A prosthodontist’s experience with the PerioLase® MVP-7™

Transcription: 

Marty Klein: Welcome to Dentistry for the New Millennium. I’m Marty Klein, training manager at the Institute for Advanced Laser Dentistry. My guest today is Dr. Gregory Louie, a prosthodontist in Danville, California.  Dr. Louie went to dental school at the University of the Pacific, and later, an implant residency at the Brookdale Hospital in Brooklyn, New York, and finally, a prosthodontics residency at the University of Illinois in Chicago. He’s been a LANAP®-trained clinician since January 2020.  Dr Louie, thanks so much for being my guest today.

Dr. Gregory Louie: My pleasure.

Marty Klein: So you first came to training relatively recently in 2020, and I understand it was kind of a long road leading up to that point. So I’d first like to have you take me back to your first exposure to the PerioLase® MVP-7™ and the journey toward finally making the plunge and incorporating it into your practice.

Dr. Gregory Louie: Well, I first heard about this laser thing many years ago. I was invited out to a dinner by Dr. Gregg and I was quite skeptical at the time. There were no real studies out and I just put it to the wayside. And then later I started hearing these rumors about this laser that can actually regrow tissue. So I revisited it and actually, at the time I was looking for a way to treat implantitis. My practice is primarily an implant practice and I’ve come across a lot of implanttitis cases and in the past I was using the old currently it’s called the Froum-Rosen technique where the old AAID technique to treat implantitis. But it’s a surgical procedure. And it’s very invasive where you actually have to cut the tissue and clean out the implant as best as you can. So, I was looking for a way that was less invasive. Most patients are very reluctant to have to go through another surgery, especially after having problems with their implants. And the last thing they want is another surgery. So anyway, I revisited this and actually I took the plunge but I backed out. I think it was 2016 and I backed out because of various reasons. And of course now I’m kicking myself. I should have, would have, could have. But you know, now that I have the machine and see what it could do, I really I really regret that I didn’t follow through in the past. Like I said, I was using the PerioLase®, I wanted to use it to treat implantitis but it actually morphed into trying to save teeth instead of just using it as for implantitis. And I’ve gotten some pretty good results. But the real thing that really helped me though to really surprised me is that, you know, patients, they want this thing, they don’t want to get their gums cut. And when they hear that there’s a minimally invasive technique to actually treat gum disease – to actually even grow back some of the tissue, they’re very, very interested. And so from a marketing point of view, it worked out very well for us. We have quite a few patients who will do anything to try to save your teeth. And some of these patients, you know, they come in with floaters. I mean nothing can help a situation like that when you have a situation like that. So it attracted a lot of actually full-arch implant cases. So we got a tremendous amount of full-arch implant cases from that. But the big shift really is thinking from implants to trying to save teeth because as you know, and there’s nothing as good as what nature has given us. And this is a very patient-friendly way to treat gum disease and to try to at least put off implant placement or even eliminate implant placement altogether.

Marty Klein: So you had talked in there about the long road and you decided to purchase at one point, but then backed off and then came back to it later. Was there something that you could have seen in that interim that maybe would have made you take the jump even sooner?

Dr. Gregory Louie: Yeah. What had happened was more research came out and speaking with my colleagues, which happened to be mostly periodontists. It’s kind of weird because I’m a prosthodontist, but I tend to hang out with the periodontists. Many of them had this PerioLase® and they were getting some amazing results. So that got my attention to take a look at it for a second look. And I made the jump.

Marty Klein: Had you used any lasers prior to that point?

Dr. Gregory Louie: Well I have a diode, which is really pretty useless. But I actually talked to one of your competitors and I spend a lot of time speaking with them and I wasn’t at the time, I wasn’t sure which one to go for. But when I learned how detailed and how complete the training is at Millennium…there is no comparison.  To actually work on live patients and not just one day or two days or three days. I mean many days actually working on live patients and seeing for yourself how it works. There’s no comparison. And the didactic is very, very detailed as compared to these other manufacturers. So that and my colleagues’ opinions really swayed me to take a second look and to make the jump. And I’m glad I did because it’s worked out really good for us and our patients.

Marty Klein: Very good. I want to make sure that all of our listeners understand the role of a prosthodontist. Can you just quickly explain what that specialty covers versus a periodontist or a general practitioner?

Dr. Gregory Louie: Well, in my situation, I’m in a little unusual position because a typical prosthodontist deals with restoring teeth or restoring missing dentition, which means crowns, bridges, dentures…things like that. But there’s been a shift in the industry to where prosthodontists are required in the schools now to actually place and restore dental implants. I got my start before all this happened and I just so happened to be in the right place at the right time. But in my particular case, dental implants is where I concentrate my efforts. A typical prosthodontist nowadays include dental implants. Whereas a periodontist, for example, tend to concentrate on gums such as saving teeth as well and gum surgery. But like I said, I was in a little bit different situation where actually took an implant residency at Brookdale Hospital. So now is becoming more and more common for prosthodontists to be able to do these things.

Marty Klein: And I believe you said earlier that the PerioLase® has – and correct me if I’m wrong here – has shifted maybe some of your productivity back to saving natural dentition as well as implants. Did I understand that correctly before?

Dr. Gregory Louie: Yes, actually that was a very big shift for us when we saw teeth that at the time we thought that were hopeless, we no longer look at them as hopeless. Now there is a possibility to actually save them instead of removing them. So that’s a big shift for us.

Marty Klein: When you first came to training, you shared with the class that your previous protocol with regards to implants was to just take out ailing implants, graft, and essentially start over with a full-mouth reconstruction And I’m curious now that you’ve had the PerioLase® for going on two years, to what extent you still do that versus save implants with the PerioLase® as much as you can.

Dr. Gregory Louie: Well we’ve been a little bit more conservative. Our shift was being worked to the conservative side. You don’t jump to the surgery as quickly as we used to. The PerioLase® is our first line of defense.

Marty Klein: So is there a need sometimes to do full-mouth reconstruction?

Dr. Gregory Louie: Yes, of course. There’s no magic bullet, there’s no cure all for everything. The PerioLase® is one tool in our armamentarium to fight gum disease.

Marty Klein: I’d like to also hear from you a little bit about how you’ve observed the gum tissue looks after treating implants, and particularly after biostimulation or photobiomodulation, which is not an FDA cleared use for the PerioLase®, but it’s something often used by our clinicians. I have heard anecdotally from other clinicians that the way the tissue responds or just looks is really remarkable. Has that been your experience?

Dr. Gregory Louie: Definitely. The tissue, when the patients come back for post op check even the next day, the tissue unbelievably heals quickly and they look so nice and pink and healthy. I used to use and I still do use a lot of the blood products spinning the blood of PRP, PRGF, PRF. And I attribute the results from biostimulation very similar to that technology as far as the way the tissue looks after surgery.

Marty Klein: We’ve talked about a few of your uses of the PerioLase®. And I’m curious if there are any other procedures that we haven’t talked about yet that you’ve been able to use the PerioLase® during…or for.

Dr. Gregory Louie: Well, I’m a recent user. I haven’t been using the PerioLase® for very long, only about two years now. So I haven’t really investigated all the additional things you can do with it, what we currently use it for, besides LANAP® and LAPIP™ is laser disinfection after a cleaning or root planing procedure, because there’s still there’s still room for old fashioned treatment for gum problems. The tissue responds very well to something as simple as a laser disinfection.

Marty Klein: Well, good – if you’re getting success with the bread and butter of the PerioLase®, that’s what counts. I never know what I’m going to hear when I ask about VAPs, or value-added procedures. So there’s plenty of time in the future to continue to find uses. I want to switch gears a bit. Another thing that you had mentioned when you came through our training – you mentioned the comprehensiveness of our training a little bit ago – but you mentioned that you felt a sense of community being a LANAP® clinician and I wanted to bring your attention to that and just ask what you meant by that.

Dr. Gregory Louie: This is hard to explain. Those that have gone through the training and they are with their colleagues for the extended amount of time. The camaraderie…you just feel like a family.  We all have the same goals in mind as far as treating our patients and we see the results that this technology can achieve. And for me, more importantly, is the personal relationships that you develop with your colleagues. And it just seems like a family.

Marty Klein: Well, LANAPers are certainly their own tribe, I’ve heard that too, many times. One last item here:  when you came to training, you had mentioned that you’d like to stay on top of current trends and that you hope that the PerioLase® would keep you occupied for the next 10-20 years. So you’re now two years in and from everything you’ve said so far, it sounds like you’re well on your way. Is that true?  So far, so good?

Dr. Gregory Louie: Well, I just scratched the surface of the capability of what this machine can do.  As time goes on, I get more confidence in venturing out to do other procedures. You know that this is going to take time. And I do like to jump on new technology.  But I also am very cautious, especially when you have this financial outlay, a large financial outlay. But the return on investment at least for me was fairly quick and like I said before, well, was I surprised, I was very surprised and I wished I…I’m just kicking myself that I didn’t do this earlier.

Marty Klein: Well, it’s been a win for you, a win for your patients. We like to hear that, as you said, many years to come still of success and maybe we’ll have to have you back in in a couple of more years and see what else you’re doing with your PerioLase®. But in the meantime, I do want to plug your website. You’re in the East San Francisco Bay area, in Danville. That’s www.trivalleyimplants.com. I want to thank you for being a part of the show. You’re the first prosthodontist we’ve had on our podcast!  For any listeners here who have not subscribed to the podcast, I encourage you to do so so you don’t miss any episodes. And all of our previous episodes now, over 50 of them, are available at LANAP.com/podcasts or wherever you download your podcasts.  Dr. Louie, thanks again for taking the time out today to speak with us.

Dr. Gregory Louie: Thank you!