Dr. Rick Newhart Updates

HOW MUCH SPACE?

Lee, Park, and Moon (JPerio 2006;77:1080-1084) studied 85 interproximal papillae in 40 patients who all had implants in place with prosthesis for longer than one year.  The authors measure the distance between the implant platforms, as well as the distance from the height of the gingival papillae to the height of the osseous crest.  The papillae were divided into groups with distances between the implants measuring greater than 3mm and those with less than 3mm.  For both groups the dimensions of the soft tissue height between both distances were approximately the same.  For horizontal distances greater than 3mm and less than 3mm, the average distance for soft distance for soft tissue height was 3.3-3.4mm.  The preservation of the papillae is an important esthetic component, especially for inter-dental implants. 

GRAFTING FAT TISSUE?

Gapski, Satheesh, and Cobb (JPerio 2006:77:1085-1090) performed a histomorphometric analysis of bone in the maxillary tuberosity of cadavers to determine its component status for bone grafting.  The maxillary tuberosity is commonly used as a source for autogenous bone for sinus elevation procedures and other procedures.  Gapski’s group took a biopsy of 20 cadavers consisting of 9 females and 11 males.  Over 35 sections were taken for each sample.  Block specimens revealed almost little or no evidence of any active bone formation in the tuberosity, but instead revealed large marrow spaces.  The marrow spaces were filled with either fibrous connective tissue or lipid or fat cells.  Males had approximately 27% vital bone in the tuberosity, while females had approximately 20% vital bone in the tuberosity, which was statistically significant. The authors concluded that the maxillary tuberosity area, because of its low percentage of vital bone and high percentage of adipose and fibrous tissue, might not be the best site for autogenous bone grafting. Dr. Newhart does not commonly use a maxillary tuberosity because his findings concur with the authors. 

PERIODONTAL DISEASE PROGRESSION

Thomson et al. (JPerio2006;77:947-954) studied the natural progression of periodontal disease in a long-standing progressive cohort study of individuals at 26 years old and at 32 years old.  Each examination included measurement of gingival recession and pocket depths in over 882 individuals.  The authors found that approximately 20% of the patients had attachment loss of greater than 4mm from the 26 to the 32 year old period.  Forty-five percent of individuals had an increase in attachment loss of 2mm or more during that time.  Pocket depth increases of greater than 2mm were found in approximately 39.1% of individuals in the 26 to 32-year-old period.  The authors found that the distal lingual sites of molars teeth had the highest risk for attachment loss, most commonly measured as in increase in pocket depth. However, the lower canines and the lower incisors are at risk for attachment loss.  In this age co-hort, increases in pocket depths were more prevalent than increases in gingival recession.  This study reminds us that we should continue to check inter-proximal molar areas in the 26-32 age group for changes in pocket depth to assist these individual in controlling their periodontal disease. 

DENTAL IMPLANTS ARE SAFE FOR SPACE FLIGHT !!!

Haignere et al. (JOMI2006;21:450-454) studied the effects of 6 months in space on the bone around a Zimmer screw vent dental implant placed in a 48-year-old male astronaut with the Mir Space Station.  The French astronaut spent 6 months in space subject to microgravity, which is approximately 1-millionth of the earth’s gravitational pull.  Microgravity can cause bone resorption and a decrease in bone density, called space osteoporosis.  Individuals can lose as much as 14% of bone density due to this space osteoporosis despite calcium and vitamin D supplements.  The results revealed .43mm of mesial bone gain and .31mm of distal bone loss. The authors concluded that the overall implant bone changes were very minimal.  The implant restoration was fully functional and symptom free for the entire space flight.  Dr. Newhart places Zimmer dental implants and wants all of his patients to know that their implants should perform outstandingly during any future space flights.

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.