Dr. Rick Newhart Updates

ARE THERE COMPLICATIONS?

Harris et al. (IJPRD2005; 25:449-459) studied the 500 patients who had undergone sub-epithelial connective tissue grafts for complications of pain, swelling, bleeding, and infection.  These patients were consecutively treated patients in his office and not a select group.  Harris found that approximately 82% of his patients reported no pain, 97% reported no bleeding, 94% reported no swelling and 99.2% reported no infection.  There was no clinical factor in the patients that could be tied to any complications.  Harris concluded the use of a sub-epithelial connective tissue graft is a relatively safe, high benefit procedure.  Dr. Newhart frequently performs sub-epithelial connective tissue grafts to obtain root coverage and has a very low complication rate with a very low infection and discomfort rate with his patients.  Although this procedure is much less uncomfortable than the standard free gingival graft technique, at Dr. Newhart’s office frequently there is some bruising and swelling (which usually resolves in one week.)

NO BON-BONS, PLEASE!

Bisphosphonate-associated osteonecrosis (BON) of the jaws was a highlight of the Journal of the American Dental Association in December 2005.  Bisphosphonates are inhibitors of osteosclastic activity, commonly used to treat osteoporosis, Paget’s disease, multiple myaloma, and hypercalcimia of a malignancy.  The most common agents are Zoledronic Acid (Zometa) and Pamidronate (Aredia).  However, Fosamax and Boniva also belong to this group of compounds.  Two case reports are presented by Markiewicz et al. and Melo, DMD and Obeid, DDS.   A position paper from the American Academy of Oral Medicine is also presented on managing patients who have been exposed to these drugs.  Dentists are encouraged to review these articles at their convenience.  The AAOMA paper suggests that the prevention of bisphosphonate-associated osteonecrosis is the best approach to management of these patients, as no satisfactory treatment has been recognized for these patients.  Dr. Newhart suggests that it might be wise to refer any patients who you know, or suspect, have been taking bisphosphonates for a long time who require any type of oral surgery, to an oral surgeon for the procedure and close follow-up.  (JADA 2005; 136: 1658-1675) 

REDUCE RISK

West Virginia Dental Association (WVDA) and Accordia of West Virginia are sponsoring a mal-practice risk management seminar on Friday, April 28 at Stonewall  Jackson Resort in Roanoke, WV.  The seminar is approved for 5 hours of credit and will begin at 8:00am and conclude at 1:00pm.  Interested dentists should contact the West Virginia Dental Association and Stonewall Jackson Resort at 1-888-278-8150 to reserve a room.

WILL PERIODONTAL THERAPY HELP YOUR VEINS?

Seinost et al. (AHJ2005;149:950-954) report in the American Heart Journal on the effects of periodontal therapy on endothelial cell function.  Seinost studied 30 patients with severe periodontitis using flow-mediated dilation of the brachial artery.  Three months after periodontal therapy, the patients were reassessed.  Seinost found that periodontal therapy led to decreased C-reactive protein levels in the bloodstream, as well as improvements in the flow-mediated dilation of the artery.   Seinost concluded that treatment of advanced periodontitis can reverse some effects of endothelial dysfunction. 

Know ye that the Lord he is God: it is he that hath made us, and not we ourselves; we are his people, and the sheep of his pasture.  Enter into his gates with thanksgiving, and into his courts with praise: be thankful unto him, and bless his name.

                                Psalm 100:3-4

Thank you for your continued referral of dental implant and periodontal patients!

Please visit our website at: thegumdr.com

Dr. Richard Newhart, Periodontist

Dental Implant Placement

1308 Market Street    

Parkersburg, WV 26101

(304) 422-4867

Dr. Newhart’s periodontal update is a scientific, referenced literature and research review and newsletter.  Dr. Newhart is not claiming to perform, endorse, or achieve the results of every surgical technique or procedure published in this newsletter.  Dr. Newhart is a licensed periodontal specialist, who has achieved significant post-doctoral implant and periodontal education and training.