Author Archive

Problem Solvers

Socket adjustment allows for pain-free, comfortable fit.

There isn’t much about the horrific motorcycle accident that forever altered his life that John Hartley can remember. As for the disabling aftermath, the recently retired 64-year-old production manager is reminded of that every minute of every day.

Photo by Jordan Pysz.

John Hartley

“The accident happened in 2010,” John relates. “Some kid hit me while I was on my motorcycle, and I wound up with a crushed pelvis, a femur that was broken in half and a broken right tibia.”

The latter of those three injuries was irreparable and resulted in the amputation of John’s right leg just below the knee joint. John now wears a prosthesis on that leg, but that hasn’t slowed him down much.

“I ride a road bike on local trails most every day, and when the weather’s good, I’ll get in a good twenty miles,” John reports. “I also work out about six days a week at the gym, so I’ve been able to move on pretty well from the accident.”

In moving on, John has put a lot of wear and tear on his prosthesis, which he received from a national distributor. That distributor also serviced John’s prosthesis until a couple years ago, when it was unable to solve a nagging and painful problem.

“For the first six years I had the prosthesis, everything was fine,” John relates. “Then I started to have problems with it. After wearing it for about a half an hour, it became so uncomfortable, I couldn’t stand to have it on anymore.

“You know how your arm feels after you sleep on it, where you wake up and it feels numb and like you’re being stabbed with needles? That’s how my leg felt. The people servicing it tried figuring out why that was happening but could never put a finger on it.

“They tried creating different sockets for me and padding it in different ways, but nothing worked, so eventually, I decided to go to Sonlife and see what they could do for me.”

Customized Design

At Sonlife Prosthetics and Orthotics, David S. Goris, CPO, LPO, specializes in designing, building and fitting prostheses and orthoses based on each patient’s individual needs. It took David a while to figure it out, but what he eventually learned is that John requires a specially designed socket, which is the shell that encases the lowest portion of what remains of his leg.

“Each amputee is unique,” David explains. “What works for one person does not work for everyone, so our goal was to find the best fit for John. Now, there are a couple of different ways to hold a prosthesis on. One is a gel liner with a locking mechanism. That’s what John had, but it wasn’t working for him. So we went with a suction socket that suspends John’s prosthesis with suction or vacuum.

“We also found that John doesn’t like a super-tight fit. His limb needs room to move, so his prosthesis fits a little loose, and he wears a varying number of socks around the residuum to give him a little more comfort.”

Comfort is exactly what John got from the fitting he had at Sonlife. He says David worked tirelessly in rectifying the problem and succeeded far beyond his expectations.

“My new socket gives me the leeway to put a little more padding in there, and that has made all the difference in the world for me,” John enthuses. “It’s allowed me to get back to being active the way I want to be.

“I was afraid I might have to give some of that stuff up, but Dave at Sonlife listened to what I had to say and solved the issue. We worked as a team to fix the problem, and Dave is a good guy to have on your team.”

Beam Me Up, Doc

State-of-the-art therapy easily removes skin cancer.

In preparation for what they feared might be an attack by the Soviet Union somewhere else in the world, Presidents Truman and Eisenhower both opted to keep the distinguished 82nd Airborne Division of the US Army at home during the Korean War.

Photo by Jordan Pysz.

Electron beam spray therapy has made skin cancer treatment easier for Herbert.

Herbert Robinson was among the soldiers who benefitted from those orders.

“I guess I was in the service at a good time, because I never got out of the states,” says Herbert, who served in the 82nd from 1952-55. “There were a few times when we thought we might be going to Korea, but it never happened. Obviously, I’m glad for that.”

Herbert’s good fortune allowed him to eventually build a life in Central New York, where he spent 40 years in the construction industry working as a crane operator. Those 40 years of work came at a cost, however.

Since retiring to Florida nearly 20 years ago, Herbert, 86, has had to make regular visits to area dermatologists to address the many skins cancers that have developed as a result of all the days he spent working in the sun.

“I’ve had them on my shoulders, both ears, my eyebrows – you name it,” Herbert says in frustration. “I’ve had so many skin cancers that for a while there, I was going to the doctor at least once every month to have one cut out.

“Not too long ago, they found one on the top of my head, but after they cut that one out, the stitches broke, and oh, what a mess it was. It was after that that my girlfriend read an article in Florida Health Care News about another doctor, so I decided to go see him.”

A New Path

The doctor Herbert’s girlfriend read about is Gerald H. Sokol, MD. He is a board-certified medical and radiation oncologist with Florida Cancer Specialists & Research Institute, which has six locations throughout Pasco County.

“When Herbert came to us, he had been following the traditional path that most skin cancer patients follow, where they go to a dermatologist, get a skin cancer biopsied and then have surgery to remove it,” Dr. Sokol states.

“But he still had a lot of skin cancers that needed to be removed, and almost all of them were on his face. His face was basically one big skin cancer, so to have done further surgery on him would have been problematic, especially at his age.

“It would have taken a long time for him to heal and recover, but he found us as an alternative option to surgery, because we have a state-of-the-art, nonsurgical alternative for skin cancer removal for patients like Herbert that is highly effective.”

Known clinically as electron beam spray therapy, the treatment Dr. Sokol speaks of is well documented as being effective in easily treating both basal cell and squamous cell skin cancers all across the body, but especially around the eyes, ears, nose and lips.

As its name suggests, electron beam spray therapy uses thin, superficially-penetrating electron beams, not x-rays, to destroy cancer cells. It does so in a specifically targeted range that only moderately disturbs healthy cells, which greatly improves the patient’s cosmetic outcome.

“A good deal of the patients we work with here in Florida are older and have multiple skin cancers,” Dr. Sokol says. “If that’s the case, surgery can be effective but challenging because you need to remove larger areas of skin.

“Take it from someone who has had to undergo a lot of skin cancer treatments: This procedure is a no-brainer. It’s so much easier than surgery.” -Herbert

“But with electron beam spray therapy, we can outline large fields for treatment and attain cure rates that are comparable to surgery without bleeding, without the risk of infection or complications and with rapid healing and excellent cosmesis.

“Often times, you can’t even tell the patient has been treated. It’s a highly effective treatment that in this day and age we consider routine, and with newer programs with immunotherapeutic agents, it’s allowing us to control advanced skin cancer like never before.”

A typical regimen of electron beam spray therapy treatments consists of daily treatments across a two- to three-week period. Each treatment lasts less than two minutes, during which the patient typically experiences no discomfort.

Side effects are limited to the area receiving treatment and typically consist of a sunburn like redness with possible transient scabbing and a moist skin reaction that begins to dissipate shortly after completion of the treatment, which has a cure rate of between 90 and 95 percent.

“With cure rates like that, I think it’s important for people to know how advantageous it can be for them to see a radiation oncologist who has the potential to treat them alternatively to surgery, which does remain very effective,” Dr. Sokol concludes.

“Surgical procedures including Mohs surgery, remain highly effective for treating skin cancer. But it’s comforting that we have an equally effective treatment for skin cancer for those who are looking for an alternative.

“And it’s important to know that we can treat not only the local disease but regional disease, where it’s spread to lymph nodes, as well as disseminated disease through new methodologies of electron beam treatment and new drugs that are effective against skin cancer.”

Safe, Easy, Effective

Herbert is proof of that. He had grown weary of having skin cancers removed on a monthly basis, only to have a skin cancer reappear a year or two later in a different spot. He found the electron beam spray therapy much easier to tolerate and as effective as surgery.

“I’ve been seeing Dr. Sokol for a couple of years now, and the treatment is excellent,” Herbert raves. “It doesn’t hurt at all, and once you’ve had it done on an area where you have skin cancer, the skin cancer doesn’t come back. And it’s so easy.

“It takes me longer to take my shirt off than it does to have the treatment done. Take it from someone who has had to undergo a lot of skin cancer treatments: This procedure is a no-brainer. It’s so much easier than surgery.

“And Dr. Sokol is very personable, which I like. You can joke around with him, and he does great work. I only see him once every six months now, and that’s great. The best part is that I’ve found a procedure that really works well for me.”

Size Does Matter

Traditional dental implants restore proper function, enhance confidence

An adage dating back to the 16th century that says the shoemaker’s son wears no shoes suggests the family of a person with a favorable skill set or occupation is always the last to benefit from that person’s expertise or position.

Photo by Jordan Pysz.

Millie smiles with confidence now.

That adage held true through the 22 years Millie Conard spent running her own travel agency. Though the opportunity to travel was often presented to her, Millie was seldom in a position to take advantage of it.

“My daughter was little then, so that prevented us from traveling, and a lot of times when those perks were offered, you had to go right then and there or in the dead of winter,” Millie explains. “So we really didn’t travel as much we would have liked to.”

Millie eventually transferred out of the travel industry and into the medical field, where she now serves a team of doctors as a medical receptionist. A few years ago, she had to answer the call of a medical issue of her own.

The problem stemmed from an injury she sustained during an automobile accident in which her car caromed into a guard rail after it was hit from behind by a driver attempting to pass her on the interstate.

At the moment Millie’s car made impact with the guard rail, the air bag did not deploy. Millie’s mouth hit the steering wheel as a result, causing a bridge containing virtually all the teeth on the upper left side of her mouth to come loose.

After a couple of dentists attempted but failed to repair the bridge, Millie decided to get a dental-implant-supported upper denture, in part because she also had a partial on the upper right side and was tired of wearing two separate bridges.

Dental implants are root-shaped screw-like bodies that are surgically placed into the jawbone. A single implant supports an abutment and a crown, thus creating a new tooth. Two or more implants can support a fixed bridge or a full denture.

Implants are considered the gold standard for replacement teeth, but they didn’t work for Millie, because the mini-implants she was initially fit with were too small to provide the foundation necessary to keep the denture from moving when she tried to eat.

“I was miserable,” Millie complains. “I was so miserable I didn’t even want to go out and eat with people because my denture was always moving around. It’s pretty bad when you watch TV and you’re envious of someone just eating a potato chip.

“The other problem was that, because I couldn’t chew my food properly, I wasn’t able to digest my food properly. That was causing me not to feel good physically, so there were a lot of things going on all at once because of this.

“That’s the point I eventually got to about two years after the car accident. What made it even more frustrating was that the dentist who put the implants in eventually dropped me as a patient because she couldn’t fix it.

“Finally, I got so fed up one day that I literally got in the car and went to every dentist’s office I could find asking if someone could fix this problem for me. I even went out as far as Lakeland looking for someone to help me.”

Rescue Mission

It was after she visited about 10 dentists that Millie finally found one willing to take her on as a patient and resolve her problem. That dentist is C. Edgar Davila, DDS, MS, of Tampa Advanced Dental Solutions.

Dr. Davila is a board-certified prosthodontist, which means he specializes in the treatment and restoration of dental problems that are the result of missing teeth or damaged jaw structure, including temporomandibular disorders (TMJ/TMD).

Upon first examining Millie, Dr. Davila discovered that the reason Millie was initially fit with mini-implants was because her jaw bone lacked the volume necessary to support regular implants, which are slightly larger than mini-implants and therefore require a larger base.

“I tear up sometimes when I think about what Dr. Davila’s done for me. … I can’t tell you how many dentists I’ve been to, but there is truly no one else like him.” – Millie

c.The loss of volume in the jaw bone is a natural occurrence that takes place over time whenever someone loses one or more teeth. Without a tooth to support, the jaw bone deteriorates through lack of function. The longer a tooth is missing the more the jaw bone deteriorates.

In cases such as Millie’s, where there is not enough bone to properly support traditional implants, mini-implants can work, Dr. Davila emphasis, but a better option includes performing a bone graft procedure where a bone particulate is used to generate new bone growth that allows for traditional implants to be seated properly.

In many cases, the bone graft can be performed, and the patient can be fit with implants and a temporary crown, bridge or denture during one visit. After the implant has fused with the bone, a process that can take a few months, the temporary prosthetic is replaced with a permanent one.

New and Improved

That was the approach that Dr. Davila took in treating Millie, who had her old mini-implants removed, underwent a bone graft and received new implants as well as a full temporary upper denture in just one visit.

But Dr. Davila didn’t stop there.

He later replaced two failing bridges on Millie’s lower arch. In each of those cases, he used two implants to support two bridges made of zirconia ceramic, which offers better strength and aesthetics than standard porcelain bridges.

“The look of the zirconia ceramic teeth is closer to natural teeth,” Dr. Davila educates. “And there is definitely less wear with zirconia because it’s a stronger material. Those are the main advantages of zirconia: It’s stronger, more durable and it offers better aesthetics.

“And it was part of a major change for Millie. It had been several years since she was able to eat normally and smile with confidence, but now she can do all of that and she has no limitations on what she can eat.”

Almost immediately after receiving her permanent denture and lower bridges, Millie tested those limitations. Though she’s not much of a fan of apples, she says she bit hard into one just to test the stability of her new teeth.

“I wanted to try it to see if I could do it, thinking, if I can bite into an apple and nothing happens, I should be fine with eating anything,” Millie says. “So, I bit into that apple and I was just amazed. My teeth didn’t move at all.

“It’s literally like having real teeth again, because I can eat anything I want now. I got a part of my life back from these new teeth. And that’s why I so highly recommend Dr. Davila to everyone I know that has a dental problem.

“My whole family sees him now, and I want to add that he is the most compassionate man in his field. He’s actually one of the most compassionate men I know. I consider him to be among the highest order of angels.

“I tear up sometimes when I think about what Dr. Davila has done for me. He’s just so wonderful, and he has hands not of gold, but platinum. I can’t tell you how many dentists I’ve been to, but there is truly no one else like him.”

 

Making Waves

Safe nonsurgical alternative to drugs erases erectile dysfunction.

When Esteban* married his wife 48 years ago, the native of Barcelona, Spain knew he was entering into a lifelong romantic partnership. What he didn’t know was that he was also entering into what would eventually become a business partnership.Stock photo from iStockphoto.

“My wife is from Portugal, and after we moved to Florida some thirty-five years ago, we realized there was a business opportunity here for us translating legal and medical documents from Spanish and Portuguese into English,’’ Esteban explains.

“We’ve been doing that for more than thirty years now, and it’s been a good business for us. It’s something we can do out of our home, which is convenient, and there’s enough demand to make a good living from it.”

Esteban, who turned 80 earlier this year, says he keeps his translation business going in part because it keeps him mentally active. As for physical activity, Esteban stays in tune by walking daily and working out at a gym three days a week.

Esteban says those workouts have him feeling like he’s at least 20 years younger than he really is. There is, however, one area where, for a little more than a year, Esteban hasn’t been feeling so young and vibrant. That area is in the bedroom.

“It wasn’t quite two years ago that I suddenly began to have problems with erectile dysfunction,’’ Esteban reveals. “After struggling with that for a couple of months, I finally decided to get some treatment for it.

“The first doctor I went to told me my testosterone was low, so he gave me testosterone treatments. But that really didn’t help much. In fact, it made things worse because it gave me bad acne on my chest.

“Then one day, I was in a doctor’s office with my wife, and she was reading this newspaper, Florida Health Care News. She saw an article about a doctor who had a new treatment for erectile dysfunction and suggested I go see him.”

The doctor Esteban’s wife read about is Rene M. Reed, DC, NMD. Dr. Reed is a chiropractic orthopedic specialist and naturopathic medical doctor who specializes in integrative medicine and a revolutionary, noninvasive treatment for erectile dysfunction.

That treatment is called extracorporeal acoustic wave therapy, and it does what medications such as VIAGRA® and CIALIS® cannot do, which is correct the underlying cause of erectile dysfunction, or ED.

That underlying cause is often the result of a lack of circulation to the penis caused by a build-up of plaque in the chambers of the penis that normally expand when filled with blood. The plaque build-up interferes with blood flow to this vital area responsible for good erections.

“Wholistic” Approach

“I started providing acoustic wave treatments because I’ve seen erectile dysfunction, or ED, destroy relationships and devastate men,” Dr. Reed explains. “I’ve literally had grown men cry in front of me over it.

“I also do genetic testing to determine if genetic defects are contributing to a patient’s ED, because acoustic wave therapy may work more effectively if the underlying genetic issues are treated.

“We look at all the players responsible for good erections and sexual function because when a man is not functioning like he is used to, he feels like less of a man. When Esteban came to me, that’s how he was feeling.”

Like Esteban’s previous physician, Dr. Reed discovered through his testing that one of the causes of Esteban’s erectile dysfunction was a lack of testosterone, which is not abnormal for a man over the age of 40.

Every year after that age, testosterone levels in men drop by ten to 20 percent, Dr. Reed educates. His first objective in treating Esteban, then, was to regulate his hormones, which Dr. Reed had done with bio-identical hormone replacement therapy, or BHRT.

BHRT is designed to boost hormone levels through the application of a natural testosterone cream to the inner thighs or scrotum. It is one of several treatments that Dr. Reed combines with acoustic wave therapy to obtain optimum results.

“We look at everything, including any side effects from medications the patient may be taking, to learn the true cause of his erectile dysfunction,” Dr. Reed says. “And, in treating that, we take what I call an integrative wholistic approach, meaning we treat everything.’’

That treatment begins with acoustic wave therapy, which is delivered through a small, handheld device that creates a series of short, painless pulsations that break up the plaque and calcium that have built up inside the blood vessels in the penis.

Those pulsations not only stimulate the growth of new nerve tissue, which is vital for achieving and maintaining healthy erections, but they also correct Peyronie’s disease, a condition where tissue build-up causes an abnormal left or right bend to the penis.

“In addition to the acoustic wave therapy, we also put patients on a penis pump,’’ Dr. Reed notes. “We have them use the pump for about fifteen minutes each night in an effort to engorge the penis with blood on a nightly basis.

“We do that because it pulls blood into the sacs on either side of the shaft of the penis that are accountable for an erection. That daily blood flow is important because it helps to wash out the plaque that is being broken up by the acoustic wave therapy.

“Another thing we do is ask our patients to take two nitric oxide pills each day. That helps to dilate the blood vessels all throughout the body, including in the penis, which allows for even further blood flow.

“So again, we’re hitting this problem from all angles. It’s a concentrated effort to break up the plaque, improve blood flow to the penis, generate new blood vessels and provide nutrients that help all that happen.”

Remarkable Results

Acoustic wave therapy treatments last about 30 minutes, with patients typically receiving two such treatments per week for a span of six weeks. Esteban underwent his first treatment in June and began BHRT shortly thereafter. The results have astounded him.

“I’m eighty years old, and I honestly thought I’d reached the end of the line in terms of sexual performance, but that’s not the case,’’ he says. “My ability to obtain an erection and keep it has been improving steadily for the past few months.

“It doesn’t come back all at once. It takes some time. But the combination of treatments Dr. Reed prescribed for me has definitely worked. Now, I not only feel like I’m a lot younger, but in the bedroom, I can perform like I’m a lot younger.

“I’m really glad I found Dr. Reed and so is my wife. He’s very down to earth and very smart. When I first went to see him, he told me he doesn’t believe in just throwing a pill at this problem because that won’t work, and now, I know what he means.”

Dr. Reed says Esteban is one of his best success stories.

“Most men who are eighty years old have long since hung up their holster, but that’s not Esteban,’’ he says. “He’s still very active sexually. He hasn’t thrown in the towel, and I can see what a difference it’s made for him.

“He feels, acts and talks like a man much younger than he is, and when you feel younger, you think younger and move like a younger man. That’s what I’ve seen with him, so yes, he is definitely one of our great success stories.”

*Patient’s name changed at his request

Goodbye Toenail Fungus

While serving in the United States Armed Forces, Chet Young did three tours of duty in Vietnam. At some point, during at least one of those tours, Chet was exposed to Agent Orange, a hazardous material that can cause diabetes, kidney disease and many other chronic conditions.

Years later, when he first learned he had indeed contracted Type 2 diabetes, the diagnosis came as no surprise to Chet, who more recently thought a problem with toenail fungus was being caused by his diabetes. He soon found out differently.

“I have my feet examined on a regular basis because diabetes can cause circulatory issues and problems with the feet,” he explains. “When the fungus appeared, I assumed the two were connected, but they’re not.

After moving to Fort Myers a few years ago, Chet was referred to Hal L. Bozof, DPM, a board-certified podiatric physician, for treatment. Dr. Bozof explained to Chet that toenail fungus can be difficult to eliminate.

Laser Advantages

Photo by Nerissa Johnson.

Chet can wear flip-flops once again and no longer has to hide his feet.

“It typically grows in a dark, warm, moist environment,” Dr. Bozof explains. “Once it gets under the skin or nail, that’s a perfect place for the fungus to thrive. It can then spread from one toenail to the next. Oftentimes, the fungus will develop underneath the nail plate.”

Historically, treatment for fungal nails has included topical medications, oral agents (pills) or surgical removal of the nail plate, which have been relatively ineffective.

“The most efficient way to kill the fungus is with the Fox Laser, which we use in my office,” Dr. Bozof explains. “It is essentially pain free, and there are no side effects. It takes only a short time per treatment and may require two or three sessions, depending on how many nails are treated and the extent of the fungus.

“The laser produces heat that penetrates the nail plate and thereby kills the fungus, which lives in and underneath the toenail,” continues Dr. Bozof.

“One of the most impressive features is that there is no recovery time,” adds Dr. Bozof. “Shoes can be worn immediately after the treatment, unlike having the nails removed.”

Toenails grow very slowly. It can take up to a year or more to grow a new toenail, which is why it can be so hard to get rid of toenail fungus. The fungus often doesn’t go away until a new toenail can grow back.

Chet is thrilled with the care he received and says that the fungus condition has been resolved and his nails are now normal once again.

“I don’t have to be embarrassed about my feet anymore!” he exclaims. “I can wear sandals and flip-flops and not be worried about how my feet look. It’s a relief!”

 

 

Eliminate Hammertoes

In-office procedure eliminates unsightly, painful condition.

Photo by Jordan Pysz.

Ellie happily shows off her feet.

Ellie Cherwick has always hated her feet. “I’ve never really liked the way they look,’’ Ellie laments. “And I’ve always had problems with them.’’

One of those problems is hammertoes, which is a bending or curling of the toes that often results in the formation of corns or calluses as the toe deformity presses unnaturally against the patient’s footwear and/or the ground.

The condition is one that Ellie’s mother and daughter have had to deal with as well, and for years, Ellie dealt with it rather simply by wearing closed-toe shoes to mask the hammertoes’ unsightly nature.

“Mostly, I just hated the way they looked,” Ellie explains. “They weren’t uncomfortable, so I never had much pain, until recently. I guess they just got a lot worse over time, so I decided to do something for myself and get them repaired.”

Ellie’s decision resulted in a visit to her long-time podiatrist, Hal Bozof, DPM, who says hammertoes are typically caused by an irregular and potentially permanent shortening of tendons and muscles that results in the deformity of the toe joints.

“This contracture is often the cause of a muscle imbalance in the foot that causes the toe to dorsally contract, meaning the toe pushes up and the end of the toe hammers to the ground,” Dr. Bozof explains. “Frequently, it is inherited or caused by wearing shoes that are the wrong fit.”

Dr. Bozof adds that hammertoes can develop at any age. They can occur in people as young as 30 or even 20 years of age, he says.

“It can develop at a young age, especially in women who wear high heels a lot,” Dr. Bozof explains. “The older we get, the more likely the hammertoes are to get worse. They are more prevalent in women, but I do see men with them as well.

“Hammertoes can become very painful,” the doctor continues. “Sometimes, they can rub against the inside of the shoe, causing a corn to occur. Unless the affected toe is straightened out, there will inevitably be an issue with corns or calluses.

“Sometimes, an ulcer can form as well. This results in extreme discomfort caused from the toe hammering against the ground and can lead to an infection. Also, painful calluses may develop on the bottom of the foot due to the underlying contracture of the hammertoes.”

Progressive Procedure

Photo courtesy of Ellie Cherwick .Dr. Bozof says hammertoes are very common and notes that in the past, treatment was performed in a surgery center or a hosptial and typically required four to six weeks of recovery time. Today, however, there is a pain-free in-office procedure that eliminates hammertoes quickly.

“This new procedure starts with the application of a local anesthetic that numbs the toe,” Dr. Bozof explains. “After that, a very small opening requiring no stitches is made to release the tendon, which allows the toe to straighten out.

Dr. Bozof says that following the procedure, the patient’s toe is put in a bandage that is worn only for a day. He adds that most patients can walk on the foot with the treated toe the very same day, “usually without any pain.”

Ellie confirms that the procedure was indeed painless and adds that she is back to enjoying working in her yard and wearing most any shoe she wants again.

“I couldn’t wait to get a pedicure once the procedure was finished,” Ellie says. “Dr. Bozof does great work. I am ecstatic with the results! I love my feet again!”

 

Word of Mouth

Patient recommendations pave way for dental restorations.

Photo courtesy of Sue Chaplin.

Sue Chaplin

With more than ten billion tons of raw materials, finished goods and foodstuffs being moved across the US by truck each year, the trucking industry is considered the lifeblood of the US economy.

Without those trucks, economists fear the economy would come to a virtual standstill. That’s why the service company Sue Chaplin took over after her husband passed away a few years ago is so important.

“The company is like AAA for trucks,” Sue explains. “When a truck breaks down anywhere in the United States, the driver calls into a call center, and we have vendors that will go out and find the driver and their truck and get them moving again.”

With the help of her son, Sue runs her family’s company from the home in Punta Gorda she moved to after spending the previous 38 years in Green Bay, Wisconsin, where she raised her family and helped her husband create and run the company.

“Green Bay is a great place to raise a family,” Sue says. “The people are all very nice and friendly, but it’s very cold there. So, we built a home in Florida and moved here in 2013. My husband died a few years after we moved, in 2016.”

Before passing, Sue’s husband became a patient of Joseph H. Farag, DMD, of Advanced Dentistry of Fort Myers. Sue, 71, says her husband used to rave about Dr. Farag’s work. She remembered that recently when a dental problem of her own arose.

“It wasn’t long after we first moved to Florida that I was eating an olive that I didn’t know had a seed in it,” Sue explains. “When I bit down on that seed, it cracked a tooth, and I went back to Green Bay to get it fixed.

“They wound up doing a root canal, but it must not have been done correctly because it was always very tender and had kind of a zing to it. About the time my husband died, it was really bothering me, so I decided to see if Dr. Farag could do something about it.”

Though it was the problem stemming from the root canal that prompted Sue to visit Dr. Farag, that was not the only issue she voiced a concern about during her first visit to Advanced Dentistry of Fort Myers.

“The other problem was one I’d had for a number of years,” Sue confesses. “At first, I didn’t think it was a dental problem because it started out as me getting earaches and having some slight neck and jaw pain. But over time, it just got progressively worse.

“I went to a few medical doctors for it, but none of them ever put together what the problem was. One of them actually told me, No, you don’t have an earache. I knew that I did, of course, and knew that I had this constant neck and jaw pain, too.

“I think it was probably due to the stress of my husband passing, but about three years ago, it got really bad. So while I was visiting with Dr. Farag, I mentioned this pain I was having to him and asked him if he had any idea what may be causing it.”

More Than Meets the Eye

It didn’t take long for Dr. Farag to solve the mystery behind Sue’s discomfort. During his initial examination, he found she had previously undergone an extensive dental restoration, the finishing touches of which were proving problematic for her.

“She had received a number of crowns,” Dr. Farag reports. “In fact, most of her teeth had been given crowns. The problem was that the crowns as they were weren’t allowing her teeth to meet properly when she closed her mouth.

“Bottom line, she had a bite problem. Because the crowns weren’t meeting properly when her mouth was in the closed position, her jaw was not resting properly. That’s what was causing the earaches and the neck and jaw pain.”

Dr. Farag’s discovery came with a bit of bad news. Though he had clearly found the cause of Sue’s pain, it became immediately clear to him that the only way to resolve the issue and rid Sue of her discomfort was to re-crown all of her teeth.

“I really thought I might have to live with this problem forever. But Dr. Farag took care of it, and I’d recommend him to anyone because he’s very thorough, very patient and he obviously does great work.” – Sue

Knowing it was the best thing for her, Sue agreed to what amounted to another full dental reconstruction. This one, however, proved to be a bit more extensive, in part because of the cracked tooth she created when she bit into the olive pit.

The repair of that tooth, a lower molar, required more than just a crown. Because the crack ran so deep, it required the tooth to be pulled and the root to be replaced with a dental implant.

Dental implants are screw-like posts that are made of a titanium alloy that are surgically implanted within the bone of the patient’s jaw. Once the implants are in the jaw, they fuse over time with the bone and become a solid unit.

It typically takes three to six months to complete the fusion process, but once that solid unit is formed, it provides stability for an abutment, which is then capped off with a crown for a single tooth or a partial or full denture for patients replacing multiple teeth.

Dr. Farag also provided Sue with an implant for a tooth that was missing. In that case, he first had to perform a bone graft, where bone particulate is injected into the empty socket to ensure the jawbone will support the implant.

“The bone graft does a number of things,” Dr. Farag explains. “One of those things is, it helps to maintain the volume of bone that is already present in the jaw so that we don’t have any atrophy in the height, width and depth of the bone.”

Bone grafts are not always necessary. When they are, it takes about three months for the bone to heal to a point where it can receive and support an implant, which is put in place with the aid of a computer-assisted, 3-D guidance system.

A Comfortable Fit

Photo courtesy of Advanced Dentistry of Fort Myers. The crown itself looks like a real tooth and is fashioned out of ceramic using a machine that allows the dentist to make it on the spot on the day it is screwed onto the implant. In Sue’s case, this crown was one of more than 20 that Dr. Farag created for her.

“We did all of her lower teeth first and got her into temporary crowns, which I kept her in for about three months,” Dr. Farag says. “We did that so that she was sure she was going to be comfortable with the fit.

“We eventually had to make some adjustments, but we finalized both the lower teeth and the upper teeth, including another implant where the crown wasn’t fitting right. She now has the comfortable bite she was missing and is out pain.”

The entire reconstruction of Sue’s mouth took about two years to complete, but Sue says the outcome was well worth the investment in time. She says her teeth now look and feel better than they ever have.

“The best thing is that the earaches are gone,” she exudes. “So is the neck stiffness and jaw pain. Everything fits the way it’s supposed to now. I’m so glad I went to see Dr. Farag, because he solved this longstanding pain problem I had when no one else could.

“I really thought I might have to live with this problem forever. But Dr. Farag took care of it, and I’d recommend him to anyone because he’s very thorough, very patient and he obviously does great work.”

Arrested Development

Syracuse, New York native John Eastman decided at a relatively early age that the cold, snowy Northeastern winters weren’t for him, so about eight years ago, he and his wife packed up their lives and moved to Florida.

Now an inventory specialist for Charlotte County Fire and EMS, John currently spends not only his winters but every other season making sure the fire trucks, ambulances and animal control trucks used across Charlotte County stay in tip-top shape.

“Whenever one of those emergency vehicles needs a part, I order it, and I keep a stock count of everything we have and what we use the most so that we have everything we need to keep those vehicles on the road and running,” John relates.

“What I do now is a bit of a combination of what I used to do in New York, where I worked in the parts department for J.B. Hunt Transportation and spent about fifteen years serving as a volunteer firefighter.”

John’s New York-based firefighter training did not transfer to Florida, so his days as a volunteer firefighter have been put on hold. He recently wound up fighting a three-alarm fire all his own nevertheless.

“I was not one of those guys who went to the dentist all the time, and it eventually caught up with me, because I got to a point recently where I could not brush my teeth without my gums bleeding and bleeding badly,” John explains.

“Every day, my gums would bleed when I brushed my teeth, and I also had what I later found out was tartar build-up on the back of my bottom front teeth that was breaking off. At the time, though, I thought it was parts of my teeth that were chipping off.”

Those two issues sparked an earnest search for a dentist that began with John asking some of his co-workers for recommendations. One co-worker recommended he visit Dr. Farag at Advanced Dentistry of Fort Myers.

“This guy could not say enough good things about Dr. Farag, so I decided to see if he could take me on as a new patient,” John relates “When I called the office, they said to come on in, so I went ahead and gave Dr. Farag a try.”

John first saw Dr. Farag the first week of January 2018. During that visit, Dr. Farag learned that John was a heavy smoker who had neglected his teeth for years. A full examination revealed the result of those habits was a severe case of periodontal disease.

“We noticed he had a lot of deep pockets in the gums around his teeth,” Dr. Farag explains. “Most of those pockets were five millimeters deep, but in some cases, they were up to ten millimeters deep, whereas healthy pockets are between one and three millimeters.

“In addition, the x-rays we took showed he had a lot of bone loss around the teeth and that there was a great deal of tartar build-up on his teeth. Both of those were signs of a chronic condition that was ongoing.”

Regenerative Procedure

Photo by Fred Bellet.

John Eastman

Based on his findings, Dr. Farag recommended John undergo a specific minimally invasive laser treatment that he’s been performing for more than a decade called LANAP®, which stands for laser-assisted new attachment procedure.

LANAP is not the only treatment option for patients suffering from periodontal disease, but Dr. Farag considers it best because it improves the attachment between the gums and teeth, does not result in a gross loss of tissue or gum recession and is pain free.

“If you use another laser with a different methodology, you’ll end up with tissue harm, necrosis or a recession of the gums around the tooth bridge,” Dr. Farag educates. “We do not want the gums to recede because that can make the teeth appear longer. The goal is healthy gums that reattach naturally to the teeth, and LANAP does this without harming the healthy tissue.”

Another reason Dr. Farag recommended the LANAP procedure for John is because of the significant loss of bone he had suffered around his teeth. In addition to healing gum tissue, Dr. Farag explains, LANAP can also improve bone quality and density.

“The LANAP procedure does improve the quality of the existing bone, and in some cases, we can re-grow bone,” Dr. Farag confirms. “But in cases involving a smoker such as John, we’re often happy if we can stop the bone loss.

“Smoking amplifies the periodontal disease. It makes it worse because nicotine in the cigarette constricts the capillaries, which are the blood vessels in the tissue, stalls healing and creates an environment where bacteria thrive.

“Those bacteria thrive because they’re not getting attacked by the immune system. Blood supply to the tissue is reduced. There’s some, but the tissue is not healthy, and that’s why heavy smokers usually have worse cases, including more bone loss.”

In John’s case, the bone loss was, in some areas, significant. Though the loss was 20 percent in most areas, there were areas where the loss was nearly 40 percent and some others where it was greater than 70 percent.

Because of the bone loss and the advanced nature of his periodontal disease, John was on a track that would have resulted in him eventually losing several teeth. That bottom line made him an ideal candidate for the LANAP procedure, which John agreed to.

“No Discomfort at All”

“My only hesitation was that I have a problem holding my mouth open for long periods of time because I always begin to gag,” John says. “That’s one of the reasons why I’ve never really gone to the dentist a lot.

“But Dr. Farag assured me everything would be fine and gave me a very light relaxant of some kind, something I took about an hour before the surgery and that helped to settle me down, which made the procedure even easier on me.

“And just like Dr. Farag said, it really was pain free. I was surprised by that, because the thought of a laser cleaning between my gums and teeth scared me. I was thinking, How can this not hurt? But it didn’t. There was no discomfort at all.”

Despite the advanced nature of his periodontal disease, John’s LANAP procedure took only about two hours to complete, which is typical. During those two hours, the entire mouth was treated through three steps.

“The treatment worked great, so if you need it, don’t hesitate to get it. And if you need to get it, get it done by Dr. Farag. My experience with Dr. Farag was by far the best dental experience I’ve ever had.” – John

Dr. Farag explains that during the first laser pass, the energy from the laser kills any bacteria in the gums, vaporizes the diseased gum tissue and dehydrates the tartar on the teeth, making it brittle and easy to remove.

During the second step, the tartar is removed with a fine-tipped, vibrating, ultrasonic instrument. The teeth are then rinsed with an antimicrobial substance that halts the growth of new bacteria. During this step, the diseased lining of the tissue is removed and the bone surrounding the teeth is debride of infected tissue.

Finally, during a third pass of the laser at a different setting than the first two, an antimicrobial seal is created that prevents re-infection and releases growth factors from blood cells that help regenerate the attachment between the gums and the teeth.

“The patient doesn’t have any sensation of what we’re doing during the procedure because we use a local dental anesthetic, just as we do if we’re doing a filling,” Dr. Farag says. “That’s how patients stay comfortable during the process.

“And there is no post-op discomfort because we’re not traumatizing anything. The gums are not inflamed, so they’re not painful. Afterward, however, we do ask patients to briefly stay on a soft-food diet to prevent any tearing of the new tissue that’s forming.”

That soft-food directive wasn’t the only post-procedure instruction John received. He was also ordered not to smoke during the healing process. For a man with a nearly two-pack-a-day habit, that figured to be a difficult order to follow. John managed, however.

“Dr. Farag told me that if I smoked at all during the healing process, it would do more damage than what I had in the first place,” John notes. “So, I didn’t. From that day on, I literally did not smoke one cigarette for four months.”

John recently resumed his smoking habit, but he says he is smoking only about ten cigarettes a day now and is on a “quit plan” that he is confident will rid him of the habit for good. Meanwhile, his gums have healed nicely, and his overall oral health has improved markedly.

“My teeth feel much, much better, and there’s no more bleeding when I brush anymore,” John exudes. “I’m forty-five years old, and for the first time in my life, really, I’m taking care of my teeth the right way because Dr. Farag and his staff showed me how to brush and floss properly. Now, I know why my buddy couldn’t stop talking so highly of Dr. Farag.

“The treatment worked great, so if you need it, don’t hesitate to get it. And if you need to get it, get it done by Dr. Farag. My experience with Dr. Farag was by far the best dental experience I’ve ever had.”

I Can Hear Clearly Now

Technological advancements create new, improved world of sound.

For years, Cecile Engel filled her free time playing cards or riding a bike. Then, at the age of 80, she moved to Florida and took a ride alongside her daughter during a day out on the golf course. Cards and biking have taken a backseat to golf ever since.

Photo by Nerissa Johnson.

Cecile Engel

“I had never played golf before, but as I rode along the course with my daughter that day, the game looked like so much fun to me that I decided to take lessons

and learn how to play,” Cecile says. “Now, I’m addicted. It’s really a great game.”

Like most golf lovers, Cecile, 83, has also discovered just how frustrating the game can be. Her frustration with the occasional errant shot, though, is always offset by the beauty of the course and the relationship with nature it offers.

“The golf courses are so gorgeous, and except for the hot summertime, it’s great to be outdoors like that,” she says. “And I really find the game to be relaxing. It’s frustrating as well, but it’s also very relaxing for me. I really love it.”

Cecile is loving her days on the golf course even more now that she’s rectified a hearing problem that crept up on her about 15 years ago. It’s a problem Cecile tried to correct on more than one occasion.

“My kids were probably the first ones to really notice it,” says Cecile, who moved to Florida from Silver Springs, Maryland, where she once managed her husband’s podiatry practice and later managed another daughter’s veterinary hospital.

“They got tired of me always asking them to repeat what they were saying and me saying, ‘Huh, what did you say?’ After a while, I realized I needed to get my hearing checked, and I eventually got hearing aids.”

Cecile initially had her hearing checked and later bought her first pair of hearing aids from a Costco® wholesale club store in Maryland. She kept those hearing aids until just after she moved to Florida, where she bought her second pair from a Sam’s Club.

Cecile found both pairs of hearing aids to be little more than adequate, however, largely because she still struggled to hear conversations clearly. One day, while discussing the matter with a friend, she was advised to visit EarCare.

Best in Show

“When Cecile first came to us, she was having difficulty with her hearing aids, so the first thing we tried to do was service them,” says Glenn A. Oberbeck, a board-certified Hearing Aid Specialist, who co-owns EarCare along with his wife, Karen Cowan-Oberbeck, AuD, a board-certified Doctor of Audiology.

“The problem we had there was that her hearing aids contained a fixed chip, meaning they can only be serviced or adjusted at the store where they were purchased. All we could do was clean them, which we did.

“As for the hearing aids, I don’t know what more I can say other than they’re the best hearing aids I’ve ever had. They’re wonderful.” – Cecile

“But that didn’t help her hearing, because the problem she was having was with understanding and clarity. When we tested her hearing, we discovered that her speech discrimination score, which is the measure of what a person understands when hearing someone speak, was thirty-six percent in the right ear and fifty-six percent in the left.

“That was without hearing aids. But even with her old hearing aids, the best we could do was get those scores up to eighty percent. So we offered her an opportunity to try out some new technology for free to see if we could get her hearing better.”

Cecile accepted that offer and was fit with a pair of ReSound LiNX 3D 9 hearing aids. Considered an excellent choice for anyone living an active lifestyle, the ReSound LiNX 3D 9 hearing aids are the most technologically advanced in the ReSound line.

They include customized programs that allow the wearer to hear clearly in any environment and contain Bluetooth® technology that allows the wearer to stream music or sound from a TV, computer or smartphone directly into their hearing aids.

Vast Improvement

“Once we fit her with the new technology, we did the validation, fine-tuned the instruments and retested her,” Glenn says. “At that point, Cecile’s hearing clarity improved to ninety-six percent in the left ear and one hundred percent in the right.

“Improving the clarity is always one of the biggest challenges we face, but Cecile responded very well to the new technology, and she’s really enjoying the difference these new hearing aids are making for her.

“She’s got them paired with her iPad® so that the sound from any audio or videos that would normally come out of her iPad now goes directly into her hearing aids. She can do the same with her TV or with FaceTime®, which is great.

“And the technology Cecile’s been fit with is an open platform, so it can be programmed or adjusted by any provider in any city. You don’t have to go back to the same provider you received it from, which is a big difference from what she had before.”

Cecile agrees that there is a big difference between the hearing aids she was wearing before and those she received from EarCare. But that’s not the only difference she noticed while being fit for the hearing aids she purchased from EarCare.

“First of all, the hearing test I was given at EarCare was very comprehensive,” she says. “It was the most comprehensive I’ve had. That’s one of the reasons I’ve already recommended EarCare to some friends of mine.

“The people there are great and so professional. And as for the hearing aids, I don’t know what more I can say other than they’re the best hearing aids I’ve ever had. They’re wonderful. I’ve literally never had anything like them.”

“When Glenn and I first started talking about me getting new hearing aids, he asked me what I wanted to accomplish. I said that I wanted to be able to hear the rain on the roof again, and now, I can hear the rain on the roof and so much more.

“I’m hearing conversations much more clearly than I did before, and when I hit my golf ball in the water now, I can actually hear the splash. That’s how good these hearing aids are.”

Cool off Period

State-of-the-art nonsurgical procedure freezes away stubborn fat.

The fact that all three of her children are actively involved in competitive athletics comes as no surprise to Lana*. After all, this 40-year-old nurse liaison has always been quite active and athletic herself.

“I was involved in gymnastics from the time I was four until I was a junior in high school, and I also played tennis and volleyball,” Lana says. “Even after I got older and got married, my husband and I used to dance competitively.

“With the kids and everything we didn’t have the time to devote to it that a lot of other couples did, but it was something we enjoyed doing and had a lot of fun with. My biggest activity nowadays is watching my children’s games.”

Lana recently had to devote some time between watching games to resolving an aesthetic issue with her arms that she first took note of after seeing a photo a friend had taken of her and her daughter.

“There’s always that one picture that you look at and say, oh my goodness, how did I let it go this far?” Lana says. “For me, it was a photo where I looked at my arms and thought they belonged to another woman. I thought, that’s not me.

“For whatever reason my arms have always been a bit of a problem area for me. After being a gymnast and dancing, I lost muscle in them and even when I worked out, it was hard for me to reshape them and get them to where I was proud of them again.”

Lana’s pride prompted a search for a solution that began with her asking some associates in the medical field if they knew of a treatment that could resolve the problem. One of those associates suggested not only a treatment but a practice that provided it.

That practice is Physicians Body Sculpting in Melbourne, where Michael Wolfington, DO, and his staff offer a variety of anti-aging and rejuvenating services for the body and mind, including the aesthetic treatment known as CoolSculpting®.

Cloud Nine

Referred to clinically as cryolipolysis, CoolSculpting is a unique FDA-approved nonsurgical cosmetic treatment that is designed to remove visible areas of body fat through a process where fat cells are destroyed through a controlled freezing process.

It can be used to treat nine different problem areas of the body where fat collects, including under the chin and jawline, around the abdomen and flanks, under the buttocks, across the back, inside and outside the thighs and beneath the upper arms.

Delivered through paneled applicators that use vacuum pressure to draw the fatty tissue away from the body, the CoolSculpting process stimulates the fat cells by cooling them, which sparks their destruction and eventual removal from the body.

As it does for all new patients, Lana’s experience at Physicians Body Sculpting began with a free consultation during which she expressed her concerns and Dr. Wolfington suggested a treatment designed to correct them.

Like with Lana’s friend, Dr. Wolfington suggested she try CoolSculpting, which does not affect muscle, nerves or skin and is aided by a short post-treatment massaging period during which the fat cells are broken down.

“Once the fat cells are broken down,” Dr. Wolfington explains, “the contents come out and then, over a period of a couple of months, those contents are reabsorbed by the body and flushed out. It’s a very safe and effective procedure.”

Effective is precisely how Lana describes CoolSculpting. About three weeks after undergoing a single 45-minute treatment, she began to see results that made her feel much better about herself.

Not only did I see a difference, I felt a difference,” she raves. “My shirts were no longer tight on my arms, so there was a big difference in terms of comfort. And my arms looked stronger, not like leg chops from someone else.

“For me the results have been spectacular, so I definitely recommend CoolSculpting. And I definitely recommend Physicians Body Sculpting. They did a great job. They really killed it.”

*Patient’s name withheld at her request.

Renovation Reality

Expertise pivotal during difficult restoration.

tense, two-week stay on alert in the Mediterranean Sea awaiting the outcome of the Cuban Missile Crisis and a couple of trips to the South China Sea during the Vietnam War highlighted Charles Davis’ ten-year career in the United States Navy.

“I worked electronics maintenance on the planes that flew off two aircraft carriers,” Charles says of his Naval duties. “I was on the Forrestal during

Photos by Nerissa Johnson.

Charles served ten years
in the US Navy aboard
two aircraft carriers.

the Cuba crisis. We were in the Mediterranean at the time and woke up one morning with four Russian boats around us.

“I was on the Ranger for the two tours of Vietnam I did. Our squadron was the one that ran all the photo reconnaissance missions over Hanoi and places like that. I eventually got out of the Navy after ten years because I was tired of going to Vietnam.”

Charles left with enough experience to forge a career servicing planes for one of the country’s biggest commercial carriers. He has since retired and moved from Denver, Colorado to Florida, where he recently chose to correct a longstanding dental issue.

“About thirty years ago, I had to have all my bottom teeth, except for the six in the front, pulled out,” Charles explains. “They gave me a partial for

each side where they’d pulled the teeth, but the partials never fit or looked right.

“The way they fit was the biggest problem – especially when I ate. It got so bad that after a while, I just stopped wearing them when I ate. I still ate whatever I wanted, but I had to eat in the middle of my mouth like a chipmunk. That was a little time-consuming.

And I was always self-conscious about not having those teeth, so I finally decided to find out if there was anything else that could be done about them. What got me going was this article I read in Florida Health Care News.”

The article Charles read was about Richard Leong, Jr., DDS, a general and implant dentist who practices comprehensive, full-treatment dentistry, including full mouth reconstructions, at his offices in Melbourne.

A strong recommendation from a friend further steered Charles in the direction of Dr. Leong, whose work on Charles began six months ago with a thorough examination that revealed yet another challenging dental issue.

The Implant Option

“In addition to having lost the teeth on either side of the six teeth that remained on the bottom front, Charles had a lot of cavities and some abscesses in those six remaining bottom teeth,” Dr. Leong reveals.

“One of the first things we had to decide then was whether he wanted to keep those teeth and repair them or pull them and go with a full denture on the bottom. Because he already had a full upper denture, that was one of the options I presented to him.”

That option was actually one of several Dr. Leong presented to Charles, who eventually decided to have Dr. Leong restore his six existing teeth while he replaced the missing teeth on his lower arch with bridges secured by dental implants.

Implants are screw-like posts that are surgically placed into the jawbone to serve as the foundation for replacement teeth. After they are placed in the jaw, dental implants fuse over time with the jawbone and become a solid unit with the bone.

Once they are secure in the jaw, implants are capped with an abutment that is topped with a crown for a single tooth or a bridge or dentures when replacing several teeth. When secured by implants, bridges and dentures don’t slip or move when patients speak and eat.

In order to be seated securely in the jaw, implants require the jawbone to be of a certain density to support them. Dr. Leong’s examination of Charles revealed he lacked the requisite bone density, but that did not prohibit Charles from getting implants.

By using implants that are designed specifically for patients who have very little jaw bone, such as Charles, Dr. Leong was able to grant Charles’ wish for implant-secured bridges on either side of his remaining six teeth.

“When a person doesn’t have enough bone to support implants, it is customary to do a bone graft to increase the bone density,” Dr. Leong educates. “In Charles’ case, however, we were able to fit him with specially designed implants.

“The implants used actually do their own bone graft. When placed, a special drill is used in creating the space for the implant that actually harvests the bone. The harvested bone is put back on top of the implant.

“It’s a fantastic technique, in part because we’re using the patient’s own bone, which is always best, and because it’s bone from the jawbone rather than from the hip, which is another place where we can get bone if we need it.”

Taking Out the Guesswork

In creating the environment for Charles’ new bridges, Dr. Leong placed three implants on each side of Charles’ lower jaw. Because of the lack of bone, he used implants that are smaller than normal but can still withstand the normal pressures of chewing once secured.

The time required for the implants to fuse with the bone is approximately three months. While waiting for the implants to fuse, Dr. Leong repaired the cavities and cleared the abscesses in Charles’ remaining lower teeth.

He then took on the task of completing the implant process, which always begins with a series of steps taken to ensure the patient’s bite is properly reproportioned so that chewing happens naturally.

“You don’t start out just guessing where the bite should be,” Dr. Leong notes. “You have to take measurements and do computerized mock-ups and special procedures to make sure the upper jaw is aligned with the skull and lower jaw.

“Temporary teeth are for the patient to be sure they can accommodate their new bite. There’s a lot to it, but that planning is what determines the placement and angle of the implant and assures we get the perfect outcome we want.”

Charles’ outcome was even greater than he expected and hoped for. The work on him was completed this past spring, and he says he now feels confident while eating and smiling for the first time in years.

“I’m very happy with my new teeth,” he says. “My wife and everyone else tell me my teeth look great, and I agree with them. I really love the way they look, and I’m eating normally again, using all my teeth.

“As for Dr. Leong, he’s a real professional. He’s very business-like and very good. I never felt any pain during the whole process, so I really liked that. I was so impressed with him that I’ve already told some friends about him, and I will continue to do so.”

Doctor Approved

Elective procedures and surgeries are among the many things women are advised to avoid when pregnant. That’s why Magaly Villafradez-Diaz decided a few years ago to wait until after she gave birth to replace a fractured second upper molar.

“I still don’t know how it happened, but there were fractures in the root of that molar, so they had to take the tooth out,” Magaly explains. “The next step was to get a dental implant to replace the tooth, but I was pregnant at the time, so I decided to wait.”

And wait she did. A rheumatologist then working in Dothan, Alabama, Magaly waited nearly three years before she again inquired about the possibility of replacing that missing molar, in part because the gap was not in her smile line.

“It’s one of the last teeth, and because you can’t see it, you think it’s not a problem,” Magaly explains. “But being in the medical field, I know you have a specific number of teeth for a reason, so I knew I needed to have it checked out eventually.

“So, I waited until after we relocated to Florida. I first started looking for a dentist because I needed some general maintenance done. By then, my husband found a dentist in our area whom he was really impressed with.

“He found this dentist to be very professional, thoughtful and thorough, and he really liked that he took a lot of time to listen to him. I decided to go see for myself how good this dentist was and see what his plan and recommendations for me would be.”

The dentist Magaly went to see is Dr. Leong, who found several issues that needed to be addressed when he first examined her.

A Complicated Case

Photos by Nerissa Johnson.

Magaly Villafradez-Diaz

“When Magaly first came to me, she had some periodontal problems and she needed a crown, but the main reason she came to me was to have that missing molar replaced using a dental implant,” Dr. Leong informs.

Implant surgery is considered routine, but Magaly’s case was a complicated one, the complications stemming largely from the fact that she waited so long to have the tooth replaced.

“When a tooth is missing for a long period of time, there is no reason for the jaw bone to stay there anymore, so that part of the jawbone just shrinks away, naturally,” Dr. Leong educates. “That was part of the problem. The other problem was the location of the missing tooth.

“This tooth happened to be in the back upper left, where there was very little bone left between the roof of the mouth and the sinus, which meant I would need to lift up the floor of the sinus and add, or graft in, more bone in order to place the implant.

“She had even more complications than that because she also had a part of the bone that was right in the sinus where I needed to place the implant. That made it almost impossible for me to place an implant there.

“The good news is that I specialize in difficult cases. That’s why people come to me. I also do a lot of teaching, including teaching the placement of dental implants, and my residents refer a lot of difficult cases to me, so this was typical of what I see.”

After learning of the difficulties Dr. Leong faced in treating her, Magaly agreed to go ahead with the implant surgery. That surgery began with Dr. Leong removing the part of the bone that was blocking the area where the implant needed to be placed.

Once Dr. Leong completed that task, his next step was to create a support system for the implant. He accomplished that by mixing a blood derivative called platelet-rich fibrin with synthetic bone grafting material that grows over time into supportive bone structure.

“To obtain the platelet-rich fibrin, blood is taken from the patient’s arm and put in a centrifuge that forms a product that contains concentrated growth factors,” Dr. Leong educates. “It is then mixed with the bone graft material to expedite new bone growth.”

It typically takes about six months for new bone to grow strong enough to support an implant. The addition of the platelet-rich fibrin speeds up that process and allows for the implant to be seated at the same time the bone graft is done.

“By adding the platelet-rich fibrin, we actually save about six months of time because we can place the implant at the same time,” Dr. Leong explains. “Then, over the course of the next six months, the new bone grows and matures faster
around the implant.”

Half the Time

Dr. Leong completed the first phase of the implant procedure, which included capping the implant with a healing abutment, during a single visit one day in March 2018. He finished the project in September after first testing the strength of the newly developed bone.

“We have instruments now that can measure the maturity of the bone that’s surrounding the implant,” Dr. Leong says. “The instruments work on the principles of magnetism and actually measure the density of the bone and the solidity of the bone around the implant.

“With this and other newer techniques, the procedure can be accelerated and the new tooth put in about two months after placing the implant. I couldn’t do that in this case because she had absolutely no bone left, but I have done it before.”

Considering all the work that had to be done and the complicated nature of her case, Magaly says she was elated to have completed the process in just six months. And she lauds Dr. Leong for what she describes as exceptional work.

“Certainly, there were a lot of complications. But in the end, everything went very well,” she says. “And the new tooth is working great. It feels fantastic, like a real tooth, very functional and secure, the way it should be.

“Overall, I am very, very happy with the surgery and with Dr. Leong. He was extremely receptive and professional. I definitely recommend him because the treatment I received was excellent, just what you want when you’re a patient.”

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