August 17, 2020
A Skeptic’s Road to Giving LANAP® a Try
Roman Melnyk, DDS, MS
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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 Roman Melnyk, a periodontist in New Hartford, New York. Dr. Melnyk earned his DDS degree from Case Western an MS degree in periodontology from the University of Minnesota in Minneapolis. He’s been practicing periodontics in New Hartford since 1988. Today, we’ll talk about how he got started with LANAP as a self-acknowledged skeptic, how he defines LANAP’s predictability and success, and what led him to compile data for a LANAP Study. Dr. Melnyk, thanks for being my guest today.
Dr. Roman Melnyk: My pleasure.
MK: So you’ve been LANAP trained since 2012. I first want to start from before that time – how you first heard about LANAP and the PerioLase and your journey to get started with it.
RM: Well, my journey to get started with it was pretty convoluted. My experience or knowledge of the PerrioLase was, “That was that crazy, expensive laser. Why would you want to spend that kind of money for a laser?” Then I started getting contacts from one of the reps, who my name was given to by one of my friends who practices in Chicago, and just kind of was starting to get calls and starting to get e-mails and started to look at literature a little bit. Colleagues started talking about it, but I was a skeptic of the first degree. I was not convinced, and it took a little bit of work to get me on board.
MK: You mentioned one of the first things you knew was that it was crazy expensive, but at some point you decided it must be still worth it. How did that the financial aspect play out? And how did you overcome that particular concern?
RM: Well, my whole problem was that he had this device and there really wasn’t any at the time good, what I consider good research, to justify that kind of an expenditure. There are case reports, a number of them, but that, to me, didn’t carry enough weight to make that kind of an investment. Where I realized that something was going to happen was I attended an Upper New York State Society of Periodontists meeting, in Albany in October of 2011, and our speaker was Marc Nevins. This was a month before the AAP meeting in Miami, and we were at a break and he was setting up the presentation, the rest of the show so to speak. We were standing around and he said, “You guys want to see something interesting?” And I said, “Sure.” So he started showing this histology of these incredible regenerative results. We started asking, “What? How are you doing that? What? What’s the secret here?” He mentioned LANAP, and to be honest, at the time, I didn’t really know what that meant. He explained that he was doing research for Millennium, and that he was going to be presenting this material in a month at the AAP in Miami. So it was at that point I realized that something was up. I went to the AAP meeting in Miami, attended Dr. Nevins’ presentation, was overwhelmed by the results, probably because now I knew I was going to have to look into this, and I remembered leaving the presentation.
One of the reps came up to me and I still gave them some kind of a weak excuse. I went down to the lobby, called my wife and told my wife, “You know, check our finances because we’re gonna be spending some money!” And that’s kind of how I decided this was something that at least had to be explored.
MK: For listeners not familiar of the research that you’re referring to, it’s from Dr. Marc Nevins. It was published in IJPRD. And for anyone who would like to read that for themselves, we do have it up at LANAP.com/research. So that was, back to your story here, back in 2011. Dr. Nevins presents that. You’re liking what you’re seeing – his regeneration in histology. There’s still a financial component, and then and now Millennium Dental Technologies offers a six-month clinical results guarantee. Did that help your thinking in terms of the financial component of incorporating the PerioLase?
RM: It was critical. There was no way I was going to take that kind of a chance without at least having that to fall back upon. When I finally said “Okay,” then I started making sure. I wanted the details of this guarantee, and so I was assured that it’s real, but there was a little caveat that was given at the time, and that caveat was, “Well, you have to show that it’s not working.” I thought, “Well, that’s kind of interesting. How does one show that something doesn’t work?” So I agreed, signed, attended the BootCamp, but I also determined that I was gonna cover myself by documenting everything that I did with this device. I went back into my archives. I found some old blank perio charts from the University of Minnesota’s clinic, and I started documenting attachment levels and pocket depths and furcations, and all the stuff that I did in grad school. I was determined, actually, to show that it doesn’t work. That was my goal. My goal was to play for six months, show it doesn’t work, get my money back, send the device back, and have peace and quiet. It turned out differently.
MK: I was just going to ask if you ever considered actually exercising that clinical results guarantee? It sounds like you didn’t.
RM: No. At five months I did my first reevaluation, and clinically I was having difficulty accepting what I was seeing. I took a radiograph, and at five months there was bone growing back. I’m thinking, “Hmm, when I do my guided tissue regeneration procedures, I normally don’t see that kind of bone for 9 to 12 months.” But I thought, “Well, maybe. OK, that’s one.” The very next week my 2nd 5-month reevaluation came in and – same thing. It was that after that one, I realized that Millennium was going to keep my money and I was going to keep my device. There was no way I was going to send that back.
MK: So it’s been eight, well, about eight years since that point. Have those results been consistent? Or how do you really measure consistency or success with the PerioLase and LANAP?
RM: Well, I was. I’ve always been into periodontal regeneration. I started practicing in September of 1985. In February of 1986 I attended a Stir Neiman’s GORE-TEX training course in Washington, D. C, one of the earliest groups to take that course, and so I did a lot of guided tissue regeneration with GORE-TEX membranes up until they stopped making them and had great results. Then some of the other products came along like emdogain and other regenerative products. When I started to compare my results with the Millennium PerioLase, I would use my previous regenerative cases as a reference. What I found was the results were comparable with much less hassle, was much less technique sensitive, no material costs once the lasers paid for, obviously, but there are no grafting materials to buy & place. It was easier to do and the results were comparable. And so it was a no brainer. It’s still the really the only form of regenerative therapy I do around teeth.
MK: I believe you’ve said in the past that it feels like you started a new career since adopting the one at protocol. Was that still accurate? And what do you mean by that?
RM: Well, at the at the time, if you look back 12 years ago, or eight years ago, periodontics sort of has shifted more towards placing implants and seem to have been getting away from saving teeth and keeping natural dentition intact and, instead of compromise, to take it out, replace it with an implant. That always kind of bothered me. That’s not why I went into periodontics, and that’s why regenerative therapy was always important to me and has always been a favorite thing for me to do. And so now I’m doing a lot of regenerative therapy, and I’m not as concerned. I mean, the implant part of my practice probably has leveled off or maybe even kind of gone down. Yet my well, if you want to get into numbers, my production and my office production has just been going up and up and up and up, even as my implant practice has kind of plateaued or even declined. And to me, there’s much less stress doing LANAP than doing implants. So it’s a win win for me. And that was one of my comments to Anthony Cannon, one of the reps, that I thanked him, I said, “You made me a periodontist again!
MK: I understand, too, that you have compiled some data for a study. I’d like to hear more about that if it’s your data or data with others as well, and what some of the, if any, challenges were with that and what the next steps are in terms of anyone else being able to see what you’ve done with that.
RM: As I mentioned before, I started documenting everything that I touched with the PerioLase. Once I decided that I had proof enough to keep this device, and really, documentation of that level was no longer necessary, I also realized that there wasn’t any kind of data out there published. And so I looked at the number of cases I had started, and I realized that I had a number of cases already started. So at that point I consulted with my mentor at University of Minnesota, Dr Jim Hinrichs, and ask him, “What do I have to do to actually have incredible paper?” And so, with his guidance, I got calibrated with his guidance, I set up a control program with scaling and root planing. We fully documented 32 LANAP cases at baseline, six months, and one year, and we did 17 scaling and root planing controls in the same intervals, and so we’ve completed all of that data collection. We analyzed all of the data. And so now it’s just a question of getting a paper written, and we’re working on that at the moment.
MK: Okay, so stay tuned, in other words. I’ll be curious to see that data! I did have one last question for you, and you mentioned earlier about being a skeptic in the first degree. Certainly there are a lot of skeptical periodontists when it comes to laser therapy, and they still exist today. And it’s not like that has gone away. So I’m interested in what you would say to another dentist out there who is still skeptical about the efficacy or the return on investment of incorporating LANAP into their practice.
RM: Come on in. The water’s fine. It was one of those things that if you speak to a LANAPer, somebody who’s doing this, almost everyone will tell you that they had similar misgivings. Similar skepticism, maybe not as strong as mine, but everyone was. And everyone I’ve talked to has said, I regret not starting sooner because I could have I could have been providing these services to my patients that much sooner; could have been providing them that much longer. Now, it does take a little leap of faith, but it’s not like there is no evidence out there. There are two proof of principle studies – human histological studies – that are out there. The Nevins paper that we talked about; Ray Yukna previously had human histology study. Case reports. Go online. Take a look. How many teeth does it take to convince you that this stuff, that bone grows when you do this the right way? On my personal website, I have four slide shows. I think just before and afters of, I think, 40 cases. And recently I put one up for LAPIP. I did a slide show that documents the successes that I’ve had about getting periimplantitis successfully treated, at least stopped. Some regeneration occurred and documented with radiographically anyway, so just take a leap of faith! Do it. You’ll have fun.
MK: Did you make your money back? By the way? Eventually?
RM: If you just go by increased production, I did it in less than a year.
MK: Well, that’s fantastic. Well, you mentioned your website. I do want to plug that for anyone listening who would like to see, you have many of your own cases on your website, which is www.drromanmelnyk.com. And the studies, again, that we’ve discussed in this podcast are available is well at LANAP.com/research. If you’re listening and have not yet subscribed to this podcast, please do so wherever you are downloading your podcasts to get a new episode each Monday or at LANAP.com/podcast. Dr. Melnyk, thank you for joining me and being our guest today.
RM: Thank you for having me. My pleasure.