The Dentist’s Dentist

Trusted colleague resolves painful dental issue.

Gene List, DDS

Of the 35 years that Gene List, DDS, devoted to practicing dentistry, two of those years stand out above all the others. They are the two years he spent practicing his craft in Busan, South Korea, where he answered a much higher calling.

“While I was in college, I met a young man who had escaped from North Korea,” Dr. List relates. “Through him, I was later introduced to the president of the hospital and the medical school in Busan, South Korea.

“The president later asked me if I was interested in doing something other than just practicing dentistry. I told him I was, and so together with my wife and young children, I traveled to Busan and opened up a teaching clinic in the hospital there.”

That extended visit to Busan was part of a mission trip sponsored by the Orthodox Presbyterian Church. Several years later, Dr. List made another mission trip, this time to London, where he worked with refugees and their families.

Now retired, Dr. List remains active in the church and still works as a missionary. On several of those trips, he’s traveled alongside a fellow dentist, Richard Leong, Jr., DDS.
Not long ago, Dr. List found himself in need of Dr. Leong’s services.

“It was probably about a year ago that I realized I was having some pain in a couple of teeth where another dentist attempted to do root canals,” Dr. List explains. “I knew what the issue was, but I don’t generally diagnose myself so I went to see Dr. Leong.”

Dr. Leong quickly confirmed Dr. List’s belief that the root canals failed and informed him the teeth needed to be removed. He also discovered another issue that promised to make the job of replacing the failing teeth a bit more complicated than usual.

“Dr. List takes great care of his teeth, but like a lot of people, he has a hereditary propensity toward gum problems,” Dr. Leong explains. “When you have gum disease, you also lose bone, and that was part of the problem I found with Dr. List.

“He was having trouble with two teeth, a lower left molar and an upper right premolar. Both had inadequate bone, so to replace the teeth I needed to do a bone graft and fit him with special dental implants that are made specifically for low-bone situations.”

Replacement Roots

Dental implants are screw-like bodies surgically seated in the jawbone as replacements for the roots of missing teeth. Once an implant is in place, new bone naturally grows around it to form the foundation for an abutment and replacement teeth.

The replacement teeth can be a single crown cemented or screwed onto the abutment, a partial bridge affixed to one or more implants, or a full denture fastened to a series of implants.

Dr. List is no stranger to the technology. He fit “hundreds of patients with dental implants”before he stopped practicing 20 years ago, but acknowledges that technology has changed remarkably since then.

“We worked off two-dimensional x-rays, and it was more like a hunt-and-peck process,” Dr. List shares. “You’d make an incision and take a little bone away. Then you’d back off, take another x-ray, then go back in and take a little more bone away.

“You kept taking the x-rays because you had to know how far you could go before you did damage to the nerve. But now, Dr. Leong has a very modern radiographic system that allows him to examine and pre-measure everything before he even makes an incision.”

Using that system, Dr. Leong began the process of replacing Dr. List’s failing teeth by taking a CT scan. It was through the imaging that he discovered the lack of bone and realized he would need to do the bone graft before seating the implants.

Designed to add bone where it has been lost, bone grafts can be completed using cadaver bone, a synthetic bone substitute or bone material taken from the patient. Dr. Leong used a synthetic bone substitute to treat Dr. List.

In addition, he added a blood product called platelet rich fibrin to speed up the bone-growing process. Platelet rich fibrin is obtained by drawing the patient’s blood and spinning it in a centrifuge that separates the fibrin clot material, which is high in growth factors.

“When you mix the platelet rich fibrin with the bone grafting material, you get a much better bone graft,” Dr. Leong educates. “But for treating Dr. List’s upper right premolar, I had to take some extra steps using some of the latest techniques.”

Stronger, Faster Growth

One such technique involved the use of special barriers designed to protect the bone graft. If soft tissue, which grows faster than bone, gets into the bone, the graft can be compromised, and the bone will not be as strong as it needs to be to secure the implant.

To keep that from happening, Dr. Leong employed a technique called guided tissue regeneration, where he uses barriers that last as much as six months. That allows more bone to grow stronger where the graft is done.

“I also fit Dr. List with special smaller implants that work well with less bone,” Dr. Leong reveals. “These implants have better engineering and better shaping. All of this allows the implants to be seated sooner than normal.

“I don’t know if I’m a very good patient, but I do know that Dr. Leong is an exceptional dentist.” – Dr. List

“After doing the bone graft, I usually wait about six months to seat the implants. But thanks to these advanced accelerated techniques, we were able to place the implants in about half that time.”

Dr. Leong began his treatment of Dr. List early last summer. By late December, the bone grafts and a gum graft on the upper right premolar were established and both implants were seated.

Today, Dr. List is enjoying the benefits of Dr. Leong’s work.

“I don’t know if I’m a very good patient, but I do know that Dr. Leong is an exceptional dentist,” Dr. List exudes. “Thanks to him, this problem has been resolved and my teeth are very sound. I can chew and bite with no problem at all and with no pain.

“As I said, Dr. Leong is exceptional, top of the class, and he has all the tools necessary to do the best job possible. He does implants quite well, and that’s why I went to see him. He’s among the best at what he does, and I gladly recommend him.”

© FHCN article by Roy Cummings. Photos courtesy of Dr. Gene List. mkb


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