Cosmetic Tribune U.S. No. 1, 2017

Periodontal esthetics with soft-tissue lasers / Dentistry’s ‘Legends - Illusionists and High Rollers’ reveal techniques - AACD annual scientific session in Las Vegas April 18–21

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Periodontal esthetics with soft-tissue lasers
01 - 02 view
Dentistry’s ‘Legends - Illusionists and High Rollers’ reveal techniques - AACD annual scientific session in Las Vegas April 18–21
01 - 03 view

COSMETIC TRIBUNE
The World’s Cosmetic Dentistry Newspaper · U.S. Edition

April 2017 — Vol. 10, No. 1

www.dental-tribune.com

Dentistry’s ‘Legends, Illusionists
and High Rollers’ reveal techniques
AACD annual scientific session in Las Vegas April 18–21
The American Academy of Cosmetic
Dentistry (AACD) 33rd Annual Scientific
Session will be held from April 18– 21
(Tuesday–Friday), in Las Vegas, Nevada.
The conference, described by organizers as “the world’s largest continuing
education program for cosmetic dentistry,” will feature more than 35 hands-on
workshops, 60 lectures and 100 speakers. The annual event typically draws between 1,300 to 1,500 dental professionals
and includes courses and events serving dentists, lab technicians, hygienists,
and dental team members to help them
refine their skills, learn the latest techniques and share ideas.

General session speakers
The 2017 conference will take place at
the Venetian Resort Hotel & Casino and
will feature three groups of educators:
the “Legends,” the “Illusionists” and the
“High Rollers,” who will reveal their techniques and share their expertise.
The Venetian Resort Hotel & Casino is
one of Forbes Travel Guide’s Four-Star
hotels for the 13th year in a row and has
been described as being one of the seven
“Greatest Hotels in the World.”
General sessions at AACD 2017 in Las
Vegas will feature some of the industry’s
top speakers with messages for the entire
dental team. Speakers include:
• Daniel “Rudy” Ruettiger, who overcame obstacles and criticisms to attend

Notre Dame and play football for the
Fighting Irish. As fans cheered “RU-DY,
RU-DY,” he sacked the quarterback in the
last 27 seconds of the only play in the only
game of his college football career. He is
the only player in the school’s history to
be carried off the field on his teammates’
shoulders. Today, he is considered to be
one of the most popular motivational
speakers in the United States.
• Doug Hanson, an internationally recognized speaker, consultant and peakperformance coach, will reveal why
businesses with high expectations and
a positive approach are innovative, efficient, productive, have lower costs, lower
turnover, fewer distractions and are
quicker to respond to change. Hanson
will show how great teams create relationships that last a lifetime.
• Dr. Jackie Freiberg will lay out the
preconditions leaders must create to
ensure that “innovation” is a deeply embedded part of your practice’s cultural
DNA, where teams are hungry for change
and inspired to find innovative ways to
overcome challenges in part by reducing
costs while improving quality of patient
care. Freiberg will share strategies for
collaborating, thinking creatively, turning liabilities to assets and finding ideas
outside of your industry. Attendees will
learn how the most creative companies
in the world innovate beyond customer
expectations.

The Venetian Resort Hotel & Casino, host site of AACD17, is one of Forbes Travel Guide’s
Four-Star hotels for the 13th year in a row and has been described as being one of the seven
‘Greatest Hotels in the World.’ Photo/Provided by Venetian Resort Hotel & Casino

The AACD is the world’s largest nonprofit member organization dedicated to
advancing excellence in comprehensive
oral care that combines art and science to
optimally improve dental health, esthetics and function.
Comprising more than 6,300 cosmetic
dental professionals in 70 countries, the
AACD fulfills its mission by offering educational opportunities, promoting and
supporting an accreditation credential,
serving as a forum for the creative ex-

change of knowledge and ideas and providing accurate information to the public and the profession.
The academy is a recognized credit provider for the Academy of General Dentistry, the American Dental Association,
and the National Association of Dental
Laboratories.
Learn more about the annual meeting
at www.aacdconference.com.
” See LEGENDS, page C3

Clinical

Periodontal esthetics with soft-tissue lasers
By David L. Hoexter, DMD, FACD, FICD
Editor in Chief

Fig. 1
Fig. 1: Dense hyperplastic tissue interproximally between the tooth #11 and tooth #12.
Because the hyperplastic overgrowth inhibits accessibility, the patient is unable to reach the
desired area to maintain good oral hygiene. Photos/Provided by Dr. David L. Hoexter

he use of lasers in dentistry
— and in medical procedures
in general — has made great
strides in recent years, not
only in effectiveness but also in acceptance by patients. Our colleagues
in medicine, such as dermatologists
and ophthalmologists, have used lasers for years for myriad reasons. Visiting a dermatologist’s office recently,
I observed a variety of large, bulky
and costly lasers. The different types
have been needed because the doctor’s

choice of laser power source will vary
based on the desired outcome goals for
the procedure. Dermatological procedures are chiefly concerned with soft
tissue — its responses and reactions
defensively as well as offensively.
As has been true with general medical
uses of lasers, the laser systems recommended for dentistry have been relegated primarily to soft-tissue procedures.
The reason for this is that with the exception of relatively recently introduced
technology, using lasers on hard tissue
in dentistry would typically cause desiccation of the tooth or bone being treated,
” See LASERS, page C2

[2] =>

CLINICAL

Cosmetic Tribune U.S. Edition | April 2017

◊ LASERS, page C1
leaving the affected hard tissue dried out
and brittle. Early laser technology that
was promoted as appropriate for hardtissue procedures made lots of noise,
cost lots of money and at best achieved
minimal and limited results. Recently,
however, new laser technology for use on
hard-tissue dental structures has proved
to be more capable of meeting goals of
both practicality and effectiveness.
This article, though, will limit its focus to the soft-tissue side: specifically,
achieving desired esthetic results by using soft-tissue laser technology to treat
gingival hyperplasia.
My personal experience with lasers
dates back more than 25 years to when I
bought a CO2 laser for my private practice. It was an adventurous and costly
(about $60,000 in early ’90s dollars)
commitment. There were no laser dental societies back then — just a few of us
dentists trying to find newer techniques
to more effectively and comfortably
achieve the results our patients desired.
Hyperplasia of epithelial tissue of the
gingival area breaks the smooth appearance of the periodontal tissue, compromising esthetic goals. It also makes it
difficult for patients to maintain good
oral hygiene, leading to inflammation of
tissue and increasing risk of progression
to periodontitis.

Case 1
As illustrated in Fig. 1, a patient presented in my office with a singular localized dense hyperplastic area, confirmed
through oral examination. The 31-yearold female had neat clothes and clean,
well-maintained hands and nails. She
related how difficult the local area was
to clean, describing that cleaning efforts
hurt and caused bleeding, especially
when she flossed. The local area also
didn’t look clean visually, creating an unesthetic appearance. There was a break in
the continuity of the smooth appearance
of the gingiva, causing the tooth to appear uneven.
As mentioned, there are and have been
several laser devices available for years
for use in a variety of soft-tissue dental
procedures. All have the ability to achieve
desired results when the practitioner is
experienced with the technology and
procedure. Some laser devices have the
adaptability for different strengths, but,
when used correctly, all can treat softtissue disease with desired results.
To correct this particular defect, we had
the choice of using a sharp, cold-steel instrument or a laser. We opted to use a diode laser, which is easy to use and causes
no bleeding in the wound, thus avoiding
the need for a periodontal dressing that
would be necessary to cover the resulting
wound if cold steel was used.
The results documented in Figs. 1–4
were achieved using the AMD Picasso
(Indianapolis) diode laser exclusively.
Instead of being heavy or bulky, it is portable and lightweight. It can be moved
easily into each operatory as needed,
removing the need to purchase separate
units for each operatory. Also, the fiber
tips are disposable, ensuring sterility.
A key factor for me in choosing the
AMD Picasso laser was cost. Traditionally, costs for soft-tissue lasers seemed
relatively high, ranging from $12,000
to $120,000. This light, portable system
ranges from $2,000 to $2,500. In my ex-

COSMETIC TRIBUNE
Publisher & Chairman
Torsten Oemus t.oemus@dental-tribune.com

Fig. 2

Fig. 3

Fig. 4

Fig. 2: In case No. 1, diode laser removes dense, undesired hyperplastic tissue in minutes with
no bleeding. Fig. 3: Periodontal probe in the treated area. There is no tissue depth at all, and
the patient is able to maintain her oral health. Fig. 4: Area healed, esthetically blended.

President & Chief Executive Officer
Eric Seid e.seid@dental-tribune.com
Group Editor
Kristine Colker k.colker@dental-tribune.com
Editor in Chief Dental Tribune
Dr. David L. Hoexter feedback@dental-tribune.com
Managing Editor U.S. and Canada editions
Robert Selleck r.selleck@dental-tribune.com
Managing Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Managing Editor
Sierra Rendon s.rendon@dental-tribune.com
Product/Account Manager
Humberto Estrada h.estrada@dental-tribune.com
Product/Account Manager
Will Kenyon w.kenyon@dental-tribune.com
Product/Account Manager
Maria Kaiser m.kaiser@dental-tribune.com

Fig. 5
Fig. 5: In case No. 2, initial labial view of teenage patient with inflamed hyperplastic gingiva of
maxillary anteriors.

CLIENT RELATIONS Manager
Leerol Colquhoun l.colquhoun@dental-tribune.com
Education Director
Christiane Ferret c.ferret@dtstudyclub.com
Accounting Coordinator
Nirmala Singh n.singh@dental-tribune.com

Fig. 6

Fig. 7

Fig. 6: Removal of undesired hyperplastic tissue using AMD diode laser with disposable laser
tip. Fig. 7: Tissue removed from maxillary anterior area, progressing toward desired results.

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All rights reserved.
Tribune America strives to maintain the utmost accuracy in its news and clinical reports. If you find a
factual error or content that requires clarification,
please contact Managing Editor Robert Selleck at
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Tribune America cannot assume responsibility for
the validity of product claims or for typographical
errors. The publisher also does not assume responsibility for product names or statements made by
advertisers. Opinions expressed by authors are their
own and may not reflect those of Tribune America.

Fig. 8
Fig. 8: Healed, healthy gingival tissue, homogeneous in color. Patient ready for orthodontics.

perience, the system not only achieves
results comparable to the more expensive systems, but it does so with ease.
In this particular case, a diode laser was
used. The result was an esthetic, smooth,
homogeneous color background that
blends unnoticed with its environment
and enables oral hygiene techniques that
keep the area healthy, esthetically pleasing and easily maintainable.

thus would not treat him), until the acute
periodontitis had been eliminated and
overall oral health restored. With the parents’ permission secured and the patient
showing newly minted enthusiasm, we
proceeded with the case, as illustrated in
Figs. 5–8. The figures and captions document the treatment of a simple local hyperplastic tissue area, as well as a complex acutely inflamed hyperplastic area.

Case 2

Conclusion

This second case demonstrates use of the
diode laser in an acutely inflamed hyperplastic situation in the maxillary anterior of a male teenager who desired a more
pleasing smile (Fig. 5).
Initially, the patient visited an orthodontist to seek treatment of his rotated,
overlapping dentition and red, acutely
edematous, easily bleeding tissue. The
orthodontist advised the patient that
he could not treat him predictably (and

In both of these cases, the patients were
treated by using a soft-tissue laser to
achieve correct, desired results. While
any soft-tissue laser system might have
achieved similar results, in these cases, a
diode AMD Picasso laser was used.
I chose this particular laser primarily
because of what I consider to be its reasonable cost when compared with others, its ease of use and the disposable tips
that make it easy to maintain sterility.

David L. Hoexter, DMD, FICD, FACD, is director of the International Academy for Dental Facial Esthetics and a clinical professor in periodontics and
implantology at Temple University, Philadelphia. He is a diplomate in the
International Congress of Oral Implantologists, the American Society of Osseointegration and the American Board of Aesthetic Dentistry. He lectures
throughout the world and has published nationally and internationally. He
has been awarded 12 fellowships, including FACD, FICD and Pierre Fauchard.
He has a practice in New York City limited to periodontics, implantology and
esthetic surgery. Contact him at (212) 355-0004 or drdavidlh@gmail.com.

Editorial Board
Dr. Joel Berg
Dr. L. Stephen Buchanan
Dr. Arnaldo Castellucci
Dr. Gorden Christensen
Dr. Rella Christensen
Dr. William Dickerson
Hugh Doherty
Dr. James Doundoulakis
Dr. David Garber
Dr. Fay Goldstep
Dr. Howard Glazer
Dr. Harold Heymann
Dr. Karl Leinfelder
Dr. Roger Levin
Dr. Carl E. Misch
Dr. Dan Nathanson
Dr. Chester Redhead
Dr. Irwin Smigel
Dr. Jon Suzuki
Dr. Dennis Tartakow
Dr. Dan Ward

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[3] =>

INDUSTRY

Dental Tribune U.S. Edition | April 2017

Straightforward patient financing free of surprises
Lending Club Patient Solutions offers patients low monthly payments, simple terms and flexible plans
Lending Club Patient Solutions is
committed to getting your patients to
the next level of affordability. With low
monthly payments, simple terms and
superior customer service, the company
promises to make it easy for your patients to say “yes” to treatment.
Moving forward with treatments like
dental implants and restorations is more
convenient with the longer terms and
flexible rates of Extended Plans offered
through Lending Club Patient Solutions.
You can offer your patients plans up
to $50,000 with terms up to 84 months1
and fixed rates ranging from 3.99 to
24.99 percent APR1.
True no-interest plans2 give your patients even more options. An economical alternative to major credit cards, the
plans are ideal for borrowers who can pay
off their purchase within the promotional period, according to the company.
Lending Club Patient Solutions is
committed to getting your patients to
the next level of affordability. With low
monthly payments, simple terms and
superior customer service, the company
is committed to making it easy for your
patients to say “yes” to treatment.
Available for six, 12, 18 and 24 months,
the plans feature:
• An APF or 0.0 percent if paid in full
within the promotional period
• No retroactive interest (also known as
deferred interest)
For more information, call (800) 6301663 or visit lendingclub.com/providers.
Lending Club Patient Solutions products

◊ LEGENDS, page C1

Download the mobile app
The mobile app for AACD17 enables attendees to connect and share information between devices and browsers. The
app can operate offline, requiring an
internet connection only for syncing.
Personal schedule items can be added.
Features include:
• Continuing education: Track courses,
complete evaluations, check your credits.
• MyAgenda: Add sessions, events and
more to your customized schedule.
• Educators: Get speaker bios with photos and links to their meeting sessions.
• Sessions: Locate and add sessions,
review abstracts, take session-specific
notes and email speakers for follow-up.
• Exhibitors: Find information and
booth locations with animated mapping.
• Abstracts and handouts: View, download and print abstracts and handouts.
• Maps: Use the geolocator and site
maps to quickly find locations.
• Search: Find events and courses.
• Local information: Access details on
restaurants, hotels, travel arrangements,
weather and shopping.
The app is available on iTunes and
Google Play. Be sure to “Sync to Cloud”
to view your personal agenda in the app.
Team members registered by their dentist will need to use the dentist’s username and password for initial login.
(Source: AACD)

and services provided through Springstone Financial LLC, a subsidiary of LendingClub Corp.. Payment plans made by
issuing bank partners.

ÿ References
1.

Rates range from 3.99 percent to 24.99 percent APR. Terms available based on amount
financed and credit history. All Extended
Plan loans made by NBT Bank, N.A., member FDIC. Please visit www.lendingclub.
com/providers for current rate information.
No interest for 6, 12, 18 or 24 months, after
that 23.48 percent variable APR. Interest
will be charged to your account at standard
variable APR of 23.48 percent (based on
Prime Rate) from the end of the promotional period on the remaining balance if the

purchase balance is not paid in full within
promotional period. Minimum monthly
payments for this plan during the promotional period will be the greater of the
amount of the purchase divided by the
number of months in the promotional period (rounded up to the nearest $1); or $5.
Required minimum purchase of $499 for
the 6-month plan; $999 for the 12-month
plan; $1,499 for the 18-month plan; $2,499
for the 24-month plan. Lending Club Patient Solutions credit accounts are offered
by Comenity Capital Bank who determines
qualifications for credit and promotion eligibility. Minimum interest charge is $1 per
credit plan. Standard variable APR of 23.48
percent.

(Source: Lending Club Patient Solutions)

Lending Club Patient Solutions is committed
to making it easy for your patients to say
‘yes’ to treatment. Photo/Provided by Lending
Club Patient Solutions

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[cover] => Cosmetic Tribune U.S. No. 1, 2017

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Table of contents

[toc_titles] =>

Periodontal esthetics with soft-tissue lasers / Dentistry’s ‘Legends - Illusionists and High Rollers’ reveal techniques - AACD annual scientific session in Las Vegas April 18–21

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