Meet a group of Rockford dental surgeons who aren’t squeamish about its medical practice, and is constantly pushing the latest technology and techniques.
Dr. Edward Rentschler remembers the first moment he thought about becoming an oral surgeon. He was in middle school, and he and other neighborhood kids were sledding on an icy driveway. The neighbor boy crashed and split his lip open.
“Everyone went running and screaming,” Rentschler remembers. “I thought to myself, ‘This is kind of cool.’ It didn’t bother me, even back then. I just wanted to suture it, but I didn’t know how yet.”
In a profession that can make even other surgeons squeamish, Rentschler and his partners, Dr. Anthony Spina and Dr. Matthew Bruksch, serve patients at Rockford Oral & Maxillofacial Surgery, 425 Roxbury Road. Rentschler has practiced in Rockford since 1986, and moved to the present location 10 years after starting. Spina joined him in 2009, and Bruksch came onboard this year.
Part of their work involves handling hospital trauma cases, where injuries can range from sports mishaps to bar fights, or from domestic violence to traffic accidents. The latter has shown the most positive change over the years, Rentschler says.
“I think airbags have significantly cut down on the number of broken faces that we see,” he says. “Before, most people who were in automobile accidents would strike their faces on the steering wheel or the dashboard. If they were in the back seat they’d hit the front seat. Even with seatbelts. But with the airbag and the combination of airbags and seatbelts, there’s been a tremendous difference in the amount of injuries that we see. People say, ‘I got a facial abrasion from an airbag.’ But that’s minor compared to what used to happen.”
More athletes, in more sports than ever, are routinely using mouthguards, he adds. That’s cut down on the amount and severity of sports injuries to the mouth.
Surgical techniques and technology have changed radically over the years, too. Bioengineering technology – including techniques like reconstructive bone grafting to increase the likelihood that dental implants will succeed – is changing patient outcomes. For instance, if a costly root canal might not save a hopeless tooth, surgeons can opt for implants.
“I used to get called a lot to the emergency room for someone who had a tooth that was knocked out,” Rentschler says. “We would go all-out in trying to save that tooth. And in six months to a year, that tooth was probably going to fail. Now, it’s not as critical that we can save that tooth, because we have so many options ahead of us that we can use to recreate jawbone and put implants in.”
That doesn’t necessarily negate the old advice of bringing in a knocked-out tooth in a glass of milk.
“It’s still a big thing, but we have better options if things fail,” Spina says. “It used to be that, if that failed, patients were destined to some prosthetic device – a bridge. Now we can grow bone, grow soft tissue, put implants in. So we have better options if it fails. But we still like to try to keep teeth if we can.”
The newer surgical technology is familiar to Bruksch, who joined Rockford OMS fresh out of residency this past summer. He’s quick to add, though, that he has nothing on Rentschler and Spina, who update their training constantly.
“Ed and Anthony are caught up in everything I was trained in,” Bruksch says, “whether it’s the electronic medical charting or using BMP [protein that’s used to help grow bone]. I was impressed. They’re extremely modern.”
“We attend a lot of continuing education,” Rentschler says. “The state mandates that we have 48 hours every three years. The hospitals actually require 50 hours every two years, so they actually have a little stricter rules on continuing education. But we far exceed that in the course of three years.”
One relatively new advancement for Rockford OMS is called Virtual Treatment Planning. Formerly, reconstructive surgeries were planned and rehearsed based on X-rays and plaster models of the patient’s jaw. Today, that can be achieved more precisely by using three-dimensional computer modeling.
“So we can simulate surgical moves, and actually do the surgery on the computer before we do the surgery in the operating room,” Rentschler says.
“It’s like CAD/CAM stuff – computer-generated models and guides and stents,” Bruksch adds, displaying a CT scan printout with blue and green areas to denote parts of a patient’s jaw that would be cut and moved.
“We do this online with a company that’s based out of Colorado, and it tells us exactly where we’re moving, to the hundredth of a millimeter in every direction,” he says. “We plan the movements and then they fabricate the splints to help guide that exactly. It’s more accurate, and it’s quicker in the OR, with fewer unforeseen complications.”
Bruksch mentions one scenario where that kind of precision helps immensely: Everyone has a nerve running through the lower jaw. Surgeons can’t see that nerve because it’s inside the mandible. But the patient’s 3-D scan tells them exactly where it is, so they know exactly where to cut in order to avoid it.
“This takes it to a whole other level,” Spina says, “because not only is it just the teeth, but we start to see the jaws, and the bone. So when you do the model surgery, and you do it on a virtual computer, you get to see the moves of the entire skeletal complex, not just the little stone models. And it’s much more accurate. You can tweak things – tenths of millimeters.”
“There’s no one else in Rockford doing this,” Rentschler says.
The bottom line for the Rockford OMS surgeons is patient care. They never lose sight of the fact that it’s people’s mouths and faces they’re working on.
“When we do our jaw surgeries, our orthognathic surgeries, where we may be lengthening somebody’s jaw, or shortening somebody’s jaw, allowing them to eat and function – that’s very rewarding,” Rentschler says.
As dental implants have become more commonplace – and single-day procedures are marketed – Rentschler worries that some of what’s being advertised may not have the patient’s wellbeing as top priority. Yes, in some cases a surgeon can remove a patient’s decayed teeth, install implant posts and then create and install prosthetic teeth all in one day. But not always – particularly when a few weeks are needed to allow grafted bone particles to develop and form a solid foundation for the implants.
“‘Buyer beware’ is the thing I would say on that,” Rentschler says. “But it’s one of the directions we would like to proceed with, because we feel confident that we have the expertise and the knowledge to make that happen. There are a lot of patients who could benefit from that.
“My concern is people trying to push the parameters without science backing them up,” he continues. “The companies are kind of pushing people that maybe don’t have the expertise and the experience in doing these procedures to do them. With them, it’s about sales. With us, it’s about what’s best for the patients.”
Sometimes, that’s about addressing fears of the unknown when it comes to oral surgery, Rentschler says. Many people get unreliable information from the Internet, or from people they know, and then make decisions based on uninformed fears.
“Come in and talk to us,” he says. “We have to alleviate a lot of fears because people come in with preconceived notions either about what we do or how we do it. All those stories that people tell – ‘I was in the Army and I had 14 people taking my wisdom teeth out.’ There are a lot of stories out there that just aren’t true.”