Having received my dental education at Boston University Goldman School of Dentistry in the early 1980’s from some of the finest academicians and clinicians, the foundation of my periodontal specialty training centered around a comprehensive treatment planning approach which I continue to employ every day in clinical practice.
Along with disease elimination and control of the etiologic factors, attainment of the classic “periodontal prosthesis” was the mainstay and goal of treatment for the most challenging cases. With the advent of predictable bone regeneration and osseointegration of dental implants, contemporary treatment plans no longer include the more “heroic” aspects of the classic approach such as hemisections and root resections.
Yet, many of our patients whom were treated with the classic periodontal prosthesis protocol still enjoy successful outcomes today, decades later. Check out an interesting case report by Dr. Myron Nevins and Dr. David Kim to be published in the Journal of Periodontology. The treatment approach and outcome from 1969 is compared to a hypothetical approach in 2009 based upon contemporary options. Kudos to the authors for this perspective and their continued contributions to the dental profession.
Facebook, the world’s premier social network for the general public, turned six the other day. The growth has been astounding with over 400 million registered members. If Facebook were a country, it would have the third largest population in the world behind China and India!
WebDental continues to grow at a steady pace as members of the dental profession embrace technology and the benefits of social networking, community and media. Check out the amazing growth of Facebook on a video from CNN.
I am currently attending the Yankee Dental Congress in Boston. Many of my dental colleagues have expressed disappointment with other dental social networks because members can oftentimes become a bit “unruly” with their comments and blog posts. It is truly exhilarating to be a part of a community that is dedicated to professionalism and integrity as members share and communicate their ideas.
Plasma jets could offer a painless alternative to dentists’ drills, according to German researchers. The study is in the February issue of the Journal of Medical Microbiology.
Plasmas are known as the fourth state of matter after solids, liquids and gases and have an increasing number of technical and medical applications. Plasmas are common everywhere in the cosmos, and are produced when high-energy processes strip atoms of one or more of their electrons. This forms high-temperature reactive oxygen species that are capable of destroying microbes. These hot plasmas are already used to disinfect surgical instruments.
Researchers found that firing low temperature plasma beams at dentin — the fibrous tooth structure beneath the enamel coating — reduced the amount of dental bacteria by up to 10,000-fold. The results suggest that plasma jets could be used to remove infected tissue in tooth cavities, a procedure that currently requires a drill.
For the study, the researchers infected dentin from extracted human molars with four strains of bacteria and then exposed the dentin to plasma jets for 6, 12 or 18 seconds. The amount of bacteria that was eliminated increased the longer the dentin was exposed to the plasma jets.
Dr Stefan Rupf from Saarland University who led the research said that the recent development of cold plasmas that have temperatures of around 40 degrees Celsius showed great promise for use in dentistry. “The low temperature means they can kill the microbes while preserving the tooth. The dental pulp at the centre of the tooth, underneath the dentin, is linked to the blood supply and nerves and heat damage to it must be avoided at all costs.
Once again, a new technology in dentistry seems promising and exciting! Comments?
More information: Science Daily; Journal of Medical Microbiology
Photo: Applied Plasma Technology Institute/Old Dominion University
Hats off to Henry Schein. In response to the devastating earthquake in Haiti, Henry Schein, Inc. (Nasdaq: HSIC), the largest provider of health care products and services to office-based dental, medical and animal health practitioners, and its supplier partners have earmarked $1 million in life-saving medical supplies to partner non-governmental organizations (NGOs) that are providing relief. Within hours of the reports of the earthquake, pallets of much needed supplies were prepared for shipment to partner NGOs, including AmeriCares, Direct Relief International, Heart to Heart International, International Medical Corps, LDS Charities and Medshare through Henry Schein Cares, the Company’s global social responsibility program. As part of Henry Schein Cares disaster preparedness efforts, the Company already had pallets of essential supplies packed and on site at the warehouses of several partner NGOs to ensure immediate response to humanitarian emergencies.
One of our members brought the following story from the BBC to my attention. Scientists in Italy have developed a way of turning rattan wood into bone that is almost identical to the human tissue. The team is lead by Dr Anna Tampieri. “It’s proving very promising” she says. “This new bone material is strong, so it can take heavy loads that bodies will put on it. “It is also durable, so, unlike existing bone substitutes, it won’t need replacing”.
In our periodontal and implant practice, we have been using bone grafts for decades to restore normal physiologic bony parameters around teeth, as well as to facilitate ideal dental implant placement and restoration. In our experience, the synthetic graft materials, although successful, have yielded results that are less desirable than the outcomes achieved with autografts, allografts, and xenografts. However, this is very interesting and promising. Time will tell if it will truly be a viable bone graft material. Check it out.
With the emergence and growth of CAD/CAM dentistry and fabrication of simple in-office dental restorations, one might regard this as a threat to the dental laboratory technician. However, the experience, expertise, knowledge, and guidance provided by the dental lab technician are critical for successful outcomes for our patients, especially for larger, more sophisticated cases. The lab technician remains a vital member of the dental team from the initial diagnosis to the delivery of the final restoration, as well as during long term maintenance. The importance of this relationship is elaborated upon in an article by Lee Culp, CDT & Lida Swann, DDS. Comments?
Photo: E4D
It seems as though we are learning more about the relationship between periodontal disease and Diabetes every day. Information about the link between the two continues to grow as new scientific literature is published.
A recent study led by Dr. Sheila Strauss, Associate Professor of Nursing and Co-Director of the Statistics and Data Management Core for NYU’s Colleges of Dentistry and Nursing, examined data from 2,923 adult participants in the 2003-2004 National Health and Nutrition Examination Survey who had not been diagnosed with diabetes.
Using guidelines established by the American Diabetes Association, Dr. Strauss determined that 93 percent of subjects who had periodontal disease, compared to 63 percent of those without the disease, were considered to be at high risk for diabetes and should be screened for diabetes. Screening could be performed by dentists using a simple glucometer with blood taken from inflamed periodontal pockets.
Dr. Strauss stated, “In light of these findings, the dental visit could be a useful opportunity to conduct an initial diabetes screening — an important first step in identifying those patients who need follow-up testing to diagnose the disease.”
“It’s been estimated that 5.7 million Americans with diabetes were undiagnosed in 2007,” Dr. Strauss added, “with the number expected to increase dramatically in coming years. The issue of undiagnosed diabetes is especially critical because early treatment and secondary prevention efforts may help to prevent or delay the long-term complications of diabetes that are responsible for reduced quality of life and increased levels of mortality among these patients. Thus, there is a critical need to increase opportunities for diabetes screening and early diabetes detection.”
Given the findings of this study, do you think you would incorporate routine Diabetes screening into your daily practice?
Source: The Journal of Public Health Dentistry
photo: Babble
A new study on the surface chemistry of silver-colored, mercury-based dental fillings suggests that the surface forms of mercury may be less toxic than previously thought. In the study, Graham George and colleagues note that amalgam (mercury-based) fillings have been used by dentists to repair teeth for well-over a century. In recent decades their use has become controversial because of concerns about exposure to potentially toxic mercury. However, mercury can potentially exist in several different chemical forms, each with a different toxicity. Prior to this report, little was known about how the chemical forms of mercury in dental amalgam might change over time.
Using a special X-ray technique, the scientists analyzed the surface of freshly prepared metal fillings and compared these with the surface of aged fillings (about 20 years old) from a dental clinic. Fresh fillings contained metallic mercury, which can be toxic. Aged fillings, however, typically contain a form of mercury, called beta-mercuric sulfide or metacinnabar, which is unlikely to be toxic in the body.
The scientists found that the surfaces of metal fillings seem to lose up to 95 percent of their mercury over time. Loss of potentially toxic mercury from amalgam may be due to evaporation, exposure to some kinds of dental hygiene products, exposure to certain foods, or other factors.
The scientists caution that “human exposure to mercury lost from fillings is still of concern.”
Source: Science Daily, American Chemical Society
Photo Credit: American Dental Association
Our Periodontal Associates study club co-hosted a meeting the other night with Dentsply on the topic of overdentures. The material was expertly presented by Ira Dickerman of Dickerman Dental Prosthetics and Dr. Theo Kapos from Harvard Dental School. In particular, the Ankylos Syncone protocol was reviewed.
This seems to be an extremely precise, stable, and cost-effective method for delivery of an implant-supported overdenture prosthesis. It also appears as though the protocol may be modified to support a fixed “hybrid” prosthesis on four implant fixtures.
Even though I have been involved with implant dentistry for over 21 years, it is exciting to see new developments and technologies that can have a tremendous impact on improving the quality of life for our patients. Comment or thoughts (especially from our international members)?