June 29, 2020
How a Dual Specialist in Ortho & Perio uses the PerioLase® MVP-7™
Frank Celenza, DDS
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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. Frank Celenza. Dr. Celenza obtained his dental degree from McGill University in Montreal. He followed up with post graduate work, both at the University of Pennsylvania for a certificate in periodontology and NYU for a certificate in orthodontics. Today we’ll talk about his unique perspectives as a dual specialist in orthodontics and periodontics and how that has affected his story with LANAP and his patients. Dr. Celenza, thanks for being our guest today.
Dr. Frank Celenza: Thank you, Marty, to pleasure to be here. Thanks for having me.
MK: So how did you first hear about the PerioLase MVP-7 and LANAP? And what made you really consider that for your practice?
FC: Well, it’s an interesting question. It’s had a big presence in periodontal circles for quite a while, and I do run some of the academies where we have meetings, so we’ve had our eye on it for quite a while. When I joined faculty at Rutgers University they were implementing that technology. I got exposed to it and immediately saw the efficacy of it, and decided to invest and get it going, and I’m glad I did. That’s about five or six years ago.
MK: Yeah, you mentioned there, Rutgers, I believe you are an assistant professor of orthodontics. And just for those who don’t know, the LANAP protocol is a part of their postgraduate periodontal residency program. So, their postgraduate students learn LANAP as a part of their curriculum at Rutgers. How much exposure did you have to LANAP because of that?
FC: Yeah, well, actually, my appointment there in the faculty is a dual appointment, in both faculties of periodontics and orthodontics, and I’m coordinating the interdisciplinary cases – as I did at New York University for many, many years. The beauty of our facility there at Rutgers is that we have all the postgraduate programs together in one big clinic, so it’s really nice to coordinate interdisciplinary work. They use the Millennium device extensively.
MK: I will definitely want to talk some more about your duel specialty, but first I want to just bridge a gap here. I know that Dr. Neal Lehrman is also on faculty at Rutgers. Did he have a role in explaining LANAP?
FC: I’d say that more than anybody, he was instrumental in getting me going. We actually bumped into each other in the elevator and renewed a friendship from many years ago. He’s very active and proficient in the use of the device, and he immediately started demonstrating to me. I thought, “Wow, if we’re here together to do this, you could really teach me in that.” He’s really the reason I got on board, and he showed me quite a few things that were impressive that he was able to accomplish with it.
MK: Great. So let’s get back to the dual specialty. And that’s something that is unique, at least in terms of doctors who do LANAP. A majority of our customers are either periodontists or general dentists, and I want to talk about how your dual specialty either made LANAP an easier fit for you. Or just talk a little bit about how you use the PerioLase both on the orthodontic side and the perio side and how that works together for you.
FC: Yeah, it’s a great topic, Marty. You know, paramount to my treatment philosophy and what I was trained at University of Pennsylvania, because I do limit my orthodontic treatment to adult orthodontics – frequently with periodontal involvements and lots of treatment planning dilemmas – but fundamental to that treatment philosophy is that to successfully achieve orthodontic success, you have to manage inflammation, soft-tissue inflammation, from the very beginning. I immediately saw the benefit of using laser to do that as a very effective means. Historically, I’ve been doing extensive procedures of scaling and root planing, oftentimes open flap, curettage, & surgical entrance to control inflammation and debride roots. But the LANAP protocol greatly simplifies things, is far more comfortable to the patient, and expedites the treatment. So in terms of preparation for orthodontic treatment, it’s a great tool.
MK: Now, what was it that persuaded you originally to become a dual specialist? I believe, the minority of specialists that go two different ways.
FC: I get this question all the time. First of all, I come from a dental family and my dad and my older brother are prosthodontists, very well known, and early in my training we decided what would be cool is if I could partner with my brother, not by being in the same specialty but supporting him, so that we could work together on patients. I went to University of Pennsylvania to train in periodontics and an integral part of their periodontal philosophy is minor tooth movements. I became exposed to things you can accomplish, periodontally with minor tooth movement. I got very interested in orthodontics, largely because of my mindset is I’m sort of mechanically oriented and I like devices and mechanical things. I left University of Pennsylvania with a periodontal certificate and a year of orthodontic training. When I got to New York, I was approached and told I really should get a certificate in orthodontics, it would do a lot to further my career, so of course I was interested and I completed the orthodontic training there. Ever since then I’ve very successfully combined with too specialties. It’s been a nice niche. There’s about 8 or 10 of us in the country, and it gets me a little speaking opportunities and opens a lot of doors for me. But I’ve had a really good time with it.
MK: Wow – I didn’t realize there were that few! Your website mentions your groundbreaking work combining the two, I believe you’ve published some papers as well. What do you feel you have brought to that dual specialty or to the profession in combining ortho and perio?
FC: Well, as implant technology and techniques became so important to us and established in periodontics, it seemed the natural thing to me to combine implant technology with orthodontic treatment. So there were a lot of publications and some implants that we developed that led to the use of implants to facilitate orthodontic mechanotherapy and the use of anchorage. Now that’s just mainstream – using mini screws and temporary anchorage devices as part of orthodontic mechanotherapy. I was in on the early days of that.
MK: On the topic of implants, have you used the PerioLase around implants for the LAPIP Protocol at all?
FC: Yeah, Marty, that was a big, big encouragement for me. One reason why I wanted to do it, was because we’re seeing so much peri-implantitis now and really not knowing what to do there. They’re enthusiastic that this might be a good solution and a good way to decontaminate implant surfaces. It’s something that I’ve been doing a lot of and trying, and I’m very optimistic that this will be a big help to us. The next wave of periodontics will become peri-implantitis.
MK: In addition to LAPIP, are you doing LANAP as well, and just in general, how do you use your PerioLase to accelerate orthodontics?
FC: the LANAP protocol is a pretty strict protocol of a full mouth-type treatment, so a lot of what I do is not strict LANAP protocol. I do a lot of laser debridement a lot of inflammation control. My hygienist is very adept at doing laser hygiene procedures. The machine is on at all times in the office, and we’re doing very minor little things here and there and controlling inflammation, largely. In terms of acceleration for orthodontics, this has become a very hot topic, and very, very encouraging things we’re doing there. We’re finally, instead of focusing on the appliance designed to expedite movement, we’re focusing now on the biology of tooth movement and altering the host response to expedite remodeling capabilities and speed up to movements very effectively. I don’t know what role the laser will play in actual acceleration, but it does impart a rapid healing response, which is what we need into movement for remodeling. So we’re trying different things to help facilitate tooth movement.
MK: Can you think of any particular patient or a group of patients that have benefited from PerioLase in their ortho treatment. If so, how so? What would their story be?
FC: So far for me, it’s still largely in the preparatory phase, getting these patients’ dentitions and periodontium healthy so that they can successfully undergo orthodontics. So getting it ready for ortho has been much quicker than the traditional means and more effective and more comfortable. So not really using it to accelerate tooth movement yet, but getting patients into orthodontics and getting them started more quickly is the main thrust right now.
MK: I’ve often heard that you need a solid foundation first, in other words, addressing the periodontal disease state before other procedures. Is that a fair statement?
FC: It’s absolutely critical. If there’s any bleeding on probing, or pocket depth, the things like that, you will incur attachment loss when you move teeth. That’s clear in the literature. I’m directed always towards minimizing the inflammatory response and getting it under control.
MK: I understand you work in multiple practices and you have one PerioLase unit. You mentioned it’s on all the time, but do you ever move your PerioLase between offices, or does it stay in the same place? And how does that work, if you do move it?
FC: Yeah, it stays in my main Manhattan office, which is where I am most frequently. It’s not difficult to move around and transport it, but I don’t I don’t want to take that chance. And there’s another reason too – I frequently commute by bicycle into Manhattan, so I’m not exactly gonna ride home with that on my back! But it is transportable. If I see patients in other offices and they’re good candidate, it’s usually not difficult to get them to come to the main office where we’re best to do it.
MK: It’s transportable, but not exactly on your back on a bicycle.
FC: That might be a little tricky.
MK: All right, well, thanks so much for discussing these topics with us. I do want to mention your website. It’s www.frankcelenza.com, Last name. C-E-L-E-N-Z-A. I do encourage you, as a listener, to subscribe to this podcast wherever you download your podcasts. And thanks so much Dr Celenza for being our guest today!
FC: Nice speaking with you, Marty.