Technology Helps Periodontist Take Service to New Level

January 2, 2017
Ed Rabinowitz

Daniel Kubikian, DMD, specializes in a procedure called Teeth-in-a-Day. He believes he is the only periodontist in his area to own and combine two unique, advanced technologies in order to ensure a more accurate diagnosis and treatment placement.

Both of Daniel Kubikian’s parents were dentists, so it was pretty much a done deal that Kubikian himself would follow in their footsteps, right? Well, that’s not exactly what his initial intentions were.

However, it was during Kubikian’s third year as a pharmacy major at St. John’s University that he realized he didn’t want a career in pharmacy. But he still had to figure out what to do next.

The pennding battery of three qualifying exams made him rethink his career choice. So Kubikian decided, “Alright, let me be a dentist.”

As for periodontics, he didn’t intend to go down that pathway, either. But several of his mentors had done dual degrees programs in periodontics, and periodontal prosthesis. So, he followed in their footsteps, to some degree.

“Most of them practice both as periodontists and prosthodontists, which basically means that they’re acting as general dentists,” Kubikian explains. “For me, I only specialize in doing the periodontics.”

And specializing, as it turns out, has paid off.

Teeth in A Day

At his practice, Kubikian specializes in a procedure called Teeth-in-a-Day. He believes he is the only periodontist in his area to own and combine two unique, advanced technologies in order to ensure a more accurate diagnosis and treatment placement.

“The idea of putting an implant in, and then attaching a tooth to it the same day has been happening for about 12 or 15 years,” Kubikian explains. “What’s changed is, over a period of time, certain technology has evolved allowing the process to be a little bit quicker, more predictable, and hopefully more time and cost efficient.”

What Kubikian does is use a 3-D technology machine called a cone beam computed tomography that provides detailed 3-D views of the patient’s face and teeth by projecting a cone-shaped beam of x-rays that are digitally compiled into 3-D radiographic images. The information is stored in a computer and can be reformatted into multiple views, allowing all the necessary information to be obtained from one scan.

“This is not new anymore,” Kubikian acknowledges. “Almost anybody who does surgery relies on it for diagnostic purposes.”

What is unique is when Kubikian combines the information from the cone beam scanner with a digital scanner. This allows him to practice more guided, precise surgery with a more predictable outcome by increasing the success of implant placement.

“This digital scanner … takes so many pictures so fast that it essentially captures your mouth in a model,” Kubikian says. “And because it’s digital, that can be superimposed over the 3-D x-ray. The laboratory can then custom-make teeth for anybody’s face, shape or position, in advance of doing the surgery.”

The result, he says, is the ability to put the implants in the preselected position with high accuracy so that the pre-made tooth or teeth can sit exactly in the specified space. The entire procedure takes approximately three to four hours.

Word of Mouth

There is, however, an argument against the procedure: Cost. Kubikain says he spent upward of $30,000 for the digital scanner, and approximately $120,000 for the cone beam machine.

“So,” he says, “you had better be doing a lot of these so that you can sort of absorb the cost. But if you want to be able to offer more services, it helps you get a reputation of being able to do more complex types of cases.”

Is Kubikian doing many of these procedures? His goal is to be able to look back and say that he’s doing more in the current year than the previous. For example, in this, his first full year doing the procedure, he’s performed between 15 and 20 of them.

“With a technology that’s so new that almost nobody is doing it, I think that’s a lot,” he says. “But if we have the same conversation next year, I’d like to think I’d be telling you, ‘Oh my, I did 15 last month,’ as opposed to 15 in a year.”

The patients who have had the procedure have had very positive comments. But Kubikian knows his main audience is general dentists who serve as his main referral source. That’s one of the reasons he founded the South Jersey Dental Study Club in 2008.

“Like any profession, there’s a certain amount of continuing education credits that are required so you can renew your license,” he explains. “I wanted to have access to top lecturers in our hometown, so that people could attend these lectures after work and not lose time from their office.”

And as these dental professionals become familiar with each other, they transition from competitors to colleagues. That, Kubikian says, helps his practice and his business model.

“I don’t typically advertise, and I don’t have any coupons in the newspaper,” he says. “I’m really relying on the education of the doctor to refer their patient. So, I might not be their number one referral choice, but I want to be there.”

Family, Staff and Patients

Kubikian played a great deal of baseball and basketball when he was younger. Now he says he’s mostly a spectator -- except on Tuesday nights when he’s not taking his three daughters to dance classes, you can find him playing recreational basketball.

“Frankly, most people would say I’m not the right person for basketball, because I’m 5-foot-6,” Kubikian admits. “But I really like it.”

But if you recall NBA players like Spud Webb and Nate “Tiny” Archibald, it’s more about heart than it is about size. For Kubikian, it’s all about heart when it comes to his family and his practice.

“I feel like I’m such a lucky guy,” he says. “The people who work in my office are like my second family. And it makes me feel good to be on top of stuff with technology. I may swing and miss a lot, but I don’t think about that. I think about the hits. And it’s nice when you can put a period at the end of a sentence that you accomplished something before you begin that next sentence.”