Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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1101 How to Make it Happen with Jack T. Krauser, DMD Live at MegaGen, Las Vegas: Dentistry Uncensored

1101 How to Make it Happen with Jack T. Krauser, DMD Live at MegaGen, Las Vegas: Dentistry Uncensored

10/17/2018 3:25:00 PM   |   Comments: 0   |   Views: 208

Jack T Krauser, DMD is clearly ahead of the pack.  He has genuinely been involved in implant surgical therapy since 1988 and a distinguished member of various implant and surgical organizations.  Not only was he the first practicing Periodontist in Palm Beach County to be trained in Osseointegration- The Swedish method- that all modern case procedures are based upon, he has significantly contributed the dental implants advances with his innovations in product design and treatment methodologies.  For example, several of his designs are patented and are being utilized by major American and international implant companies.

He has been a consultant to several major implant manufacturers. He has lectured on six continents.  He has co-authored a definitive textbook on the subject entitled “Dental Implants: The Art and Science” by Elsivier publishing.  He has achieved the honor of Fellow in the prestigious global academy- The Academy of Osseointegration.  He is one a very small group  clinicians who has been invited to share his thoughts and treatment outcomes to the USA  Food and Drug Administration on the effectiveness of dental implant care administered to the public.  There are four  textbook chapters as well as over 24 peer reviewed journal articles on the subject matter.  As a leader of several global and national implant societies, he has enthusiastically encouraged his colleagues to join learn and share material for the overall growth of the field.

Curiously, in this crowded field of talented local clinicians, his text books’ cover [edition published in 2011], depicts a clinical example of the now popular “All-on-Four” clinical procedure and concept. He has recently introduced the “K4 Implant Express™”, The “True Final Restoration™” solution and the “Three Final Restoration tm” which incorporate the newest designs materials and CAD/CAM techniques to make your case esthetic and long lasting.

He is fair, courteous and a warm clinician.  Several cases for truly indigent and needy patients have received pro bono work and care.

Jack Krauser welcomes you for top service implant care in a calm one on one treatment environment.  If you would like second opinion, we are here for you as well.  Finally, he has been featured on the cover of Dentistry Today as one of the top dental educators for the last 15 years [since 2001}.


AUDIO-DUwHF #1101 Jack T. Krauser


VIDEO-DUwHF #1101 Jack T. Krauser

Howard: It's just a huge honor for me today to be podcast interviewing Dr. Jack krauser, who I first met I don't know if it was 25 or 30 years ago is that a Carl Misch seminar you were lecturing. I've been a huge fan of yours I've been trying to get him on the show for three years and we're at the Megagen conference and I just kidnapped him and pulled him into this room because I've been trying to get him on this show for three years thank you so much for coming on the show.

Jack: Thank You Howard and it is true that you've been trying to corral me but so happy to be here with you today at this Megagen event in where are we Oh Las Vegas.

Howard: In Sin City

Jack: Sin City or Cincinnati

Howard: Well Las Vegas and your sick because you were lecturing in Italy?

Jack: Yes in Naples Italy for Sename it's an organization in the Mediterranean countries and I think you spoke at that in Portugal a few years ago?

Howard: Tell them what Sename name is for all the countries...

Jack: Sename Southern Europe, northern Africa Middle East, so all the countries that border the Mediterranean now I've been friends with some of the organizers for many years so they said Krauser the Atlantic Ocean touches the Mediterranean so we'll make you part of the board of directors. So I'm actually the only non actual tsunami country's member of their board of directors.

Howard: and my Michael out of Portugal

Jack: Miguel Stanley who's the host of this Megagen meeting right now, he lives in the suburb of Lisbon Portugal.

Howard: Which was my first trip to Europe when I was 16 Oh first time I ever went to Europe was Lisbon Portugal that was my introduction to Europe god that's got to be the most beautiful country.

Jack: That's a very nice town and Portuguese people are lovely and so I've been lecturing for probably thirty years already and I can't even believe that when I was a student of the sciences 30 years ago  Brånemark and Lenny Linkow were younger than I am now and we used to think those are the old guys so I'm in denial I don't think that I'm an old guy and I just keep on pushing myself to constantly learn, adopt new technologies and offer patients some new experiences. I'd like to share with you one thing I happen to bring my laptop this was from the last part of my workshop I did two of them this week, Howard you could see it says the K2 Krauser kinetic Experience and it has ten points if I go back one slide this is my handwritten notes a friend Jay Watson who was a developer of this brand-new technology chrome guided chrome smile very popular at this meeting he's been a buddy of mine for awhile and he said Krauser you got to put together like a high-powered program and I'm making sure you must come up with 10 points. So I dated it for 10 18 this is actually my notes and I came up with the idea of the Krauser Kinetic Experience or the K2 Experience. Now kinetic I'd like to go back in time to 2007 Scott Ganz is one of my closest buddies and we love guided surgery, so we try to come up with a company name to teach and educate colleagues back in the middle 2000s. So we looked in the thesaurus and we wanted to come up with words that began with letter K for me and letter G for him and whichever sounded better that would be the first word didn't really matter, so when we came on the case and we saw kinetic we said krauser you're definitely shy and quiet and demure but most of your kinetic so we said I'm kinetic then Ganz is a little bit more studious so we came up with the word guidance so we came up with a company that still exists called Kinetic Guidance and we started teaching guided surgery. We had two sponsors Nobel guide from Nobel biocare and sim plant from the Simplant Company and we used to run seminars we self-promoted and we had maybe five maybe seven people in different venues I remember we did one in Atlanta a ritz-carlton and when they were the hostess came around said okay I had to give like my Platinum American Express card because we were $12,000 over the income. So we were actually doing courses losing money but we really liked it a lot. What I look back at that is the guided surgery concept is really only starting now and then it was like ahead of its time so now we're seeing more interest in it but our company was starting eleven years ago Kinetic Guidance. So I came up with this Vision Quest and I want to just review it to you Howard for your audience. I accepted Jay Watson's challenge to come up with a little project so the first thing I have on here is called vision quest. Vision quest it took me some time to actually think what do I really want to do and how do I achieve it. Now when I was younger I was with a prosthodontist and Clive Bonner and we met Gerald Disnick the corvent inventor he flew us out to California back in the middle 80s like 87 and he sat us on his Terrace outside his office in Encino California and he said what do you guys want for your careers, so Clive Bonner was thinking and he said he wants fortune he wants to make more money by being a lecturer they looked at me and I said no I'm interested in Fame. So he says he already knew that about the two of us and he said that's why you'd be a perfect team to be put together so that was the first time I actually thought about what I wanted that goes way back but I really had ups and downs and I was meandering and I had nice arrangements with implant companies and bone grafting companies and I probably met you at a Misch course when I was teaching various bone regeneration therapies that was my topic with Carl's courses. So now I'm in my it sees my last third of my career or my fourth quarter I like football so it's called the fourth quarter I don't like baseball so much so it's not the ninth inning so I really want to do what I really want and I really like what I'm doing and when I get to the end I'm gonna tell you I figured it out and I'm actually making it happen. Next on the list were mundane things that Howard talks about all the time personnel, skills, and training, knowledge, knowledge of business in your practice, knowledge of marketing and promoting the practice think back at dental school did any of you like dental materials it was one of the most hated courses in the curriculum. I happen to love dental materials these days I could talk about Pete Peck trial or Kevlar reinforced carbon how it all interacts with the methods that I'm giving to our patients. Next I found interesting was really come up with a marketing strategy or a plan for what I want to go from point A to point B and how do I actually get there. Howard would agree with me office control is critical, phone calls, incoming, outgoing out of the receptionist's behave or all the phone calls actually answered. I've been involved in various seminars with various marketing companies and staff management companies some of them are phenomenal and they actually will tape our telephone calls coming in and then we use a like a staff experience, I'm not critical of them but I use it to show them like listen to your voice the way you went like I don't really want to help you, you know like you could tell from listening to the size on the call whether the person on my staff wants to help or not., so staff control is important. Patient report I actually once saw one of my staff take a medical history form look at it she was in a very bad mood and she actually liked flipped it back birthdate and we actually lost the patient and I'm only seeing full arch reconstruction cases. Now I don't know whether I would have had him anyway but she never flips the clipboard out the window again, so patient rapport is important. One thing that my staff does do well is they interact with the patient's become friendlier with the people so the patients are very comfortable telling the staff that something doesn't feel right it's bothering them so there's good rapport and there's not secrets before I walk into the room and I know that Mrs. Smith is having a you know her cheek is getting caught so we can help her out. Next concept was patient flow, that's number five on my list, how does it go from the initial visit to the surgical process the prosthetic process and did I have the ability to create protocols and a roadmap that are simple, easy and our followable for the staff and I write them down and we have a protocol for an uppercase with a protocol for manipular cases and when we follow it correctly it's great. Howard have you ever seen the Ferrari pitstop video? There's a pit stop you can get on the YouTube it's like 3.2 second video the Ferrari comes in from LeMans race pulls into the pit stop you see 14 or 15 people working boom boom in out 3.2 seconds. Now it obviously happens very fast now if I'm doing accelerated therapy for my patients we of course have biology that we don't interrupt but we have products materials processes sequences where we do multiple steps in each chair visit. So I like to minimize the number of visits to the practice yet maximize the amount of things we do within each patient visit. So it reminds me of the Ferrari race team so when we were doing the workshop today it was on all on four but I showed the Ferrari video and the guys were clapping they thought it was great as a metaphor for what we're doing in our practice. So I've heard from someone else that you should be firm in principle yet flexible in delivery I'm sure you've heard that before. To me that means I don't want to deviate from any of the principles that I believe in that are based on evidence literature support or if it's so brand-new it's my own personal experiences but I want to be flexible and able to deliver to the patient, so I don't want to if it's a case that I know a removable would not work I won't do it I'll either tell them to go someplace else or I'll even tell them you know what is it about finances about money and we have a couple of financing companies we work with we try to help the patients out if it's truly not even doable I'd still rather do a fixed case at a lower fee to give the patients something that the love they'll be smiling about and when I get to my last point you'll understand what actually powers my whole process. So then I've heard other gurus in the field talk about ready set aim and I like that because if you just shoot right away and then you look to see how you did you probably did it at a sequence. So when you're ready you get everything organized and then you aim and then you do it I'm also doing what I call a pause are reflect to evaluate my commitment level and evaluate the results of what we've implemented, so I've been very careful getting into various advertising strategies it's expensive I want to track it I don't want to be off target I don't want to spend several thousands of dollars a month for six months and only find out that, that didn't work at all whereas something else that was much more cost-effective worked out nicely for us. Then number eight when everything is ready I paused I reflected I'm ready to unleash the kinetic energy, that means that I'm now able to use the colleagues that I put together my marketing people my staff my lab technicians. I have incredible relationship with a local laboratory I work with them years ago then I started my own laboratory with a lab technician we had state-of-the-art CAD CAM 5-axis milling with the heavy-duty spindles. We were able to mill zirconia Pete Peck pectin PMMA and unfortunately this lab technician was an artist and like many artists he you know becomes a little bit flaky and he wound up going to Texas. So I have all my equipment now in a storage facility but the local lab that I was working with before we've rekindled our relationship and they have now incorporated some of the requirements that I had for my cases and they've said it's amazing they like they've used some of the materials that I brought to them and they say it's working out great for their other dental colleagues as well. So then we do I'm not at the next phase review, reflect and adjust and once I know what's going on we start humming along. Now I have a buddy who's a paradise I don't know if Howard mentioned earlier that I am I parried on us by training but I might have given that up a couple years ago, he's ready to join my practice as kind of a protege or an associate to with the purpose of taking it over he's several years younger. So we have that in mind it's a mutual goal but we're not ready yet because we don't have the patient flow and my concluding comment number ten is what am I trying to achieve, what does it say here Howard? Number ten

Howard: Hugs and smiles

Jack: Exactly now every patient let's say 9 out of 10 patients who are ready to leave after they get their teeth we're taking photographs in the iPhone, the patient's spouses are taking pictures and I so much enjoy the hugs and the smile. I had this one guy had half dentate half of teeth were out the other teeth were rotten and I said you know what your lip form is beautiful you have a beautiful smile now look at my smile I said I can see it it's like I'm not saying I'm Michelangelo but I could see his smile in his face and it was just a matter of us putting it together with my lab colleagues to build it to him and when I put it in there he hold the mirror he went oh my and he like he couldn't even close his lips he was beaming you had that video that we looked at prior to the interview her name is Elizabeth, fantastic lady she had a really mutilated dentition she had a high-power job in a physician office. So Elizabeth you could look at her eyes her eyes are saying like I'm thrilled and she's saying the bite is good and it cuts well and she's so happy then I asked her are you ready to go to your daughter's wedding she's oh my yes it's like in a month and a half I'd never thought we'd be done and ready to go and I'm so thrilled and I could smile and dance and be in pictures. So these patient relations are what really turns me on. If I could have one more story

Howard: Keep going, I could listen to you all day long.

Jack: Faye is great, Faye is a executive at American Airlines down at the Miami Airport. I think she speaks like six languages and complaining patients go up the line and eventually get to her and she solves the problem when she came to see me she had some crappy Provisionals, you could see the cement hanging over the facial aspect then I said well smile and she goes I can I go why not she was if I smile a teeth fall out so she smiles boom they fell right out can you help me, I go you have a job of customer service for a major company in the United States and you're talking languages to the guests from foreign countries we definitely have to help you. So we did her case in a rapid accelerated manner she was freaked out she was thrilled and she sent me a picture of her 60th birthday party she was all dolled up in a beautiful gown her hair was made up and her teeth were like beaming and she wrote me a letter in Italian because I told her I was going to lecture in Italy and the lecture translated to like hi Dr. Krauser thank you so much for changing my life I love my smile my co-workers think it's great I feel so good and now I'm floating around the airport and so she was great. One more story?

Howard: Knock yourself out.

Jack: Betty, Betty was a gal that worked at one of the local banks and she was being promoted or being interviewed for promotion to be a branch manager and she failed and then she failed again she failed three or four times she came to me and said here's my problem I have lower teeth I have an upper denture when I get nervous and I talk to the interview I had this nervous twitch so I'm like tapping on my upper teeth and it's like click click click click click. So while they're waiting for they're asking me a question I'm clicking and they like Betty are you ok and they she never got the job, so she said I need teeth that don't click so I said we got implants and prosthetics you won't click. So we did it and it worked out great she was so thrilled she got the job and today she like is head of four branches for like a Wells Fargo group of banks so it worked out well for her. Then we used to have health fairs in like local high schools so I'll come so she would come and she hand out brochures and show everybody her smile on her teeth she was great then one day she comes in then I knew she got divorced from her husband and maybe six month follow-up she comes in with a big healthy looking guy and she says this is my new boyfriend Dexter and I said to Dexter Oh bet he's great how do you like her implants and Dexter turned white as a sheet she punches me and grabs me into the back of the office and she said she says I had breast implants but Dexter doesn't know anything about my teeth implants so when he heard me asking how about my implants he thought I was asking about her breast implants but anyway so you gotta have fun doing what we're doing. So I have more patient stories but I'm gonna let Howard ask me a questions.

Howard: I got to tell you if any one time I did an implant and a young girl was missing her two first bicuspids and so we did implants and I put into first bicuspids and she's at work she works at Taco Bell she was not anybody oh I just love my new implants a doctor Farran put in and the manager pulled in the deal and says we don't she thought she was talking about breast implants don't you ever talk about your breasts and went and she's like I've never had breast implants had to dental implants.

Jack: One more story?

Howard: Oh please

Jack: So I'm at Academy of Osseointegration meeting in Dallas Texas there's a famous would you call it a gentlemen's club I can't remember the name of it but it was famous at the time

Howard: In what city?

Jack: Dallas yeah you don't know about things like that so about six of us went and as I told you earlier I'm kind of shy and quiet so I went up to the manager and said we're implant doctors on a conference do we have special permission to tell the girls what we do and if they don't mind we could do whatever we do and the guy said no problem as long as the girls say it's okay so we're hanging around with different ladies and have a great time and I asked why do you like coming here Oh we'd like some of the nice guys like you guys and so when we're ready to leave I said by the way here's my card and she says dental implants we thought you were all breast surgeons, so we had a good time.

Howard: I think ten years ago you go to place 10,000 implants I mean you you podcasters are young, so they all come out and they say dude I'm $400,000 in debt and guess the implants they've placed?

Jack: 2

Howard: Zero

Jack: Okay

Howard: None, walk them through that. How do you go from she's listening now she's never placed implant to Jack whos placed 10 to 20 thousand implants and how many years have you been a dentist?

Jack: I started doing implants in 1985

Howard: Okay so over 30 years

Jack: So half of your listeners weren't born then

Howard: Yeah

Jack: I told you I'm in denial okay

Howard: So are you in the fourth quarter or the third quarter?

Jack: No no the third third of the fourth quarter.

Howard: The what?

Jack: The third third third trimester of the fourth quarter.

Howard: For me I had to switch from football to hockey but they only have

Jack: Three periods

Howard: and I just say im in my third period because I started to get footballs like dear me am I in the third quarter of 50 sec or am I in the fourth quarter. So but how do you go from coming out of school four hundred thousand dollars in debt to being like Jack?

Jack: My tenth principle was hugs and smiles if that's what you focus on you'll achieve whatever you want. If you want to be the greatest endodontist but you're thinking about hugs and smiles you're gonna get it. So these young colleagues they don't have any clue what they really want some of them might be towardzing something and might be leaning towards veneers or bonding or you know full reconstructions on teeth, some people like implants I'm like so fine - now in - all on four I actually call it all on more is what I call it not because it's more implants sometimes it is but it's more than just the original all on four protocol and includes the different materials the different prosthetic choices. So if a younger person wants to focus in on what do they really want to achieve they have to have as Tony Robbins used to say success leaves Clues and you want somebody to model somebody the model. Now do you remember Jack Han?

Howard: Absolutely Cleveland, Ohio.

Jack: Cincinnati, Babish is in Cleveland.

Howard: Okay

Jack: Okay now babish and Han are two gentlemen senior to me that are my mentors among a few others but they're my key mentors and Jack Han in particular I used the model because he had a beautiful family he had beautiful cases and he was doing the kind of work that I liked he dressed perfectly he was the best-dressed colleague at the meetings. So I used to like look at what he was wearing and he would get a Zanya suit what do I have here Zanya Zanya yes so I decided to upgrade my apparel one meaning I showed up with a tie that it was like the spring tie it was I think I had the like orange rust version he had the same exact tie in blue then I realized that I was making it because the guy that I was modeling without knowing what ties we were gonna wear we actually had a similar tie. So for the younger colleagues we didn't even have telephones when I started doing dentistry then we had this big thing that was that big it was like bigger than this hello I could talk to you it's a dollar or a second but you have the opportunities to do webs and podcasts and join Internet groups and it's insane how much you could absorb but you must not just visualize what other people are doing you have to smell it, you want to be someone's protege you want to go there for a visualization of what's going on maybe do a hands-on course with beautiful educators. There's some friends of mine through Megagen teaching great courses will you actually work on live patients. So you shouldn't I don't think in my opinion jump like did you ever hear of the newscaster he was from Washington DC anyway he drove it to a pool and it was too shallow and he became paralyzed so you should like not dive into something without knowing you know where the depth is and I'm not saying to be a mamby-pamby but you should have have it all figured out first and you want as little complication and problem as possible. So modeling is good you could I know some young colleagues on the internet that I've never met them and they're posting every day the all-on-four case that they're doing and they're doing six a week and it's like it's amazing how they get it they know how to mark it with Google and LinkedIn and Facebook and it's the younger ones know that way better than the older ones like us. When I used to teach the the guided surgery course it took us almost an hour to teach the doctors how to use a mouse think about it. So computers in dentistry were so new at that time now you know everybody has the ability to seek information through the cloud through the web of major colleagues. Now if any of you belong to dentalXP do any of you people do dental XP?

Howard: Sure it's huge.

Jack: I was one of the original dental...

Howard: I still haven't been able to get he's my idol and marisol and his older brother

Jack: Henry

Howard: Henry, I've been trying to get them on the show for three years, maybe you can twist their arm.

Jack: Alright but there's a fee

Howard: Okay yeah I'll give you a hug and smile.

Jack: So I used to be an interviewer for them at the beginning because I'm shy

Howard: You keep saying your shy are you really shy? I've never thought of you as shy...

Jack: Please it's a joke.

Howard: Oh it's a joke okay trust me Jack is not quiet or shy.

Jack: In the first two years I'm Jack krauser and you're not and we would then interview somebody and I there's like 30 or 40 interviews you got to go back to the archives and see these interviews and then I did some my own interviews of myself and then they interviewed me and so we have a history with them right from the beginning and I see how that thing has grown in leaps and bounds. I've done a webinar the other day another learning company.

Howard: Viva

Jack: Viva and they had 786 people in the webinar, now I didn't do a lot of webinars so I thought wow that seems to me to be a good number and then I got a roster of who they were and they came from Qatar, Malaysia, Russia, Israel, South America, Venezuela, they were all around the world and I was doing it at 7 o'clock East Coast United States time wherever they were they were they woke up in the middle of the night to hear me it was mind-blowing. So don't think you can't do it because you can but don't bite off too much than you could chew right from the beginning so I think if you do everything in steps. Now doctors who are not in the earliest years let's say their intermediate doctors you have tons of implant patients in your practice it's just a matter of mindset with treatment planning, there's a first molar do you know who Zibs Simon is from Beverly Hills?

Howard: Yeah

Jack: He's a cool guy, so Zibs calls the first molar the million dollar tooth because of over the course of a lifetime of that patient everything happens mesial decay, mod, chip, onlay, chipped crown, endo, edo retreatment, furcation, pareo, crown lengthening, again and crown a new crown, finally an extraction graft implant. So it's funny so in your practice when you look at an x-ray think about it well is there another opportunity another alternative and when you do your own analysis of the return on investment of time, materials, implant therapy can be very lucrative to a practice but you clearly get the best hugs and smile in implant dentistry, there's nothing like that. Now a friend of mine oral surgeon in Miami Tony Sklar brilliant oral surgeon one of the best little surgeons in our area does a beautiful job. I was talking to him a few months ago he has totally phased his oral surgery practice down to just doing the all-on-four concept cases because of what I just said the patients are so grateful and happy and they hug and they bring you cranberry pies and salami sandwiches they bring all sorts of goodies to the office and so I agree 100% with him. So in your own practice these patients exist. Studies on baby boomers growing older with decent amounts of money Howard knows way more about that than me is one of the sources that I go to for those type of demographics. There's tons of affluence coming into our ripe treatment age for me it's 55 to 102 and that's my threshold I've done three people who are a hundred in my career and they got what they wanted, they wanted to go to a holiday meal where their teeth were in place and the great-grandchildren when it weren't giggling at granny's teeth rattling around. So the typical patient is above 55 to 85 they're doing great, so we have so the young ones coming out if you're just starting out you have to be ethical, straightforward, find a niche like go to a senior citizen home or be part of the Boys and Girls Club and or be part of the church community or just do different things. I have friends that are we have a church in Florida called Christ Fellowship Church do you have that here? It's ginormous it started after I started in practice they have like three mega campuses just in Palm Beach County. I've done work on the pastor there, several of my referring dentist friends belong there I have patients that go there. So people take care of each other. I had a Greek associate in the past he is so tight with the Greek Church that when I went to one of their parties for Greek Easter he was like dancing around and he knows how to do Greek dances and he said oh it's so great up the Greek community supports me. So ethnic wise people will support each other and help each other but today everybody like works with everybody and it's really nice, so the very young you got to think what you really want to do and like reach out and find some person a little bit older more experienced to help you out and then as far as the middle-aged people there's tons of work in your practice, if you can't find one implant related event in every day of your hygiene practice one something's wrong. There's always broken teeth infected teeth a pareo case that's going south so that's that. Now I also touched earlier Howard that I am sort of a periodontist, now I went to the University of Pennsylvania at the time not because of me was probably the greatest dental school at the time in the United States and it had tremendous pareo professors and the thrust of the whole school was pareo. It taught that the center of Dentistry was the periodontium and everything else came off of an endo ortho etc so it was a really pareo program. Now I went to dental school thinking I was going to be an orthodontist when I was at that dental school I became a periodontist for sure. Then I went up to Boston University which was an extremely fine pareo program very well known for its surgical therapies more so than research and that's what I was looking for I wanted to hone in my fine skills. So I came out and I was a surgical periodontist and I very much enjoyed what I was doing. So over the years when I went down to Florida cuz I had worked in New York for three or four years first I got stuck in a big snowstorm and I said that's it so snow is good if you like to ski but other than that it's not good to work in. So I moved down to Florida in 1983 and started my practice, so starting a specialty practice from scratch you don't have that much time I mean all you have is time so I started taking courses and my first courses were Chuck Babish, Gerald Niznick and I was in the first group of periodontist to take a branamarc system training in Belgium and I loved it it was so fantastic and I said this is exactly what I want to do have implants help our patients. Believe it or not maybe three four or five years ago and I can be corrected if I'm a little off the Academy of Perio voted with the general membership of the academy to include the phrase dental implants in our procedures that define our profession and the membership voted it down not bureaucrats the membership voted it down. Now I believe it might have include included implants today I'm not positive but I remember a few years ago it was voted down.

Howard: It lost my one vote this last vote this year's meeting you lost by one vote.

Jack: Oh so it's still out okay there you go thank you Howard.

Howard: By one vote.

Jack: It's outrageous it's nuts so I have two principles when I start a surgery, blood supply, prosthesis. So for the younger ones think the blood supply of the case and the prosthetic design so if I'm putting in an implant like here and the teeth are going this way my prosthetic design is not good and if I cut through the tissue and I have a mucosal margin the blood supply is different to the area where I'm placing the implants also. So I'm always thinking the blood flow to the area which will proper healing and the prosthetic design which will give the patient what they want and give longevity to the case. So I started doing some small prosthetic procedures against the bylaws of the Academy of Perio I guess today 8 out of 10 arches that I treat I do the prosthetics and I have gotten proficient because I've paid attention to the teammates that I was working with particularly the ones that really knew what they were doing. Now Howard a few months ago you interviewed a prosthodontist from Boca Raton Steven Fight so you may remember that interview. Now one of the most important things that I learned with Steve and he probably talked to your podcasters is the role of the occlusion and how the function of the teeth actually works and if you set the case up properly at the beginning the case will function properly and you'll have way less complications. So we oftentimes get a case let's say I'm doing an upper set of implants I may get a template from the laboratory that shows me where to reduce the mandibular teeth to plane them out so they're not high interferences, so I've learned a lot from my teammates and now I'm comfortable doing the prosthetic steps myself. What I have to admit is I'm still learning how to overcome any let's say a prosthetic challenge or an issue, now with surgical things I'm used to surgical things because I've been doing surgery for my career so it's actually fun to learn what to do and nobody in my practice freaks out or loses their cool if something's going wrong so we just call on our technician to help a prosthodontics teammate to help and we gathered information from here and there. So my take home message is hugs and smiles and everything else will follow. So Howard it's a as we say on the East Coast it was a kibbutz chatting with you today and I am shocked at how much you actually contributed to this podcast.

Howard: Hey I love you to death been a big fan to me that was a very romantic it was almost like a father-son conversation my homies obviously podcasters are young I'd love to get a online CE course from you. You have so much credibility and also I just can't believe how much implants have changed from 30 years ago to today oh my god.

Jack: When I did my first set of osseointegrated implants they did not come packaged sterile we had almost one hour of preparation to bathe the implants in certain solutions that we had to buy from the DuPont Chemical Corporation we had titanium tongs and then there was a way that we would put it into a sterile bag without touching it after it went through two half-hour washes of different solvents to clean the titanium.

Howard: and in many dental school and the oral surgery department maybe like one oral surgeon replaced implants and the other oral surgeons would openly openly refer to them as the butcher and the other thing that I think is the most sad is that 30 years ago a lot of these pioneers that were doing implant cases and restoring people's lives and functions and making dental cripples whole again, the first time they had a major case fail the local State Board of Dental Examiners would take their license away. People tell me their controversy or their it's like it's like do you have any arrows in your back I mean there were guys that had their license I know one guy in particular and you know I know you know him too and when his license was taken away his depression was so bad he he went from a millionaire jet side implantologist to just drinking alone in a trailer and right out there and then Apache Junction and it is just so sad so remember the guy that's trying something new that you're so ready to throw off a bridge and all that kind of stuff thirty years later might be looking like a genius. How many dental implant pioneers were there Ramos frames subperiosteal.

Jack: Well Lenny Linkow gave me slides, the young ones I don't know if you even know what a slide is. It's what we used to...

Howard: They don't even know who Lenny Linkow is.

Jack: All right well he was one of the pioneers, it was like a little cardboard thing that we put into a carousel that went around and it would project on the screen it was a it was a picture a cartoon of a cowboy riding in the Prairie with about ten arrows in his back because either Indians shot him or other colleagues turned them in. So if you're not a leader you get arrow shot. Heliane Canepa the former president CEO of Nobel Biocare she used to

Howard: Heliane

Jack: Yeah remember the red head.

Howard: I always call her Heliane but you call her Heliane?

Jack: Yes that's the correct pronunciation okay but you're from Arizona people give you a break. Heliane, she and I we would have like cerebral conversations about like so Jack tell me what do you think we should do so I said sled dogs she goes what do you mean I said there are lead sled dogs and there are pack dogs I said you need to find more lead sled dogs she said why I said because they get to see the new scenery and we'll pull everybody forward and they'll be coming along in the sled train. So she that's great I need more lead dogs. I want to do a shout-out to my dearest buddy Jack Han, now what I love about Jack is he did subperiosteal frames invented blade implants tried everything did everything he treated Marcello Mastroianni a famous Italian designer Sophia Loren he did implants on three popes earlier he used to have a practice in Zurich a practice in Rome he was like my major hero he's my major hero. So but contemporaneously he has evolved and if you look at the work that he does now it's right on target he's a chief clinician with the Glidewell laboratory they're doing all sorts of guided cases, bone regeneration cases, all the current topics that we do he's still doing. So my attitude is if he's still doing it and he's senior to me and I could still do it too. So Hey Jack.

Howard: Jack I've been trying to get you on the show I'm sorry I said you were from what I say is from Cleveland.

Jack: Oh Jack Han's from Cincinnati

Howard: Okay sorry I said you're from Cleveland Cincinnati Cleveland. I was close Jack but I yeah big mentor of his yeah. Again thank you jack for all you've done for dentistry thank you so much for letting me kidnap you today at the Megagen conference and I hope you feel better sorry you got a bug in Italy thank you so much.



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