Watch on YouTube - Watch on Rumble - Watch on Vimeo

Dr. Steiner’s two main interests are travel and a love of the ocean. Dr. Steiner has circumnavigated the globe, taking two weeks off every three months while practicing periodontics to sail from California across the Pacific Ocean, Indian Ocean, Mediterranean Sea, and finally the Atlantic Ocean. Currently, his interests include sailing, surfing, and outrigger canoe paddling.

Dr. Steiner took a sabbatical from dentistry in 1995 to pursue other interests, which led to research identifying the causative agent for the reduction of the cancer incidence rate found in the Pacific Island Nations. Other research led to the development of a medical treatment for alcoholism, which resulted in the issuance of a US patent. As a result of this work, Dr. Steiner was asked to be co-author of the monologue on Cancer in Africa, published by the National Cancer Institute of France.

Eventually turning his interests back to dentistry, Dr. Steiner founded Steiner Laboratories, one of the few companies currently applying tissue engineering principals to the field of bone regeneration. In 2006, Steiner Laboratories received FDA approval for its line of bone grafts. Today, Steiner Laboratories is active in the development of innovative bone grafting materials and surgical therapies to solve some of dentistry’s most challenging problems. At this time, Dr. Steiner splits his time acting as CEO of Steiner Laboratories in Henderson, Nevada, and practicing periodontics and dental implants at Blue Oak Dental.

Dr. Barrett 01:06 Introduction of Dr. Greg Steiner

Dr. Steiner is a periodontist and has been involved in the development of improved bone grafting since 2006. He heads up a corporation called Steiner bio. And we have a fascinating discussion about bone grafting some of the famous fallacies of categoric bone grafting, we get into bone physiology, and also talk about osteoporosis. I think anybody who has dealt with bone or deals with bone will be interested in this discussion. So please enjoy this conversation that I had with Dr. Gregory Steiner. All right, I'm here with Dr. Greg Steiner. And I first was introduced to his work when he gave a lecture back at in May of 2023, for Dr. Shallenberger ozone therapy conference, and I was tremendously impressed with what you presented there and I'm anxious to talk about bone grafting, it's something that I think our audience will have a great interest.

Dr. Steiner 02:23

Well, thank you very much for inviting me, it's a pleasure to be here. I'm always willing and eager to share anything I can share with you and your community. As far as the one thing I know about, which is bone and bone grafting.

Dr. Barrett 02:36

Let's talk about your journey into the bone grafting world and and why you were compelled and ultimately to develop this level of expertise in bone grafting.

Dr. Steiner 02:49

Well, basically, my training is in dentistry, dental school. Then I went into Periodontics, after dental school specialty training, and I love my profession, I just couldn't get enough of it. I love doing it. I love studying it. I love treating patients. But the problem I had is that as the years wore on, I realized that there weren't any improvements in the therapy that I was providing my patients there was, there were no advancements in the type of things that we were doing. And I was sitting there simply regurgitating the same things that I learned in school, and there was nothing new on the horizon. And that I dealt with that for about five years in practice and thought that well, maybe I was just so well trained that I already knew everything that was coming out. And after about another five years, I realized there's never going to be anything new. I was going to spend the rest of my career saying the same things and doing the exact same therapy. And I just could not do that. So, I quit. And I didn't want to do that I didn't want to throw away, you know, all these years of education. And I didn't actually have anything to directly fall back on. But I knew I would just be an extremely unhappy clinician hating my job if I never saw improvement in the type of things that I was doing and never saw change. And so, I quit, moved, moved the family to Hawaii, and started looking around for what else I wanted to do with my life. And actually got into doing some epidemiology and cancer research and had some interesting findings there. In fact, if anybody's interested, I would encourage them to look at the research that's been done on a product called kava, it's an actually root and it's been found to greatly reduce cancer rates in the South Pacific Islands. And so, I did work in that area published the paper and then I got a call from a colleague that was disabled, and he needed somebody to keep his practice alive. And till he could sell it, right? And I told him, Okay, I'll do that, I'll help you. I'll keep your practice alive, so you can sell it. So, I went back and reviewed all the research that was done in those five years to make sure I was current. And what I found is exactly the same thing I knew what I would find is there was nothing new. And when I went back to start treating patients, again, I just decided that nobody's coming up with anything new, so it's gonna have to be me. So, I went back, and I started developing new techniques, looking at the products that were out there seeing the shortcomings. That's how I got into developing bone grafts. And that's why I'm here today is because what was being used at the time simply wasn't working, and wasn't acceptable. And I wanted to make something that was acceptable in my hands for treating my patients. And that's why Steiner bio came into existence.

Dr. Barrett 06:06 What was primarily the failure of cadaver bone grafts?

Dr. Steiner 06:12 Nothing that dentists are taught today about cadaver bone grafts is true.

And you might think that's stunning. But it is stunning. And it is stunning that they're simply told what they're supposed to believe. And they're totally, and it's told so many times, and so many of them believe it, they actually accept it as factual, but it's all wrong. And it's all actually inaccurate. And it was the fact that I was actually using cadaver bone grafts, you know, 20 years ago before I started this, and I just looked at it, and I said, this is really a terrible bone graft. And I don't like what it's doing. And so not only did I decide to produce a different type of bone graft that actually was science based and, and creating a laboratory, but I also looked at what the problems were with the other types of bone grafts on the market, mainly cadaver bone grafts.  I've done a lot of research on how they work in the body, what they do to the body, what damage they do to the body. And basically, look at it this way, if you have a kidney or a liver transplant, there is meticulous effort put into making sure that that's a good match from the donor to the host. And it's the responsibility of the transplant team to make sure that that match is going to be successful. Well, in a in a bone graft, or you're using a cadaver bone graft, there's no matching, there's no effort to see if the bone graft is going to work or how it's going to react. And so consequently, the results are extremely poor, because there's not even any effort to make any match. Even if they did match it, the results would be the same, the bone graft would produce a scar type of tissue, and it would never turn into normal bone. And so basically, that type of information was the knowledge that we developed over time. And needless to say, it was not well received by the profession, when I was starting to talk about this. But I had the advantage of the fact that 20 years ago, I started doing nothing but studying bone and bone grafts full time, I would work part time few days a month, pay the bills, but all I did was study bone and bone grass. And the problem in in dentistry is that a dentist never even gets the lecture on bone. Okay, they never have anybody talking to them about what bone is. And so it's just the void of misinformation. And dentists get very little information on bone and bone and virtually none on bone grafts. And when I had dedicated my life to studying this, the information I was finding was not well recieved at all. And you know, when I started telling people about what my findings were 15 years ago, oh, they'd be furious. They would cuss at me, they would tell me I have no right to say these things. I was danger to the profession. That was 15 years ago. 10 years ago, they went quiet. Now they're turning to me because they're realizing that what I've been saying all along, yeah, is becoming factual. So, there's been a that switch. So, when you talk about going up against academia, and the established norms that are in academia, the problem is, is that if you are in a certain area of academia, whatever your specialty is, it could be periodontics. It could be podiatry. They all believe the same thing. They all teach the same things, right? They don't accept anything outside that norm. Because they all know the answers. Right? Right. And when you go against the norm, it's not well received.

Dr. Barrett 10:16 No, I know that for a fact myself.

Dr. Steiner 10:41

It's absolutely stunning. And it's an unusual thing, because in the United States, cadaver bone grafts is the only bone graft that's taught in all of the universities, there is nothing else taught. That's not the truth. In Europe, in Europe, there's a lot of hesitancy for the population to use cadaver bone grafts. So, they're not, they're not the 100% answer. And there's a variety of bone grafts and they're very open to different types of bone grafts. In Asia, many of those Asian cultures absolutely refuse to have cadaver bone graft put in their body. So, it's only the United States that has this monolithic concept of what a bone graft should be for their patients. But that's where I, that's where I am. And so that's, that's what I have to deal with. But basically, what a dentist is taught when they're in, in any type of level of training, whether it's a regular dentist, or they're in specialty training, but periodontics or oral surgery, they're simply taught, you use it, you use a human tissue, use cadaver bone grafts, you take the cadaver bone graft, you put it in your patient, it stimulates bone to grow. And as it's stimulating bone to grow, the bone fills in the area that you want it to fill in, it turns into nice, healthy, vital bone. And then the body resolves it all and it all goes away and you're left with nothing but normal, healthy, vital bone. And everything I told you, is completely wrong. And there is not one published paper that supports anything I just told you. But that's the entire profession believes. And when you when you review the science with them, you sit down and say, Okay, let's go over these issues. And let's study each one of them one by one, you share with me the science that supports your position, I'll share you the science that supports mine. Well, they're up against a wall because they got nothing to support it, and they get angry, and then they won't talk to you anymore. I've been through it many times.

Dr. Barrett 12:47 When someone doesn't have an answer to you know, a very strongly proffered question based on science, then they just have to attack the messenger

Dr. Steiner 13:02 It's just routine and I'm accustomed to it.

Dr. Barrett 13:05

It's almost reflexive. It's almost like, there's no thought whatsoever. It's just a reflex. It just, you know, but I think this would be pretty hard to argue if you have the actual histology slides there that you showed in your lecture when I was in the audience. It's kind of hard to argue with real histology, isn't it?

Dr. Steiner 13:28

You know, there's a concept. And basically, you probably heard of this concept. That's called a paradigm. Right? Right. Okay, so something so cadaver among grafts in the United States is the paradigm. That's what everybody teaches and believes, right? Okay. Well, a very smart man. And I may have brought this up in my lecture. A physicist by Max Planck, and most anybody who studied science knows that Max Planck is one of the most brilliant men that ever lived. And what he said is that if you are interested in changing people's minds, by reasoning with them, and showing them that they are not correct, and what they believe is not accurate. You will never accomplish it, and you simply have to wait for them to die for a new generation to come along. Yeah. Which is, you know, and when I read that quote, and he's talking about a paradigm, which I'm dealing with in dentistry, it's the actual truth, they won't accept the science that's in front of them. And, you know, it's human nature. It's not that they're bad people. None of these people are bad. They're all really good people. But they've been taught and, and everybody believes the same thing. And when they're challenged, they just cannot accept it. They're wrong.  But the thing is, though, like I showed you, I showed you the histology and the science. And you may have known that I actually criticize a lot of the research. It's out there because it's so blatantly biased. And, and I point out the deficiencies in it. And it is having a serious and significant effect. That letter that I sent to the new editor that you mentioned a while ago, of the Journal of Periodontology. Well, she just took over a couple of months ago. Okay. And the recent issue of that journal has been completely revised, according to the recommendations that I made to her.

Dr. Barrett 15:39

I know, evidence based medicine is a term that is fraught with difficulty in and of itself, a lot of times, that's a fence to keep an insurance company from pain, the provider, the clinician, because it's not evidence based. But when you look at some of the evidence based, real evidence-based stuff, our histology, our objective findings, not subjective findings, and that, I would think, with bone grafting, it's pretty hard to argue with a, you know, a histology slide.

Dr. Steiner 16:33

You have to look at it this way. Like I told you, dentists get no training in bone, okay? And, and you know, your podiatrist, you spend a lot more time with bone, the dentist, by far. But when I showed dentist histology, it may be the first time they've ever looked at a picture of bone. And they don't know they're taking my word for it, which they may or may not want to so. So, it's a field that is really, you know, you really have to have a deep amount of education to be able to look at that slide and understanding what you're looking at. And because it is a very complicated thing, and in my mind, I don't know you're in podiatry, you deal with bones all the time. But people think of bone is that's sort of a simple thing. You know, it's just a hard object, right? I think I think bone is probably the most complex organ in the whole human body. You think of all that it does, you think not only does it support us, make gives us form. Not only does that it supplies, all of our immune system, it supplies all of our blood cells, right? This is one of the most complicated organs in the entire body. And because of that, you just can't simply can't take a weekend course and really understand what you're dealing with. And it doesn't give you the depth of understanding. But you know, there are a lot of people in my profession and in all professions that are that are dedicated to understanding what's happening. And we have seen a big change in our profession, because our profession is is is definitely moving away from cadaver and into science-based bone grafting, and it's in. And the reason I know that firsthand, is because we see it on how it affects our sales because we're, we're seeing the change. And we've been working at it a long time. And it's finally getting to that point.

Dr. Barrett 18:35

The same paradigm exists in orthopedics and podiatry—that you know, bone is this pseudo inanimate tissue that you can cut it, screw it, move it, play with it, whatever you want to do, and it's all going to be good. You know. And that is so far from the truth that, you know, but it's almost like this just keeps getting perpetuated from year after year after year in the training. And what one of the first times I realized the nuances of bone was when I crossed paths with a guy named Wolfgang Schaden. I don't know if you've ever heard of him, but he was very big in using extracorporeal shock wave therapy to treat non-unions of the tibia. And they would shock the contralateral leg and show healing. And, I mean, this guy was such an expert in bone, he could tell you the interosseous pressure of all the different bones in the entire body. I mean, he was really into it and I'm thinking, wow, this guy has dedicated his life to this stuff that we just screw it, play with, move it, etc. You don't even have any conceptualization of how complex it really is. But like you talk about it, the immune system in and of itself is a whole different thing. You know, I mean, what happens if you kill all the marrow in a patient? They don't live very long.

Dr. Steiner 20:05

All the immune system is all based in our in our bones. And it's one of the things I love about studying it, because I know I will spend the rest of my life studying something that I'll never fully understand. And that's the good part of it.

Dr. Barrett 20:22

Well, the more you study, the more you'll know that there's that much more you don't understand it in the true Yeah, right. I mean, I feel like that same way I specialize in peripheral nerve. And the more I study, the more I get humbled. And we almost get to a point where there's just so much you realize that you don't know it's almost paralyzing. In a way I guess it kind of goes to that paralysis by analysis thing, you know, sometimes, you know, but I think that's what happens. So, what's going on with cadaver bone, I mean, you make the point that it doesn't really create the bone that it's perceived to create it ends up as sclerotic bone tissues have difficult times growing over it. Give me some more insight on that.

Dr. Steiner 21:08

Well, what's interesting is that you understand it very well, I wish my audience is what I'll be picking up on it like you are. But the interesting thing is, is there's a difference between what dentistry does with bone grafts and what orthopedics does with bone grafts. Because when orthopedic medicine in my experience, and from what I see when they place a cadaver bone graft, they're basically using it as a filler, it's filling in defect, but it's not designed to be the structural support, right. And it's mainly just to fill a hole and let the bone heal around it. And that's all well and good. But in dentistry, it's a very big, very big difference, because what happens in dentistry is that you'll take out a tooth, you'll put in a cadaver bone graft, and then you put an implant in that site. And all of a sudden, is not just a filler, it's actually providing support, and it has to handle load. And when you put load on the cadaver bone graft, that's when it fails, right? So, basically, in orthopedic medicine, they don't rely upon simple cadaver bone grafts to support the your leg, they're going to put braces and bars and struts like that, and they might pack a little cadaver bone wrapped around it. There's a big difference in dentistry, the cadaver bone grafts fail a lot more frequently, because they're relied upon to support the load of the dental implant. And so that's a difference. But there's also another interesting thing is that, believe it or not, bone grafting and bone regeneration is more advanced in the dental field than it is in the orthopedic field. I don't doubt that at all. Oh, explain to you why that is? Yes, please do well, for instance, when you do a search on orthopedic surgical procedure, and no matter where it is in the body, and you put a bone graft in there, well, you can't go open that patient up to look at it and analyze it and see what it's doing. That's a human being, you can't do that, right? That's harmful? Well, in my situation, I will take out a tooth, I'll put my bone graft in the extraction socket, I'll let it heal, and then I'm going to put an implant in there. But I'm opening the tissue, I'm taking a core sample, I'm analyzing every single bone graft that I do. So, I can do constant research on all the samples that I get out of human beings that orthopedics can't do. So, a lot of the bone graft surgery and a lot of the bone graft understanding is actually happening in dentistry simply because we have the availability to harvest our grafting sites.

Dr. Barrett 23:56

Well, you know, and one of the things I don't know if you mentioned this at your lecture, or I picked it up from another lecture, but I thought I really had never thought about it in this in this realm is that, you know, we have like when we do something with a bone you made the the, the great point that we close it up, we have a soft tissue envelope, except when we use maybe an external fixator or you know, a percutaneous pin or something like that. But in the jaw, or in you know, both the mandible and maxilla. The bone is essentially exposed with this percutaneous thing called a tooth that it's not sequestered away, and it's kind of amazing, really, that we have this this oral microbiome, and we have this it's not a sealed container from where the tooth is going into the bone. Whether or not at

Dr. Steiner 24:58

As far as bacteria and infection and all that stuff, you know, back in the day, many people sort of poopoo the concept that you know, something in one part of the body could affect the other part of the body. That doesn't make any sense. But there's the as you know, I'm sure you fully understand, we're all connected, and anything that's going on in one part of the body can easily affect some other part of the body. And in dentistry, you know, the bacteria that's present in the mouth and in and around disease teeth, does gain access into the rest of the body. And for instance, in orthopedics, a very big thing most orthopedic surgeons are going to do any significantly invasive orthopedic surgery will require that their patients go see their dentist and get the dental disease taken care of, because they don't want a tooth extracted a month after they've done their orthopedic surgery, and that bacteria winds up in their surgical site. Exact so yeah, I mean, we're all connected. And it's very critical that, you know, we maintain the health of our entire body, because it affects everything else.

Dr. Barrett 26:06

Now, when you were putting in bone for Periodontics, you were putting in the cadaver grafts? Was it more susceptible to developing an osteomyelitis or didn't see that or why isn't there? I guess the question would be, how often is there a development of an infection in the bone graft you place it.

Dr. Steiner 28:08

Well, it's that's a very interesting question. Now. In normal instances, infections in the jaw, never almost never. I've never seen one, put it that way. Never developed into osteomyelitis, the infection and we're talking swelling, draining pus, horrible infections. Wow. Where if those infections were anyplace else in the skeleton, the patient would be an ICU struggling to live. But the mouth is unique. In fact, even the structure of the maxilla and the mandible. They're different from the rest of the skeleton in the maxim of the mandible. We don't have marrow, there's no bone marrow in the jaws, even though dentists believe there is but there's none. There's actually something called stroma which is has no bone, blood producing cells in it at all. It's a very simple tissue. And I believe the jaws are different from the rest of the body. Because I believe that's what allows it to sort of compartmentalize the infections that are constantly present in people's mouths. You know, people have tremendous infections, but they don't spread throughout the body. They don't they don't develop into osteomyelitis, they're, they're compartmentalized. Because I think that's how the jaws have evolved. They they've evolved this ability to handle these infections without it. Because you think before modern medicine, you know, everybody had teeth problem, everybody was losing teeth. And if every one of those persons developed osteomyelitis of the jaw, they'd be dead. Right? And because there's no way to back in the day, how to treat it and so the body developed his own mechanisms for dealing with oral infections that are somewhat different from the rest of the body.

Dr. Barrett 29:53

Yeah, because you would think, you know, you have this incredible pot of different bacteria swimming around what you put in there, it's not like you can put a, an antiseptic dressing over that spot. While it you know what I mean? It's still exposed?

Dr. Steiner 30:13

Well, that's one of my biggest complaints of dentistry. Because in medicine, and this is how I that's how I talk to my patients, I say in medicine, you know, even the most minor wound, even the simplest procedure that is done to you, your medical health professionals, again, I clean it, close it and dress it. There never let me walk out with an open wound. But in dentistry, what did dentists do, they take these pliers, and they grab that tooth, and they put tremendous force on that tooth, they pull it out of the body. And here we got this big, huge gaping wound in the jaw that the patient walks out the door with, right. And it blows my mind. Because terrible things have the jaw collapses, you get dry sockets, you got bacteria everywhere, and dentists don't think anything of it. And so, it's one of my biggest pushes is that if you have a tooth extraction, and you want to protect your health and your job, you need to do what medicine does, you need to clean it, close it and dress it so that wound is protected when you walk out the door. And one of the things that we use is we close it with a bone graft and recover it with a membrane similar to a bandage. But I believe strongly that anybody that's at all interested in good health should never have a tooth extracted, and walk out the door with some big gaping wound in their jaw. And that's one of my main complaints about dentistry is that it's barbaric in that respect.

Dr. Barrett 31:47

Now, what about topical ozone?

Dr. Steiner 31:57

It's used afterwards after the tooth is removed. It's usually applied to the area to try to control any residual infection that might be left behind. And it is it's also a problem in dentistry. Because you know, the I don't know you know much about it. But there's some legal issues with the application of ozone. And many of the early users of ozone had significant problems because other dentists are saying you shouldn't be doing this to patients without justification. And the use of ozone is becoming much more common for the treatment of residual infections.

Dr. Barrett 32:41

Well ozone, it's pretty commonly used in Europe on the day to day, but it's still kind of frowned upon here in the United States. But that's another discussion. So aside from the cadaver bone graft, just not incorporating in the jaw, and then subsequently holding the implant. Did you see any changes as far as rate of healing as you morphed into the more modern bone graft that we're going to talk about in a little bit?

Dr. Steiner 33:11

Can you repeat that again?

Dr.  Barrett 33:14

So basically, what I'm saying is that we've already declared or you've already declared that the cadaveric bone graft doesn't really incorporate it becomes a scaffold, it's sclerotic, it doesn't adjust from a histological standpoint, like you would ideally want it so that your implant would hold and, and handle those load forces that you were talking about. I guess my, my point was, from a healing standpoint, was there a difference in your bone graft as far as how long after you grafted it until you could put the implant into it? versus the old technology?

Dr. Steiner 33:58

Oh, yes, there's a tremendous difference. First off, nothing should be put in bone that doesn't completely goes away. You should never use any type of bone graft that leaves behind any residual material, because that's not real bone anymore, right? I mean, if there's stuff stuck in it, right, it's not going to be normal bone, and it's pretty much all going to be sclerotic. Even if you use a synthetic bone graft that is non resorbable, and doesn't go away, it isn't taken away by the body that is not normal, healthy, vital bone and you're going to have problems with it. Now, it may not be pathologic. So, you know, it may just be very dense and it may not support your implant well, but it's only the cadaver bone grafts that actually produce pathologic tissue, that's called sclerotic bone. That that is the biggest problem. So, it's the inflammatory that cadaver bone grafts warmth as a result of this tremendous inflammation that they create, and the mineralization Well, let me like an explain it to you really simple. If you cut yourself and the wound is slow to heal, you'll get a scar. Well, what is that scar, its just dense collagen is all it is the scar is going to be there forever, it's never going to go away. And it's never going to change. Well, the same exact thing happens inside the bone because the cadaver bone graft creates an inflammatory process. And it's the inflammation that produces this dense collagen in that scar that you had. So, it produces a dense collagen bit because it's in the bone and mineralizes. So, you basically have an area of scar tissue that is mineralized in bone, where it's just normal collagen on your skin. And the only time you ever get scar tissue formation is when you don't transition from a knee initial insult, you need to go from acute inflammation, which is the initial insult to regeneration. If you ever go from if you ever have a wound that goes from acute inflammation to chronic inflammation, you're gonna get a scar. So, you need to avoid the chronic inflammation in order to have proper healing.

Dr. Barrett 36:36 Mohs Surgery

Dr. Steiner 36:38

Yeah, right. I am amazed because those people can cut out a big part of your face and not leave a mark. Yeah, and the reason they do that is because they're so fine with their incisions, that they that the wound immediately goes from the acute trauma to regeneration, and no scar tissue. It's an amazing, I'm amazed at those guys, because I know myself, I've had a number of them. And I might look scarred, but it's actually hard to see from the most that I've had done. And if you avoid chronic inflammation, you'll avoid scarring. That's how simple it is. And, and various bone grafts that caught that cause chronic inflammation. They're never going to produce normal tissue.

Dr. Barrett 37:25

What is the complication rate with cadaveric bone for the periodontic? Implants? What's the what's the, for lack of a better term than non-union rate or when that that post or the implant just doesn't? You know, it just doesn't. snug in there like it's supposed to?

Dr. Steiner 37:55

Unknown.

Dr. Barrett 37:57

What's your gut instinct?

Dr. Steiner 38:00

Oh, I know, it's a much higher failure rate? Well, there's a couple of things. There was a couple of studies that are out on short term implant failure. What? And these studies I probably mentioned it, and these days are very well-done studies because huge health care institutions are constantly doing statistical analysis on what works and what doesn't. Right, you know, Mayo Clinic, Kaiser, they all have a bevy of statisticians, because they want to know, the cheapest way and the best way to do the treatment. And they do statistical analysis on everything. Well, it just so happens in two big major institutions. Mayo Clinic being one of them, they did that for dental implant placement. They looked at what works and what doesn't. And I mean, when they look at it, they look at, you know, what was the room temperature when it was placed? How much experience did this I mean, every variable that you can imagine they look at, and they only found one thing that resulted in early implant loss, which is in the first year, there was only one thing that statistically resulted in that and that was putting an implant in a site grafted with the cadaver bone graft. Nothing else caused it. Okay. But we go from that, and we go sick, but then you say, Well, what about long-term effects? What are the long-term effects of putting an implant in a site grafted with a cadaver bone graft? Now, I might tell you, that procedure is done 1000s of times a day in the United States. Its what people do. When they take out a tooth, they put in a cadaver bone graft, and it's done in dental offices across the United States a few 1000 times a day at least. And the long-term success rate has never been studied. Interesting, okay. We have no scientific basis for it. Personally, I believe it's been done, but they didn't like the results and they didn't publish it. That's my personal opinion. But for our profession, to talk all the time about science based dentistry or evidence based dentistry, and then do this procedure that they have no statistical support for, and no science to back it up is ridiculous. And they shouldn't be doing it with no science base for doing it. And I do believe when those studies, I know they've been done, they just haven't been published. But when they are published, then we're going to find the real effects of it. And I could go into a great amount of detail that would bore your audience to death. But basically, to be honest with you, for cadaver bone grafts. Those studies have not been done for synthetics, they have been done. They've been done. And for our products ourselves. What we did is we did a study, it was a three-year study we put in, we took out the tooth we put in the bone graft, we put in the implant, once the crown went on the tooth when it was in function. We followed 100 people for three years, and we had 100% success that's published. That doesn't exist for cadaver bone grafts. It does exist for ours. There's a couple other synthetics that have published research also. But yes, there is science-based evidence for some bone grafts but not cadaver bone grafts.

Dr. Barrett 41:15

That's excellent. So, let's go into what you guys are doing the difference between your grafts and now that we've relegated cadaver to the you know, the persona non grata of bone grafting. Let's talk about what you've done and your innovations.

Dr. Steiner 41:32

When I first looked at bone grafts as a problem, I realized that number one, I didn't like the way the bone looked, I just thought this is not normal. And, and at that time, I was just as ignorant as everybody else that never had any bone education. And I just said, this doesn't look normal, and I don't like it. I'm just going to try to develop a bone graft that produces normal bone. So, the goals were two things. One, I wanted a bone graft that stimulated the formation of bone, so it healed quicker and better. And I wanted something that totally disappeared and removed from the body, that there's nothing residual nothing should ever be residual in a patient's body that you don't have to have there. I mean, if you've got a piece of metal that's holding your body apart, together, that has to be there, but there shouldn't be anything else there that can cause problems down the road. So those two are to go goals. And that's what we accomplished. And we're basically the only bone graft on the market, that we're allowed to claim that we actually stimulate bone formation. And that's in both medicine and dentistry. And we were the only bone graft that actually is a bone grafts at the FDA are defined as a device, like you use a metal plate. The FDA says this is a device, a bone graft, they, they define it as a device, because devices typically don't have fidget physiologic effects there, there to solve the problem. pacemaker what happened. But then you have the pharmaceutical division, which is for the drugs, but our bone graft contains a drug. And it's that drug that stimulates the formation of bone. And we're the only one on the market that has that type of graft.

Stephen Barrett  43:18

Ard you're able to share that what is the drug that you combine it with? And how what's give us a little insight into the physiology of that if you could?

Dr. Steiner 43:28

Well, it is a small chain organic compound, okay, and it is already in the body. All right. And there is not one thing in our bone graft that isn't already present in our patients. And that's why we can easily say you can't have an allergic reaction, you can't have an adverse event because everything's already there. And what we found is this molecule is critical for bone formation. With without this molecule, bone will not form. Okay. And the problem, the thing that we found is that in a wound in bone, when there's the physiologic process of what's going on in the bone, doesn't allow this molecule to get to the site. Okay, okay. So that's why bone grafts are never that fully successful, because they run out of this molecule, they, they're done. And they can't form any more bone because they don't have this molecule. So, our innovation in our patent is to because of that discovery, and of that molecule, we put it in our bone grafts, so it never runs out of it. And in essence, the cells never run out of gas, so to speak, so they continue to form bone and that's, and that's how our bow wrap works. And that's why, you know, people think of drugs as a problem with a lot of complications. Yeah, they are, but not if it's natural to the body.

Dr. Barrett 44:55

So the graft that you all have, is it in a flowable form? Or is it kind of a matrix? How is that?

Dr. Steiner 45:13

Well, yeah, the graph that actually stimulates the bone formation is it sort of mostly like a putty, okay, because a putty you can form shape and put it into place, and it will stay put. So that's the one that stimulates the bone growth. And you asked earlier about, you know, what's the difference between your bone grafts and how long it takes to put an implant in and how fast it grows and all that stuff? Well, traditionally, in the past, you take out a tooth, you put in a cadaver bone graft, and maybe three to six, eight months later, you put in your implant, and then maybe four or five months later that you put on a crown. So, you're, you're looking at six months to a year before you get a tooth to chew with, well, with our bone graft, because we stimulate bone formation, we put an implant in one month after the tooth is extracted, wow. And in essence, what we're doing with that is that because our, our bone graft stimulates bone formation, we put the implant in while the socket is healing. Okay, everybody else puts the implant in after the socket has fully mineralized with bone. And nobody's come up with the concept of maybe I should put it in earlier because that's when the cells are rapidly growing, that's when the bone is forming. And so that's why we have what we call a one-month early implant placement, because that's the time when the bone is growing the fastest. And those are the cells that attached to the implant. So, the same cells that make the bone are the same cells that bonded the implant. And so put your implant in, when you got the majority of those cells are active, because once bone fully formed, those cells go to sleep, and you gotta jar them awake if you want them to get active again. So, our early implant is one of the biggest innovations.

Dr. Barrett 46:56

So that reminds me of Wolff's law, that bones react to the stresses that are put upon them, for lack of a better way to put it. Is there some play because you're able to implant this quicker? While it is still, you know, going through its, let's call it a consolidation or whatever you want to call it? Is there some benefit to having actually some stress put on that, that to that, that accelerates it?

Dr. Steiner 47:27

Actually, it's opposite, you can't put load on it during that time. Because, because if the implant isn't stable, right, there's any movement, the cells won't bond to it, okay? It's like, it's like, you break a bone, well, you put it in a cast, because you need to stabilize it for it to die. Same thing with an implant, okay? So, we have to, we put it in and we sort of isolated from the body, we don't put a crown on it at that point in time, we let it heal for a while.

Dr. Barrett 47:54

I was wondering how you did that. But then I was also wondering if in the, in the normal regenerative process sometimes, I mean, with tendon for example, we know that when we repair attended, we don't really want to put much stress or, or tension on that repair for the first 28 days. But that day 28, we want to start putting a little bit of tension on that, because that actually helps the tendon repair itself, it's kind of a, you know, the physiological response to the physical stress.

Dr. Steiner 48:22

There is definitely some of that going on. But you have to wait a time period, like your 28 days, that's a pretty good time period. Because what we do with when we put these early implants, and we wait six weeks, for before we started the crown process, but and the thing is in the bone will form, but it won't form mature bone, it forms immature bone, when it's just growing on it doesn't have any load. In order for them mature bone to form, you have to put load on it because the body reacts to that load and reorganize itself. And so yes, you do want it loaded. But you do have to wait long enough for the implant to be stable.

Dr. Barrett 49:04

Thank you for getting me straight on that. So, you've mentioned something wonderful before we came on air about osteoporosis. What? Give me some a little bit of a primer on that. And what you guys are looking at from an osteoporotic standpoint?

Dr. Steiner 49:23

Osteoporosis is a huge disease. I mean, it is, I mean, there, there are a lot of people that actually break bones by walking, normal daily activities, and it's and you see it probably more than I do, because I'm a dentist, people don't come to me with broken jaws because of osteoporosis, but I mean, so it's a dramatic, significant disease. But the interesting thing about osteoporosis, it's not really a disease. There's nothing wrong with a person's bones that has even severe osteoporosis. The only problem that exists is that A bone has been removed faster than it's been built. Right. So, in bone, you know, there's two processes, there's a process of growing bone and removing bone. And for instance, if you go to the gym, and you start lifting weights, you're going to have bone removed, and that bone is going to be replaced in order for your bone to carry a heavy load. So, this process of formation and removal is constant in our bodies, it goes on all the time, right? And osteoporosis, the only thing that's goes on is that the removal process is more predominant than the formation process. So over time, bone gets weaker and weaker and weaker, but there's nothing wrong with it, I can go in there and I can take an osteo product bone and regenerate that bone perfectly fine. Because I'm giving that bone it needs to regenerate. And that's what we're doing with osteoporosis. And it's mainly focused on hips and joints like that, because the biggest problem in osteoporosis is hip fracture. And people will fracture their hips with for no reason. Or if they fall, they're elderly, if they fall. And what we're doing is we're doing more of a preventive type of therapy, where we simply give a patient a little local anesthetic, and we just inject our bone graft into that hip and we regenerate that bone back to normal, because we're stimulating bone formation. And our bone graft is the only bone graft that that actually stimulates bone formation so we can regenerate bones and prevent osteoporosis fractures.

Dr. Barrett 51:40

I've got to talk to you about when we finish up recording, I got to talk to you about a patient that's a very interesting patient from an osteoporosis standpoint, but I got to kind of wrap up, how do we, how do we get the audience to contact your company and look at some of the I mean, I know, I've been to your website, you've got a really nice videos there, that type of thing. You want to tell, tell the folks how to get a hold of you. And? Well, it's very simple, you know, the one thing is, is just like in your field, everybody has feet, and everybody has teeth, and everybody's gonna have to deal with dental problems at some point in time in their life. And people really need to educate themselves, because you know, you're going into a person's office, and it's just, you know, as well as I, and some people really know what they're doing, and some people are gonna get you in trouble. And the best thing that a patient can do for itself is educate themselves, because they can actually educate themselves sometimes better, because they don't walk in with any bias. A patient that is listening to what you're telling them is taking your information and analyzing it, they don't come in with a set of knowledge. And they're able to sort of weigh the pros and cons of what makes sense to them. And they oftentimes come with a better result because they don't walk in with a preconceived educational bias. And what we have on our website, is we have a section for patients, because we get calls all the time. Doctor, I'm in this town, I want your product used in my mouth, who uses your product in our area, because they've gone to the website, they looked at what there is available, and they say, I want you I want this in my mouth. So, at Steiner bio, all you have to do is type in Steinerbio into Google, it'll take you to the website. And the first thing you'll see is there's a section for professionals and there's a section for for patients, they can get all the information they need on what's the best thing for taking care of their particular problem. Fantastic. Dr. Steiner, thank you so much. I could come back and you know, have you probably on another 10 hours just talking about bone physiology, because I find it so fascinating. You know, this tissue that we once thought was just basically a rock that we could cut and move and glue back together. But I appreciate it so much. I think the audience will find this incredibly useful. And thank you for taking the time today.