on the same day?

A: I have heard that some insurance companies have issues, only because they are years behind the times when it comes to current dental procedures. They still don’t reimburse for laboratory resin crowns when at times they are indicated over porcelain. A photograph and explanation may help. However, you are saving your patient extra appointments and sometimes an invasive surgical procedure. In my office, I charge $350 per tooth for closed flap crown lengthening. Most periodontists in my area charge $1,000 to $1,200 for a single tooth surgical crown lengthening. Even with 80% reimbursement, the out of pocket is comparable to my charge without any coverage. So…bottom line…let the patient chose. Insurance has never been an obsticle for me in this area.

Q: Dr. Lowe: what is healing time on the closed flap crown lengthening? How soon can you seat the crown?

A: Healing time for a closed flap crown lengthening procedure can take from 4-6 weeks to several months, however, the beauty is that you take the impression the day of surgery, deliver the crown 3 to 4 weeks later, and let the tissue mature around the definitive restoration rather than an ill-fitted, over-contoured temporary restoration.

Q: Dr. Lowe: is there a risk of damaging the root surfaces when doing closed flap bone reduction with the laser?

A: Only if you fall asleep with the laser pointing at the tooth…seriously, the ErCr, YSGG laser is an end cutting instrument. As long as the tip of the laser is parallel with and in contact with the tooth/root surface, it can not possibly harm the root. The same cannot be said for rotary instruments (burs). It is also less invasive as far as potential damage to the root surface than a Cavitron or sonic scaler!

Q: Dr. Lowe: why all the controversy over closed flap osseous recontouring (crown lengthening)?

A: Why the controversy? Because people voice opinions without ever having done the procedure, or the procedure is done in less than minimal circumstances where an open flap procedure would be more appropriate. I have done hundreds of closed flap procedures for esthetic crown lengthening of gingival zenith areas and for minor proximal biologic width corrections…this procedure works! As far as how smooth is the bone after laser treatment…not as smooth as when treated with hand instrumentation, but the bone remodels. How smooth is the bony crest after a tooth is extracted without laying a flap? Does the bone remain jagged? Does the marginal tissue remain hemorrhagic and edematous? The answer is no. As far as I am concerned, if the tissue is pink, if there is a probable sulcus that does not bleed, the tissue is healthy. Again, I don’t need to flap it and look at it to verify this like some of the comments I see in the “dental forums”.

Find more questions and answers in Part II »

Three days of great education came to a close with Saturday’s Moderators’ Forum, which was moderated by Dr. Ronald Goldstein.

The forum gave DPRWorld08 attendees an opportunity to ask questions on a variety of topics they came up with after listening to great educators for three days.

Panelists included Drs. Joel Berg, Robert Genco, Alan Boghosian, John Flucke, Noah Chivian, Louis F. Rose and Fred Eichmiller, and Lee Culp, CDT.

A number of attendees stood up and asked questions, while the panelists also addressed questions attendees submitted during panel sessions throughout the event. Topics included fluoride in bottled water, considerations when purchasing new technology, adhesive systems, evidenced-based dentistry, implants, laser choices, sealants, shade guides, oral systemic links and caries detection systems.

Dr. Flucke, the Technology Editor for Dental Practice Report Digital Edition, offered advice for one doctor looking for the “tipping point” when buying technology.

“The tipping point is quality of care and efficiency,” Dr. Flucke said. “Don’t buy a ‘dental treadmill.’ Before you buy it, get educated and force yourself to use it.”

Advanstar Dental Media Vice President and General Manager Richard Fisher closed out the session by saying, “Thank you for giving us a fine experience. The feedback from attendees has been overwhelmingly positive.”

Matt Hendrickson of PracticeWorks, Exclusive Maker of Kodak Dental Systems, shows off the benefits of the Kodak 9000 3D extraoral imaging system that provides both panoramic and 3D images.

Missie Warwick, CE Senior Event Planner for Dentsply Raintree Essix, highlights the company’s esthetic tooth repositioning products.

With a fair amount of back and forth over whether or not light improves bleaching quality, Discus Dental just released two new clinical studies supporting the efficacy of light-enhanced whitening procedures.

Below, Dr. Marilyn Ward, Director of Global Education for Discus, shares why the company is excited to make this new information available.

To download the studies for yourself, click here.