Dr. Rick Newhart Updates

 Best Wishes for a Safe and Successful

Happy New Year!

 Management of Localized Buccal Dehiscence Defects with Allografts and Acellular Dermal Matrix

Park and Wang (IJPRD2006 ;26:589-595) present  a case series of 5 implants placed in 4 deficient ridges using acellular dermal matrix as a barrier membrane for guided bone regeneration. The authors deliberately placed implants into ridges knowing that they would have anywhere from 5 to 17 threads of dental implant exposed on the facial, at the time of implant placement. The authors then placed puros cancellous and then cortical bone grafts and acellular dermal matrix allografts and then covered the areas.  The authors report, though many of the cases did not have any barrier exposure during the entire time period. After a six-month re-entry period, they had achieved complete thread coverage for all the implants as well as a bone thickness on the facial surface of 1.8mm or greater, which they feel sufficient to be maintained for the life of the implant. Park and Wang were excited about this material because it may have a lower rate of complications when exposed than Teflon. Dr. Newhart has frequently used guided bone regeneration in the placement of dental implants, but has not used acellular dermal matrix due to the relatively high expense of the material and the thickness that increases difficulty in surgical closure.

Watch that Hole !

Karabuda et al. (JPerio2006; 77:1991-1997) reports on the effects of sinus membrane perforations on the success of dental implants. In this Turkish study, Karabuda studied over 259 implants that were inserted in the 91 patients. Sinus perforations were clinically verified in 12 sinus sites and were properly treated by the use of a barrier technique. Overall, 26 implants were placed into areas of sinus perforations. The authors found that out of 259 implants, 11 implants were lost during the follow-up period. Two failures occurred in the group of 26 implants with sinus perforations. The authors conclude that there is no significant difference between perio-implant bone resorption and the success rates for dental implants placed into areas with sinus tears as long as these areas are carefully managed. Dr. Newhart does perform maxillary sinus elevation and there are times, despite careful elevation of the membrane that sinus perforation does occur. He always repairs this with a suitable membrane at the time of sinus elevation surgery.

More Q10 Over Here Please

Dennis Flanagan (InsideDentistry2006; Nov/Dec:44- 45) presents a literature review and summary of the studies of Coenzyme Q10. Coenzyme Q10 (ubiquinone) has always held some particular interest for periodontal treatment. Coenzyme Q10 is an antioxidant and also is involved in facilitate energy production membrane mitachondrian cells. There is currently no recommended daily allowance of Q10 as with other substances. Flanagan points out that most of the Coenzyme Q10 studies were performed between 15 to 30 years ago. A more recent study done in 1994 by Hanioka found that Coenzyme Q10 alone had no affect on the treatment of periodontal disease by itself, but when combined with conventional periodontal therapy it did increase benefits to some patients. It concludes by saying that randomized, blinded clinical trials in humans are needed to demonstrate the effects of Q10. Dr. Newhart agrees with Dr. Flanagan that more study is needed before recommending this either for short or long term use for our patients and at what dosages we should suggest to them.

Successfully Single ?

Levin et al. (JPerio; 77: 2080-2083) report on 1,387 single tooth implants placed over a six-year period. They evaluated these consecutive implants during the years of 1999-2005. The average time for implant placement to study evaluation was about 2 ½ years. They authors found that most of the single tooth implants they placed were in the maxillary premolar area and the maxillary anterior area. They had 96 out of 1,387 implants fail with the survival rate of 93.1%. About 95% of those failures occurred during the first year of placement. The authors also noticed that the highest survival rate in the maxillary premolar area. The authors conclude that the single tooth implant restoration is a highly successful procedure and Dr. Newhart agrees with their assessment.

“The heavens declare

 the glory of God:

and the firmament sheweth

 his handywork.”

Psalms 19:1

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 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 significant post-doctoral implant and periodontal education & training.