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Second Opinion

Second opinions are common in healthcare; whether a doctor is sorting out a difficult
case or a patient is not sure what to do next. In the context of our magazine, the first
opinion will always belong to the reader. This feature will allow fellow dentists to share
their opinions on various topics, providing you with a “Second Opinion.” Perhaps some of
these dentists’ observations will change your mind; while others will solidify your position.
In the end, our goal is to create discussion and debate to enrich our profession.
–– Thomas Giacobbi, DDS, FAGD, Dentaltown Editorial Director

Innovation and the Dentist

William B. Dragan, DDS

Centrix CEO

Much of the progress occurring in the everyday practice of den- courses and always buying and trying the newest products and
tistry comes from those who involve themselves in it on a daily devices. Dr. Jack Buckman was my inspiration and mentor, open-
basis. Dentists are a very innovative group because there are many ing my eyes to all the developing possibilities that started to emerge
times we encounter problems that are not in any textbook. What do in the late 1960s and early 1970s.
we do? We all have to innovate in order to solve some of these out- I had graduated from Temple Dental School in 1958. We had
of-the-ordinary situations. been taught in, what I would call, the Stone Age of Dentistry. Some
Four years of dental school gives us the most basic of ideas about of the few basic changes I saw in dentistry started with the high-
what dentistry is. It isn’t until we are out in the world actually prac- speed air rotor and disposable needles. It is hard to believe now, but
ticing dentistry that, if we are lucky, we realize how little we actu- in dental school the anesthetic needles were cleaned, sharpened,
ally know. I was one of those who, after school, thought they knew resterilized and reused. Synthetic impression materials were not
it all. For nine years I was ignorant of all the potential dentistry had heard of in school. We used compound, alginate, wax and plaster of
to offer. Slowly, I became disenchanted and depressed with my prac- Paris as our major impression materials in school. Changes, such as
tice. I finally decided I could not go on the same way I had been the introduction of composites and VPS silicone impression mate-
going. I had to change. I decided to sell my practice, get out of the rials, have occurred to make our lives, and those of our patients, eas-
area and become associated with another dentist. I lost money on ier. When I finally realized all the potential that existed, I became
the sale of my practice, but I never looked back. I never regretted excited with dentistry again. My association with Jack’s dynamic
the monetary loss because if I didn’t change I think I would have practice was opening my potential and career possibilities.
just given up dentistry. Jack, as I said, would buy anything new. I was very fortunate to
My dental associateship gave me a new life. The dentist I be there when the first practical composite was introduced to the
worked with was a constant student, starting study clubs, going to profession. That composite was sold by Johnson & Johnson and
continued on page 12
August 2006
Second Opinion
continued from page 10

I became an entrepreneur, but then again,

every dentist is an entrepreneur in one form or another.

called Adaptic. It was a paste/paste material that was mixed in equal That was then. Now, I see all the new, unlimited possibilities
parts and placed into a cavity preparation with a spatula. Not an that are open to all the wet-gloved dentists today. Because there are
ideal method, filling with a spatula, it many times incorporated air so many products and techniques that are exciting, I am sorry I can-
into your restoration. Air in my restorations was a problem for me not physically practice dentistry today. Opportunity exists everyday
that became an opportunity and the start of my odyssey into inven- for all dentists to be on the lookout for different uses for technol-
tion. I became an entrepreneur, but then again, every dentist is an ogy. Maybe there are ways to improve what you are doing and using
entrepreneur in one form or another. today. Every problem, new product and/or technique create oppor-
My entrepreneurial exploits started when I became interested in tunities for those who are inquisitive and want to make their lives,
the problems I was having when I filled class III cavities. Many and those of their colleagues, easier or more efficient.
times, I ended up with voids at the surface. I had to redo the restora- Centrix and I have always looked for simple products that can
tion and hope I would not – again – incorporate more air. My redos help the dentist; and therefore, help make the patient’s visit less
began taking too much time in my schedule. To regain control, I traumatic. I believe that, for the most part, we do accomplish our
thought and came up with several composite placement concepts goal. It amazes me how long it can be before a simple product is
that were impractical. Finally, I thought I had the right idea to cure accepted and becomes standard in everyone’s dental office. My first
problem of voids in my composites. If I could syringe the compos- product took over 10 years to became the accepted method of plac-
ite directly into the cavity preparation from the bottom out, I would ing composite resins and this was a simple disposable tube and plug.
eliminate or at least minimize the incorporation of air. There was I would like to challenge all dentists, young and not so young,
not a device on the market to do this, so I made my first two syringe to keep your eyes open and be always looking, and especially think-
prototypes. This was only part one of the concept. To test out the ing, how they might solve the everyday problems that you have or
whole concept, I had to design and invest in a prototype injection will have. Don’t be afraid to say there may be a better way for both
mold to make a disposable plastic tube, which would be the reser- you and your patients.
A suggestion to all dentists with an idea for a product or idea:
voir for holding and expelling the composite. This is where you
Don’t quit you day job. During my time trying to build Centrix, I
have to separate the men from the boys. In 1969, the mold cost was
was a full-time dentist and practiced for 40 plus years. Keeping your
$6,000; all the savings I had in the bank. I had no guarantee this
practice doesn’t mean you should forget developing your ideas. It
concept would work. I made the leap of faith and invested to make
means you may have to work at night and weekends. The dentist is
my first syringe with a tube and a plug. The moment of truth came
the only one truly able to improve the techniques and products that
when I first tried the prototypes and the system worked! I had
are and will be necessary. If the dentist does not innovate, the large
solved my problem, but what to do next?
companies will give you good chemistry and large items like digital
To protect myself, I decided to spend more money and file for x-rays, milling machines and other big-ticket items; but it is up to
a patent. To reassure myself that my syringe technique was good and you to make them work and work efficiently in your practice.
I was not blinded by my genius, I gave my other prototype to a fel- Unfortunately, I have found that it is easy to innovate, but very dif-
low dentist I had known since dental school. He liked it. Now what ficult to get the story across to our colleagues. That doesn’t mean
do I do? I was totally convinced that placing composites with a you should be discouraged, it means that you have to believe in your
syringe system was the way to go. ideas and persevere.
We dentists are not taught manufacturing, so I decided to intro- Though it can be a difficult road, there is nothing more reward-
duce Johnson & Johnson to the concept of using a syringe system ing than seeing an idea go from the drawing board to actuality, and
to place composites into cavity preparations. Johnson & Johnson, as finally, become accepted by the profession worldwide. There are
did other large manufactures, refused even to look at my concept. many dentists who have created products dentists use every day. Just
This is a crossroad that any independent inventor must consider: a few of these men are Drs. Bob Ibsen of Den-Mat; Dan Fisher of
Do I invest my own money and form a company? Or, do I just for- Ultradent; Josh Friedman, who started Demetron; as well as Barry
get the whole thing and write off my losses as experience? I decided Musikant and Allan Deutsch of EDS. Some other innovators are
to form a company. I called my company “Centrix,” taking the Drs. Raphael Bowen, who discovered modern composites, and
name from centric relation. I truly believed the idea of syringing Angelo Buonocore, who developed bonding resins and preventive
composites would take off and my fortune was made. (A delusion sealants. There are many more people who should be on the list, but
many inventors have is that a good idea will make you rich over I haven’t the space to name them all. It’s time for you to join this
night. There are exceptions, but it would be like hitting the lottery.) list. Centrix’s motto is “Making Dentistry Easier.” I challenge you
For me, I found my road to success was a long and very hard road. to keep thinking and dreaming, some dreams do come true.
August 2006