A prosthodontist’s perspective on the LANAP® Protocol

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. Robert Mokbel, a prosthodontist in Orange County, California. Dr. Mokbel received his degree in dental surgery in France and continued his training in prosthodontics, as well as a teaching opportunity at the University of Paris. He serves as a clinical assistant professor, teaching restorative dentistry and prosthetics at the University of Southern California and practices in Fountain Valley, California. Dr. Mokbel. Thanks so much for being my guest today.

Robert Mokbel: Thank you very much, Marty, for having me here with you today.

Marty Klein: So I know that you’re trained in both periodontics and prosthodontics, and you are the first prosthodontist that I’ve had as a guest on this show. So for those listening who may not be familiar, can you tell us just briefly what a prosthodontist does?

Robert Mokbel: Well, a prosthodontist is a, it’s super general dentist. We actually do additional training and mostly restoring teeth, which, restoring teeth means, crowns, bridges, dentures, partial dentures, and porcelain veneers. I trained in prosthodontics in Paris and the same time I did periodontology as a second training. So my practice is mostly geared toward prosthodontics with emphasis on periodontology, which I always I think the two go together very well when you making complex treatments like when prosthodontics do that.

Marty Klein: You trained on the LANAP® Protocol back in 2010. So I’d like to hear from you what led you to come to training when no other prosthodontist had done before? Did you even know that you were the first at that time?

Robert Mokbel: No. I just wanted to explore other areas in treating periodontology, because at that time, I was doing the cutting procedures, cutting patients, and suturing  in order for me to enhance the tissue when I’m placing those advanced restorations and multiple illustrations. I know that I wanted to get a less invasive procedure, so when I knew there was something else better than this. So I at that time wanted to just provide my patients with better treatment.

Marty Klein: And is it true that you were yourself a LANAP® patient?

Robert Mokbel: Yeah, Yes. The story is that I did the surgery for other for my patients, and I know it was not very painless. Patients would always have pain and they had to take medications sometimes takes two weeks for the pain to go away. And I didn’t want that to happen to me, so I really was looking for something less painful. So, the story is that I went to the convention, with my receptionist, and I knew that there is a laser company there that provide an alternative to regular periodontal surgery. So I spoke to Dr. Gregg, (Robert Gregg, who’s one of the founders off the Millennium Laser Technology and Dr. McCarthy as well at that time), I think in 2010, 10 years ago, and I see the cases and I was really impressed. I’m kind of impulsive in a way. But I was kind of amazed by the procedure, by the healing, and by the outcomes. I see a lot of those cases that normally I would have to recommend extraction, and they saved the teeth. So I was really intrigued, I wanted to get into that technology, and that’s how it started.

Marty Klein: Just to circle back and you got the LANAP® treatment yourself, is that right?

Robert Mokbel: Oh, yes. So I had the training when we had the training. Dr. Dawn Gregg, whose Dr. [Robert] Gregg’s wife, and she was actually the trainer. And I had the procedure done there during actually the surgical training because you get three days or four days training at the beginning when you buy the laser, because you can’t buy it without training, which is really I think it’s a plus, because really, this is a specific procedure and has to be really done very well and there is a protocol that you have to follow in order to achieve those results. And yeah, I was very pleased. I had the treatment on Friday. They did half of the mouth and I came back the next day on Saturday and they did the other half of my mouth. I had maybe taken one Advil on Friday night, and Saturday I was OK. All I had to do was just follow the diet procedures and recommendations.  I had to just be careful with it for a few weeks, and I tell you, it was like, day and night.

Marty Klein: Well, I have to ask for a follow up. That was almost a decade ago. Did your periodontal disease reverse?

Robert Mokbel: Oh, yeah. I’m very stable, I don’t have the issue anymore. I just get my teeth cleaned regularly. I mean, I have maybe one area that has a four millimeters in my pockets were around six millimeters, and some of my teeth where I had some mobility… They were mobile, and I knew that some of my teeth would have needed more extensive surgery. But with the laser it was blessing. I think all my teeth right now are stable. I don’t have any mobility. I don’t have inflammation. There’s no bleeding, really. And you know that’s it. I’m okay. I’m happy with it.

Marty Klein: Well, it’s rare I get to speak with a trained LANAP® doctor who’s also a patient. So I just wanted to hear from you about that, but shifting gears back to you as the treating doctor, I want to hear a little more about what it was like after getting trained. And if there was a learning curve at all starting to treat your own patients back in your practice,

Robert Mokbel: Yeah. I mean, that was really good. After I was done with the first session of training, I felt like I wanna really try it, especially that they did it for me. So for me, when they did it, I really learned a lot being a patient, because I felt all these movements. I was kind of more confident doing it. My first patient was one of my assistants because she was into technology, and I was all excited. The rep at that time came to the office and gave them a little… big idea, actually: how we’re doing it, why we’re doing it, and so on, and they were all excited about it. So she wanted to get it done, and I did it for her and she was very, very happy and everything went well with her. I did half mouth on one side and the other half month after a few days. Then, actually, her husband wanted to get it done. So her husband came and we did it for her husband too. That was my first two patients, basically.

Marty Klein: So, as a prosthodontist over time, you I’m guessing you use your PerioLase® for multiple different procedures, not the least of which is LAPIP™, or the peri-implantitis procedure. Can you tell me more about your experience with LAPIP™?

Robert Mokbel: Yeah, I do LAPIP™ sometimes. And I see patients that had multiple implants, and they have a denture over it, or they have a fixed bridge or something. I have several patients that have bleeding around the implants, and they had pockets like 6-7 millimeter and sometimes pus.  I believe that using the laser around these areas does improve the outcome and save those implants, because I had patients that before that I tried to open the gums, cut open the flap, clean the implants with whatever they recommend (like brushes), and put some etching on it (like acid), or sandblasting and rinsing them and so on. I didn’t get as much healing that I expected, but with the laser that was an added procedure to disinfect all these pockets, killed the bacteria that is growing there. The tissue response is very, very nice. They don’t bleed after that, and the tissue looks nicer. I tell you, it makes a big difference.

Marty Klein: And you’ve been using your PerioLase® now for about a decade, like I had mentioned, would you say that your clinical results over time over that period have been consistent?

Robert Mokbel: Oh, yeah. Oh, yeah, I think consistent. I believe that all the patients that followed up, because some patients, no matter what you do, they don’t follow up. They feel better right away. After year, they disappear. They never come back. Those I cannot speak for, but the ones that keep coming back, they’re really, really doing well. Over 10 years, I think I would say I have very, very high success rate. I don’t want to say 100%, but it is really, really much better than what I expected doing the other procedures where I would cut the gums and then the patient has longer teeth, and they have more sensitivity, stuff like that. So, yeah, it does improve over time and very consistent with that. Yeah.

Marty Klein: So if somebody listening is a prosthodontist and had heard about the PerioLase® and LANAP® but assumes that it is more so for periodontists or even general dentists, what would you say to that prosthodontist who is considering the PerioLase®?

Robert Mokbel: Really, I mean, you have to be into it. You have to be doing periodontal treatment for patients. Most prosthodontists work with a periodontist – and I work with periodontist as well – because I cannot do everything. But I’m saying if you’re interested in trying the PerioLase® it makes a big difference around implants, around natural teeth. If sometimes you have the crowns or bridges that goes down very deep inside the gums, it is always good to have the laser because it helps save some of the crowns that normally you’d have to take out or you have redo.

Marty Klein: Well, I do appreciate the time that we’ve spent today. I want to give a plug to your website if anyone would like to hear more or learn more about Dr. Mokbel in Fountain Valley, California. The website is scdentalimplants.com. If anyone listening here has not yet subscribe to the podcast, please do, so that you don’t miss any episodes. You can also find all of the episodes available at lanap.com/podcast. Dr. Mokbel, Thanks again for taking the time out of your afternoon and joining me today.

Robert Mokbel: Yeah, thank you very much. I want to thank LANAP® for giving me the opportunity to improve my skills and to provide better treatment for my patients. My goal is to provide better treatment for my patients, really. Thank you very much.