Author Bryan McLelland

EP009: Emergencies and Protocols in the Dental Office Part 1

Most days in the dental office are pretty routine with drill and fill but every now and then the emergency demons come out to play.  This is episode one of this five part series on emergencies that can and willhappen in your office and how to plan ahead so that you can effectively deal with these situations as a team.  I recommend that you have all of your team members watch and listen to these five episodes and when on boarding ANY new team member have them watch the series at www.dentistbraincandy.com

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EP008: Omni Grip Screws & Special Guest

Interesting Case ButtonIn this episode Dr McLelland and Nick Grishin with Golden Dental Lab in Spokane will be discussing a cool new product called the Omni Grip screw by Nobel Biocare which will allow for angulation corrections up to 25 degrees.  This is useful in the Esthetic Zone but also in the posterior where interarch space is an issue.

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EP007: Thrive rather than just survive, 80/20 Sales and Marketing, Esthetics and Dental Implants and Missing front teeth are replaced with Implants concluding with a beautiful smile.

Interesting Case ButtonQuote of the Day

Maya Angelou born in 1928

My mission in life is not only to survive but to thrive and do so with some passion, compassion, some humor and some style.

More than 50 honorary degrees

80/20 Sales and Marketing by Perry Marshall

Chapter 20

Getting famous by polarizing your market

  1. Not interested
  2. Mildly interested
  3. Interest
  4. Interested Now
  5. Extremely interested
  6. Fascinated and Transfixed
  7. Insanely Obsessed and Addicted

Chapter 21

8020 Market research in an afternoon

Glenn Livingston

PhD in Advertising

  1. Decide what one key work you want to advertise and use on Google Adwords

www.perrmarshall.com/google Free online course

 

Look on You Tube and search the word, Blog search on www.technortai.com for the keyword/phrase and search the comments and then google alerts and find the most emotional and engaged comments and the language they use.

 

Send out survey’s with 3 questions:

  1. What is your single most important question about ______ (insert keyword here)
  2. Why would it make a difference in your life to solve this problem
  3. How difficult has it been to find answers to the above question?

Analyze the longest and most emotional results and analyze to discover the problem and language to use in marketing.

ITI Consensus Statement

Group #3

Optimizing Esthetic Outcomes in Implant Dentistry

Restorative Procedures affect esthetic outcomes

Limited RCT and data accuracy about this topic

Simple, Advanced, Complex ranking system allows you to rank the complexity and difficulty of implant cases.

Prevention is key because sometime it is impossible to improve the esthetics after the implant is in place.

1mm or greater of midfacial recession 25% over time with implant placement 9-41% range

Thin facial bone or a lack there of, facial placement of the implant and thin biotype all lead to recession.

A small number of studies suggest that there may be no recession with immediate placement.

Esthetic results can occur with immediate, early or late implant placement but each has it’s own challenges

Immediate implants require a clinician with a high degree of skill.  

Correct implant placement with 2mm of bone between the facial surface of the implant and the facial soft tissue.  If this cannot be met then early placement is preferred.

Use ridge preservation and soft tissue grafting may be required.  There are no consensus on what procedures are best or preferred.

A team approach is recommended, diagnose the problem, set appropriate patient expectations and smile line.  Look at the restoration contour and implant position.

Grafting and salvage of unaesthetic implants is unpredictable.

Platform switching can be helpful to improve esthetics.

Immediate loading is only recommended in the esthetic zone and limited.

Avoid over contoured restorative materials and abutments.  Use esthetic abutments in the esthetic zone!

Case Presentation

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Screw retained temporary restorations are used during uncovering to hold the palatal roll forward for 10-12 weeks to maximize facial soft tissue esthetics and volume.

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EP006: Genghis Khan, 80/20 Sales and Marketing, ITI Consensus Statements on Cone Beam Scans, Mini Implants and Grafting Horizontal Defects, Dislocated Mandible

Interesting Case ButtonQuote of the Day

Genghis Khan : Not even a mighty warrior can break a frail arrow when it is multiplied and supported by its fellows.  As long as, you brothers, support one another and render assistance to one another your enemies can never gain the victory over you but if you fall away from each other your enemy can break you like frail arrows one at a time.

8% of people living in the world today are related

 

Book Review

80/20 Sales and Marketing by Perry Marshall

Chapter 14

Harnessing natural forces to find leverage points : Reward people over time.

Chapter 15

Outsource the easy stuff first.  Make a list of the things you hate or don’t like or want to do and hire someone to do it.  The dentist should do only what they can do and the rest should be done by someone else to maximize efficiency

Chapter 16

Market

www.perrymarshall.com/8020supplement

Invest in you strengths and ignore your weaknesses

Strength Finders 2.0

https://www.gallupstrengthscenter.com/?utm_source=googadwords&utm_medium=web&utm_campaign=newhomepage&gclid=CjwKEAjw8NaxBRDhiafR-uvkpywSJAAxcl6frn7Wg0W_M0bl7HKFatU_aEhLf1iJx9_rMSyCS0XVcRoCnPPw_wcB

Invest in your strengths and hire out your weaknesses

Ask five friends to email you about what your strengths are to start building an objective list

Chapter 17

Take salespeople on a test drive and see who can sell and who can’t sell.  Give ten people the task of selling over a week or two and then hire the top one or two.  Greatly accelerates your success.

https://www.upwork.com/

https://www.fiverr.com/?u_sou=google&u_med=cpc&u_cam=brand/ge_sh_bd_us&u_ter=one%20word%20brand%20typos_(broad)&u_con=AdID^88238110768^Keyword^www%20fivr^Placement^^Device^c&gclid=CjwKEAjw8NaxBRDhiafR-uvkpywSJAAxcl6f9wr6JkFxzswSJH6EsL9UtYp-WUqKDCsfMI9YjiWE5BoCg77w_wcB

When you post a job, post it and hire two people for the same job.

Post a job with a 35 dollar application fee to week out only those that are serious

Chapter 18

Everyone making over 30 dollars per hour should have a personal assistant (PA).  They can save you up to 10 hours a week.  They need to respect confidentiality

Chapter 19

Fire your bottom 10 per cent of your customers and employees.  Pay them a big severance pay if you must, to feel better.

 

Article Review

ITI Consensus Statements Group 1

Surgical and radiographic techniques in implant dentistry

Cone beam is the test of choice.

Discussed items are consensus based and not research based

CBCT add information, radiographic template is recommended

Use DICOM files/format

CT guided surgery  : average is .9mm error in entry point and up to 1.3 mm at apex and 3.5 degrees in angulation.  Wide range in these numbers.

Tissue supported guides are more accurate than bone supported guides

2mm should be considered and added as a buffer with guided surgery

Use guided surgery to increase accuracy of placement

Narrow Diameter Implants

Defined as being less than 3.5 mm

One or two pieces

One piece implant is less than 3 mm

91% success rates in less than 3 mm over 3.9 years with four lower mandibular implants/edentulous arch

96 % survival with two piece implants over about 4 years

Must be 10mm in length

My Opinion:

Started off strong but need to plan for failure if one piece narrow diameter implants are used and over engineer the case

Horizontal width augmentation

Ideally 2 mm of bone on the facial aspect to maintain soft tissue support long term

My Opinion:

Ridge split technique is a clever and predictable way to increase width in the maxilla.

 

Interesting Case

DOWNLOAD INTERESTING CASE FILES

Trauma Case

Nasal Bone, Nasal Septum fracture and the strange CT of the left TMJ which was read as a dislocation by radiology.  Turns out he posture his jaw habitually and the joint was not dislocated.

www.dentistbraincandy.com shows the CT scan and cross section of the joint (saggital).  Heme arthrosis was on the differential.

 

Resources

Feb 2016 CE Event in Spokane WA, Restoring Hybrids Predictably by Bryan McLelland and  Nick Grishin

See the links above

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EP005: 80/20 Sales and Marketing, ITI Consensus Group on Restorative Materials in Implant Dentistry, Head on Collision Leads to Jaw Surgery and Dental Implants

Interesting Case ButtonQuote of the Day

Julius Caesar : “Cowards die many times before they die their actual deaths” and “Experience is the teacher of all things”

Take action on knowledge learned

 

Book Review

Make More from every customer.  

Guarantees are important.  Use the following format for a Power Guarantee ::  If you are ______, and you are ________ then you will achieve ________ or else ________________

 

Sell results not procedures

People pay for certainty, be confident and solve their problem.

 

Article Review

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ITI Consensus Group discusses screw retained vs cement retained restorations and discovered the integration rate is the same.  More technical and biological events with cement retained vs screw retained restorations.  I suggest using screw retained restorations whenever possible.

Chipping and fracture of the ceramic or porcelain occurred more often with screw retained restorations.

Does the abutment type, metal vs ceramic, have difference in survival rates?   No!

CAD/CAM crowns abutments/bars.restorations are just as successful as any other method of construction.

Retrievability and the lack of cement make screw retained restorations preferable.

Zirconium abutments are ok in the anterior and premolar sites and caution is suggested in molar sites.

Margins should be at or above the FGM for cemented restorations.  When 1.5 mm or deeper it is almost impossible to remove cement

 

Interesting Case : Melanie

DOWNLOAD  INTERESTING CASE PHOTOS

Severe MVC

Bilateral Subcondylar fracture

BSSO to fix collapse of posterior height of the mandible bilaterally.

Extraction of all upper teeth with the placement of four implants in the maxilla

www.dentistbraincandy.com

 

Resources

info@dentistbraincandy.com

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EP004: 80/20 Sales and Marketing, Martin Luther King Jr, Medical Management of the Dentoalveolar Patient and Dental Implants are better than Dentures

Interesting Case ButtonQuote of the Day

Martin Luther King Jr

The ultimate measure of a man is not where he stands in the moment of comfort but where he stands at times of challenge and controversy.

 

Book Review

80/20 Sales and Marketing by Perry Marshall

Chapter 8

USP : Unique Selling Proposition: What makes you, you?  What do you offer than no one else offers?

With dentistry : What kind of service or experience do you offer that no one else can offer?

www.perrymarshall.com/8020supplement for a USP Video and worksheet.  Work on your business and personal USP

Chapter 9 : Testing with Google Adwords.  Get educated first or Google will steal your money! Split test between two different ads and then pick the best and constantly improve amplifying results.

Chapter 10: Scale up massively once you have split tested and maximized to the 80/20 and get massive ROI.  Use the 8020 rule to focus on the 20% and don’t worry about perfection but rather success.  In dentistry some things require perfection (clinical delivery of dentistry) but many things don’t.

Top Ten List of Marketing and traffic sources is discussed in order of importance.

The concept is to use the first items on the list to hone accuracy and then move up the list to maximize success.

www.fbforme.com

Is Facebook for you?  Take the test above.  Google is like Yellow pages and Facebook is like a coffee shop.  If you are B2B then LinkedIn is probably better than Facebook.

 

Article Review

DOWNLOAD ARTICLE REVIEW

Medical Management of the Dentoalveolar Surgery Patient by Abramowicz et al

 

Interesting Case

Kathleen B. DOWNLOAD CASE FILES

Failing teeth, hates her dentures and does not feel attractive anymore to her husband.  Her dentures are affecting her self confidence, taste of her food and ability to chew and nutritional health.  She had to have all her teeth removed and then four implants were placed in the upper jaw and two in the lower jaw and implant retained over dentures were made in the lower jaw and a fixed hybrid was made for the upper jaw

 

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EP003: Gandhi and Ronald Reagan, 80/20 Sales and Marketing, How Can a Dentist Get more Patients and Jaw Surgery Changes Lives

Interesting Case ButtonQuote of the Day
#1 Be the change that you wish to see in the world : Gandhi
#2 The greatest leader is not necessarily the one who does great things. He is the one that gets the people to do the greatest things. Ronald Reagan

Book Review
80/20 Sales and Marketing Book : The definitive guide to making more and working less
Perry Marshall
Chapter 6
Simplify Your Life
Traffic, Conversion and Economics are the key parts of the power triangle .
Core of marketing is how much are you willing to pay for new patients
Lists can help you reach these patients. Compiled and Response lists. Response Lists may be
hotlists if the names are current and within the last 90 days
www.srds.com
www.iblistdirect.com
www.nextmark.com
www.hoovers.com
www.kristalytics.com
Chapter 7 : Make them move
Do they have money? Do they have a bleeding neck? Do they buy into your USP? Test fast, fail fast and move on.
If your copy was a yellow pages ad would the phone ring?

Article Review
Opinion Article on the topic of Are you busy enough Mr Dentist?
Increase supply of dentist
Decreasing adult patient visits to the dentist
Affordable Care Act expands coverage of medicaid 8.3 million more people
19.4 million people go to their physician but not the dentist and have PRIVATE INSURANCE!
If 50% of these people went, all dentists would have 50 new patients per year
Click here to read article: Article

Interesting Case
*These case files are not be shared out of respect for the individuals who were kind enough to volunteer their situation to be shared for educational purposes.
DOWNLOAD PHOTOS
Orthognathic surgery. Jaw Surgery Case. Leforte 1, Bilateral Sagittal Split Osteotomy and Genioplasty
Benefits of jaw surgery discussed include not losing their teeth at the age of 40,50 or 60 years of age
Psychological benefits can be massive.
Prediction tracings shown are two dimensional and virtual jaw surgery is done with facial
morphing. At www.dentistbraincandy.com you can see the prediction of facial profile changes
and the actual post surgery appearance of the patient.
TAD’s or temporary anchorage devices were used to retract the lower front teeth (lower six)

Preop Layout

Prediction layout

Screen Shot 2015-10-12 at 9.40.13 PM Screen Shot 2015-10-12 at 9.40.04 PM Screen Shot 2015-10-12 at 9.39.49 PM

Resources

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EP002: Steve Covey, Pareto Principle, Distraction Osteogenesis and Does Taking Advil before my Surgery Help reduce PAIN?

Interesting Case ButtonQuote of the Day
Just as we develop our physical muscles through overcoming opposition such as lifting weights we develop our character muscles by overcoming challenges and adversity.
Seven Habit of Highly Effective People by Stephen Covey
https://www.stephencovey.com/

Book Review
80/20 Sales and Marketing Book : The definitive guide to making more and working less
Perry Marshall
Chapter 3
Leverage points exists no matter where you are at on your journey to amplify your results in multiples
Chapter 4
Getting traffic and customers and getting those customers to identify themselves. He discusses the use of a sales funnel.
Seven Cardinal rule of the 80/20 Sales Professional are discussed
Chapter 5
Invisible Money finder at http://www.8020curve.com/
People spend insane amounts of money on their passion

Article Review
Do NSAID’s given pre surgery decrease post surgery PAIN?
Cox 2 inhibitors such as Celebrex may be helpful but traditional NSAID’s do not
Click here for article: Does giving NSAID’s before Surgery Help_

Interesting Case
*These case files are not be shared out of respect for the individuals who were kind enough to volunteer their situation to be shared for educational purposes.
DOWNLOAD PHOTOS
Cleft Lip and Palate Board
Chromosome 16 duplication
Hypotonic, hypotonia, with a hypoplastic mandible and siezures and the baby (Abby) could not eat or breath correctly.
https://en.wikipedia.org/wiki/Chromosome_16_(human)
http://ghr.nlm.nih.gov/chromosome/16
Tracheostomy
Gastric Tube (G tube)
Lower Jaw surgery with a mandibular osteotomy with the placement of distraction appliances
bilaterally and growing a new jaw (mandible)
Sleep study proved that the obstructive sleep apnea was cured (OSA)
Tracheostomy was removed
Abby is now learning how to eat
Click here to read: Abbi’s Letter

 

Resources
https://en.wikipedia.org/wiki/Obstructive_sleep_apnea

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EP001: Jim Collins, Pareto Principle, a Broken Mandible and Does Topical Dental Anesthetic Really Work?

Interesting Case ButtonQuote of the Day
Good is the enemy of great and that is one of the key reason why we have so little that becomes great. We don’t have great schools principally because we have good schools. We don’t have great government principally because we have good government. Few people attain great lives in large part because it is just so easy to settle for a good life.
Jim Collins from the book of Good To Great : Why some companies make the leap and others don’t
http://www.jimcollins.com/

Book Review
80/20 Sales and Marketing Book : The definitive guide to making more and working less
Perry Marshall
Chapter 1
https://www.perrymarshall.com/8020­book/
Pareto Principle
https://en.wikipedia.org/wiki/Pareto_principle
80/20 rule : 80 percent of our results comes from 20% of our efforts
Summary of the book is available at this site https://www.perrymarshall.com/80­20/supplement/
80 percent of all profits come from 20% of our patients and from that, 20% of those people are
willing to spend a lot more money on you and your practice
Top performers are not twice as good but rather multiple times better
Chapter 2 : Rack the Shotgun
The term used in this book to quickly explain the concept of identifying your 20% and then marketing to those 20%

Article Review
Does 20% Benzocaine work better than Placebo?
No difference in the VAS with ASA 1 and 2 patients
Click here for article: Does Topical Work_

Interesting Case
*These case files are not be shared out of respect for the individuals who were kind enough to volunteer their situation to be shared for educational purposes.
Interesting Cases Files: DOWNLOAD HERE 
Mandible fracture from a fall
Atrophic mandible
Bilateral mandibular body fracture
Placement of plates and screws on both sides to stabilize the fractures
Placement of four implants between the nerve
Bone graft using Bone Morphogenic Protein (BMP) and Allogenic bone grafting
The implants are required to maintain the bone in the mandibular bone or the graft will resorb over time
Robert Marx “Tent Pole Technique”

 

 

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Introduction to Dr. Bryan McLelland, DDS, Oral and Maxillofacial Surgeon Episode 000

dr-mclelland-oral-surgeon

Who is he?

Married for 16 years, 3 girls aged 2-15yrs old
Practicing, wet fingered Oral Surgeon in Spokane, Washington and Post Falls, Idaho
Pre Dent : Red Deer College
Dental School : University of Alberta
General Practice Residency : Denver General Hospital (Go Avalanche!)
OMS Residency : Cook County Hospital in Chicago, Illinois
Associate
Partnership
Solo practioner

What is the point?

Kick off the episode with a Quote of the day
Start the week off with positive vibes
Bring value to my restorative colleagues
Help them dabble in OMS literature without all the fuss
Break down a book over several episodes that I am reading

Sit back and enjoy the sweet treat of Dentist Brain Candy

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