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- 1, 2, 3, 4.

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- On today's episode of this podcast,

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we've got a very exciting
guest with Dr. Daniel Galindo,

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chief Clinical Officer at
Integrity Dental Services.

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For those of you that don't
know, my name is Rob Dinker,

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I'm the founder and CEO of
Integrity Dental Services.

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Before we get started
in talking about some

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of these full arch topics and,

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and what's going on in,
in, in the landscape

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and space of the full arch world, uh, Dr.

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Glendo, do you mind giving us

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a little background about yourself?

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- Absolutely. Thanks
Rob for the invitation.

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Love being here with you and,

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and, uh, sharing some of my experiences.

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I'm a second generation dentist,

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originally from Bogota, Columbia.

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I trained and did dental
school in Bogota at Uni Ana,

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and in 1996 moved to the US

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to pursue my protic
training at the University

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of Rochester in Rochester, New York.

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After completing my residency,

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I took a teaching position at
the University of Connecticut

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and was there for three years

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learning about the academic
environment in the US

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and then coming from the
tropics, I had to move out

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of snow country and relocated
to Scottsdale, Arizona in 2002

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where I've been in private practice since.

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- So let's talk about sort
of the full arch landscape

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and uh, I know you, along
with a few others are sort

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of known as the, the early trailblazers

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or pioneers of the full arch space.

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And, and I know it looked a lot different,

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let's say back in the
early days to where to

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where we are now with the makeup

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of intraoral scanning, photogrammetry.

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A lot of those fun things we'll get

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to later on in in today's episode.

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But why don't you sort
of talk for a minute,

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briefly about the day
in the life of your role

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as a prosthodontist and
the, the original days of,

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of all on four when you first
started at Clear Choice.

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- Yeah, so I joined Clear Choice in 2008.

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We were the seventh center
that they opened at the time,

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and we were basically
adopting a treatment modality

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that was brand new to the United States.

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There weren't many people doing all on

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four treatment back then.

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So we had to one, learn the protocols

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that were initially established
by Pablo Malo in Portugal

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and one of the trailblazers

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of the All On four in the US Mark Adams,

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and be able to adopt those systems into

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a brand new operation

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and transforming patients
on a daily basis,

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but at the same time learning how

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to complete those transformations.

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So it, it was a lot of hard work,

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it was really rewarding work,

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but we put a lot of
hours in the office and,

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and learn how to make it better.

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We're talking about a
scale of, of not doing one

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of these once a month or once a week,

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but actually doing three
or four of these per day.

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So it, it helped us develop
the skillset that clearly

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was above the line of what was
being presented out there at,

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at the time and, and became
the reference place for how

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to do these procedures.

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- How bet that made for
some pretty long days

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in the, in the beginning,

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- Oh my goodness.

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There, there was days in
which we were walking out

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of the office at eight
o'clock, nine o'clock and

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and again, this is not to
talk about the skill set

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'cause the skill was
there, was just being able

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to develop the methods
of how to get this done

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and get it done right the first time.

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If there's something that
I've learned is I just want

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to get things done the right
way from the beginning.

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- Yeah, I think that's a good point in a,

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in a good transition or segue
into to one of our next topics

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and talking about fast
forward now into 2024,

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we're seeing a lot more of, of GPS wanting

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to get into the full arch space,

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and let's talk about, I know a lot

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of people have had success with it in the,

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in the practice you came from
when you were practicing, uh,

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prior to your new role.

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I know you, you had a oral
surgeon in the office with you

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for, for every case
than you would take over

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as a prosthodontist

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and that was sort of the
model that you all adapted

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and scaled, which has
been very successful.

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What, let's talk about this, the new space

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and maybe some, some insight
for gps that are listening

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that could be some possible challenges

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or hurdles from them that you
guys learned in the early days

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and stuff maybe they could
be aware of when wanting

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to get into the full arch space.

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- Initially, when we started doing this,

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it was two specialists that
were using their skills

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to be able to get a patient completed.

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And the most important
thing that I learned is

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I couldn't just be a prosthetist.

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I also had to know oral surgery

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and on the same end,
the oral surgeon needed

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to understand some
prosthodontic principles

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because at the end of the
day, we wanted to make sure

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that the patient would go home with,

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with a satisfactory outcome
based on the planning

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and the execution that we had done.

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So I had to revisit
anatomy, complete anatomy

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of, of, of the maxella, the
mandible facial anatomy, and,

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and the surgeon had to
kind of relearn principles

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of biomechanics and occlusion and whatnot.

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So fast forward to 2024,

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when you have a single
practitioner delivering these

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procedures, you, your knowledge
has to be very broad based

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and you have to understand
both phases of treatment,

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the surgical and the restorative phase so

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that you can have a
really successful outcome.

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And that's the goal for
every single patient

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that accepts this as a treatment modality

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to address their problems. Yeah,

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- It makes a lot of sense and

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and that's some of the things
we see in the lab on a daily

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basis and where people
are wanting to change

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and adapt new workflows.

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For example, if, uh, some,

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some offices out there now
are are marketing, you know,

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going to the final restoration

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to a final zirconia
within 24 hours, I guess

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to be more appealing

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or marketing to the patient,
like, hey, you don't have to go

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through so many steps or so
many interims until the final.

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Also, it's a cost savings from the,

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the doctor's standpoint on office visits.

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But let's stop for a second

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and say, what are we giving up,
you know, if, if for so long

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and so many years the benchmark

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or the standard has been,
you know, the protocol

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of understanding when the,
the soft tissue in the mouth,

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everything becomes stabilized,

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the osteointegration of the implants.

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I mean, in some of these
gps that are wanting

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to do the surgery, utilize photogrammetry

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and go to final zirconia that day

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or the next day, what,
what are some concerns

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or areas that, that would concern you

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as a pro orthodontist in doing that?

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- Well, let's talk about
another one of our passions.

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We like fast cars, correct?

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We, we love fast cars,

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but you need to know when you're
gonna drive a fast car fast

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and when you're gonna drive it cautiously.

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You can't just take a turn
at one 20 miles per hour

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because you're gonna be
slamming into a wall.

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So the variable

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that is not being considered right now

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is the patient's biology.

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And no matter how fast I want
to go with the treatment,

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I've gotta respect
biology tissues swell up

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during the course of surgery.

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There's a healing phase that will happen

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that includes inflammation

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and if you don't account for that,

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the end result is not going

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to accommodate the healed tissue.

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So it's very important to
keep that variable in mind.

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There's, there's treatment
alternatives that will allow

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for the correction of any
variance that occurs from,

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let's call it day one

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after surgery to day 120 after surgery.

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But there's some others that are static

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and there's no way of modifying it without

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compromising the final outcome.

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We were talking about this the other day,

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you can't reline zirconia in
a way in which you're gonna be

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happy for it for the long term.

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So again, you need to know
when you step on the gas,

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but you also need to know when
you step on the brake pedal

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and slow down the procedure

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and respect all phases of, of

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what biology involved in a human. Yeah,

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- And I think that that sort of plays into

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what we're seeing on a daily basis

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and talking with some
of our clients who have,

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I'm not gonna say jumped in
with both feet, like some

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of these other implant
groups out there, you know,

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maybe there's an elderly
patient that they're,

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they're only doing an arch on the lower

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and they feel like doing
a high water design.

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It, it could work. And
others, you know, it's like,

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well when we get to the
point, if the tissues change

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that much, then I'm gonna make
them another zirconia at the

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4, 5, 6 month phase.

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But then it's like, then
what was, in my opinion,

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what was the, the speed, the
urgency, the rush to go ahead

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and get them in a zirconia within 24 hours

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if the possible treatment
protocol was talking with one

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of our docs in Chicago.

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And I asked him the question, not

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to challenge, but I want to learn.

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I'm like, I want to understand

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because the nature of this landscape of

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what we're doing is changing

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and I wanna make sure that
integrity's always up to speed

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and understanding the
expectations of our clients.

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Uh, and he told me, he said,
Rob, you know, I'm really,

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I'm sort of taking it as I go and,

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and this is unchartered waters.

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I'm, I'm wanting to
learn what's acceptable,

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what's clinically acceptable,

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but chances are, like you
said, I'm not gonna be happy

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with relining, the zirconia

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to really give the patient
the best treatment out there.

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Probably gonna make them another zirconia

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several months down the road.

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So, you know, we're all cause

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conscious, you know, in the lab.

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Sure. I would love to make
multiple zirconia for,

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for the doctor, but let's talk

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about what's best for the patient.

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And I think that will
be a great transition

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or segment into our next piece
when we talk about education.

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One thing I'm super excited about and

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and with you coming on

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as Chief Clinical Officer at
Integrity is the education

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facility that we've built
and the infrastructure at the

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Scottsdale location for
integrity of what's coming.

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Uh, for those of you that
want to check out our website

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to learn more on future dates for events,

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but we're gonna take a few
minutes to talk now about

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what we're wanting to offer
as a service because education

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and anything we do, dental
non-dental is very key

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that we're educated by those of our peers

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that have been there and experienced.

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And I'm very excited, you know,
we're, we don't just have a

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a lecture hall set up to play PowerPoints.

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We actually have a fully
operational operatory so

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that we can bring in a live patient.

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So everything that you're
sitting there talking about

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that could be on a PowerPoint slide,

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we can show them real,
you know, real time.

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So I want to take a second
and let you talk about the

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education piece and, and what we're hoping

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and what we will be offering at the

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Scottsdale integrity location.

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- That's one of the things
that excites me the most.

250
00:10:15,025 --> 00:10:16,805
So, you know, in my previous career

251
00:10:17,565 --> 00:10:20,165
I completed about 6,000 arches

252
00:10:20,465 --> 00:10:22,805
of full mouth
reconstructions using the all

253
00:10:22,805 --> 00:10:23,845
on four treatment concept.

254
00:10:24,185 --> 00:10:27,925
And that has allowed
me to learn what works

255
00:10:27,985 --> 00:10:30,405
and what doesn't work and
what you can implement

256
00:10:30,505 --> 00:10:32,805
and you can't implement
and what's the next step.

257
00:10:32,955 --> 00:10:34,845
Well, being able to share that with people

258
00:10:34,995 --> 00:10:37,645
that are motivated by the same passion

259
00:10:37,675 --> 00:10:41,285
that I have in helping restore
somebody's dental condition

260
00:10:41,305 --> 00:10:44,645
to a state of the art type of situation.

261
00:10:44,745 --> 00:10:48,725
So we are going to break down each step of

262
00:10:49,265 --> 00:10:52,885
the procedure into sessions
that clinicians come,

263
00:10:53,065 --> 00:10:55,565
can come over, see how they're performed,

264
00:10:55,985 --> 00:10:59,405
see them in in a real life
situation, see photographs

265
00:10:59,425 --> 00:11:01,485
and sequences of what
we've done with patients

266
00:11:01,665 --> 00:11:06,085
and understand how they
can deliver a result

267
00:11:06,085 --> 00:11:09,325
that's more predictable, more
successful, more long-lasting.

268
00:11:09,765 --> 00:11:12,565
Ultimately, I think that's
the goal of any clinician

269
00:11:12,875 --> 00:11:17,125
that is helping somebody as a
patient address a particular

270
00:11:17,725 --> 00:11:19,525
situation that they have
in their mouth evangelism

271
00:11:19,585 --> 00:11:23,285
or broken teeth or
extensive decay or trauma

272
00:11:23,545 --> 00:11:24,845
or whatever it is.

273
00:11:25,265 --> 00:11:27,045
The ultimate goal is to be able to let

274
00:11:27,045 --> 00:11:28,085
that patient move forward

275
00:11:28,345 --> 00:11:31,725
and carry on with a normal
life, unimpeded life.

276
00:11:31,955 --> 00:11:34,525
- Yeah. To play into that, one
thing I've learned over time,

277
00:11:34,875 --> 00:11:36,325
good friend of mine and, and a doctor

278
00:11:36,325 --> 00:11:37,685
that used to work with uh, Dr.

279
00:11:37,685 --> 00:11:40,085
Mark Andras, he really sort of educated

280
00:11:40,085 --> 00:11:43,365
and brought light to me about,
it's not just the education

281
00:11:43,365 --> 00:11:44,405
for the day of the surgery

282
00:11:44,585 --> 00:11:46,885
and what you guys do
with the oral surgeon,

283
00:11:46,945 --> 00:11:48,605
the prosthodontist, but also

284
00:11:48,775 --> 00:11:50,565
after surgery when it comes to hygiene.

285
00:11:50,955 --> 00:11:53,045
Then my brain started thinking about it

286
00:11:53,050 --> 00:11:55,450
and I had to start asking
different clients We have,

287
00:11:55,475 --> 00:11:57,845
what is your hygiene protocol
for for your patient?

288
00:11:58,315 --> 00:12:00,285
Some of them could answer
the question, some couldn't.

289
00:12:00,285 --> 00:12:02,925
And obviously speaking with
you, I know that you, you hold

290
00:12:02,925 --> 00:12:04,605
that to a very high standard regard

291
00:12:04,665 --> 00:12:06,885
and that's one thing for any
patients out there listening.

292
00:12:06,885 --> 00:12:09,325
If you're thinking of getting
this treatment, not here

293
00:12:09,325 --> 00:12:10,445
to sell you on where to go,

294
00:12:10,865 --> 00:12:12,725
but ask the questions of what happens

295
00:12:12,815 --> 00:12:16,285
after surgery once I've had
this all on on all on four,

296
00:12:16,345 --> 00:12:19,125
all on X procedure done,
what is the standard of care

297
00:12:19,225 --> 00:12:21,085
and what is, what's
gonna happen for hygiene?

298
00:12:21,325 --> 00:12:22,525
I want to talk about that for a minute.

299
00:12:22,725 --> 00:12:25,005
'cause I think that's something
in this industry we're

300
00:12:25,005 --> 00:12:28,525
so eager to get the treatment
done, let's close the patient,

301
00:12:28,655 --> 00:12:29,725
let's get 'em better treatment.

302
00:12:29,845 --> 00:12:31,525
'cause we are giving the
patient, you know, a,

303
00:12:31,685 --> 00:12:33,805
a better quality of life
and a path for hope.

304
00:12:33,945 --> 00:12:37,405
And it's like, what, what is
the standard for for hygiene?

305
00:12:37,605 --> 00:12:39,645
I think a lot of patients
haven't even thought about that.

306
00:12:39,705 --> 00:12:41,605
You know, you, for some of these patients,

307
00:12:41,605 --> 00:12:43,765
there's a reason you're
having this surgery done is

308
00:12:43,765 --> 00:12:46,605
because of how you took care
of the, the oral environment.

309
00:12:46,995 --> 00:12:49,445
Some of them other things have
happened they can't control.

310
00:12:49,865 --> 00:12:52,565
But let's talk about it for
what you think, you know,

311
00:12:52,625 --> 00:12:54,925
the standard of hygiene should
be for one of these patients.

312
00:12:55,075 --> 00:12:57,365
- Yeah. And and I think that
what you were mentioning

313
00:12:57,365 --> 00:12:59,285
before is, is very important.

314
00:13:00,025 --> 00:13:01,805
The conversation with the patient has

315
00:13:01,805 --> 00:13:03,245
to be a comprehensive conversation.

316
00:13:03,745 --> 00:13:07,005
Not only what's going to
happen the day of surgery and

317
00:13:07,025 --> 00:13:09,565
and what to expect with
swelling and bruising

318
00:13:09,585 --> 00:13:10,805
and, and discomfort.

319
00:13:11,505 --> 00:13:13,765
Not only what's gonna happen
when you make the definitive

320
00:13:13,765 --> 00:13:15,085
bridge, but there's a life

321
00:13:15,295 --> 00:13:17,605
after you put the definitive bridge

322
00:13:17,905 --> 00:13:20,725
and the care that a
patient gives themselves

323
00:13:20,985 --> 00:13:24,005
and the the care that they
seek afterwards, whether

324
00:13:24,395 --> 00:13:27,245
with a dentist or a dental
hygienist for the maintenance

325
00:13:27,245 --> 00:13:29,685
of their bridge is incredibly important

326
00:13:29,785 --> 00:13:32,525
for the long lasting
result of this treatment.

327
00:13:33,025 --> 00:13:35,125
You cannot just assume that

328
00:13:35,515 --> 00:13:39,645
because I'm getting some
titanium implants in my mouth

329
00:13:39,645 --> 00:13:42,285
and a zirconia bridge,
it's the end of the road.

330
00:13:42,285 --> 00:13:45,885
Correct. It's, it's just
really not that you need

331
00:13:45,885 --> 00:13:49,005
to be meticulous as a
patient, as a clinician, how

332
00:13:49,005 --> 00:13:52,365
to teach the patient on the
regular home care that they need

333
00:13:52,365 --> 00:13:54,965
to follow the brushing,
the flossing, the use

334
00:13:54,965 --> 00:13:57,765
of the water pick, and
then a regular program

335
00:13:57,975 --> 00:14:01,925
where you see the patient in
the office every six months,

336
00:14:02,015 --> 00:14:03,885
every four months, every three months.

337
00:14:03,905 --> 00:14:05,005
It all depends on,

338
00:14:05,065 --> 00:14:07,285
on the individual
situation of the patient.

339
00:14:07,465 --> 00:14:10,245
But you want to be able
to see this patient

340
00:14:10,465 --> 00:14:13,445
and if there's a habit
that you discover in one

341
00:14:13,445 --> 00:14:16,245
of these post-op visits, you wanna break

342
00:14:16,245 --> 00:14:18,165
that habit if it's one
that's creating harm

343
00:14:18,225 --> 00:14:21,325
or that could potentially
create harm for the patient.

344
00:14:21,825 --> 00:14:25,045
The goal is that these are the
teeth that are going to last

345
00:14:25,545 --> 00:14:27,165
for a very, very long time.

346
00:14:27,645 --> 00:14:29,685
I hear it often where

347
00:14:30,365 --> 00:14:32,765
patients are told these are
gonna last a last a lifetime,

348
00:14:32,985 --> 00:14:36,605
but okay, what are you
doing in, in the process of

349
00:14:36,605 --> 00:14:38,405
that lifetime to take care of it?

350
00:14:38,505 --> 00:14:42,005
You can't expect just to not
need to do anything for it.

351
00:14:42,185 --> 00:14:47,125
So that that care aftercare
is incredibly important

352
00:14:47,705 --> 00:14:51,005
key to success and again,
will allow the dentist

353
00:14:51,265 --> 00:14:53,365
to discover a problem early on

354
00:14:53,865 --> 00:14:55,205
and make the fixing of

355
00:14:55,205 --> 00:14:58,125
that problem a lot simpler
than if you wait five

356
00:14:58,125 --> 00:14:59,205
years to see a patient.

357
00:14:59,925 --> 00:15:01,285
- Absolutely. And that sort

358
00:15:01,285 --> 00:15:02,845
of made me think last night when you

359
00:15:02,845 --> 00:15:04,165
and I were talking at dinner, um,

360
00:15:04,225 --> 00:15:05,405
we were talking about some meetings

361
00:15:05,405 --> 00:15:07,165
and the AO meeting that you were just at

362
00:15:07,225 --> 00:15:10,805
and sort of, uh, education
that's out there now is sort

363
00:15:10,805 --> 00:15:13,845
of a, an unknown, but there's
definitely a fear amongst you

364
00:15:13,845 --> 00:15:16,125
and and and your colleagues
of periimplantitis

365
00:15:16,665 --> 00:15:19,645
and without having these
type of hygiene visits and,

366
00:15:19,645 --> 00:15:22,485
and bringing the patient in
to see, you know, this is,

367
00:15:22,485 --> 00:15:24,885
you know, this is I guess
over my level of education,

368
00:15:24,885 --> 00:15:28,205
but is this when you would
be noticing these trends

369
00:15:28,245 --> 00:15:30,925
that the patient's developing
perim, implantitis, you know,

370
00:15:31,105 --> 00:15:32,445
if that's the case, what's gonna

371
00:15:32,445 --> 00:15:33,645
become the standard protocol?

372
00:15:33,665 --> 00:15:36,165
We don't know. You know, there's
a lot of unknown out there,

373
00:15:36,265 --> 00:15:38,925
but back to the point, if you're
not coming in for a regular

374
00:15:39,575 --> 00:15:42,005
visit for hygiene, if
you're not going back

375
00:15:42,025 --> 00:15:44,485
and developing a protocol
for your patient so

376
00:15:44,485 --> 00:15:47,485
that you can monitor and
track the, the success of

377
00:15:47,555 --> 00:15:50,045
that restoration in their
mouth, I tell people,

378
00:15:50,045 --> 00:15:51,725
tell me it's like having
an air conditioning unit.

379
00:15:51,865 --> 00:15:53,125
The filter's very important.

380
00:15:53,385 --> 00:15:55,085
If you don't ever change the filter,

381
00:15:55,385 --> 00:15:56,725
you're never going there to check,

382
00:15:56,725 --> 00:15:58,565
but then all of a sudden
your unit's freezing up.

383
00:15:58,675 --> 00:15:59,885
That could have been preventative.

384
00:16:00,185 --> 00:16:03,085
So like as you said, as is
important, it is, we want to get

385
00:16:03,085 --> 00:16:04,525
to that definitive restoration.

386
00:16:04,525 --> 00:16:06,725
Whether the patient's
getting into zirconia,

387
00:16:07,245 --> 00:16:09,325
zirconia over a ty bar, whatever the,

388
00:16:09,325 --> 00:16:11,045
the restoration may be, that's great.

389
00:16:11,385 --> 00:16:12,685
But we have to talk about life

390
00:16:12,855 --> 00:16:15,165
after that final restoration seating and,

391
00:16:15,165 --> 00:16:16,365
and what is the protocol.

392
00:16:16,545 --> 00:16:19,205
And I can tell you with the
large number of doctors we work

393
00:16:19,205 --> 00:16:21,605
with and the thousands of
prosthetics that we've made

394
00:16:21,625 --> 00:16:25,085
for patients, not that many,
I can tell you only a handful

395
00:16:25,195 --> 00:16:26,805
that really are disgusting

396
00:16:26,805 --> 00:16:29,365
or talking about the
hygiene with their patient.

397
00:16:29,565 --> 00:16:31,605
I mean, I'm not saying
that more aren't doing it,

398
00:16:31,985 --> 00:16:34,205
but I just feel like the patients we talk

399
00:16:34,205 --> 00:16:36,045
to when they call us and
they say, Hey, you know,

400
00:16:36,085 --> 00:16:37,245
I know you're in this industry.

401
00:16:37,625 --> 00:16:40,485
My grandmother's thinking of
this restoration, my sister,

402
00:16:40,555 --> 00:16:42,205
whoever, who do you recommend?

403
00:16:42,245 --> 00:16:43,325
This person has this price.

404
00:16:43,325 --> 00:16:45,045
And they said, I can get
to the final this fast.

405
00:16:45,835 --> 00:16:47,685
Well, you know, let's
sit back for a second

406
00:16:47,705 --> 00:16:48,765
and think, like you said,

407
00:16:48,775 --> 00:16:51,285
we're hoping these teeth
last a long a lifetime.

408
00:16:52,105 --> 00:16:55,205
Why are we rushing or why
does a few extra weeks make

409
00:16:55,205 --> 00:16:57,925
that big of a deal if we're
able to know that we're able

410
00:16:57,925 --> 00:16:59,965
to eliminate something that could arise

411
00:17:00,345 --> 00:17:03,205
or become a compromise just
because the competition

412
00:17:03,225 --> 00:17:07,085
or someone's marketing on, on,
on Snapchat or tip TikTok or,

413
00:17:07,105 --> 00:17:10,885
or Facebook that hey, I can do
an arch at X amount <laugh>.

414
00:17:11,435 --> 00:17:14,045
It's guys, we're we're not
going out buying a new jacket.

415
00:17:14,255 --> 00:17:16,085
We're not going out buying some commodity.

416
00:17:16,165 --> 00:17:17,885
I mean, we're talking about
something that's going

417
00:17:18,065 --> 00:17:21,125
to become part of your body
and it's gotta adapt and,

418
00:17:21,385 --> 00:17:24,405
and the biology of it and the
quality of the restoration

419
00:17:24,465 --> 00:17:26,845
and there's so many out
there that do it so well,

420
00:17:27,465 --> 00:17:29,805
but my fear and we're
seeing there's so many

421
00:17:29,805 --> 00:17:31,645
that are wanting to enter this space

422
00:17:32,145 --> 00:17:34,125
and their motive behind it is just cost

423
00:17:34,125 --> 00:17:36,125
that patient care is being jeopardized.

424
00:17:36,345 --> 00:17:38,005
And that really worries me. Yeah.

425
00:17:38,305 --> 00:17:40,125
- And, and it, it has to worry.

426
00:17:40,705 --> 00:17:43,245
All of us in the industry, we go back

427
00:17:43,245 --> 00:17:44,565
to setting expectations.

428
00:17:45,025 --> 00:17:47,965
If you set the expectation of
how long a treatment is going

429
00:17:47,965 --> 00:17:51,325
to take and how long it's
gonna take to get it done right

430
00:17:51,425 --> 00:17:54,365
and properly, I think
most everybody will agree.

431
00:17:54,695 --> 00:17:57,125
There might be situations
where you need to compromise

432
00:17:57,125 --> 00:18:00,765
because there's an urgent trip
or an event that's coming up

433
00:18:00,765 --> 00:18:02,725
and, and you do want to accelerate,

434
00:18:02,725 --> 00:18:04,925
but I mean, you have to know how to do it.

435
00:18:05,025 --> 00:18:07,445
We go back to when you can step on the gas

436
00:18:07,465 --> 00:18:08,565
and when you shouldn't.

437
00:18:08,675 --> 00:18:10,965
What we were talking about
the meeting of the Academy

438
00:18:10,985 --> 00:18:12,885
of Os Osteointegration, you know,

439
00:18:12,885 --> 00:18:16,245
the topic being
periimplantitis, it, it's kind

440
00:18:16,245 --> 00:18:17,285
of a depressing topic,

441
00:18:17,705 --> 00:18:20,765
but we've come full
circle with the practice

442
00:18:20,765 --> 00:18:21,805
of implant dentistry.

443
00:18:21,825 --> 00:18:25,005
You know, in, in the, in the
nineties we were learning about

444
00:18:25,565 --> 00:18:27,125
cosmetics and what we could do

445
00:18:27,145 --> 00:18:30,485
to achieve a great result
in the two thousands we were

446
00:18:30,685 --> 00:18:33,685
learning how to restore full
larges with dental implants.

447
00:18:33,745 --> 00:18:36,445
And, and now in the 2010s we were learning

448
00:18:36,515 --> 00:18:38,885
that we don't have to
work only with hybrids.

449
00:18:38,885 --> 00:18:40,005
We can use zirconia

450
00:18:40,265 --> 00:18:42,205
and ceramics to obtain some results

451
00:18:42,205 --> 00:18:43,605
that are, that are amazing.

452
00:18:44,785 --> 00:18:48,245
Now we're learning that there's something

453
00:18:48,245 --> 00:18:50,205
that can affect the,
all that beautiful work

454
00:18:50,205 --> 00:18:51,245
that we've done in the past

455
00:18:51,385 --> 00:18:54,245
and we need to learn
how to break that cycle.

456
00:18:54,585 --> 00:18:56,805
And I attended several
of the lectures and,

457
00:18:56,805 --> 00:18:59,165
and it's interesting
that there's still a lot

458
00:18:59,165 --> 00:19:02,485
of puzzle pieces that
we haven't found out how

459
00:19:02,485 --> 00:19:05,885
to put them together to
understand what triggers

460
00:19:06,605 --> 00:19:09,685
somebody all of a sudden losing
some bone around an implant,

461
00:19:09,825 --> 00:19:12,045
losing bone around all of their implants.

462
00:19:12,225 --> 00:19:14,245
We don't know if it was
a previous condition

463
00:19:14,245 --> 00:19:17,285
that the patient had that's
leading to the compromise of one

464
00:19:17,285 --> 00:19:21,765
of the sites or if it's
generated by medications

465
00:19:21,765 --> 00:19:23,805
that the patients are taking or whatnot.

466
00:19:23,945 --> 00:19:27,805
So it, it really opens
our eyes to the fact that

467
00:19:28,405 --> 00:19:31,205
a conversation with the patient before,

468
00:19:31,705 --> 00:19:33,765
before you grab a scalpel

469
00:19:33,905 --> 00:19:36,565
or a handpiece needs to
be had with the patient

470
00:19:36,665 --> 00:19:38,405
to set the expectation

471
00:19:38,745 --> 00:19:42,125
and to get them investment
invested in their treatment,

472
00:19:42,425 --> 00:19:44,405
not only from a financial perspective,

473
00:19:44,775 --> 00:19:48,125
which I know drives a lot
of what, what what we do,

474
00:19:48,265 --> 00:19:52,285
but also from a commitment
perspective so that that result

475
00:19:53,075 --> 00:19:54,485
will be a long lasting one.

476
00:19:55,125 --> 00:19:56,645
- Absolutely. Well, Dr. Glendo, thank you

477
00:19:56,645 --> 00:19:57,685
so much for your time today.

478
00:19:57,835 --> 00:19:59,245
It's been a, a, a great topic.

479
00:19:59,365 --> 00:20:00,805
I know we could sit
here and talk for hours,

480
00:20:00,905 --> 00:20:02,405
but I, you know, we wanted to just sort

481
00:20:02,405 --> 00:20:03,445
of hit some high level points.

482
00:20:03,615 --> 00:20:05,485
Definitely look forward
to having you back.

483
00:20:05,555 --> 00:20:07,285
Like I said, we'll, we'll be continuing

484
00:20:07,285 --> 00:20:09,325
to check back on a lot of these
things we're talking about.

485
00:20:09,505 --> 00:20:12,325
I'm looking forward to some
technology that's out there

486
00:20:12,325 --> 00:20:14,445
that I've been privileged
to for Periimplantitis

487
00:20:14,445 --> 00:20:16,125
that could possibly be
a solution for that.

488
00:20:16,385 --> 00:20:17,805
Um, as well as some other things.

489
00:20:17,805 --> 00:20:19,925
There's some exciting
materials, there's some great,

490
00:20:20,015 --> 00:20:23,125
right now it's such an exciting
time in full arch dentistry,

491
00:20:23,505 --> 00:20:25,445
but at the same time, we have to make sure

492
00:20:25,445 --> 00:20:27,005
that we don't get in front of our skis.

493
00:20:27,185 --> 00:20:28,805
We make sure that the materials

494
00:20:28,805 --> 00:20:30,685
that are being developed are tested and,

495
00:20:30,705 --> 00:20:33,205
and the benchmark test is not only out

496
00:20:33,205 --> 00:20:35,525
of the oral environment, but
also in the oral environment

497
00:20:35,545 --> 00:20:37,285
to make sure that we're giving the patient

498
00:20:37,465 --> 00:20:38,525
the best quality of care.

499
00:20:38,745 --> 00:20:41,325
Um, and it's the same thing
from the lab side where I'm at.

500
00:20:41,325 --> 00:20:43,645
We're wanting to make sure that just

501
00:20:43,645 --> 00:20:45,365
because we could possibly get faster,

502
00:20:45,665 --> 00:20:47,045
are we still, are we jeopardize?

503
00:20:47,125 --> 00:20:49,205
What are we jeopardizing? I
mean that's been something

504
00:20:49,205 --> 00:20:51,165
to talk about with a lot
of these iOS scanners

505
00:20:51,165 --> 00:20:53,125
as they get faster, what are we giving up?

506
00:20:53,425 --> 00:20:56,325
So thank you again, look
forward to, to working

507
00:20:56,325 --> 00:20:58,285
with you in the future and
like I said, looking forward

508
00:20:58,285 --> 00:21:00,605
to possibly six months to a
year coming back and, and,

509
00:21:00,605 --> 00:21:01,685
and circling back on some of

510
00:21:01,685 --> 00:21:03,285
these topics we discussed today. This

511
00:21:03,285 --> 00:21:04,285
- Is so exciting.

512
00:21:04,285 --> 00:21:05,045
Thanks for the invitation

513
00:21:05,265 --> 00:21:07,045
and can hardly wait for the next time.