April 2010, Volume 31, Issue 3
Published by AEGIS Communications
Laser Treatment Innovations From Millennium
Robert Gregg, DDS, a founder of Millennium Dental Technologies Inc, has been a pivotal figure in laser dentistry since 1989, when he and Delwin McCarthy, DDS, began their research that would eventually lead to the PerioLase® dental laser.
In reviewing the progress of the past two decades, Gregg focuses on the advancement of laser applications. “In 1990 the first laser suitable for general dentistry was cleared by the FDA, and the indication was for incising, ablating, and excising soft tissue. This was the first clearance for reducing a periodontal pocket, but it was done by excision, not by any use inside the pocket. In fact, that use was specifically not cleared.” The next milestone was in 1997, with the first FDA clearance for improving gingival indices. “This was the first use of a laser in a pocket for gum disease, which was a huge advancement.”
In 2004 Millennium received the next level of FDA clearance for periodontal treatment using an Nd:YAG—the Laser Assisted New Attachment Procedure™ (LANAP™). “That was the first unique, novel clearance for an actual treatment outcome, not just an indication for use,” Gregg says. “The claim that we received for LANAP was for cementum-mediated new periodontal ligament attachment to the root surface in the absence of long junctional epithelium. That was a major step forward in terms of an outcomes claim that was meaningful in dentistry.”
As its use has expanded, laser dentistry has demonstrated a number of critical advantages compared to traditional methods of soft- and hard-tissue surgeries, Gregg explains. There are significant antibacterial effects because the target tissue is disinfected and greatly decontaminated. Also, sealing the lymphatics and blood vessels prevents bacterial transport into those tissues and a resultant infection. Cauterizing or sealing afferent C fibers or nerve endings greatly reduces the pain from the firing of raw nerve endings.
Furthermore, the advantages of using the PerioLase® MVP-7 for periodontal disease treatment are quite substantial, Gregg says. “Scalpels don’t have many of the disinfecting and wound-sealing capabilities of lasers. But one of the most important aspects we’ve discovered is the ability for the right type of operating parameters to establish a stable fibrin clot, which is crucial for periodontal regeneration.”
Millennium is the only company that requires customers to complete its 3 days of ADA CERP and AGD PACE recognized training before shipping the laser. If they don’t successfully complete the course, the company refunds their money. “During this first session, they’re learning a technology as well as a skill,” Gregg says. “Most dentists are tactile clinicians. But now they’re learning to use energy, which has no tactile feedback, as a treatment modality. That’s a real challenge. So we put the customers through some physics on day one; they treat live patients on day two; and on day three, they’re seeing postoperative patients. The coursework is hands-on, just like dental school, with live patients.”
Six months later, Millennium requires the dentists to return for a fourth day of training (“boot camp”). “Essentially, they’ve had a 6-month residency back in their offices where they’ve practiced what they learned. During that time, they have an assigned clinical instructor and access to company support: they can e-mail or call us any time with questions.”
In boot camp, the clinicians learn how to be more efficacious in their techniques. “The initial training focused on safety over efficacy,” Gregg says. “At this next level, we maintain the safety while increasing their efficacy.” The final level of training 1 year later continues along that path. Through each round of comprehensive instruction, the dentists are trained in an additional level of skill, difficulty, and sophistication, all focused on LANAP. “We have a saying that we underpromise and overdeliver,” Gregg says. “We like our customers to come away from training happily surprised and impressed.”
As for future directions, Gregg says, “Our company is called Millennium Dental Technologies, not Millennium Dental Lasers. We have several technologies that we’re working on that don’t necessarily relate to periodontal disease treatment but are companion devices. We’ll continue to innovate, and I think in the next 5 years, you’ll see a couple new products that will be appealing not just to the laser aficionados but to other dentists, as well.”
Millennium Dental Technologies Inc
10945 South Street, Suite #104-A
Cerritos, CA 90703