Edward Shellard, DMD
If you asked me to describe Dr. Chad Yenchesky in one word, my choice would be "scholar." Dr. Yenchesky, owner of Fox View Dental in De Pere, Wisconsin, maintains an ongoing commitment to education, as is evident by his affiliation with a number of dental groups, including the Clinical Mastery Series and BioResearch (based out of Milwaukee). I recently spoke with him about cone beam computed tomography (CBCT) technology and how it helps with his esthetic, temporomandibular (TMD), and sleep medicine cases.
When did you realize CBCT was something you needed to bring into your practice?
Through my continuing education, I started taking on a lot of esthetic cases, and was interested in working toward more of a comprehensive restorative practice here in the Green Bay area. Logistically, focusing only on cosmetic and full-mouth rehabilitation would be difficult, so I also started studying TMD and sleep dentistry. Once I began to delve into those areas, the importance of having a full CT scan to look at the airway and different slices of the condyles within the TMD complex became essential to my treatment planning process.
In addition to those subjects, I was also studying implant placement, and that became yet another part of the equation when I began considering whether CBCT technology was something I should bring into the office. I quickly realized that being able to look at the area of interest, take a scan, and do guided surgery offered more predictability than placing implants freehand.
For about two years, I sent my patients to a local orthodontist, who would then provide the scans to me. After figuring how many referrals I was sending out each month, I realized how much revenue I could keep in my practice - a figure that allowed me to move forward with purchasing the CS 9300 CBCT unit.
You perform a number of different procedures. How did this influence your decision when choosing the right 3-D imaging machine?
I knew I needed the ability to capture full scans for my TMD cases and 5 cm x 5 cm scans for implant placement evaluation. I also needed these scans for general diagnostics when a 2-D periapical wasn't going to show me the whole picture. I liked the unit I chose for its ability to collimate fields of view and the corresponding radiation level.
When measuring your return on investment (ROI) in regard to CBCT, what things do you evaluate?
First, I looked at what I was referring out - often two scans a week - and considered what it took for the patient to actually go get the scan and then come back to my office. I knew that if I had the machine readily available, I would have the opportunity to take more scans. My main consideration of ROI was to make sure what I was already doing would cover the cost of bringing the machine in, and two scans a week certainly did that.
Because the machine is on all day long, I am able to do more implants and TMD therapy, if needed, to set up my restorative cases. So it's not just the revenue generated from the scans, but the value to treatment as well.
My biggest priority was peace of mind when placing an implant with a surgical guide or working with a TMD patient. Because the CBCT allows for comprehensive diagnosis and treatment planning, I know the treatment plan is the best I can provide for my patients. As an educator for the Clinical Mastery Series, it was also personally important that I was able to teach integration of concepts in implant, TMD, and occlusion training that I deliver. Proverbially, "walking my talk" was integral.
I have to say that I couldn't practice without the information 3-D imaging provides. I couldn't even imagine doing the procedures I do without that information, because those details are critical to my diagnosis - it's just an integral part of my office. I'm glad I bit the bullet three years ago and decided it was something I needed.
How do you see 3-D evolving in the future?
The biggest thing would be the combination of taking a 3-D image using an intraoral scanner and bringing those elements together to make it much more synergistic, providing exceptional outcomes within the office.
Dr. Chad Yenchesky: A graduate of the University of Minnesota School of Dentistry, Chad Yenchesky, DDS, is a faculty member of the Clinical Mastery Series in the areas of occlusion, anterior esthetics, and full-mouth rehabilitation, as well as a member of BioResearch's Dentist Development and Education Team. Dr. Yenchesky can be contacted at [email protected].
