John Chao, DDS, Developer of the Pinhole Implant Rejuvenation technique, discusses how the procedure works and his efforts to expand it to health care providers worldwide.
Interview conducted by Ivanhoe Broadcast News in August 2017.
Explain what Pinhole Implant Rejuvenation is?
Dr. Chao: Over 500,000 people get implants in the United States a year, and the most of them work out really well, but in certain cases it will result in gum loss; where something needs to be done to resolve it. So far we can only do grafting, where we get tissue from another part of the mouth or we use tissue from another source. But now we have Pinhole Implant Rejuvenation where we can just basically move the gums down to where they should be without any of the cutting stitching that is required of the normal grafting procedures.
How does that work?
Dr. Chao: When we cover exposed roots with the Pinhole surgery technique; this is just a variation of that standard procedure where we actually move the crown and the abutment that connects the crown to the implant and then we do the procedure a little differently, but in a similar way where we might even use some growth factors to enhance the growth of soft tissue; this way you get the gums to go back to where they were.
Explain to me how you pull the tissue down?
Dr. Chao: We use a pinhole above the gum line, and using specialized instruments we go in there and release the gum tissue from the underline attachment, basically loosening it up so much that it actually drapes down; and then we put strips of collagen underneath the gums through the pinhole and low and behold we have the gums where they used to be and the gums will grow to where it needs to be and attach to the implant.
Compare for me recovery time, threshold time and pain level?
Dr. Chao: The recovery from Pinhole procedure is very, very easy; because we are not cutting or stitching there is hardly any discomfort, there is hardly any bleeding, and basically patients take one or two Tylenol’s or Advil’s and that is it, there is hardly any down time because it is so conservative.
How does cost compare to the procedure and the more traditional grafting?
Dr. Chao: The traditional grafting and pinhole is about the same; except there is less down time by the doctor, so actually we could say, that a lot of times we could do more than one side, it is actually more cost effective for the patient.
How long does the procedure take?
Dr. Chao: For the patient it takes about maybe about an hour to hour and a half to do one tooth; if we have multiple teeth than it may take a little bit more than this; it generally only takes no more than an hour to do what we want to accomplish.
You did this Pinhole procedure for gum recession, how did that evolve? Did they come around the same time or after doing the recession procedure for a while you thought, this could work for implants too?
Dr. Chao: It actually is a progression and as we became more and more successful in teaching it there was more of a demand for filling the gap to try to also take care of gum recession, a loss of gum around implants and then we found out with our method we can successfully treat gum loss around implants and the results are just as good as if we are working on natural teeth.
What about longevity; is it one time for the whole life or do you have to get it redone?
Dr. Chao: We feel that it is about the same as when we do gum recession treatment on permanent teeth. We see results that are holding up; we see no changes so far, so we are happy with the prospects of long-term results.
How long have you been doing this for the dental implants?
Dr. Chao: We have been doing this for the last two or three years.
How long have you been doing it for gum recession, longer than that?
Dr. Chao: The procedure for gum recession has been available to the public for about four years; while gum recession research and instrumentation and so on has been around for over 16 years during the development stages.
Tell me a little bit about what other surgeons or dental professions you are teaching, how does that happen?
Dr. Chao: Well we have taught over 2,500 doctors in the United States, Canada and all around the world how to do the Pinhole surgery technique; with some special instructions all of them can actually go and apply the same technique to implants. I can say that most of these 2,500 or 2,600 doctors can actually perform this procedure.
Tell me more about the growth factors?
Dr. Chao: We can apply growth factors to try and enhance the soft tissue regeneration, this is synthetic or we can also use growth factors from the patient’s own blood. We recommend doctors to use that to bolster the amount of tissue growth we want to see.
And our patient today, what was her situation?
Dr. Chao: She had a lot of gum loss around the implants afterwards and one tooth didn’t even have enough gum to began with; she had had grafting surgery done before which was not as successful as she wanted. So she came to see me to take care of her two teeth, which I implanted right in the front. We were able to help her quite a bit, and one is extremely severe. We were able to really help her quite a bit, but we could not get all of it. Even so it was still a great improvement, and then the other one we were able to get a hundred percent.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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John Chao
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