Latest / HKB Uncut | A Cosmetic Surgery Podcast / 31. The Dental Facelift | Smile Design, Airway Health & How Teeth Transform Your Face with Joseph Chichetti, DMD

Transcript

31. The Dental Facelift | Smile Design, Airway Health & How Teeth Transform Your Face with Joseph Chichetti, DMD · HKB Uncut | A Cosmetic Surgery Podcast

• 0:00
  SPEAKER_00: I've been doing this for 19 years, and one thing I have I have found is that health is beauty.
• 0:07
  SPEAKER_00: So as a result, the aesthetic and functional piece within dentistry is very much interrelated.
• 0:14
  SPEAKER_00: If a smile or a patient's teeth does not look right or look optimal, there's usually a functional component contributing to that behind it.
• 0:31
  SPEAKER_01: On this show, we unpack the newest techniques and trends in cosmetic surgery, how to tune out the social media noise to make empowered decisions about your appearance and what you need to know before you book a procedure.
• 0:41
  SPEAKER_01: I'm Dr.
• 0:41
  SPEAKER_01: Bill Cortezis.
• 0:43
  SPEAKER_01: And I'm Gora Baharty.
• 0:44
  SPEAKER_01: We are board-certified plastic surgeons and co-founders of HKB Cosmetic Surgery, an award-winning practice with 11 locations across six states.
• 0:52
  SPEAKER_02: In other words, when it comes to aesthetics and cosmetic surgery, we've pretty much seen it all and we want to share our knowledge and unique approach to aesthetics and beauty with you.
• 1:01
  SPEAKER_02: Whether you're interested in cosmetic surgery for yourself or want to separate fact from fiction in the plastic surgery world, we hope you'll tune in each week.
• 1:26
  SPEAKER_01: Is that right?
• 1:29
  SPEAKER_00: You're definitely now that bullet in the chamber who was ready.
• 1:37
  SPEAKER_01: So, Joe, let's talk about the first time we hung out.
• 1:40
  SPEAKER_02: No, let's get the pronunciation correctly.
• 1:42
  SPEAKER_02: Joe Chicketti.
• 1:45
  SPEAKER_01: Chicketti.
• 1:46
  SPEAKER_01: Say it again.
• 1:47
  SPEAKER_01: Do it.
• 1:48
  SPEAKER_01: Chicketti.
• 1:49
  SPEAKER_01: Joe Chicetti.
• 1:51
  SPEAKER_01: There we go.
• 1:52
  SPEAKER_01: In the house.
• 1:53
  SPEAKER_01: Joe, you approve?
• 1:54
  SPEAKER_01: Yeah, you got it, man.
• 1:55
  SPEAKER_01: You nailed it.
• 1:56
  SPEAKER_01: Joe, how did what was our first meetup at Way Forest in Winston Salem?
• 2:01
  SPEAKER_00: Um I think we met in the operating room once.
• 2:04
  SPEAKER_00: Like I was coming in to take out some teeth before you did your thing.
• 2:07
  SPEAKER_00: But then I think at one of the uh um it was either at one of the bars or possibly at our house.
• 2:14
  SPEAKER_00: Or when you were you were performing.
• 2:16
  SPEAKER_00: Yeah, yeah, exactly.
• 2:17
  SPEAKER_00: I used to play shows at uh those places uh on 4th Street on on uh at at Wake.
• 2:23
  SPEAKER_00: So yeah.
• 2:24
  SPEAKER_02: Seems like yesterday, right?
• 2:26
  SPEAKER_02: Yeah, it does.
• 2:26
  SPEAKER_02: It really does.
• 2:27
  SPEAKER_02: And we're full circle.
• 2:28
  SPEAKER_00: Yeah, yeah.
• 2:29
  SPEAKER_02: We're excited to have you on the show.
• 2:31
  SPEAKER_02: You know, the the goal today is kind of talk about how kind of teeth play a part into the overall aesthetics of the face.
• 2:38
  SPEAKER_00: Yeah, absolutely.
• 2:39
  SPEAKER_02: And how everybody's like, hold up, you guys are associated with a uh cosmetic dental practice, and how does that go in with aesthetic surgery?
• 2:48
  SPEAKER_02: And actually, it goes in hand in hand.
• 2:51
  SPEAKER_01: Yeah, it's pretty remarkable.
• 2:53
  SPEAKER_01: Joe, explain to us, you know, you've been doing functional dentistry for a long time.
• 2:58
  SPEAKER_01: Yes, sir.
• 2:59
  SPEAKER_01: And you know, when we talk to patients, sometimes we talk about this idea of we as plastic surgeons or aesthetic surgeons restore form and function.
• 3:10
  SPEAKER_01: Talk to us about, you know, what's the difference with aesthetic dental surgery and or dental procedures and then functional, like explain kind of how you got to where the point you're at now.
• 3:20
  SPEAKER_00: I've been doing this for 19 years, and one thing I have I have found is that health is beauty.
• 3:27
  SPEAKER_00: So as a result, the aesthetic and functional piece within dentistry is very much interrelated.
• 3:34
  SPEAKER_00: If a smile or a patient's teeth does not look right or look optimal, there's usually a functional component contributing to that behind it.
• 3:44
  SPEAKER_00: So we have found in uh treating the functional areas in conjunction with enhancing with the smile, we we just get stellar results and the prognosis, meaning the longevity of the results we're generating is is is much longer.
• 3:58
  SPEAKER_02: Let's look let's dive deeper into that.
• 4:00
  SPEAKER_02: What do you mean by like functional?
• 4:02
  SPEAKER_02: What functional things are you seeing that play a part into the aesthetics of how the teeth look?
• 4:08
  SPEAKER_00: Aaron Ross Powell There's two main there's two main pieces to that.
• 4:11
  SPEAKER_00: One is actually the airway, um a good open functional airway, because if a patient has a tight airway, they will compensate, okay?
• 4:21
  SPEAKER_00: And the way they compensate is uh usually in their sleep, uh open mouth breathing posture while they're sleeping.
• 4:29
  SPEAKER_00: Um they'll have incorrect myofunctional habits, incorrect swallows, um, which will move teeth.
• 4:36
  SPEAKER_00: Our lips and tongues will move teeth a lot better than braces or aligners.
• 4:41
  SPEAKER_00: Um so that's a big component.
• 4:43
  SPEAKER_00: So every treatment plan we uh take a CBCT so we can math the airway, so we can kind of develop it around that, and then moving um uh downstream from from that, then getting into the bite, making sure that's level because when you when you're working on airway, is it is it the dentition moving out in this dimension that helps with that?
• 5:02
  SPEAKER_01: Or is it AP?
• 5:03
  SPEAKER_01: Which which dimension of it?
• 5:04
  SPEAKER_00: It's anterior posterior.
• 5:05
  SPEAKER_00: Okay.
• 5:05
  SPEAKER_00: Okay, so the upper airway is a simple way to think about it is neck to the end of the teeth.
• 5:11
  SPEAKER_00: So when we take a CBCT, we're looking behind the tongue primarily in relation to that uh that space uh uh available for air to pass through.
• 5:21
  SPEAKER_00: We want low upper airway resistance, little to no resistance for the air to go through.
• 5:26
  SPEAKER_00: Patients with high upper airway resistance, those are your patients who snore, those are your patients who might have apnea, that sort of thing.
• 5:33
  SPEAKER_02: Is there any way you can see that externally without getting imaging or the testing that you're talking about?
• 5:39
  SPEAKER_02: What what are some of the characteristics?
• 5:42
  SPEAKER_00: Sure, sure.
• 5:42
  SPEAKER_00: So there's there's several signs we see.
• 5:45
  SPEAKER_00: Um one of the biggest signs we see within the dentition is chronic grinding.
• 5:49
  SPEAKER_00: Chronic grinding um and uh dental wear, uh premature, premature teeth wear.
• 5:55
  SPEAKER_00: So how you might see that externally, say if if you're in a room with a group of group of people, is um tooth display in relation to the age.
• 6:05
  SPEAKER_00: So for example, with with a uh in a 20-year-old patient, I would expect to see a lot of tooth while they're speaking, the lip at rest, um, versus uh an older patient just with time they'll have wear.
• 6:17
  SPEAKER_00: But if that 20-year-old is not showing any any teeth, there's either a positional or wear issue or both contributing to that.
• 6:26
  SPEAKER_00: And sometimes it can be parafunctional habits as a result of the collapsed airway.
• 6:30
  SPEAKER_00: So back to your original question, uh, functionally speaking, we want to open the airway um and then we want to make sure the bite is level and atramatic.
• 6:40
  SPEAKER_00: We chew in a circle, and if anything is unlevel and things aren't guiding in such a way, teeth will rub and wear unevenly, and that can have um major functional consequences, um, but also aesthetic uh consequences as well.
• 6:56
  SPEAKER_01: It's a remarkable thing how incredible our bodies are, and we when I'm talking specifically about the way that our dentition is and how we maintain and achieve occlusion, which is when your teeth are together, right?
• 7:08
  SPEAKER_01: I mean, you can tell when it's off by like just a little teeniest like micromillimeter.
• 7:14
  SPEAKER_01: Oh, yeah.
• 7:15
  SPEAKER_01: And I and and and I think that's just that's just it blows my mind.
• 7:18
  SPEAKER_01: It drives you crazy.
• 7:19
  SPEAKER_01: Oh, it drives you crazy.
• 7:20
  SPEAKER_01: I'm like, I'm like, uh Joe, I still can feel this.
• 7:23
  SPEAKER_01: But it's it's it's amazing how that that can happen.
• 7:25
  SPEAKER_02: It's like if you had a piece of food stuck in there, like you could just tell it just drives you bonkers.
• 7:29
  SPEAKER_00: And parent patients are very attuned, and doctors are are very attuned as well.
• 7:33
  SPEAKER_00: But those those small details are are the difference between a fantastic outcome and a not so fantastic outcome.
• 7:41
  SPEAKER_00: So it's it's interesting.
• 7:43
  SPEAKER_00: Uh, you know, this methodology we leverage.
• 7:45
  SPEAKER_00: Um, I'm a cosmetic uh dentist, but yes, giving you outstanding cosmetics, going uh going through this pathway, we can also help many functional functional problems.
• 7:57
  SPEAKER_02: How do you how do you talk to patients about that?
• 7:58
  SPEAKER_02: Because again, to your point, patients come in, they're like, hey doc, I just want them to look good.
• 8:03
  SPEAKER_02: Right.
• 8:04
  SPEAKER_02: That's my main goal.
• 8:04
  SPEAKER_02: I just I need them to look good, I want them to look great, I don't want them to look fake.
• 8:09
  SPEAKER_02: Um, how do we make that happen?
• 8:10
  SPEAKER_02: How do you discuss the functional piece?
• 8:12
  SPEAKER_00: So so uh we talk about why it doesn't look good.
• 8:16
  SPEAKER_00: Okay, so I uh for uh I can a patient can come in and say, Oh, I want an aesthetic solution, and quite frankly, I could put veneers here or there, and it would look better.
• 8:26
  SPEAKER_00: But let's talk about why it doesn't look right.
• 8:28
  SPEAKER_00: Okay, this is why your teeth don't look right.
• 8:31
  SPEAKER_00: What caused that?
• 8:32
  SPEAKER_00: Let's fix that.
• 8:34
  SPEAKER_00: And then that'll render even better aesthetic.
• 8:37
  SPEAKER_00: So that's that's that's how we do that.
• 8:39
  SPEAKER_00: We we make sure we understand more foundation.
• 8:41
  SPEAKER_00: Yeah, yeah, we understand what what let's understand the patient's chief complaint and let's find the etiology behind it and solve that, and then let the uh cosmetic dentistry fall into place.
• 8:51
  SPEAKER_02: Can you walk us through what a patient, a new patient interaction looks like?
• 8:56
  SPEAKER_02: You know, you have an HKB patient that comes in for evaluation, they're like, hey doc, I want better looking teeth.
• 9:01
  SPEAKER_02: I'm not happy with how things look.
• 9:03
  SPEAKER_02: What does that evaluation look like for them?
• 9:05
  SPEAKER_00: So when a patient comes into our practice, um they're greeted by our new patient coordinator, Greta, she's a rock star, and she really uh tries to understand what those patients' needs are, that patient's why.
• 9:17
  SPEAKER_00: That's the term we use a lot in our practice.
• 9:19
  SPEAKER_00: They then um, once we have a good understanding of that, we walk them through our evaluation process.
• 9:25
  SPEAKER_00: It takes about an hour.
• 9:27
  SPEAKER_00: Um, and during that time, we take a 3D CBCT that helps us map the airway, but also looks at each individual tooth.
• 9:36
  SPEAKER_00: Uh we take a photo series.
• 9:39
  SPEAKER_00: Um we also take just a few standard dental x-rays to uh it still helps me really get a good idea of the bone levels, the periodontium around around the teeth.
• 9:50
  SPEAKER_00: Um, and then we take an optical scan, which is a digital impression.
• 9:54
  SPEAKER_00: It's a special camera.
• 9:55
  SPEAKER_00: It takes 50,000 photos a second and generates a 3D three-dimensional image.
• 10:00
  SPEAKER_00: Um, from there, um, we're then able to look at everything really holistically in relation to the patient's chief complaint, um, talk about how we can fix that.
• 10:10
  SPEAKER_00: Well, well, excuse me, talk about what's causing that number one, and then how we can fix that in our process for for doing that.
• 10:18
  SPEAKER_00: And uh depending on the situation, there's a there's several different ways we might we might execute that for a patient.
• 10:24
  SPEAKER_02: And how does that work from a treatment standpoint?
• 10:26
  SPEAKER_02: Like it are patients coming in and getting temporary solution and then a permanent solution, or is it you know a multi-day process, or is it over over multi-months?
• 10:36
  SPEAKER_00: So let's uh I'm gonna let's let's paint that into a couple scenarios.
• 10:40
  SPEAKER_00: So one one great thing about um uh our the way we do things um is uh we have our own full full dental lab.
• 10:49
  SPEAKER_00: So how that would play into a situation you were talking about if a patient's pursuing cosmetic dentistry after that um initial uh well here's a great scenario.
• 10:58
  SPEAKER_00: I had one just the other day.
• 11:00
  SPEAKER_00: Patient's why was her daughter's getting married and she wants to look good for the wedding.
• 11:03
  SPEAKER_00: Okay, so we we need to make sure these pictures look outstanding.
• 11:07
  SPEAKER_00: Uh her main etiology was tooth wear, dental wear.
• 11:11
  SPEAKER_00: She was ground ground her teeth down, and so her teeth were shorter.
• 11:15
  SPEAKER_00: As a result, when she was talking or in conversation, she doesn't show a lot of tooth.
• 11:21
  SPEAKER_00: That will age a patient big time.
• 11:24
  SPEAKER_00: So I often tell patients, you know, we get your teeth to the proper contour, I can give you 10 years back.
• 11:30
  SPEAKER_00: So how that plays out after a new patient consult, I have all the records so I can design the teeth in CADCAM software.
• 11:37
  SPEAKER_00: I work with a top-tier um designer, him and I work hand in hand.
• 11:41
  SPEAKER_00: His name's Weston Hatcher, he's a rock star.
• 11:44
  SPEAKER_00: So then the patient comes in for a preparation appointment, we get the teeth ready, we then mill a prototype form, which is different from a standard dental temporary for anyone who has um uh uh experience with with this sort of thing.
• 12:00
  SPEAKER_00: And what what's different about that is I actually we actually design the smile on our software and then mill out uh the final design in a uh type of material that we can easily adjust as needed.
• 12:15
  SPEAKER_00: Um, but it looks great and it feels great.
• 12:18
  SPEAKER_00: So the patient gets a true test drive, and then we're also really able to test shade and that sort of thing.
• 12:23
  SPEAKER_00: Um we can do this relatively quickly.
• 12:26
  SPEAKER_00: So the patient, if they came in for a prep appointment and we're only treating 10 teeth, we're probably placing the prototype that day.
• 12:34
  SPEAKER_00: If it's more, if we're changing the bite, the vertical dimension, uh that might be 28 teeth.
• 12:39
  SPEAKER_00: I usually have them come back in a few days.
• 12:41
  SPEAKER_00: We'll put them in a provisional just for a day or two.
• 12:43
  SPEAKER_00: Then we seat that prototype.
• 12:45
  SPEAKER_00: And then quite frankly, then we're we're kind of cruising because they can check, they can test their new bite, they can test their new look out, we can adjust shade.
• 12:53
  SPEAKER_00: Um they'll typically then come back the following week.
• 12:56
  SPEAKER_00: We decide if we're happy with everything, and then I'm fabricating things.
• 13:00
  SPEAKER_00: So for a 10-tooth case, that's um that can be as short as three, four days, depending on uh our approval.
• 13:09
  SPEAKER_00: It can be a little bit longer.
• 13:11
  SPEAKER_00: Um, but we have total control.
• 13:14
  SPEAKER_00: I I mean I can go as fast or as long as a patient wants.
• 13:17
  SPEAKER_00: I make sure I have all the parameters I need and I have measurables digitally to make sure we're there.
• 13:22
  SPEAKER_00: Then we just really want to make sure the patient's happy with everything.
• 13:26
  SPEAKER_01: I got a couple turbo questions for you.
• 13:28
  SPEAKER_01: Quick answers, okay?
• 13:29
  SPEAKER_01: All right.
• 13:30
  SPEAKER_01: How do you make it look like people haven't had their teeth done?
• 13:33
  SPEAKER_01: Like I see some people with their teeth done, and they look like I mean, they're just like I mean, tell me what do you do?
• 13:40
  SPEAKER_00: So, so um, there's two things that go into that.
• 13:43
  SPEAKER_00: Um, one, there's shape, and shape is directed to the face.
• 13:48
  SPEAKER_00: Okay.
• 13:48
  SPEAKER_00: When we design teeth, we want to design teeth that fit the face.
• 13:52
  SPEAKER_00: So when this is done, the photos are up.
• 13:54
  SPEAKER_00: The optical scan I talked about, which is a three-dimensional photo photo image, will stitch to the two-dimensional image.
• 14:01
  SPEAKER_00: So we can adjust teeth within the face and get it to where it favors that face.
• 14:05
  SPEAKER_00: That's one.
• 14:05
  SPEAKER_00: So the teeth have to have the right shape.
• 14:07
  SPEAKER_00: That dentistry that doesn't look real, it usually is a very standard shape.
• 14:13
  SPEAKER_00: Everyone can tell tell what's going what's happened.
• 14:16
  SPEAKER_00: Number two is actually material and translucency.
• 14:20
  SPEAKER_00: Okay, so in our lab upstairs, when we're designing these restorations, we are adding characterizations to make the uh restorations um reflect light like natural teeth.
• 14:33
  SPEAKER_00: Certain pieces of our teeth reflect light differently.
• 14:36
  SPEAKER_00: There's more translucent in the incisal translucency rather, excuse me, in the incisal edges versus the cervical.
• 14:42
  SPEAKER_00: You want, uh, depending on how much lip the patient's showing, I might add higher value in certain areas so it'll so it'll pop more or less.
• 14:50
  SPEAKER_00: And um, so that's how that's that's where that comes in.
• 14:54
  SPEAKER_00: So the actual restoration itself in regards to shape and translucency.
• 14:59
  SPEAKER_00: Because our natural teeth, light um reflects back differently on different pieces of that too.
• 15:05
  SPEAKER_01: How often do you brush your teeth?
• 15:06
  SPEAKER_00: Twice a day.
• 15:08
  SPEAKER_01: Twice a day?
• 15:08
  SPEAKER_01: Twice a day.
• 15:09
  SPEAKER_01: That's it?
• 15:09
  SPEAKER_01: Yeah.
• 15:10
  SPEAKER_01: How about if we're gonna do a panfacial rejuvenation?
• 15:12
  SPEAKER_01: So this is someone who's gonna get panfacial restoration.
• 15:14
  SPEAKER_01: Okay.
• 15:16
  SPEAKER_01: What's the sequence?
• 15:18
  SPEAKER_02: What do you mean when you say panfacial?
• 15:19
  SPEAKER_01: So panfacial when someone is gonna get, you know, periorbital rejuvenation, which means around the eyes, can get, you know, hair restoration, can get ear restoration, can get rhinoplasty, can get facelift.
• 15:30
  SPEAKER_01: I'm not saying they have to get all of them, but like, you know, there's different needs that people have in their face and the dentition are part of that.
• 15:37
  SPEAKER_01: Um if people are gonna have surgical interventions outside of dental work, is there a sequence that needs to happen?
• 15:43
  SPEAKER_01: What's what's the favorable way to approach this?
• 15:45
  SPEAKER_00: So the favorite way to approach it would be to evaluate tooth display.
• 15:49
  SPEAKER_00: Um, as you're going through uh a panfacial rejuvenation, this patient's trying to look younger.
• 15:55
  SPEAKER_00: Okay, so are they showing enough tooth in relation to their age?
• 16:00
  SPEAKER_00: Um if so say it's a 50-year-old patient, and when their uh uh lip is at rest or as they're speaking, um, you're seeing about uh a lip at rest, you're seeing a millimeter, millimeter and a half when speaking, you're seeing good tooth display, then it might make more sense to go um uh the surgical side first.
• 16:22
  SPEAKER_00: If they're not showing any tooth, and I mean it looks like they don't have teeth, that's a situation where it would make more sense to take care of the dentistry first because I might have to change the jawline to establish um to get the teeth where we want it, rebuild the bite.
• 16:41
  SPEAKER_00: That could potentially affect your results if that happened on the back.
• 16:44
  SPEAKER_02: That's one of the advantages we have here, right?
• 16:46
  SPEAKER_02: Being house in our megacenter that we have here and knowing our camaraderie, we can have a patient see both of us and we can come up with a game plan together to dictate exactly what the best course of action is.
• 16:58
  SPEAKER_01: And it could be done simultaneously.
• 16:59
  SPEAKER_00: Right, right.
• 17:00
  SPEAKER_00: It's it's so good for the patient because they might be seeing seeing you guys, you have a dental quest, and you you know, paying me, I come downstairs, and vice versa.
• 17:07
  SPEAKER_00: Um which we've already done multiple times.
• 17:09
  SPEAKER_00: Oh, yeah, yeah, yeah.
• 17:10
  SPEAKER_00: And and it's but it's the the results are amazing when when done in collaboration.
• 17:17
  SPEAKER_01: The interdisciplinary care in this this area is is I saw I was in clinic the other day and saw um a patient of mine who I've done a fair amount of facial restor restoration stuff on, and he recently is having his total, you know, dental restoration happening, and like I mean, totally defying like aging.
• 17:38
  SPEAKER_01: Like it is insane.
• 17:39
  SPEAKER_01: Like, Bill, this guy looks like 30 years.
• 17:41
  SPEAKER_02: People don't realize how the teeth age you.
• 17:45
  SPEAKER_02: Yeah.
• 17:45
  SPEAKER_02: I mean, I've tell you I've since you've been here, I've noticed people's teeth more and more.
• 17:49
  SPEAKER_02: I'm like, man, you need to get those six.
• 17:51
  SPEAKER_02: You need to get those six.
• 17:52
  SPEAKER_02: Yeah, it's a lot of things.
• 17:52
  SPEAKER_02: Am I showing dentist or not?
• 17:54
  SPEAKER_00: You're you're trying to make sure I'm showing so so yeah, so uh but so that that patient, wonderful patient.
• 18:01
  SPEAKER_00: That that was that was one of the issues.
• 18:02
  SPEAKER_00: Uh that weren't weren't showing a lot of uh teeth at rest or while speaking.
• 18:11
  SPEAKER_00: And he he's he's uh had a level reflux, right?
• 18:15
  SPEAKER_00: Yeah, and there's reflux issues as well.
• 18:18
  SPEAKER_02: Does a prior history of having a chin implant affect what you do or a mailer implant?
• 18:25
  SPEAKER_00: Not really.
• 18:26
  SPEAKER_00: No, no, it it doesn't.
• 18:28
  SPEAKER_00: I can't say think of a scenario where it would um uh because depending on the patient's age, usually if a patient needs a chin implant, they're usually a skeletal class two situation.
• 18:39
  SPEAKER_00: Um and if I was to reconstruct someone in a class two position, um depending on the severity, there's there's very predictable ways to to do that and also protect the airway as well.
• 18:52
  SPEAKER_00: So that's that not to get too much of the minutiae, but a skeletal class two uh patient is uh is more susceptible to an airway problem than than a skeletal class one or three.
• 19:05
  SPEAKER_00: So whenever we're we're working with vertical dimensions and those patients are really careful about that.
• 19:09
  SPEAKER_00: So if I meet a patient who's had a uh chin implant and everything looks good from a facial standpoint, um I can work around that very, very easily um in relation to uh protecting the airway, and that usually means some sort of vertical dimension increase.
• 19:26
  SPEAKER_01: So what is your favorite rock band?
• 19:29
  SPEAKER_00: Metallica.
• 19:30
  SPEAKER_00: How many times have you seen Metallica?
• 19:32
  SPEAKER_00: I've seen them going on, I think 15 times.
• 19:36
  SPEAKER_00: I'm seeing them at the sphere this fall, too.
• 19:38
  SPEAKER_00: Oh, that's gonna be great tickets to that.
• 19:39
  SPEAKER_00: That'll be the sphere is that'll be great.
• 19:41
  SPEAKER_00: I need to go see them.
• 19:42
  SPEAKER_00: Yeah, I highly recommend it.
• 19:44
  SPEAKER_00: Uh and what is it?
• 19:45
  SPEAKER_00: Are you is there are you guys your band touring now?
• 19:48
  SPEAKER_00: We're not we're not on tour right now.
• 19:50
  SPEAKER_00: We're recording at the moment, so we're we're we'll probably have a single out uh in the next couple weeks.
• 19:56
  SPEAKER_00: Um so and your role in the band.
• 19:59
  SPEAKER_00: I'm the guitarist, and then I I also mix and master everything.
• 20:03
  SPEAKER_01: And then what about jumping around in regards to the severity or level of of restorative things that you'll do?
• 20:10
  SPEAKER_01: What's the most simple thing that you'll do for a patient and the most complex thing that you'll do for a patient?
• 20:14
  SPEAKER_00: I I mean we we meet patients right here at HKB all the time for whitening solutions.
• 20:19
  SPEAKER_00: Um a big part of our protocol is also aligners.
• 20:23
  SPEAKER_00: We do a lot of orthodontics, um uh so that which is relatively uh simple uh uh uh for patients.
• 20:31
  SPEAKER_00: Um we'll do um composite bonding where indicated.
• 20:36
  SPEAKER_00: Uh but then we'll do all the way up to uh a full uh restoration.
• 20:40
  SPEAKER_00: Uh we do a lot of dental implants or a full mouth rehabilitation where we might be rebuilding the bite by uh crowning every every tooth.
• 20:49
  SPEAKER_00: Um those are some of the most dramatic changes we'll see, some of the most fulfilling, and and those patients are definitely super happy after something like that.
• 20:57
  SPEAKER_00: Uh but no, our we can go from uh from simple to very very complex if needed.
• 21:04
  SPEAKER_01: Well we are we're so thrilled to have you um here to help you know provide that continuum of care uh to our patients because you know the facial aesthetic, the you know the harmony that the uh you know.
• 21:17
  SPEAKER_01: Oh yeah, the harmony that that that we that dentition brings to it is is is critical, which is you know, your I I think it'd be kind of cool the next time we do this to show a couple cases.
• 21:27
  SPEAKER_02: I think it'd be kind of really cool to kind of walk through the whole process of you know, somebody getting aesthetic surgery to kind of dental restoration and what that looks like.
• 21:35
  SPEAKER_00: I think it'd be really valuable for anyone watching this to understand what we're talking about with tooth display because that's definitely something you can't you can't unsee.
• 21:44
  SPEAKER_00: And I I've met patients seeking out, you know, facial work and and been uh I don't I don't want to say you know, maybe disappointed in the results because they're not getting that that bam moment with their smile.
• 21:57
  SPEAKER_00: And you know, I often uh joke, um I have a great case that we're finishing Friday.
• 22:03
  SPEAKER_00: Actually, we should show that one because that that's that's the dental uh that one's a dental facelift for sure.
• 22:08
  SPEAKER_00: That's awesome.
• 22:09
  SPEAKER_00: So we we've changed her vertical dimension, and in doing so, she looks so much more youthful.
• 22:15
  SPEAKER_00: Um really defines the jawline and she's displaying um the appropriate amount of amount of teeth.
• 22:21
  SPEAKER_00: That would be a real good one to show.
• 22:23
  SPEAKER_01: Well, Joe, you are your top of the game.
• 22:25
  SPEAKER_01: We're so can you say his last name again?
• 22:26
  SPEAKER_02: I want to make sure we got it right.
• 22:28
  SPEAKER_01: Chicketi.
• 22:29
  SPEAKER_01: Yeah.
• 22:30
  SPEAKER_01: Chicketi.
• 22:31
  SPEAKER_01: Can you say it?
• 22:32
  SPEAKER_01: Perfect.
• 22:32
  SPEAKER_01: I you just did.
• 22:34
  SPEAKER_01: Yeah.
• 22:35
  SPEAKER_01: Awesome.
• 22:36
  SPEAKER_01: Well, uh well, this has been an incredible um discussion we've had here.
• 22:40
  SPEAKER_01: You know, drop us a line on any questions or concerns or any thoughts for Dr.
• 22:44
  SPEAKER_01: Chicketi.
• 22:46
  SPEAKER_01: Chicketti.
• 22:47
  SPEAKER_02: Appreciate having you on.
• 22:48
  SPEAKER_02: Yeah, thanks for having me.
• 22:49
  SPEAKER_02: This has been a blast.
• 22:50
  SPEAKER_02: Awesome.
• 22:55
  SPEAKER_02: Thank you for listening to HKB Uncut.
• 22:57
  SPEAKER_02: If you enjoyed this episode, please subscribe to us on Apple, Spotify, or YouTube.
• 23:01
  SPEAKER_01: To book a surgery consultation or med spa appointment with our team, visit our website at hkbsurgery.com or head to the links in our show notes.