Dr. Rick Newhart Updates

IMPLANT INNOVATIONS AND DENTURE DUPLICATION

New dental implant innovations, resulting in easier, faster treatment for patients, and in a new denture technique, were the highlights of the October 17 continuing education course sponsored by Debra Parker, RDH from 3i, Tincher/Butler Dental Laboratory, and Dr. Newhart . Jodie Gunnoe demonstrated a new technique using a pre-fabricated kit to rapidly construct a new denture, which retains the good qualities of the old denture and allows for esthetic modification of the new denture.  Thank you to all who attended! The near capacity crowd also received 3 hours of CE credit if they participated in the hands-on laboratory session. Watch for more continuing education events in the future.

GLOWING GUMS?

De Oliveira et al. (JPerio2007;78:965-973) studied the effectiveness of photodynamic therapy on patients with aggressive periodontitis in comparison to scaling and root planing (SRP). Photodynamic therapy (PDT) involves a photosensitizer that binds to a target cell and then is activated by a laser, or light source. This split-mouthed study of 10 patients used a laser and a photosensitizer, which is injected below the gum tissue for activation.  Results were measured initially and after 3 months of treatment.  Suprisingly, SRP and PDT showed similar clinical results in the treatment of aggressive periodontitis. The PDT did not require any local anesthetic.  However, additional scaling was required to remove calculus which became exposed as the gum tissue improved. Dr. Newhart is very excited about PDT and would like to see FDA approval before recommending it. 

WIDE OPEN SPACES

Kupershmidt, Levin, and Schwartz-Arad (JPerio2007;78:991-996) studied bone height changes in the anterior maxilla in both immediate and post-extraction cases in relationship to the space between the implants. This retrospective study involved 45 patients and 200 implants receiving at least two adjacent anterior implants in the maxilla. Implants placed at the time of tooth removal were associated with more crestal bone loss. This crestal bone loss was a result of healing from the extraction socket, which had already occurred in the delayed placement group. The authors suggest placing implants with at least 3mm of bone between them to allow for maintenance of the alveolar crest.  Extraction with immediate implant placement does preserve more overall bone than extraction with delayed implant placement.

“THE PILL” AND “THE GUMS”!!

Mullally et al. (JPerio2007; 78:1031-1036) studied the association between periodontal status and oral contraceptive use in young adults. Forty-two percent of the 50 women aged 22-35 years were taking oral contraceptives at the time of a comprehensive periodontal examination. When the periodontal health of the two groups were compared, it was found that women on oral contraceptives had deeper probing depths, more severe attachment loss, and more sites with bleeding on probing than those not using oral contraceptives. Please note that gingival tissues have receptors for estrogen and progesterone, and the oral contraceptive users also tended to have higher plaque levels. Dr. Newhart feels that women taking oral contraceptives who do have poor oral hygiene may be at higher risk for attachment loss and may need closer periodontal monitoring. 

GLANZMANN THROMBASTHENIA

Toygar and Guzeldemir presented a case report on two patients with Glanzmann Thrombasthenia (GT).  GT is a rare, inherited disorder presenting a defect in platelet function.  Common manifestations of GT include gingival bleeding and petechiae.  This autosomal recessive bleeding syndrome occurs more commonly in areas where intermarriage is common and requires patients to be homozygous for the mutations causing GT. These patients require platelet transfusions prior to the initiation of scaling and root planing! The authors conclude that both periodontal and systemic health are important for all patients with bleeding disorders and dentists must be alert for unusual gingival bleeding and consult with a hematologist if needed.

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 & training.