An experienced LANAPer’s advice to young periodontists

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. Braden Seamons, a periodontist in Honolulu, Hawaii. Dr. Seamons attended the University of the Pacific School of Dentistry. He then entered the Naval Dental Corps, where he practiced general dentistry for 10 years. His postgraduate training was at the Naval Dental School in Bethesda, Maryland. Dr. Seamons, thanks so much for being my guest today.

Dr. Braden Seamons: My pleasure, Marty.

Marty Klein: So we like to give our guests an opportunity to tell your LANAP® story, and in your case, you were trained on the LANAP® Protocol in 2007, I believe, as the first periodontist in Hawaii. So I’d like to hear how what led you up to that point, how you first became aware of LANAP® and what pushed you to get trained.

Dr. Braden Seamons: Well, the story goes, I was actually giving a lecture at the Hawaii Dental Association meeting in January of 2007. I gave a lecture, walked out the door, and right outside the door was the Millennium booth. Of course, I had heard about this crazy laser that could grow bone and blew it off, but I stopped for a second. At the time, Dr. Yukna had his study out there. It wasn’t published in IJPRD yet, but he did have the study. The rep gave me a copy of that, and you can’t fake histo(logy), so it really kind of drew me in. What happened after I read this study was I called Dr. Yukna, and at the time he was running the program in Louisiana. He graciously spent about 45 minutes with me and told me the story of how he went in the biggest skeptic but came out the biggest advocate and, just wholly endorsed the LANAP® Protocol. So I called a couple of periodontists on the mainland that were utilizing it. The one that stands out was Lloyd Tilt, who was one of the forerunners. Everybody had nothing but positive to say about it, so I took that big leap of faith and went to BootCamp in May.

Marty Klein: First you dismiss the PerioLase® as the crazy laser. At what point did that opinion start changing?

Dr. Braden Seamons: Well, once I saw a doctor Yukna’s study, I mean again, he had human histo, documenting new attachment, new bone, so that was beyond compelling.

Marty Klein: And for those who are listening, not familiar with Dr. Ray Yukna’s histological study. It is available online at LANAP.com/research. So you came to training, now you have it in your own hands. Were you able to replicate those type of results right out of the gate, or did that take some time?

Dr. Braden Seamons: Right out of the gate, Marty! I came back and kept my mouth shut, didn’t tell anybody about what we were trying. The initial “Wow” was when you started seeing your two week post-ops, right? I mean, they just looked fantastic. Then once we waited the appropriate time and started probing and getting radiographic evidence of new bone on a routine basis, that’s when you just know you got the real deal. I went public and took a lot of heat for it. We continued to press forward and it’s been a very, very rewarding experience for me.

Marty Klein: Did you have any challenges when you were first getting LANAP® going in your own practice?

Dr. Braden Seamons: Well, the biggest challenge, you know, was dealing with the negativity put out there. There was a study club that was the biggest study club in Honolulu, and I was getting a bad rap there. So I joined it to try and defend myself. Somewhat interestingly, I requested to present to the group, but for three or four years, just they came up with all sorts of interesting reasons not to. Then fortunately for me, Dr. Jon Suzuki got on board, and he’s quite the icon over here. As soon as he came out in favor of LANAP®, they actually requested that I present to them. That was kind of an interesting evolution.

Marty Klein: Dr. Suzuki is now a certified instructor for the IALD. He trains some other dentists at BootCamps sometimes.

Dr. Braden Seamons: Yeah, he’s quite the guy!

Marty Klein: You have done quite a lot of cases over the years, both with the LANAP® Protocol and LAPIP™ for peri-implantitis, so I’d like to hear now, looking back over the last 13 years that you’ve been doing this, about first consistency of your results and then any particularly memorable patients or clinical outcomes.

Dr. Braden Seamons: Well, in terms of dealing with teeth, the consistency is huge in terms of improving clinical presentation and growing bone in vertical defects. I mean, it’s just almost routine. Implants are another story, they’re not nearly as predictable. My clinical results with implants, I think mirror what the oral surgeon in Texas presented in a study, I think it’s in General Dentistry, where roughly 90% you get clinical improvement with implants and 5% they get worse, no matter what you do. Those aren’t the exact figures, but they’re close.

I have had a couple of cases that are just off-the-charts incredible. We had one lady that was on Prolia, she had a bridge on the lower right that was 14-plus millimeter probing depths, class three mobility, had super eruption, was in severe a traumatic occlusion. It was kind of scary because she was on Prolia, but I figured treatment was less risky than pulling them. So we went ahead and did it, and almost mind boggling. She now has 3 to 4 millimeter probing depths with plus mobility and just radiographic evidence of new bone like crazy.

Marty Klein: I was going to mention that that oral surgeon you were referring to is doctor, Gary Schwartz, in Texas, that published his LAPIP™ findings.

Dr. Braden Seamons: Yeah, he’s a fun guy, but also it’s a great article. It’s just solid.

Marty Klein: So I believe you were about to mention a different patient.

Dr. Braden Seamons: Yeah, we’ve had a couple of implant cases that were just insane. You know, there’s one where we had about 80% bone loss, and it was before I had really gotten into it that much. I told the patient we might as well just take it out and she said, “No, try.” So we just grew back an enormous amount of bone. But my favorite case was a patient had a mandibular implant-supported denture on four implants and one of the implants failed. Now we’re left with three. Interestingly, one of those fixtures was okay, but the other two had 60-70% bone loss. We treated those and got once again just off-the-charts results, so we saved her prosthesis. That was, without question, one of my more rewarding cases.

Marty Klein: I believe you published some of your cases in an article in Inside Dentistry in 2015. These were LANAP® Protocol cases as opposed to LAPIP™. Can you tell me what a more about that article or how the opportunity came about?

Dr. Braden Seamons: Yeah. First of all, the implant case that I mentioned where we had 80% bone loss and grow back is presented in the article, along with three natural dentition cases. Millennium actually approached me and asked if I’d be willing to publish with the help of one of your erudite individuals. Then a lot of my colleagues over here had asked me to do it. As anybody that’s published knows, it’s a lot of work. So I held off, then finally just bit the bullet and jumped in. It was a really rewarding experience, as well. I provided the input and the Millennium individual put it into the “Scientific Perio-speak” type article. Then we forwarded that to the editor of Inside Dentistry, who’s a non-dentist, and she put it into a format that I thought was very readable. The overall process was exciting. We ended up with a pretty solid synopsis of the protocol, and then four cases presented.

Marty Klein: Okay, well, if anyone listening is interested in reading that, the article is available at LANAP.com/research. I did have one other topic to ask you about. You have a long history in the Navy, both in school and also in practice, and the U. S Navy is currently teaching LANAP® in their postgraduate periodontal program in Bethesda. I just wanted to get your thoughts on that development and what you would say to current Navy postgraduate residents who are getting LANAP® trained right out of the gate.

Dr. Braden Seamons: It’s exciting and a great service for the sailors. There’s certainly less downtime getting back to work sooner and all of that. But I think some of the things I’d mentioned are: shoot for full-mouth detoxification when it’s feasible. Like if you’ve mainly got disease in the posteriors, go ahead and detox the interiors as well. I think that’s worthwhile to keep in mind. On the other side of the coin, if you feel you need to get visualization, think there might be a fracture and enamel pearl or you just can’t seem to get the root surface smooth, don’t hesitate to lay a flap and take a look. Do it as conservatively as possible, but if you need to take a look, take a look. The only other thing that I’d like to mention is if you’ve got redundant tissue that’s coronal to the CEJ, but you know you’re not going to get reattachment there, go ahead and get rid of that hyperplastic, redundant tissue. I think that that’s a worthwhile adjunct to keep in mind.

Marty Klein: Are those advice points specific to the Navy, or is that in general? I just want to be clear?

Dr. Braden Seamons: Well, no that’s in general in general, of course. If you’re a resident just coming out of training, and we all know that there’s a learning curve and these are things that we all pick up along the way, and those were the things that I would keep in mind, particularly out the gate.

Marty Klein: Very good. I do want to give a plug for your website for any of our listeners interested in learning more about you and your practice in Honolulu, and that is periocarehawaii.com. If any of our listeners have not yet subscribed to this podcast, please do so wherever you download your podcasts. All of our episodes are available at LANAP.com/podcasts. Dr. Seamons, thanks for taking some time out of your day to talk with me today.

Dr. Braden Seamons: Marty, it was a pleasure. I enjoyed it.