ˆˇ˘˛˙ ˇ ˙˚˛ˇ ˛ pivotal during di˜ cult edental restorationmolar replaced using a dental...
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Doctor Appro edExpertise proves
pivotal during di� cult dental restoration
Elective procedures and surger-ies 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. “� e next step was to get a den-tal implant to replace the tooth, but I was pregnant at the time, so I decided to wait.”
And wait she did. A rheumatolo-gist 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 prob-lem,” Magaly explains. “But being in the medical � eld, I know you have a speci� c number of teeth for a reason, so I knew I needed to have it checked out eventually.
“So, after we relocated to Florida, I started looking for a dentist. I needed some general maintenance done. My hus-band found a dentist in our area whom he was really impressed with.
“My husband found this dentist to be very professional, thoughtful and thor-ough, 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 is and see what his plan and recommendations for me would be.”
The dentist Magaly went to see is Richard Leong, Jr., DDS, a general and implant dentist who practices comprehen-sive, full-treatment dentistry, including full mouth reconstructions. Upon � rst examining Magaly, Dr. Leong found several issues that needed to be addressed.
A Complicated Case “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.
Dental implants are screw-like bodies that are surgically placed into the jaw-bone. � e implant supports an abutment, which screws onto the implant, and a crown that is cemented on top of the abutment.
Implant surgery is considered routine, but Magaly’s case was a compli-cated 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 jawbone to stay there anymore, so that part of the jawbone just shrinks away, naturally,” Dr. Leong educates. “� at was part of the problem. � e other problem was the location of the missing tooth.
“� is 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 � oor 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 vertical shelf of bone that was right in the sinus where I needed to place the implant. � at made it almost impossible for me to place an implant there.
“� e good news is that I specialize in di� cult cases. � at’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 di� cult 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 vertical shelf of 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 sys-tem for the implant. He accomplished that by mixing a blood derivative called platelet-rich � brin with synthetic bone grafting material that grows over time into supportive bone structure.
“To obtain the platelet-rich � brin, blood is taken from the patient’s arm and put in a centrifuge that forms a prod-uct 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. � e addition of the platelet-rich � brin 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 � brin, we actually save about six months of time because we can place the implant at the same time,” Dr. Leong explains. “� en, 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 � rst phase of the implant procedure, which included capping the implant with a healing abutment, during a single visit one day last March. He � nished the project in September after � rst testing the strength of the newly developed bone.
Magaly Villafradez-Diaz
Regenerative Biologics InstituteForget Surgery,
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FHCN Special ReportRemote Control
Implant Dentistry of Florida
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Who Do Doctors See for Pain Relief?
Implant and CosmetIC dentIstry
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Brevard Health Care News
Brevard Health Care News
James N. McManus, MDGary J. Ganiban, MD
Michael N. Mandese, OD, FAAOHetal D. Vaishnav, MDPatricia K. LaFleur, MD
Jason K. Darlington, MDEric R. Straut, OD
Visit The Eye Institute for Medicine & Surgery online at www.SeeBetterBrevard.com
When it comes to your eyesight, only the best will do. Please call to schedule a comprehensive eye examination with one of the specialists at The Eye Institute for Medicine & Surgery. There are four offi ces to serve you.
Melbourne W. NASA Blvd., Suite
Rockledge S. Woods Drive
Palm Bay Babcock Street NE
Titusville Garden Street
(321) 722-4443
Comprehensive Eye Evaluations
James N. McManus, MD, is board certified by the American Board of Ophthalmology. He graduated cum laude from Dartmouth College in 1979 with a Bachelor of Science degree and earned his medical doctorate from the University of Massachusetts in 1983. He completed his res-idency at the University of Pittsburgh Medical
School and his internship at the University of Massachusetts Medical Center in Worcester. Dr. McManus is a member of the American Medical Association, the American Academy of Ophthalmology, the Brevard County Medical Society, the Florida Medical Association and the Florida Society of Ophthalmology.
Modern Symfony®
Multifocal lens improves vision, quality of life
P hiladelphia native Frank Armstrong has worn contact lenses since he was 12 years old. Over the years, his eyesight progres-sively deteriorated, and his lens prescription
became stronger and stronger. After his retirement two years ago, Frank noticed his vision was no longer sharp, even with his contacts.
“It started getting bad, especially at night, when my vision was unclear,” he describes. “Seeing was a challenge, and I became less con� dent in my ability to see well enough to drive at night.
“I saw halos, and the brightness of the headlights from the cars coming toward me would wash everything out. I couldn’t see anything and almost had to guess where I was on the road.
“I also like to read, and I was having to rely a lot on reading glasses, which I find terribly incon-venient. I would be constantly putting them on and taking them off.”
When Frank went to his eye doctor, the doctor sus-pected Frank had cataracts and referred him to James N. McManus, MD, of � e Eye Institute for Medicine & Surgery in Melbourne. Dr. McManus confirmed the cataract diagnosis and scheduled Frank for surgery. Before the procedure, they discussed replacement lenses for Frank’s cloudy natural lenses.
“I did my research and noted that with some of the lenses, I would have to lean on reading glasses a lot,”
states Frank. “When Dr. McManus said there was a new type of lens that would enable me to read without glasses, I opted for that. � at was the main driving force for me to select the Tecnis Symfony lens.”
� e Symfony lens is among the latest generation of multifocal lenses, which are lenses that allow patients to see at more than one distance. Older generation multi-focal lenses enabled patients to see in the distance and up close, but they proved to be less e� ective in provid-ing clear vision in the intermediate range, which is so important for today’s active people.
“� e intermediate distance is essentially the work-ing range,” notes Dr. McManus. “� is is the distance for people to look at their cells phones, the speedom-eter and dashboard in their cars, and their computers. � is distance is usually not well treated with conven-tional multifocal lenses.
“� e Symfony allows patients to have what’s called blended vision or extended depth of focus. It enables patients to see distant and intermediate ranges. � e Symfony decreases the patient’s dependency on corrective lenses, so it was a good option for Frank.”
Search for ExpertiseSnowbird Barbara Arnold spends most of the year in Melbourne, but returns to her native Maine for the sum-mer months. � e last time she was there, she saw her eye doctor for a routine examination. � is time, though, she had some new symptoms to report.
“I’ve had poor eyesight my whole life,” Barbara relates. “I was one of those kids who wore big, thick glasses. Then, when I was a teenager, I got contact lenses. But I always struggled to have good vision.
“Last summer, I noticed my vision was blurry, and I wasn’t able to see like I used to. I was having trouble driving at night because of the blurriness and glare. I made an appointment for a new prescrip-tion, but my eye doctor told me I had cataracts.”
� e doctor in Maine o� ered to do the surgery, but Barbara wanted a surgeon who specializes in cataract surgery to do her procedure. A friend was a patient of Jason K. Darlington, MD, at � e Eye Institute for Medicine & Surgery and highly recom-mended him. When she returned to Florida, Barbara made an appointment with Dr. Darlington.
“Dr. Darlington explained my situation and then talked to me about the di� erent types of replacement lenses available,” says Barbara. “He wanted to make sure I was well-informed as to the choices available. But he left the decision up to me. I really gave it some thought, and I picked the Symfony lens.”
Barbara had a secondary issue a� ecting her vision. In addition to cataracts, she also had a great deal of astigma-tism, a defect in the curvature of the cornea. � is caused her to be completely dependent upon glasses for every aspect of her visual needs. In the past, multifocal lens implants could not correct astigmatism.
“Barbara had a great deal of astigmatism in both eyes,” con� rms Dr. Darlington. “Just a few years ago,
her lens implant options would have been quite limited. She would likely still need glasses for both distance and near vision. Today, the options have improved with the newer-technology lenses.
“One bene� t of the Symfony lens is that it not only provides extended range of vision, it also treats astig-matism. With this lens, we do not have to make extra incisions in the eye to reshape the cornea and correct the astigmatism.”
Life-Changing AlterationsThe procedures to remove Frank’s and Barbara’s cataract-laden natural lenses and replace them with Symfony lens implants made a big di� erence in both their lives.
“After my procedures, my eyes were 20/20 in one eye and 20/15 in the other – basically perfect vision,” marvels Frank. “It was quite a revelation, after wearing
contacts for most of my life, to see very clearly when I woke up in the morning and not need to think about contacts.
“The Symfony lenses have made a big difference. I don’t wear reading glasses anymore. I don’t even carry reading glasses. I can read everything I need to read and want to read without them.”
Barbara also experienced suc-cessful results after her cataract procedures. She says she’s still in shock because the improvement in
her vision was apparent so quickly after surgery.“� e next day, I had 20/20 vision,” she enthuses. “It’s
amazing. I’ve never seen this well before. Now, I don’t need glasses or contacts for anything. I can read. I can see long distance and up close. � e blurriness is totally gone. I have great vision now.
“Dr. Darlington and the sta� at � e Eye Institute for Medicine and Surgery are very friendly. Getting cataract surgery with the Symfony lenses is one of the best things to ever happen to me.”FHCN article by Patti DiPanfilo.Photos by Nerissa Johnson. mkb
“It’s amazing. I’ve never seen this well before.
Now, I don’t need glasses
or contacts for anything.”
- Barbara
Jason K. Darlington, MD, graduated with high-est honors from the University of California Davis. He attended UC Davis Medical School, followed by an internship at Scripps Mercy Hospital in San Diego. He completed his residency in oph-thalmology at UC Davis. His fellowship in cornea diseases, transplants, cataract surgery and other advanced anterior segment surgery, glaucoma management and surgery, and LASIK and refrac-
tive surgery was completed at the prestigious Philips Eye Institute in Minneapolis under the direction of Thomas Samuelson, MD, and Richard Lindstrom, MD. Dr. Darlington is certi� ed by the American Board of Ophthalmology, and he joined the sta� at The Eye Institute for Medicine & Surgery in January 2015 after nine years of private practice in the Los Angeles area.
Barbara received the specialized treatment
she desired
Frank now has a clear
vision of his retirement
Page 2 | Brevard Health Care News | Winter 2019 ophthalmology
HAROLD J. CORDNER, MD, FIPP, ABIPP
Physicians really do know the best doctors
W hen it comes to pain management special-ists, few attain the level of expertise and respect
throughout their communities that Harold J. Cordner, MD, of Florida Pain Management Associates in Sebastian and Vero Beach has.
Eugene A. Melvin, Jr., MD, has battled back problems for years. � e excruciating ache in his lower back led to burning pain that ran down his left leg. In 2014, he had a discectomy that provided signi� cant pain relief, but a recent injury caused the pain to return with a vengeance.
Looking for quick relief, Dr. Melvin first visited several pain management physicians in the Orlando area, where the interventional pain management physician has a practice of his own. He underwent various injections and abla-tions - procedures that destroy a� ected spinal nerves using heat energy – but those treatments provided only min-imal relief. As a result, he turned to Dr. Cordner, whose skill and expertise, Dr. Melvin says, sets him apart from others in his � eld.
“� ese individuals in Orlando were good doctors, but they just did not have the skills and techniques Dr. Cordner has,” observes Dr. Melvin. “Dr. Cordner performed a unique type of injection on me that really relieved a lot of the pain I was experiencing.
“He used a special technique called a Racz catheter procedure, during which he advanced a catheter into the spinal canal through the sacrum. Once he arrived at the correct location, he broke up some of the scar tissue that was in there causing pain.”
� e Racz catheter procedure proved more effective than any of the other pain-relieving techniques Dr. Melvin had tried previously. Should his pain return,
Dr. Melvin says he will likely opt for spinal cord stimulation and will certainly have Dr. Cordner perform this surgery.
“If I need it, I will absolutely, hands down, ask Dr. Cordner to do the spi-nal cord implant procedure,’’ exudes Dr. Melvin. “He is my pain guy!”
“Highly Respected”Much like Dr. Melvin, Michael Venazio, MD, has a history of back pain radiat-ing into his legs as well. Several years ago, when the pain became too severe, he too consulted Dr. Cordner, whom he has known for more than 15 years.
“I refer a lot of my patients to him, and they’re always satis� ed,” Dr. Venazio says. “He’s very highly respected in the � eld, so when I su� ered a signi� cant herniated disc at the L4/L5 level, I went to see Dr. Cordner.
“He gave me a series of epidural steroid injections, followed by a nucle-oplasty procedure, which really helped my pain to where it’s minimal to non-existent at this point.”
� e same can be said for internal med-icine practitioner David DePutron, DO.
“I have cervical spinal stenosis, a con-dition in which the spinal canal narrows and puts pressure on the spinal cord and spinal nerves,” explains Dr. DePutron. “I also have a problem whereby arthritic change of the lower part of the cervical spine intermittently results in pressure on my spinal cord. � at causes discom-fort and numbness in the fourth and � fth � ngers of both hands.
“Dr. Cordner treats me periodically to alleviate that intermittent problem. I’ve had this condition since 1996, and have not had a need for any therapy other than what Dr. Cordner has pro-vided. I have literally referred hundreds of patients to him and consider us lucky to have him in our community.”
All in the FamilyScott Glaser, MD, agrees. Dr. Glaser � rst got to know Dr. Cordner through the American Society of Interventional Pain Physicians. Dr. Glaser became so impressed by his expertise that he called on Dr. Cordner when his father was strug-gling with a serious pain issue.
Dr. Glaser’s father su� ered with sig-nificant spinal stenosis. He was living alone at the time and was in so much pain that it became di� cult for him to get out of bed or even walk to the bathroom.
Dr. Glaser knows of many excellent pain physicians closer to Palm Coast, where his father resided, but none, he says, were as good as Dr. Cordner. That’s why he didn’t mind making
Who Do Doctors See for Pain Relief?
the two-hour drive to Florida Pain Management Associates to see him.
“Dr. Cordner’s subspecialty of inter-ventional pain medicine teaches him just where to put that medication to get the best results,” Dr. Glaser educates. “Using x-ray guidance, he injected that medicine right next to the irritated nerve in my father’s back, and it worked. It worked quite rapidly in fact, within a few days.”
As an orthopaedic surgeon, Kirk Maes, MD, is well aware of Dr. Cordner’s reputation as well, and just as Dr. Glaser did, he recently referred a family mem-ber struggling with pain management to Dr. Cordner.
“Dr. Cordner gave my family mem-ber a series of injections, and she was able to run a marathon afterwards,” Dr. Maes explains. “She’s done really well.
So has the uncle of Carlos Vizcarra, MD. A resident of Peru, Dr. Vizcarra’s uncle has suffered for many years from intractable pain from shingles. Unfortunately, physicians in Peru do not o� er some of the treatments available here.
Dr. Vizcarra felt so strongly about Dr. Cordner’s expertise in pain manage-ment that he encouraged his uncle to � y to the United States to get the best possi-ble care available and saw to it that he was treated by Dr. Cordner.
“My uncle came here and underwent two treatments with Dr. Cordner and had a great response,” says Dr. Vizcarra. “Dr. Cordner was excellent.”
Common ConclusionsDr. Cordner stays on the leading edge of interventional pain medicine, so he always has the latest treatment advances for his patients.
“� ere’s not a second thought in my mind that if you need a pain specialist, it should be Dr. Cordner,” adds Dr. Venazio. “He’s one of the best pain physicians in Florida. He’s intelligent and well-versed, his pain knowledge is excellent, and his technique is stellar.”
“I wholeheartedly recommend Dr. Cordner,’’ adds Dr. Glaser. “� ink about it. I recommended him to my dad. If I trusted him with a family member, I would trust him with anybody.”
“My patients come to me and they are very happy with Dr. Cordner’s approach, his manners, and his knowledge about pain management,” says Dr. Vizcarra. “I refer at least ninety percent of my pain patients to him.”
“He is without a doubt the most skilled and insightful pain manage-ment doctor within two hundred miles,” assures Dr. Maes. “He is the go-to guy around here.”FHCN staff article. Stock graphics from Pixabay. mkb
Harold J. Cordner, MD, FIPP, ABIPP, is board certi� ed in anesthesiol-ogy and pain management by the American Board of Anesthesiology, and in interventional pain management by the American Board of Interventional Pain Physicians. He received his medical degree from St. George’s University School of Medicine. Dr. Cordner completed an internship in general surgery and residency in anesthesiology at Monmouth Medical Center, Long Branch, NJ. He is a member of the American Society of Interventional Pain Physicians, Florida Society of Interventional Pain Physicians, International Neuromodulation Society and numerous national and international pain societies, and frequently lectures and teaches physicians advanced interventional pain proce-dures nationally and internationally. Consumers Research Council of America named Dr. Cordner one of “America’s Top Physicians.”
Get Back Into the Swing of Things
Visit Florida Pain Management Associates on the web at www.� oridapain.com
Regain Your Pain-Free LifestylePain management allows individuals who experience chronic pain to enjoy life and get back into the swing of things. Dr. Cordner treats a variety of painful conditions, including arthritic back pain, cancer pain, whiplash injury, arthritis, bursitis, vascular disease, re� ex sympathetic dystrophy, herpes zoster (shingles), intercostal neuralgia, sacroiliac joint arthropathy, failed back surgery syndrome, post-laminectomy syndrome, scoliosis, diabetic neuropathy and headaches
Dr. Cordner welcomes your questions about pain management. To schedule a consultation, please call or
visit the offi ces of Florida Pain Management Associates at one of these two locations:
Sebastian US Hwy.
Vero Beach th Place, Suite
(772) 388-9998
Winter 2019 | Brevard Health Care News | Page 3paIn management
(continued from page 1)
Richard Leong, Jr., DDS, is a general and implant dentist practicing comprehensive den-tistry. He is one of the few dentists in the area who place special emphasis on treatment of dental implants and temporomandibular joint dysfunctions, lasers, CT scans and Invisalign® orthodontics. A pioneer in the � eld of dental implantology, he has been performing dental implant surgeries since 1975. Dr. Leong graduated from the University of Texas at Austin and earned his dental degree from the University of Tennessee School of Dentistry in Memphis. He is a Fellow of the American Academy of Implant Dentistry, a Master in the American Academy of Implant Prosthodontics, a Diplomate of the International Congress of Oral Implantology and a Master of the Academy of General Dentistry. His professional member-ships include the American Dental Association, the Florida Dental Association, the Brevard County Dental Association, the Academy of General Dentistry, the International Congress of Oral Implantology, the American College of Oral Implantology, the American Academy of Implants and Transplants, the International College of Cranio-Mandibular Orthopedics, the American Society of Osseointegration and the International Institute for Christian Studies. In addition, Dr. Leong is co-chairman of the implantology division at Atlantic Coast Research Center in West Palm Beach, FL, where he teaches dental implantology. He lectures nationally
and internationally on the subjects of dental implants, temporomandibular dysfunction treatments, neuromuscular occlusion, practice management, lasers in dentistry and CT 3-D scans in general dentistry.
For more information, visit Dr. Leong’s website at www.richardleongdds.com
A Dentist and a Teacher
W ith more than four decades of dental experience, Dr. Leong began teaching implantology in 1982. He recently became
an adjunct professor at the Florida Institute of Technology, where he teaches the dental aspect of biomedical engineering.
In addition, Dr. Leong also teaches dental implantology at The Atlantic Dental Research Clinic in West Palm Beach, where he lectures and oversees surgical procedures performed by practic-ing dentists who are learning about dental implants.
Dr. Leong was recently given an award for 30 years of teaching there. His career is one de� ned by his passion for learning as well as his thirst for knowledge, which he enjoys passing on to his dental students.
“At this point in my career, I really enjoy helping people in di� erent ways, either through teaching dentistry or working directly with patients. I love giving something back. � ere’s always something new to learn and incorporate into your practice. Technology is ever-evolving, and we keep up with it here in the o� ce.
“I maintain advanced equipment in my o� ce to diagnose problems and perform vari-ous dental procedures. I have students come to the o� ce, where I demonstrate the use of the equipment.”
Dr. Leong also shares his knowledge on an international level. In 1992, he had a chance to participate with his church on a mission trip to Nicaragua. He went to spread his faith and provide free dental care to those in need. In the years since, the mission trips have developed into an annual medical/dental contribution.
“I started with missions and that expanded to teaching in the dental schools, but it’s still missionary work because we take care of all of these people that really need a great deal of dental work.”
Whether he’s helping patients far from home or in his Melbourne o� ce, Dr. Leong says it’s wonderful to witness the e� ect of his e� orts.
“� e ultimate goal for me is to care for peo-ple. � at’s what I do. It is so rewarding to take what I know and help others and to teach others to do the same.”
Why Choose Dental Implants:
• Function and feel like natural teeth, allowing you to eat and speak comfortably
• Can be restored to look like natural teeth, so you can smile with con� dence
• Maintain the bone structures o f the jaws and face , preventing the premature aging process often associated with tooth and bone loss
• Firmly and securely support dental work, eliminating the need for bulky, plastic dentures, or adhesives
• Help prevent decay in the jawbone
• Dental implants will usually last a lifetime
For All Your Dental Needs
Dr. Leong and his staff invite you to call or visit their office and discover that high-quality technical expertise can coexist within a warm, casual, welcoming environment. Dr. Leong’s o� ce is located in Melbourne at:
400 South Babcock Street
(321) 723-7255
“We have instruments now that can measure the maturity of the bone that’s surrounding the implant,” Dr. Leong says. “� e instruments work on the princi-ples 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, I can sometimes accelerate the procedure and put the new tooth in about two months after placing the
Doctor Appro ed
As a doctor, Magaly lauds the professional work of Dr. Leong.
implant. I couldn’t do that in this case because she had abso-lutely 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 de� -nitely recommend him because the treatment I received was excellent, just what you want when you’re a patient.”FHCN article by Roy Cummings. Photos by
Nerissa Johnson. mkb
Page 4 | Brevard Health Care News | Winter 2019
Barry LevineExecutive Publisher
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Pain Management
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Implant Dentistry of FloridaImplant, Cosmetic and
General Dentistry
Lake Washington Foot & AnklePodiatry
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Cancer Care Centers of BrevardOncology
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Winter 2019
Implant and CosmetIC dentIstry
Melissa Dean, MD, specializes in internal and general preventative medicine and is an expert in treating menopause and andropause. She has also been expertly trained in the field of diabetes man-agement, hormone replacement and nutrition. She earned her Bachelor of Science in Nursing degree from Florida Atlantic University in 1997 and her Master’s degree in the same discipline in 1998. She earned her medical degree
from Ross University of Medicine in 2003 and completed her res-idency training in internal medicine at Orlando Regional Medical Center. She was fellowship trained at the American Academy of Anti-Aging and Regenerative Medicine and earned a sec-ond Master’s degree in Metabolic Medicine from the University of South Florida in 2012. In addition to her work domestically, Dr. Dean has traveled to Ireland, Central America and the Amazon to either study local medicine or take part in medical missions.
To learn more about their treatment options, please visit www.deanwellnessinstitute.com
Dean Wellness InstituteDean Wellness Institute has been serving Vero Beach and its surrounding areas for over 15 years. The institute is focused on providing a holistic approach to wellness and improved health and works closely with its patients to improve their quality of life. For more information or to schedule an appointment, call or visit them in Vero Beach at:
1345 36th St.Suite B
(772) 567-1500
Our Mission:To work with each patient in a team approach and provide the most up-to-date information in an integrative manner that empowers each patient to be the best they choose to be. Our focus is getting to the root cause of health issues, rather than just treating the symptom.
MELISSA DEAN, MD
Noninvasive cosmetic procedure rejuvenates skin
Anne was amazingly pleased with the
results of her Vampire Facial
Vampire Facial®
A strong desire to help people look their best runs in Anne Harrell’s family. Her brother is a Chicago-based dermatologist, and she spent several years working as a cosmetolo-
gist before earning certi� cation as a medical electrologist.
Now the owner of Laser Institute of Vero Beach, which specializes in laser hair removal, Anne shares that desire to look her best. It was, in fact, that very desire that triggered the slight turn she made in her career path.
“I had some facial hair going on that I wanted to get rid of, a little chin hair to be more speci� c,” Anne says. “I found out that laser hair removal works really well for that, and I got into it after that. It was my own curiosity that led to the change.”
Anne’s curiosity recently had her looking into yet another beauti� cation therapy. � is one is a skin treatment called the Vampire Facial. � e procedure uses the customer’s own blood to natu-rally rejuvenate their skin and promote healthy growth and activity.
“I’d heard a lot of good things about it, that it was really good for overall skin texture, reducing pore size and building collagen,” Anne relates. “� ose are some things I was looking for in a skin treat-ment, so I started looking into it.”
Anne didn’t have to look far to find someone who could perform the unique treatment. As part of her prac-tice, she performs laser hair removal services at Dean Wellness Institute, where its proprietor, Melissa Dean, MD, offers the Vampire Facial.
Dr. Dean was trained in the application of the Vampire Facial by its inventor, Charles Runels, MD, who also trademarked the procedure that uses a blood derivative called platelet-rich plasma, or PRP, to restore, shape and improve the tone and texture of the skin.
“It’s called Vampire Facial because we use your own blood products,” Dr. Dean says of the nonsurgical treatment. “� at blood product is the PRP, which is being used a lot in orthopedics now and even in some other areas of medicine.”
PRP therapy has been used to treat a variety of problems, including joint, tendon, ligament and
muscle injuries and even hair loss. It is considered e� ective because the PRP contains growth factors that naturally increase the body’s ability to heal itself.
When used as part of a skin treatment, PRP directs the body to produce new collagen that smoothes out the skin and gives it better tone and texture, including around the corners of the eyes and mouth, where it erases � ne lines and wrinkles.
Three-Step ProcessDuring the Vampire Facial, PRP therapy is performed as part of the second step of a three-step process that begins with the application of a numbing cream to the customer’s face. While the numbing cream takes e� ect, the PRP is collected.
“While the person is numbing, we draw a little bit of blood from their arm, about two teaspoons worth,” Dr. Dean explains. “We then put that blood into a special machine called a centrifuge that separates the PRP from the red blood cells.”
During the third step of the procedure, the PRP is placed in a syringe that is used to apply the PRP directly to the face while the technician uses a hand-held, pen-shaped microneedling device to inject small microtraumas to the skin.
� e feeling one gets from the injections made by the sterilized microneedling device has often been likened to that of someone pressing sandpaper onto the skin, but some customers with more sensitive skin may experience a more intense feeling.
“It sounds kind of gruesome when you’re talking about needles to the face, but these are very tiny micronee-dles, a dozen of them on a cartridge about a half-inch in diameter, and the numbing cream makes it easy to tolerate the microtraumas they create,” Dr. Dean adds.
� e administration of the PRP and its growth fac-tors to the trauma areas activates the stem cells that are already in the skin. � is sparks a healthy rejuvenation of the skin that makes it softer and leaves it looking clearer and younger.
“� e other thing we do during this step is divide the face up into areas,” Dr. Dean reveals. “� e technician will do the microneedling in one area of the face and then move on to another area, apply the PRP and do the microneedling to that area.
“She’ll do that until she’s done with the whole face, but we can also do the neck or upper chest area. When we’re done, we just let the patient sit comfortably for a few minutes before we apply some aftercare products.”
Lunchtime ProcedureA Vampire Facial takes about 45 minutes to an hour to com-plete, and little to no downtime is required for recovery. Dr. Dean says that most patients can immediately return to their normal, daily activities.
“� at’s why we refer to the Vampire Facial as a lunchtime procedure,” Dr. Dean notes. “You can get it done during your lunchtime, put on a little makeup and go right back to work, and no one will even know you had anything done.”
Anne’s description of the pro-cedure matches Dr. Dean’s. She says her Vampire Facial was “painless,” took about an hour to complete and with the exception of “some redness,” left her face looking relatively normal immediately afterward.
“And that redness goes away pretty fast,” Anne reports. “By the next day for sure, you really can’t tell you had anything done at all. And it really is painless. � e numbing cream works really well, so it’s not a big deal at all in terms of discomfort.
“� e best thing, of course, is that the results are really amazing. I could
de� nitely tell a di� erence in the overall texture of my skin, the tightness and how it evened out the color of it. I was really pleased, and I had just one treatment.
“� e recommendation is that you get three done over the course of a few months, but one will make a big di� erence, which is why I de� nitely recommend it. I know a lot of people are doing it now because they’re getting great results.
“And, of course, I recommend that they get it done by Dr. Dean. She’s a great person, an amazing wellness doctor, and she always tries to do things naturally � rst. I think that’s why patients love her so much and why they always come back to her.”FHCN article by Roy Cummings. Photo courtesy of Anne Harrell. Stock photo
from Pixabay. mkb
Winter 2019 | Brevard Health Care News | Page 5FaCIal aesthetICs
CLARK F. BROWN, JR., DDS, P.A.WILLIAM S. VAUGHN, DMD
State-of-the-Art Dental CareDr. Brown and his team look forward to meeting the readers of
Brevard Health Care News. For additional information or to schedule an appointment, visit or call the offi ces of Implant Dentistry of
Florida in Melbourne at:
Clark F. Brown, Jr., DDS, is board certi� ed by the American Board of Oral Implantology/Implant Dentistry. He earned his undergrad-uate degree from the
University of California, San Diego, and his Doctor of Dental Surgery degree from Georgetown University. Dr. Brown served as a dentist in the US Air Force from 1978 to 1981. He has been in pri-vate practice in Melbourne since 1981. He is a diplomate of the American Board of Oral Implantology/Implant Dentistry, International Congress of Oral Implantologists, American Society of Osseointegration and American College of Forensic Examiners and is a fellow of the American Academy of Implant Dentistry and International Congress of Oral Implantologists.
William S. Vaughn, DMD, earned his under-graduate degree from Kentucky Wesleyan College and his Master of Science degree in Oral Biology and Doctor
of Oral Medicine degree from the University of Louisville. Dr. Vaughn has participated in clinical research involving cone beam CT scanning, pharmacology and implant planning, and has been published in the Journal of Oral and Maxillofacial Implants. He is a member of the American Association of Implant Dentistry, Academy of General Dentistry and American Dental Society of Anesthesiology. Dr. Vaughn has been in practice at Implant Dentistry of Florida since August 2016.
For more information, please visit www.drimplant.com
Laurent Moriniere is a native of Martinique in the French Caribbean. He relocated to the United States in 1981 and set-
tled first in West Palm Beach. After eight years, he moved to Key Largo, where he owned an Arby’s® restaurant. Eventually, he sold the restaurant and dabbled in res-idential construction.
In 2001, Laurent made a home in Merritt Island. Now retired, he � nally had a chance to concentrate on his own needs, and he really needed to � nd a dentist for what had become a shabby smile.
“About four years ago, I was having problems with my two front teeth,” he shares. “They were very bad. They were loose, and the bone underneath was infected. I was having trouble chewing because I was afraid I’d break the teeth. They were almost ready to go as it was because the bone was so rotten.
“With my teeth in that condition, I avoided eating meat. I ate a lot of � sh and soft vegetables. I didn’t have any pain, but I was embarrassed by my smile. I some-times put my hand in front of my mouth to cover my teeth.”
It was one thing to admit he needed a good dentist to repair his teeth and restore his smile, but Laurent also had to acknowledge he didn’t have the slightest idea where to turn to have the work done. � en, serendipity stepped in, and he found a resolution to his problem.
“I was at the eye doctor, and I saw a copy of Brevard Health Care News,” he recalls. “There was an article in it about Dr. Brown and dental implants. It was a very good article, so I went to see him.”
In that newspaper, Laurent read about Clark F. Brown, Jr., DDS, who, with his associate, William S. Vaughn, DMD, provides a full scope of dental ser-vices at Implant Dentistry of Florida in Melbourne. Dr. Brown and Dr. Vaughn perform cosmetic and general dentistry as well as all phases of dental implant surgery and smile restoration.
At Laurent’s first appointment at Implant Dentistry of Florida, Dr. Brown thoroughly examined his mouth and took x-rays. After the evaluation, the dentist developed a complete treatment plan for Laurent.
“Laurent’s two front teeth were a� ected by gum disease, and there was a
great deal of root surface showing,” reports Dr. Brown. “� e teeth were also a bit unsightly and needed to come out. I suggested an all-porcelain bridge, secured by his natural teeth, to replace the extracted teeth.”
“Dr. Brown told me he had to pull the two front teeth and another tooth on the left side of my jaw,” relates Laurent. “He said he would make a bridge for my front teeth and place a dental implant in the other tooth space.
“During a forty-� ve-minute meeting, Dr. Brown explained exactly what he was going to do and what my mouth would look like with the bridge. I was satis� ed with what he said, so we started the process the next week.”
Ultimate Aesthetics� e bridge Dr. Brown created for Laurent is all porcelain, which provides ultimate aesthetics. Previously, most bridges were made of a mixture of materials.
“In the past, we used porcelain-fused-to-metal or porcelain-fused-to-gold bridges,” veri� es Dr. Brown. “With these, the under-lying structure was metal, and porcelain was baked over the top of it. However, if there was any gum recession, the metal would become exposed as a little, black line along the gumline where the porcelain thinned.
“With all-porcelain bridges, we use a zirconia substructure with porcelain baked on top. The big difference is zirconia is tooth colored, so if there is any gum reces-sion, there will be no black line. � is makes the all-porcelain bridges more aesthetically pleasing when patients � rst get them and also in the long run.”
Dr. Brown also placed a dental implant in the space left by the missing tooth on
the left side of Laurent’s mouth. It wasn’t a front tooth, but it was in his smile line. � e dentist topped the implant with an all-porcelain crown made using the prac-tice’s CEREC® technology.
CEREC is a computer-based machine that enables the dentist to measure, design and fabricate porcelain restorations right in the o� ce in a single visit.
“With implants, there is the screw-like body, which is surgically placed into the bone, then the abutment, which screws onto the implant. � en the tooth is cemented on top of the abutment,” describes Dr. Brown. “With our CEREC, we are able to make what’s called a TiBase, which enables us to improve the crown’s appearance.
“Traditionally, the abutment is made of metal, so if there is any gum recession, the metal can show and be somewhat unsightly. With the TiBase, we can make the abutment out of zirconia or e.Max®, which is another porcelain material. Now, we have a tooth-colored abutment, and we eliminate those aesthetic problems that can occur over time.”
concerned about the more visible upper arch. For a while, she wore a removable par-tial denture on top, but it became loose and sometimes fell out. She started looking for a new dentist, one with rejuvenation expertise to rebuild her upper teeth. A friend recom-mended Implant Dentistry of Florida.
When Rosemarie arrived for her appointment, she met with Dr. Vaughn. He recommended removing all of her remaining teeth and rebuilding her upper arch using a prosthesis that could be either a removable denture or a � xed bridge, secured by den-tal implants. Rosemarie liked and trusted Dr. Vaughn right away and agreed with his recommendation of a � xed bridge, since her lower teeth were also � xed in place.
“Last May, Dr. Vaughn pulled all of my top teeth,” she con� des. “He started getting the implants ready, but then my mouth had to heal. I wore a temporary denture on the top so I could go out and not look like an old woman. Also, if I didn’t have any teeth on the top, I wouldn’t have been able to eat.”
Implant Advantages“Rosemarie wore a temporary upper den-ture for four months while waiting for her implants to heal,” states Dr. Vaughn. “Her permanent restoration is a � xed bridge that spans from � rst molar to last molar. Having a � xed prosthesis provides a number of bene� ts.
“Oftentimes, people do not want to feel like they have dentures. � ey want to feel like they have their own teeth, and a � xed prosthesis that stays in place helps give them that feeling. It doesn’t have to come out and be put back in or be soaked in a glass in the bathroom. Using dental implants is as close as we can get to replacing natural teeth.”
In addition, traditional dentures tend to move when eating, which greatly diminishes a patient’s chewing function. � at can result in a lower quality of life because they are not able to eat all the foods they want.
“Fixed prostheses, however, are attached to the implants, which are integrated into the bone and held firmly,” explains Dr. Vaughn. “� ey are able to transmit the forces from the jaw to food while chewing, making chewing more e� cient and more like that of natural teeth. Patients can go back to eating their favorite foods, and that improves quality of life.”
Dr. Vaughn educates that while some bridges are composed only of white material to replace the teeth, others include a synthetic, gum-colored base to replace the gum tissue that is often lost when teeth are extracted. Rosemarie’s bridge was made this way.
“Sometimes, we have to replace some of the gum tissue as well, and that will be at the top part of the bridge. � e lower portion will be where the teeth sit,” he notes. “� e gum portion will have a pink shade and will be sculpted to look like natural gum tissue.”
When � tting implant-secured bridges, the dentist must adjust the bite carefully to make sure all the upper teeth are touching the lower teeth in unison. � ere can’t be any high spots because the implants and prosthe-ses don’t move the way teeth will.
“Natural teeth will shift over time. � ey also have a ligament that allows them to compress slightly. Implants do not have that,” he observes. “� ey’re � xed in place, so the dentist needs to make sure the teeth are balanced, and there’s harmony between the upper and lower bridges.”
Added Confi denceRosemarie was impressed by the quality of her temporary denture. When she received her permanent bridge, she was absolutely astounded by its excellence. To her, it is far superior to the lower bridge she had done by her previous dentist.
“My upper bridge is made of a di� er-ent material, a composite,” she reports. “It’s stronger than the lower one, which is good to know because one day I was eating, and a tooth broke o� my lower bridge, which was done by a di� erent dentist.”
Dr. Vaughn explains that Rosemarie’s bridge is one solid piece of a porcelaincomposite hybrid that � exes and has tremen-dous strength.
Having a fixed prosthesis instead of a traditional appliance means Rosemarie never has to worry about it becoming loose or slipping, and she doesn’t have to remove it. She simply needs to maintain good oral hygiene to keep it clean. Her � nished bridge also gives her added con� dence because she knows she’ll always have teeth in her mouth.
“I like knowing it’s � xed, and I don’t have to take it out at night,” she enthuses. “With a denture, you put it in a glass at night. In the morning, you might forget to put it back in and then you look in the mirror and say, Oh my God! Who is this woman with no teeth?”
� at won’t happen to Rosemarie. And with teeth in her mouth, her smile becomes more youthful and attractive. She thinks her new dental work makes her look like she did when she was younger.
“The bridge is beautiful,” she com-ments. “I had a picture from when I was twenty-two, and I showed it to them and asked if they could make the teeth in the bridge look the way my teeth looked then. Now, they look like my own teeth.”
BEFORE
AFTER
Not only is Rosemarie pleased with the appearance of her new bridge, she’s also thrilled with how perfectly it func-tions. She’s especially glad to be eating one of her favorite foods.
“I like pork chops,” she says. “When I had my dentures, it was harder to eat pork chops than chicken. Now, I can eat anything I want, even pork chops.
“I am very happy and pleased. I recom-mend Dr. Vaughn and Implant Dentistry of Florida. I tell all my neighbors about them. I say, Go to Dr. Vaughn if you have problems with your teeth and need a dentist. He’s the best!”
Proud PerformanceLike Rosemarie, Laurent is very happy with his results. His new bridge is both aestheti-cally pleasing and fully functional, and he’s proud of his new teeth and restored smile.
“� e � nished bridge is excellent,” he raves. “� e color of the teeth matches my lower teeth, and everything is perfect. Now, I have no prob-lem smiling and showing my teeth.
“I have no trouble chewing, either. I can eat good meat, hard breads, anything hard with no problem.”
� e dental implant and crown Dr. Brown placed on Laurent’s left side are also functional and appealing. He’s so satis� ed that he plans to have Dr. Brown place another implant in the space that will be left by a molar that now needs to be removed. He shares his good for-tune with those around him.
“I’ve already recommended Dr. Brown to a loved one. She went to him, and he � xed all of her teeth perfectly,” discloses Laurent. “I also recommended him to two or three of my friends.”
Laurent’s good words don’t stop there. He has a special message for Dr. Brown himself.
“I congratulate him for all the great work he did for me and my loved one,” says Laurent. “We are very, very pleased with Dr. Brown and Implant Dentistry of Florida and what they did for us!”FHCN article by Patti DiPanfilo. Photo of Laurent and staff
by Nerissa Johnson. Photo of Rosemarie by Jordan Pysz. Before
image courtesy of Implant Dentistry of Florida. mkb
Dr. Vaughn and Dr. Brown with the Implant Dentistry of Florida staff .
Reliable Smiles Dental implants and bridges assure superior function and aesthetics
“I tell all my neighbors about them. I say,
Go to Dr. Vaughn if you have problems with your teeth and need a dentist.
He’s the best!”
“The fi nished bridge
is excellent.
The color of the teeth
matches my lower teeth,
and everything is perfect.”
1801 W. Hibiscus Blvd.
(321) 372-7700
Marvelous e.Max
Many dentists today prefer to make their dental
restorations using the durable and aesthetically pleasing e.Max material.
e.Max is an ideal choice for both crowns and veneers to be used in the front of
the mouth. It off ers an all-ceramic solution for
many aesthetic problems, including:
Stained teeth
Crooked teeth
Fractured teeth
Teeth treated with root canals
With his new bridge, Laurent no longer hides
his smile
Restoring RecommendationRosemarie Blackburn, 73, a native of Germany, came to the United States in 1968. With a husband in the service, she became very involved in military life. She was less involved in taking care of her dental health, however, and eventually issues arose.
“I neglected my teeth for a long time,” she admits. “� e problems started when I got into my sixties. My teeth began to hurt, and I had root canals and other dental work done. � en, my gums started receding, and my teeth began falling out.
“I lost a lot of my back teeth, and I only had seven teeth left. I could still eat, and people couldn’t see my missing teeth when I smiled because I still had � ve teeth in the front. But I knew I couldn’t live like that anymore. I had to do something.”
Rosemarie went to her dentist at the time, and he restored her lower arch of teeth with a � xed bridge. After that, she became
Page 6 | Brevard Health Care News | Winter 2019 Implant, CosmetIC and general dentIstry
CLARK F. BROWN, JR., DDS, P.A.WILLIAM S. VAUGHN, DMD
State-of-the-Art Dental CareDr. Brown and his team look forward to meeting the readers of
Brevard Health Care News. For additional information or to schedule an appointment, visit or call the offi ces of Implant Dentistry of
Florida in Melbourne at:
Clark F. Brown, Jr., DDS, is board certi� ed by the American Board of Oral Implantology/Implant Dentistry. He earned his undergrad-uate degree from the
University of California, San Diego, and his Doctor of Dental Surgery degree from Georgetown University. Dr. Brown served as a dentist in the US Air Force from 1978 to 1981. He has been in pri-vate practice in Melbourne since 1981. He is a diplomate of the American Board of Oral Implantology/Implant Dentistry, International Congress of Oral Implantologists, American Society of Osseointegration and American College of Forensic Examiners and is a fellow of the American Academy of Implant Dentistry and International Congress of Oral Implantologists.
William S. Vaughn, DMD, earned his under-graduate degree from Kentucky Wesleyan College and his Master of Science degree in Oral Biology and Doctor
of Oral Medicine degree from the University of Louisville. Dr. Vaughn has participated in clinical research involving cone beam CT scanning, pharmacology and implant planning, and has been published in the Journal of Oral and Maxillofacial Implants. He is a member of the American Association of Implant Dentistry, Academy of General Dentistry and American Dental Society of Anesthesiology. Dr. Vaughn has been in practice at Implant Dentistry of Florida since August 2016.
For more information, please visit www.drimplant.com
Laurent Moriniere is a native of Martinique in the French Caribbean. He relocated to the United States in 1981 and set-
tled first in West Palm Beach. After eight years, he moved to Key Largo, where he owned an Arby’s® restaurant. Eventually, he sold the restaurant and dabbled in res-idential construction.
In 2001, Laurent made a home in Merritt Island. Now retired, he � nally had a chance to concentrate on his own needs, and he really needed to � nd a dentist for what had become a shabby smile.
“About four years ago, I was having problems with my two front teeth,” he shares. “They were very bad. They were loose, and the bone underneath was infected. I was having trouble chewing because I was afraid I’d break the teeth. They were almost ready to go as it was because the bone was so rotten.
“With my teeth in that condition, I avoided eating meat. I ate a lot of � sh and soft vegetables. I didn’t have any pain, but I was embarrassed by my smile. I some-times put my hand in front of my mouth to cover my teeth.”
It was one thing to admit he needed a good dentist to repair his teeth and restore his smile, but Laurent also had to acknowledge he didn’t have the slightest idea where to turn to have the work done. � en, serendipity stepped in, and he found a resolution to his problem.
“I was at the eye doctor, and I saw a copy of Brevard Health Care News,” he recalls. “There was an article in it about Dr. Brown and dental implants. It was a very good article, so I went to see him.”
In that newspaper, Laurent read about Clark F. Brown, Jr., DDS, who, with his associate, William S. Vaughn, DMD, provides a full scope of dental ser-vices at Implant Dentistry of Florida in Melbourne. Dr. Brown and Dr. Vaughn perform cosmetic and general dentistry as well as all phases of dental implant surgery and smile restoration.
At Laurent’s first appointment at Implant Dentistry of Florida, Dr. Brown thoroughly examined his mouth and took x-rays. After the evaluation, the dentist developed a complete treatment plan for Laurent.
“Laurent’s two front teeth were a� ected by gum disease, and there was a
great deal of root surface showing,” reports Dr. Brown. “� e teeth were also a bit unsightly and needed to come out. I suggested an all-porcelain bridge, secured by his natural teeth, to replace the extracted teeth.”
“Dr. Brown told me he had to pull the two front teeth and another tooth on the left side of my jaw,” relates Laurent. “He said he would make a bridge for my front teeth and place a dental implant in the other tooth space.
“During a forty-� ve-minute meeting, Dr. Brown explained exactly what he was going to do and what my mouth would look like with the bridge. I was satis� ed with what he said, so we started the process the next week.”
Ultimate Aesthetics� e bridge Dr. Brown created for Laurent is all porcelain, which provides ultimate aesthetics. Previously, most bridges were made of a mixture of materials.
“In the past, we used porcelain-fused-to-metal or porcelain-fused-to-gold bridges,” veri� es Dr. Brown. “With these, the under-lying structure was metal, and porcelain was baked over the top of it. However, if there was any gum recession, the metal would become exposed as a little, black line along the gumline where the porcelain thinned.
“With all-porcelain bridges, we use a zirconia substructure with porcelain baked on top. The big difference is zirconia is tooth colored, so if there is any gum reces-sion, there will be no black line. � is makes the all-porcelain bridges more aesthetically pleasing when patients � rst get them and also in the long run.”
Dr. Brown also placed a dental implant in the space left by the missing tooth on
the left side of Laurent’s mouth. It wasn’t a front tooth, but it was in his smile line. � e dentist topped the implant with an all-porcelain crown made using the prac-tice’s CEREC® technology.
CEREC is a computer-based machine that enables the dentist to measure, design and fabricate porcelain restorations right in the o� ce in a single visit.
“With implants, there is the screw-like body, which is surgically placed into the bone, then the abutment, which screws onto the implant. � en the tooth is cemented on top of the abutment,” describes Dr. Brown. “With our CEREC, we are able to make what’s called a TiBase, which enables us to improve the crown’s appearance.
“Traditionally, the abutment is made of metal, so if there is any gum recession, the metal can show and be somewhat unsightly. With the TiBase, we can make the abutment out of zirconia or e.Max®, which is another porcelain material. Now, we have a tooth-colored abutment, and we eliminate those aesthetic problems that can occur over time.”
concerned about the more visible upper arch. For a while, she wore a removable par-tial denture on top, but it became loose and sometimes fell out. She started looking for a new dentist, one with rejuvenation expertise to rebuild her upper teeth. A friend recom-mended Implant Dentistry of Florida.
When Rosemarie arrived for her appointment, she met with Dr. Vaughn. He recommended removing all of her remaining teeth and rebuilding her upper arch using a prosthesis that could be either a removable denture or a � xed bridge, secured by den-tal implants. Rosemarie liked and trusted Dr. Vaughn right away and agreed with his recommendation of a � xed bridge, since her lower teeth were also � xed in place.
“Last May, Dr. Vaughn pulled all of my top teeth,” she con� des. “He started getting the implants ready, but then my mouth had to heal. I wore a temporary denture on the top so I could go out and not look like an old woman. Also, if I didn’t have any teeth on the top, I wouldn’t have been able to eat.”
Implant Advantages“Rosemarie wore a temporary upper den-ture for four months while waiting for her implants to heal,” states Dr. Vaughn. “Her permanent restoration is a � xed bridge that spans from � rst molar to last molar. Having a � xed prosthesis provides a number of bene� ts.
“Oftentimes, people do not want to feel like they have dentures. � ey want to feel like they have their own teeth, and a � xed prosthesis that stays in place helps give them that feeling. It doesn’t have to come out and be put back in or be soaked in a glass in the bathroom. Using dental implants is as close as we can get to replacing natural teeth.”
In addition, traditional dentures tend to move when eating, which greatly diminishes a patient’s chewing function. � at can result in a lower quality of life because they are not able to eat all the foods they want.
“Fixed prostheses, however, are attached to the implants, which are integrated into the bone and held firmly,” explains Dr. Vaughn. “� ey are able to transmit the forces from the jaw to food while chewing, making chewing more e� cient and more like that of natural teeth. Patients can go back to eating their favorite foods, and that improves quality of life.”
Dr. Vaughn educates that while some bridges are composed only of white material to replace the teeth, others include a synthetic, gum-colored base to replace the gum tissue that is often lost when teeth are extracted. Rosemarie’s bridge was made this way.
“Sometimes, we have to replace some of the gum tissue as well, and that will be at the top part of the bridge. � e lower portion will be where the teeth sit,” he notes. “� e gum portion will have a pink shade and will be sculpted to look like natural gum tissue.”
When � tting implant-secured bridges, the dentist must adjust the bite carefully to make sure all the upper teeth are touching the lower teeth in unison. � ere can’t be any high spots because the implants and prosthe-ses don’t move the way teeth will.
“Natural teeth will shift over time. � ey also have a ligament that allows them to compress slightly. Implants do not have that,” he observes. “� ey’re � xed in place, so the dentist needs to make sure the teeth are balanced, and there’s harmony between the upper and lower bridges.”
Added Confi denceRosemarie was impressed by the quality of her temporary denture. When she received her permanent bridge, she was absolutely astounded by its excellence. To her, it is far superior to the lower bridge she had done by her previous dentist.
“My upper bridge is made of a di� er-ent material, a composite,” she reports. “It’s stronger than the lower one, which is good to know because one day I was eating, and a tooth broke o� my lower bridge, which was done by a di� erent dentist.”
Dr. Vaughn explains that Rosemarie’s bridge is one solid piece of a porcelaincomposite hybrid that � exes and has tremen-dous strength.
Having a fixed prosthesis instead of a traditional appliance means Rosemarie never has to worry about it becoming loose or slipping, and she doesn’t have to remove it. She simply needs to maintain good oral hygiene to keep it clean. Her � nished bridge also gives her added con� dence because she knows she’ll always have teeth in her mouth.
“I like knowing it’s � xed, and I don’t have to take it out at night,” she enthuses. “With a denture, you put it in a glass at night. In the morning, you might forget to put it back in and then you look in the mirror and say, Oh my God! Who is this woman with no teeth?”
� at won’t happen to Rosemarie. And with teeth in her mouth, her smile becomes more youthful and attractive. She thinks her new dental work makes her look like she did when she was younger.
“The bridge is beautiful,” she com-ments. “I had a picture from when I was twenty-two, and I showed it to them and asked if they could make the teeth in the bridge look the way my teeth looked then. Now, they look like my own teeth.”
BEFORE
AFTER
Not only is Rosemarie pleased with the appearance of her new bridge, she’s also thrilled with how perfectly it func-tions. She’s especially glad to be eating one of her favorite foods.
“I like pork chops,” she says. “When I had my dentures, it was harder to eat pork chops than chicken. Now, I can eat anything I want, even pork chops.
“I am very happy and pleased. I recom-mend Dr. Vaughn and Implant Dentistry of Florida. I tell all my neighbors about them. I say, Go to Dr. Vaughn if you have problems with your teeth and need a dentist. He’s the best!”
Proud PerformanceLike Rosemarie, Laurent is very happy with his results. His new bridge is both aestheti-cally pleasing and fully functional, and he’s proud of his new teeth and restored smile.
“� e � nished bridge is excellent,” he raves. “� e color of the teeth matches my lower teeth, and everything is perfect. Now, I have no prob-lem smiling and showing my teeth.
“I have no trouble chewing, either. I can eat good meat, hard breads, anything hard with no problem.”
� e dental implant and crown Dr. Brown placed on Laurent’s left side are also functional and appealing. He’s so satis� ed that he plans to have Dr. Brown place another implant in the space that will be left by a molar that now needs to be removed. He shares his good for-tune with those around him.
“I’ve already recommended Dr. Brown to a loved one. She went to him, and he � xed all of her teeth perfectly,” discloses Laurent. “I also recommended him to two or three of my friends.”
Laurent’s good words don’t stop there. He has a special message for Dr. Brown himself.
“I congratulate him for all the great work he did for me and my loved one,” says Laurent. “We are very, very pleased with Dr. Brown and Implant Dentistry of Florida and what they did for us!”FHCN article by Patti DiPanfilo. Photo of Laurent and staff
by Nerissa Johnson. Photo of Rosemarie by Jordan Pysz. Before
image courtesy of Implant Dentistry of Florida. mkb
Dr. Vaughn and Dr. Brown with the Implant Dentistry of Florida staff .
Reliable Smiles Dental implants and bridges assure superior function and aesthetics
“I tell all my neighbors about them. I say,
Go to Dr. Vaughn if you have problems with your teeth and need a dentist.
He’s the best!”
“The fi nished bridge
is excellent.
The color of the teeth
matches my lower teeth,
and everything is perfect.”
1801 W. Hibiscus Blvd.
(321) 372-7700
Marvelous e.Max
Many dentists today prefer to make their dental
restorations using the durable and aesthetically pleasing e.Max material.
e.Max is an ideal choice for both crowns and veneers to be used in the front of
the mouth. It off ers an all-ceramic solution for
many aesthetic problems, including:
Stained teeth
Crooked teeth
Fractured teeth
Teeth treated with root canals
With his new bridge, Laurent no longer hides
his smile
Restoring RecommendationRosemarie Blackburn, 73, a native of Germany, came to the United States in 1968. With a husband in the service, she became very involved in military life. She was less involved in taking care of her dental health, however, and eventually issues arose.
“I neglected my teeth for a long time,” she admits. “� e problems started when I got into my sixties. My teeth began to hurt, and I had root canals and other dental work done. � en, my gums started receding, and my teeth began falling out.
“I lost a lot of my back teeth, and I only had seven teeth left. I could still eat, and people couldn’t see my missing teeth when I smiled because I still had � ve teeth in the front. But I knew I couldn’t live like that anymore. I had to do something.”
Rosemarie went to her dentist at the time, and he restored her lower arch of teeth with a � xed bridge. After that, she became
Winter 2019 | Brevard Health Care News | Page 7Implant, CosmetIC and general dentIstry
Hibiscus Court off ers luxurious senior living, including assisted living and memory care. For more information or to schedule a tour, call or visit Hibiscus Court in Melbourne at:
540 East Hibiscus Blvd.(321) 345-9830
A few years ago when her father-in-law began struggling with the effects of Alzheimer’s disease, Rhonda Whitaker
took on the task of � nding just the right assisted living community for him. After considerable research, she found Hibiscus Court of Melbourne Assisted Living and Memory Care Community.
Little did Rhonda know at the time, but she had also found just the right community for her mother, Brenda Daugherty, as well.
“My mom was diagnosed with Alzheimer’s disease about ten years ago, but for many years, she functioned very well,” Rhonda says. “A little over two years ago, we started to notice some behavior that was rather odd for her.”
As any daughter would, Rhonda paid close attention to her mom and saw that she was having a hard time getting through the day without support. When she noticed additional changes, she acted on the advice of Brenda’s doctor and began looking for a community that o� ered senior day care services. She didn’t have to look far.
Enjoy Retirement Living
Visit them at HibiscusCourtMelbourne.com and Facebook.com/HibiscusCourtMelbourneAssistedLiving
A Simple Step ForwardDay program eases transition into assisted living
if it’s getting close to dinnertime because she doesn’t want to be rude and tell me to go away, but she knows her schedule, and that routine is very important to her.”
Rhonda says Brenda especially enjoys the array of activities and out-ings the residents are able to participate in and adds that she has found a greater purpose since becoming a full-time resident of Hibiscus Court.
“She really feels at home there, and I can understand why,” Rhonda exudes. “� e atmosphere and the people are really great. I’ve never been in a place where so many people genuinely care as much as they do about their residents.
“Everybody is always going above and beyond, and they treat my mom the way I would treat her. � ere’s hug-ging and interaction, and nobody is just going through the motions. � ey’re very attentive, which is why I’m confident my mom is in the best place she can be.” FHCN article by Roy Cummings. Photo by Nerissa Johnson. nj
Rhonda (left) says her mom, Brenda, is in the “best place she can be” at
Hibiscus Court.
Having already moved her father-in-law into Hibiscus Court of Melbourne, Rhonda began inquiring about Hibiscus Court’s senior day care services.
“Hibiscus Court was the only place I felt would be a good � t for my father-in-law, and it turned out to be a good � t for my mom, too,” Rhonda says. “She was and still is very active, and she really enjoyed going there. She was always excited about going and made friends very quickly.”
Brenda visited Hibiscus Court three days a week for nearly two years until she wanted to be a full-time resident at Hibiscus.
“� e thing that changed is that my mom, who is diabetic, wouldn’t eat for me,” Rhonda says. “She would always tell me, I’m not hungry. But she needed to eat in order to take her medications, so that was becoming a problem.
“Having her on a more regular sched-ule was going to be the best thing for her, so we made the move there permanently, and the transition went very smoothly because she was moving to a place she already knew where she had friends.”
Smooth Transition Making the transition even smoother for Brenda was the fact that she took up res-idence in an apartment just a few doors down from Rhonda’s father-in-law. � at move brought those two closer than they had been before.
“I don’t know if it was planned that way or not, but with those two being so close together now, they’ve became best buddies,” Rhonda relates. “� at made the transition even easier for her, and she’s really doing well there.
“One of the best things is that because she’s so active, if she gets tired, she can go to her room and lie down. And she’s eating like clockwork again.
“If I show up to visit at the wrong time, I’ll catch her looking at her watch
LAKE WASHINGTON FOOT & ANKLEROBERT P. DUNNE, DPM, FACFAS, P.A.
Robert P. Dunne, DPM, FACFAS, is a board-certi� edpodiatric surgeon and a Fellow of the American College of Foot & Ankle Surgeons. After receiv-ing his degree from Dr. William M. Scholl College
of Podiatric Medicine, he completed a podiatric surgical residency followed by a preceptorship at Pennsylvania College of Podiatric Medicine. Dr. Dunne participates in ongoing research, including double-blinded studies for phar-maceutical trials.
Tarsal Tunnel SyndromeYou don’t have to live with the pain
According to Robert P. Dunne, DPM, a board-certified podiatric surgeon at Lake Washington Foot & Ankle
Center, “Tarsal tunnel syndrome, or TTS, presents itself when nerves in the ankle, such as the tibial nerve, are compressed.
“TTS can have several di� erent cata-lysts or triggers,” he continues. “Symptoms can be of a sudden onset or can gradually get worse over time. TTS can be the result of trauma or a congenital disease.”
Arthritis is a typical cause of TTS. It causes swelling, which in turn com-presses the nerves. Like arthritis, diabetes also causes swelling that squeezes the nerves. The soft tissue swelling from sprains and strains will also create pres-sure on the nerves.
Other causes include flat feet, or fallen arches; scar tissue from a prior sur-gery or trauma, or varicose veins. Cysts or spurs can also compress the nerves and produce symptoms.
“When the symptoms initially present themselves, it is important to seek treat-ment,” cautions Dr. Dunne. “Immediate treatment of TTS can prevent permanent nerve damage and possibly reduce the need for surgical correction. Often, when a patient with TTS presents to the o� ce for the � rst time, he or she will report symp-toms similar to those of carpal tunnel in the hand,” says Dr. Dunne.
Symptoms of TTS may include tin-gling or burning. Sometimes, su� erers experience numbness, or loss of sensation, in the a� ected foot, particularly in the � rst and second toe, and the ankle. Others experience symptoms such as shooting or stabbing pains so pronounced that these sensations interfere with their day-to-day lives. Occasionally, these symptoms can be accompanied by weakness and the sensation that the ankle or foot could be “giving way.” Patients may also experience symptoms that are worse at night, radiate into the calf and can be aggravated by pro-longed standing or walking.
Fortunately, Dr. Dunne and Lake Washington Foot & Ankle Center can help with the management and treatment of TTS, giving the patient several treatment options. � ese range from conservative to invasive in nature.
Diagnosing and Treating TTSTTS is diagnosed in several ways. At Lake Washington Foot & Ankle Center, patients receive an extensive exam by Dr. Dunne, including a super� cial testing of the nerves, a complete medical history and, depending on symptoms and his-tory, x-rays. In some cases, Dr. Dunne will send the patient to a neurologist to have nerve conduction studies to learn if the patient’s symptoms are a result of TTS, or if there is another cause for the patient’s discomfort.
Lake Washington Foot & Ankle Center can o� er TTS treatment that will vary with the patient’s needs and symptoms. In some cases, symptoms can be temporarily relieved through mas-sage, rest and elevating the a� ected ankle.
“� ere are several treatment paths we can take with our patients, depending on symptoms, severity and length of discom-fort,” notes Dr. Dunne. “Our � rst option is always conservative treatment.”
Conservative treatments might include custom-molded orthotics, ankle braces or splints. Oral anti-in� ammatories may be used, as well as topical anti-in� ammatories. Another option is phys-ical therapy, including stretching and strengthening techniques.
A minimally invasive approach involves the use of cortisone, or steroid injections. � e most invasive treatment is surgical correction using a procedure called tarsal tunnel release.
“Seeking treatment at the � rst sign of symptoms will make the outcome of the treatment more successful and reduce the amount of permanent nerve damage,”
observes Dr. Dunne. “Again, earlier treat-ment can reduce or eliminate the need for surgical intervention in some cases.”
Lake Washington Foot & Ankle Center is a comprehensive podiatric medicine clinic. It o� ers treatment for everything from bunions to hammertoes to neuromas to diabetic complications.Article courtesy of Lake Washington Foot & Ankle Center. mkb
Melbourne2717 N. Wickham Road, Suite 4
Palm Bay1091 Port Malabar Road, Suite 3
(321) 253-6191
Are You Experiencing Foot Pain?
Dr. Dunne welcomes the opportunity to answer your questions about plantar warts and other foot health issues. To schedule an appointment, please call or visit one of his two offi ces:
Page 8 | Brevard Health Care News | Winter 2019
assIsted lIvIng FaCIlIty 9039
podIatry
Advanced technology precisely targets radiation to destroy cancer cells
To learn more, visit them online at www.CancerCareBrevard.com
A True BeamC ancer can be complicated.
In many cases, the cause of a cancer’s development is unknown or complex and
poorly understood. On the other hand, the fundamentals of cancer are straight-forward and well recognized. That knowledge is the inspiration behind radi-ation therapy as a cancer treatment.
“� e de� nition of cancer is uncon-trolled cellular division,” informs Rahul Chopra, MD, board-certi� ed radiation oncologist at Cancer Care Centers of Brevard. “When cells are dividing, they use their DNA, which is essentially the instruction manual on how to divide.
“With cancer, the cells continue to divide and use their DNA twenty-four seven. When this happens, especially with cells that don’t typically actively divide, such as those in the brain, they eventually form a mass, a tumor.”
Radiation therapy works as a cancer treatment by interrupting the cancer cells’ dividing process, notes Dr. Chopra.
“Radiation is basically packets of high energy that work at the molecular level,” he explains. “During radiation therapy, this energy is directed into the tumor where the DNA architecture of the cancer cells is disrupted.
“The cancer cells no longer have their instruction manual for dividing and building new cells. � erefore, the cancer cells die o� because they are not able to perform their normal functions.
“Imagine contractors building a house. When those contractors do not have a blueprint to follow, they cannot complete the structure properly to spec.”
Radiation therapy is generally used instead of or in addition to surgery to remove cancerous tumors. It is typically the treatment of choice when a patient’s tumor is not reachable through surgery, not com-pletely removed during surgery or when patients are not candidates for surgery.
“To render patients cancer free, sur-geons must have a complete resection, or removal, of the tumor and surrounding cancer cells,” Dr. Chopra educates. “If a surgeon cannot do that or if we know from oncology testing that there is still some can-cer left after surgery, radiation therapy is often used to kill the remaining cancer cells.
“When deciding to use radiation therapy, we evaluate the type of cancer, the stage of the cancer and the patient’s medical status. It is not used just in patients with late-stage disease when sur-gery has failed to remove all the cancer.
“Even a patient with stage one lung cancer, but who was a heavy smoker all their life, is on oxygen and doesn’t have adequate lung reserves is not a candidate
for surgery. Radiation therapy would be the treatment of choice for this patient.”
Some people consider radiation ther-apy and chemotherapy, the use of drugs to kill cancer cells, as competing treatments. In many cases, however, chemotherapy is used in addition to radiation therapy.
“Radiation therapy and chemo-therapy are more like complementary therapies, rather than competing ther-apies, in the treatment of most solid tumor cancers,” Dr. Chopra elaborates. “Chemotherapy is not a curative treat-ment in these cancers, so it is used as an adjunctive, or helper, treatment.
“Radiation oncology is my specialty. After a medical or surgical internship, we undergo four years of dedicated oncology training in the use of therapeutic exter-nal beam, brachytherapy and unsealed sources of radiation in the treatment of cancer and some benign disease.
“At Cancer Care Centers of Brevard, there are also hematologists-oncologists, or medical oncologists, on sta� who use chemotherapy to treat cancer patients. We o� er both treatments at our centers. Patients do not have to go to a separate center for their chemotherapy.”
Focused TechniquesRadiation therapy is not a new idea, but the past decade or so has seen the devel-opment of many advanced techniques for using radiation to kill cancer cells. � ese include intensity-modulated radiation ther-apy (IMRT) and image-guided radiation therapy (IGRT). � ese techniques allow radiation oncologists to better reach tumors with the radiation beam during treatment.
� e machine used to deliver these types of radiation therapy is called a linear accelerator. Cancer Care Centers of Brevard use the latest technology lin-ear accelerator to provide these advanced techniques of radiation therapy. It’s called the TrueBeam® radiotherapy system.
“� e TrueBeam allows us to perform the full gamut of radiation oncology,” Dr. Chopra con� rms. “With it, we can provide IMRT and IGRT as well as ste-reotactic body radiation therapy, another technique for aiming the radiation. � e TrueBeam enables us to deliver very focused volumes of radiation therapy to destroy tumors throughout the body.
“On the day of treatment, patients lie on a table. � e TrueBeam has built-in arms that take CT scans. � ese scans give us three-dimensional maps of the body, so we can see where the tumors are in relation to the rest of the patients’ organs and tissues. We then target the tumors and deliver the dose of radiation exactly where the cancer is located.”
According to Varian Medical Systems, manufacturer of TrueBeam, the technology is designed from the ground up to treat tumor targets with enhanced speed and accuracy. It can be used wherever radiation
therapy is recommended, including the lung, breast, prostate, and head and neck. It enables radiation oncologists to treat patients quickly, while delivering precise doses of radiation to the target areas.
One technique that can be performed with the TrueBeam is volumetric-modulated arc therapy, or VMAT. VMAT is a more comprehensive form of IMRT. With VMAT, radiation oncologists can shape the radiation dose around the tumor in a three-dimensional volume.
“During VMAT, we can sculpt the radiation around critical structures in the body,” Dr. Chopra relates. “With it, we are able to give a high dose of very conformed radiation right around the tumor and stay away from areas such as the spinal cord, esophagus, heart and other organs.
“We often use VMAT on metastatic brain tumors that develop from cancers that commonly spread to the brain, such as lung, breast and kidney cancer. We have fairly good rates of controlling tumors in the brain with this technology, eighty-� ve to ninety percent in some cases.”
VMAT may also be the type of radi-ation therapy used in those patients with early-stage lung cancer who are not can-didates for surgery. With VMAT using the TrueBeam, the radiation oncologist is able to deliver a high dose of radiation to destroy the lung tumor without surgery.
Independent and AccreditedCancer Care Centers of Brevard is an independent, accredited, comprehensive oncology practice that o� ers a complete range of cancer treatment services, both medical and radiation oncology.
In addition to IMRT, IGRT and VMAT on the TrueBeam radiother-apy system, the centers provide other advanced radiation services. These include CT scanning and simulation, electron beam radiation therapy, high-dose-rate brachytherapy and prostate seed implantation.
“We are the largest independent, comprehensive oncology practice in Brevard County,” Dr. Chopra states. “In addition to full radiation services, we
also provide leading-edge oncology and chemotherapy. We also have a genetic counseling program, and we perform CT and PET scans on site to help in the staging and management of cancer.
“� e centers are accredited by the American College of Radiology, the oldest accrediting body for both radiology and radiation oncology. Accreditation means we meet a standard of quality set by the ACR. Our medical oncologists are accred-ited by the American Society of Clinical Oncology through its Quality Oncology Practice Initiative.
“Cancer Care Centers of Brevard are independent, not hospital-owned or a� liated. As we are independent, we are able to work with all of the hospitals and cancer centers in the region and state of Florida to best assist patients in easily and appropriately accessing their care.”
� e centers participate in Medicare, Medicaid and all major medical insur-ance plans.FHCN article by Patti DiPanfilo. Doctor’s photo courtesy of
Cancer Care Centers of Brevard. Stock photo from Pixabay. mkb
Rahul Chopra, MD, is board certified in radiation oncology by the American Board of Radiology. He received his medical degree from the University of Florida College of Medicine, Gainesville, where he earned honors in research. He then completed a residency in radiation oncol-ogy at State University of New York Upstate Medical University, Syracuse. Dr. Chopra’s special interests include cancers of the prostate, breast, lung, head and neck, and skin.
Todd V. Panarese, MD, (left) and Rahul Chopra, MD, use the Varian TrueBeam linear accelerator to treat cancer patients.
A Better Way to Fight Cancer
The physicians and staff at Cancer Care Centers of Brevard believe in working together to fi ght cancer. They provide leading-edge cancer care, from diagnosis through treatment into recovery. To make an appointment, contact them at one of their regional locations:
Melbourne/Pine S. Pine St.
(321) 952-0898Melbourne/Eau Gallie
W. Eau Gallie Blvd., Suite (321) 854-4776
Melbourne/Wickham N. Wickham Road
(321) 752-4811Merritt Island
Cone Road(321) 453-7440
Palm Bay San Filippo Dr. SE
(321) 725-8300Rockledge
Longwood Ave.(321) 636-2111
Sebastian US Highway
(772) 589-1995
Cancer Care Centers of Brevard is an affi liate of
Winter 2019 | Brevard Health Care News | Page 9onCology
On � anksgiving Day 2017, Dante*, 26, didn’t feel much like celebrating. � at day, Dante was the victim in a
hit-and-run car accident that left him seriously injured.
“The driver essentially sideswiped my car into a pole,” Dante describes. “It resulted in me having a severe femur fracture up by my right hip. � e local hospital couldn’t do anything for me, so they sent me to a trauma hospital where I had surgery.
“After surgery, they let me try to walk, but I couldn’t. � ey said it would take time for me to walk again. I had to get my foot back to normal because I had foot drop. I also wasn’t able to bend my knee, crouch, put on my socks or do things of that nature. I had trouble just moving my leg.”
� e sta� at the hospital told Dante he needed rehabilitation to regain full mobility. He chose Encompass Health Rehabilitation Hospital of Treasure Coast, formerly HealthSouth, for his care.
A Higher Level of Comprehensive
Rehabilitation ServicesEncompass Treasure Coast Rehabilitation Hospital takes patient self-referrals and referrals by patient families or advocates. They welcome readers to tour the hospital seven days a week, no appointment required! Contact the hospital in Vero Beach for an in-home nursing evaluation.
1600 37th St.
(772) 563-4070Visit them online at www.encompasshealth.com/treasurecoastrehab
Working as a TeamDante was evaluated upon arrival at Encompass, where it was determined he required full rehabilitation ser-vices to regain mobility and function. At Encompass, patients with ortho-pedic disorders achieve their goals by par-ticipating in a program that uses a team approach.
“We have a team of providers delivering services to patients in the program,” con� rms Dawn Bucaj, RN, BSN, senior rehab liaison at Encompass. “A typical team includes case managers, nurses, occupational and physical therapists, rehab physicians and primary care physicians. A team like this worked with Dante.”
The team decided Dante needed physical and occupational therapy to help him better perform activities of daily liv-ing. He also required time working on the advanced equipment used to return patients to walking.
Kelly Shields, CRTT, is the ortho-pedic navigator at Encompass. As part of
her job, she aids patients as they progress through the program.
“I work with the physicians and case managers for patients in the orthopedic program,” Kelly explains. “I evaluate patients at all stages and make sure they’re at the correct level of care.
“During Dante’s orthopedic reha-bilitation, he became a candidate for much of our technology, including the AutoAmbulator®. � is is a sophisticated
treadmill device that uses the concept of therapeutic waves. He also used
the MOTOmed®, a machine for patients with
restricted move-ment that p r o m o t e s walking.”
D a w n notes that patients with orthopedic d i s o r d e r s c a n e n t e r
E n c o m p a s s ’s program from home through self-referral or the referral of a family member or advocate. � ose with acute injuries like Dante’s typically enter from a hospital.
“Either way, it’s important that patients and families ask for Encompass by name,” she stresses.
Mobility and IndependenceDante stayed at Encompass for less than a week, but in that short time, he regained signi� cant mobility and function in his right leg and hip.
“Every day, I had three or four therapy sessions, and I progressed very
quickly,” Dante says. “I pretty much had to learn how to walk all over again, but after � ve days of rehabilitation, I could.
“When I was done with my therapy, I was able to do most things on my own again. I could go to the bathroom on my own, walk up and down stairs, get in and out of cars and put on my socks by myself.
“I wasn’t allowed to walk out the door when I left the hospital. I had to go in a wheelchair. But as soon as I was out the door, I walked the rest of the way. Rehabilitation at Encompass Treasure Coast Rehabilitation Hospital gave me back my independence. � ey were awesome.”FHCN article by Patti DiPanfilo. Stock photo from kisspng. mkb
*Patient’s name changed at his request.
“I had to learn how to walk all over again, but after � ve days of
rehabilitation, I could.” – Dante
Bone SolidOrthopedic program restores
function and independence
Remote ControMinimally invasive, robotically assisted heart procedure proves e� ective
A dam* describes himself as a � tness fanatic. � e 55-year-old retired Naval o� cer works out at the gym at least � ve days a
week and usually gets in a jog of at least � ve miles every other day.
He’s in excellent physical condi-tion for a man his age, which is why he thought something must be wrong when he suddenly found himself out of breath midway through the 30 minutes it usually takes him to mow his lawn.
After taking the advice of his general practitioner and visiting a heart specialist, Adam was surprised to learn that he was su� ering from mitral valve disease, which is the most common form of heart valve disease in the United States.
Nearly half a million patients are admitted to a hospital each year as a result of some form of mitral valve disease. In turn, those visits result in approximately 40,000 Americans – most of them 50 or younger - undergoing surgery for the condition.
One of four heart valves, the mitral valve is the one that allows the blood received from the lungs to flow from the left atrium, also known as the upper chamber of the heart, to the left ventricle, or lower chamber of the heart.
What Adam learned upon his visit was that he was su� ering from mitral valve regurgitation, a condition where
the mitral valve fails to close tightly when the left ventricle contracts. � is failure results in a leakage or backward � ow of blood through the valve.
W h e n this leakage occurs, blood � ows through the valve in both direc-tions, causing an increase in the volume of blood in the valve as well as an increase in pressure in the atr ium. This, in turn, increases the pressure in the veins leading from the lungs to the heart.
In mild cases of mitral regur-gitation, sufferers may not feel any symptoms at all. In more severe cases, however, the lack of efficient blood flow can cause palpitations and may leave su� erers feeling tired and short of breath the way Adam did.
For years, the primary treatment for mitral valve regurgitation was a sur-gery designed to repair or replace the valve that required the surgeon to access
the a� ected area by performing open heart surgery - sawing the sternum in half, spreading the ribs and operating through the front of the chest.
As a result o f advance s i n m e d i c a l t e c h n o l o g y, surgeons can now perform the same oper-ation remotely with the aid of a small camera and thin robotic arms that are fed into the body through a series of small incis ions on the right side of the chest.
While the surgeon works at a com-puter console that provides complete control of the movement of the robotic arms, the camera provides a clear, three-dimensional view of the mitral valve and its surroundings.
Like traditional mitral valve surgery, the robotically assisted version requires general anesthesia and the use of heart-lung bypass machines to perform the functions of those organs during the procedure. It provides several advantages over open heart surgery.
In addition to alleviating the need to break or cut the breastbone, the advantages of robotically assisted mitral valve surgery include less blood loss, less post-operative patient pain, less scarring and a shorter recovery time than with traditional surgery.
Research shows that robotically assisted mitral valve surgery is just as suc-cessful as the traditional option. In an NYU Langone study of 1,000 patients who had the minimally invasive surgery, their long-term clinical outcomes were equivalent to those achieved by patients who had a traditional sternotomy.
Adam is among those who can attest to the fact that the robotically assisted surgery works. He opted for that approach after he was told of his condition and says now that the surgery has given him a new lease on life.
“When I was told I needed to have heart surgery I wasn’t just shocked, I was scared,’’ Adam says. “Along with the con-cern I had for my general overall health, I was worried about the long layo� that I thought I’d be facing after surgery.
“But I was in the hospital for only two days with this new surgery and within a month of leaving, I was back working out and going through my normal routine. If I had been forced to have the traditional surgery, it might have been months before I was active again.”FHCN article by Roy Cummings. mkb
*Patient’s name withheld at their request.
l
Page 10 | Brevard Health Care News | Winter 2019 rehabIlItatIon
speCIal to FhCn
Want to know more? Visit Regenerative Biologics Institute online at www.rbistemcell.com
BRETT HAAKE, DODON PORTELL, MD
MEL RICHARDSON, MDJAY JOHNSTON, MMS, PA-C
JASON GRIFFETH, MS
Repairing the Body a More Natural Way
The clinical team at Regenerative Biologics Institute has the expertise to o� er the most advanced anti-aging and regenerative therapies to help patients sustain their health and quality of life. For more information about the latest in anti-aging and regenerative therapies, and about achieving optimal health in a more natural way, please call or visit the Institute in Vero Beach at:
3730 7th Terrace, Suite 302A
(772) 492-6973
Ten weeks after TruGenta, Michael felt no pain in his left knee.
T he cartilage in Michael Vernon’s joints is literally dis-integrating. � e Cleveland, Ohio native has degenerative
arthritis that’s wearing away the protective tissue that cushions the bones and enables smooth movement.
Forget Surgery, Forget PillsRegenerative medicine heals knee, back pain
� e resulting pain began in his knees, where he had previously su� ered a couple of injuries and recently su� ered a third. It also a� ected his back, where he was recently diagnosed with spinal stenosis and had a couple of collapsed discs.
“I had a sports injury on my right knee back in 1970, but I had that corrected,” Michael recalls. “My left knee wasn’t as bad. I hurt it in a rec-reational accident years ago, when I fell off a golf cart.
“At the time, my doctor said that since I didn’t make my living with my legs – I’m a behavioral therapist at a weight loss clinic – there was really no reason to do anything about that knee. However, last summer, it got aggravated when I tore my medial collateral ligament [MCL] and damaged some cartilage. It became very painful after that.
“Due to the knee pain, moving around was rough. It was very hard just to get in and out of the car. I had to keep my left leg elevated as much as possible, and I was taking pain medication quite often. My pain was an eight or nine, sometimes a ten out of ten.
“I’ve had the degenerative arthritis for � fteen years, so I had to give up play-ing golf. I � gured I was about six months away from being in a wheelchair.”
� e last thing Michael wanted was to go through knee replacement surgery, then he remembered something a friend told him about years earlier. The friend, who was a veterinarian, used regenerative therapy on his patients, and he encouraged Michael to consider the treatment when it became avail-able for humans.
Michael patiently waited for medical sci-ence to catch up. By 2018, when Michael aggravated his left knee and was in excruciating pain, regenerative medicine had long since been approved for use in humans.
“I started by doing a bunch of research on regenerative medicine and inquiring about places that do it,” Michael reports. “I saw a place on the internet that uses your
own cells as opposed to getting them from other sources. I liked that. It’s quite a bless-ing to be treated with your own cells.
“After doing the research, I decided the best thing to do was get started and find out if regenerative medicine was really the treatment of the future.”
� e website Michael discovered on the internet belonged to Regenerative Biologics Institute (RBI) in Vero Beach. At RBI, Jason Gri� eth, MS, clinical direc-tor and stem cell scientist, and the other regenerative medicine specialists spent ten years optimizing RBI’s unique treatment protocol, TruGenta™ Injection � erapy.
Healing Solution“TruGenta is a proprietary formulation of the highest-quality stem cells, plate-lets and other bioactive growth factors,” Jason describes. “� e cells and growth fac-tors work together to stimulate healing
in an arthritic or injured joint. It’s an excellent non-surgical treatment option for people with degenerat-ing joints, such as Michael.
“ H e h a d d e g e n e r a t i v e arthritis in his knee and back and was looking for a way to heal without the need for surgery or
pharmaceuticals. He didn’t want to use cortisone either because he knew it could cause further tissue damage. Instead, he was looking for a more natural way to heal his condition and its underlying cause.”
TruGenta Injection � erapy involves a brief, minimally invasive procedure that
provides a bene� cial alternative to surgery for reducing joint pain and regenerating arthritic or injured tissue. It is o� ce based, with little or no downtime or recovery. Patients generally walk into the Institute for the injections and walk out a couple of hours later with minimal restrictions.
The process used for TruGenta Injection � erapy begins by isolating and concentrating the patient’s own regener-ative stem cells and platelets.
“Stem cells are the body’s natural repair cells and are capable of healing and repairing tissue,” states Jason. “� ey are also highly anti-inflammatoryand release many growth factors within the joints that stimulate healing and repair.”
Stem cells are not assigned to be a speci� c type of cell. When placed in an area and stimulated appropriately, stem cells can develop as cells of that area, replacing the worn out or damaged tissue there. In joints, for example, stem cells can become cartilage cells and rebuild that deteriorated tissue. � at’s the essence of regenerative medicine.
Platelets are specialized cells found in blood. � ey are the cells responsible for clotting at the site of an injury. Platelets contain many healing substances and growth factors that can stimulate and assist stem cells in their regenerative activity.
“Once we concentrate the platelets in the form of platelet-rich plasma, we per-form a direct injection of that concentrate and the stem cells into the patient’s area of need, either an arthritic joint or the spine,” informs Jason. “We ensure the injections are precise using the guidance of either ultrasound or � uoroscopy [live x-ray] if the injection is in the spine.
“After we inject the stems cells and platelet-rich plasma into the arthritic areas, those cells potentially form new tis-sue and reduce in� ammation and pain. By
reducing in� ammation, they’re working to treat the underlying cause of the con-dition instead of just treating symptoms. � is is the best regenerative therapy cur-rently available.”
TruGenta Injection � erapy is used to treat many orthopedic conditions of the knee, including arthritis, torn tendons and ligaments and torn menisci. It is also used successfully for many spinal prob-lems such as bulging discs, herniated discs and degenerative disc disease.
Extraordinary SuccessRBI harvested fat cells from Michael’s stomach and combined that with his own platelets to produce his TruGenta injec-tion. Michael was con� dent that would minimize any chance of rejection and give the cells the best opportunity to be e� ec-tive. He was right.
“� ey injected me in two locations – my back and my left knee – and ten months later, I couldn’t be happier,” Michael raves. “My left knee is now a brand-new knee. I have no pain in my knee whatsoever. I think I bought at least ten years with it by having the regenerative therapy.
“My back is also much better, but I still need some help there. Where I had the work done feels great; the pain level is down to a three or four. But, I’ve got a few more sites on my back I’d like to have done. I plan on going back to RBI for more injections.”
It’s not part of RBI’s TruGenta proto-col, but Michael chose to add hyperbaric oxygen therapy to help optimize his body’s ability to accept the stem cells and platelets. He believes the treatment con-tributed to his quick results.
“I started feeling a di� erence in my knee about three weeks after the injec-tion,” says Michael. “That’s when the swelling went down a little bit. At six weeks, my knee felt even better, and by ten weeks, there was no pain in it at all.
“I’ve been recommending RBI and their TruGenta Injection Therapy to everybody I know who has problems with their knees or back,” he adds. “My treatment was extraordinarily successful, and I’m going back to do it again on other areas of my back.
“One of my goals is to get back on the golf course. Who knows, with regen-erative medicine, maybe I can live to be a hundred and play basketball again. Anything’s possible.” FHCN article by Patti DiPanfilo. Photo by Nerissa Johnson. mkb
Winter 2019 | Brevard Health Care News | Page 11stem Cell treatment
KAREN COWAN-OBERBECK, AUD, FAAA, CCC-AGLENN A. OBERBECK, BC-HIS
BEATRICE MCCABE, HAS
For Expert Hearing Care
please contact EarCare at the following locations:
Melbourne7777 N. Wickham Rd., Ste. 21
Merritt Island250 North Courtenay Pkwy., Ste. 102
Indian Harbour Beach1875D S. Patrick Dr.
(321) 216-2997For further information, please visit www.earcare.net
Age is a good time to establish a hearing baseline. If you answer “yes” to three or more of these questions, it may be time to have your hearing evaluated by an audiologist.
• Do you have trouble following the conversation when two or more people are talking at the same time?
• Do people complain that you turn the TV volume up too high?
• Do you have a problem hearing over the telephone?
• Do you have to strain to understand conversation?
• Do you have trouble hearing in a noisy background?
• Do you fi nd yourself asking people to repeat themselves?
• Do many people you talk to seem to mumble (or not speak clearly)?
• Do you misunderstand what others are saying and respond inappropriately?
• Do people get annoyed because you misunderstand what they say?
When Should Your Hearing
Be Evaluated?
Music to My Ears New hearing aids hit right note with singer, songwriter
N ow that he’s retired, former behavioral health and che-motherapy nurse Patrick Deane has a lot more time
to devote to his creative endeavors, which include writing and recording original songs for the band he and some buddies formed a few years back.
“It’s called the GoFoot Band, and we do some covers, too, but we mostly record our own stu� and send the songs out to friends and family members,” Patrick, 65, explains. “Some of it’s even available on iTunes® and Spotify® and some of the other digital formats.
“We still play live once in a while, too, but not as much as we used to because we’re all retired and getting older and it’s a bit of a hassle. But we really enjoy getting together and learning each other’s songs and playing.”
Patrick’s willingness to set up and tear down a live gig isn’t the only thing that has waned a bit over the years. His hearing has faded as well. Oddly, it wasn’t while playing his music that he noticed the dete-rioration the most.
“I � rst started wearing a hearing aid in my left ear several years ago, mostly for work, because I was having trouble hear-ing people clearly,” Patrick says. “I stopped wearing it after I retired, but a while back, I noticed my hearing was getting worse.
“I was constantly asking people, What? What? What? all the time during our con-versations, and that’s what convinced me that I needed to get my ears checked again and possibly get some new hearing aids.”
Patrick leaned on his insurance company to help him � nd a new hear-ing aid center. Their recommendation was EarCare, which has locations in Melbourne, Indian Harbour Beach and
Merritt Island, which is where he met Beatrice McCabe, HAS.
“� e � rst thing we did with Patrick was give him a full diagnostic hearing exam by our board certi� ed audiologist and business owner, Dr. Karen Cowan-Oberbeck. What we found was that he did have hearing loss in both ears,” Beatrice reports. “But we also found something else that was interesting.
“Even with his hearing aid, Patrick’s speech understanding was better on one side. � at’s important because we’re not only concerned with hearing levels or volume. Good speech understanding is critical for compre-hension and clarity. � e hearing test is a critical part of the puzzle that guides us to adjust the specific frequen-cies to improve his word understand-ing to one-hundred percent.”
Acting on the discoveries made as a result of the test-ing phase, Beatrice recommended a new set of hearing aids for Patrick featuring several major technological upgrades that were not available when he purchased his single hearing aid a decade earlier.
Based on his desire for hearing aids that do not require batteries, Patrick chose a rechargeable ReSound model called the LiNX Quattro™. Its recharge-able feature is one of the many advances that makes it one of the top hearing instruments available.
ReSounding Diff erenceIn addition to eliminating the need for batteries, the ReSound LiNX Quattro creates an environment in which the wearer can better identify speech and other sounds in noisy surroundings while maintaining a better dimension of control
over all sounds, n o m a t t e r the setting.
“We’re not j u s t t a l k i n g about adjusting the volume,” explains Glenn A. Oberbeck, BC-HIS and o w n e r , a t EarCare. “With these hearing aids, the wearer has individual controls over
the microphone patterns, noise can-cellation and the manipulation of the frequency response throughout the dif-ferent hearing levels.
“You have the ability to actually modify the bass, the treble and the mid frequencies, and you have the ability to save that program after you’ve manipu-lated it so that when you get back into that environment again or into one with similar acoustics, you can retrieve that program.
“You can create up to twelve di� er-ent custom programs, which is amazing. When you get into a favorite restaurant or an auditorium, you need to be able to hear the person that’s talking. � is hearing aid saves your settings so next time you go there, you can get to that optimum setting with just a click of a button.
“With previous technologies, it could be very difficult to communi-cate in some of those scenarios. The ReSound technology also has a free app that you can download onto your smartphone which allows you to manip-ulate the hearing aids in real time.”
� e new ReSound hearing aids are also made with Bluetooth® technology and can be connected to a smartphone, thereby allowing the wearer to hear phone conversations via the phone directly into the hearing aids themselves.
“� e technology available in these new hearing aids is literally leaps and bounds ahead of where it was in the old hearing aid I had,” Patrick con� rms. “And one of the best things about it is how easy it is to use.
“For example, I was in a restaurant with some friends the other day, so on the app on my smartphone, I just tapped the restaurant program, and it automatically reduced all the back-ground noise and enhanced the voices of the people I was with at the table.
“And what a di� erence it has made with my music. I produce my own music, and it’s amazing how much I was missing before, things like the crisp sound of cymbals or even my own guitar playing. All of a sudden, it’s so much brighter and clearer.
“I’m hearing conversations better, and that’s allowing me to be a lot more engaged with friends and family. For a while, I was just sitting there and trying to make out what everyone was saying, but now, I’m a lot more outgoing.
“That’s why I feel fortunate that I was advised to go to EarCare. What they’ve done for me and my hear-ing has truly been life-changing. I’ve got my hearing back, and in a lot of instances, I feel like I’m hear-ing things for the very first time.” FHCN article by Roy Cummings. Photo by Nerissa Johnson. nj
Patrick Deane
Karen Cowan-Oberbeck, AuD, FAAA, CCC-A, completed her undergraduate work at the University of South Florida, Tampa. She earned her Master of Arts degree from the University of Central Florida, Orlando, and her Doctor of Audiology degree from Nova Southeastern University, Ft. Lauderdale. She is a fellow of the American Academy of Audiology, a fellow of the Florida Academy of Audiology, a member of the American Speech-Language-Hearing Association and of the Florida Speech-Language-Hearing Association and holds current Florida teaching certi� cates in hearing-impaired K-12.
Glenn A. Oberbeck, BC-HIS, is a licensed hearing instrument specialist. His specialty areas include personal communication assistance, cerumen management, audio-metrics and assistive listening devices. He is a member of the International Hearing Society, Florida Society of Hearing Health Professionals, Melbourne Chamber of Commerce and Cocoa Beach Chamber of Commerce.
Beatrice McCabe, HAS, is a licensed hearing aid specialist. Her specialty areas include personal communication assistance, cerumen management, audiometrics and assistive listening devices.
Page 12 | Brevard Health Care News | Winter 2019 audIology and hearIng aIds