Dr. Rick Newhart Updates

 Periodontitis, Proteins And Pregnancy

Pitiphat et al. (JPerio 2006;77:821-825) looked at the relationship between periodontitis, C-reactive protein and pregnancy in 35 subjects with periodontitis, in an ongoing cohort study.  C-reactive protein is produced by the liver in response to inflammatory proteins and is a marker of systemic inflammation.  C-reactive protein has been associated with pre-term delivery, interior ingrowth restriction and pre-eclampsia.  Periodontal disease has also been associated with low birth weight and pre-term birth.  The authors found that the mean C-reactive protein level of the 35 subjects with periodontitis was 65% higher than the pregnant age match controls with healthy gingiva.  The authors’ conclusion is that periodontitis may increase the serum C-reactive levels of proteins in pregnancy and this Serum C-reactive protein could possibly cause pregnancy complications.  Dr. Newhart feels that women who are pregnant, or trying to get pregnant, should have a thorough periodontal examination to try to eliminate any excessive sources of inflammation.  

Connective Tissue Grafts In Smokers Vs. Non-Smokers

Erly et al. (JPerio2006;77:1148-1155) studied the treatment of gingival recession with subepithelial

connective tissue grafts in 22 defects in 17 patients.  The patients were divided into smokers and non-smokers by their level of serum cotinine levels and the number of cigarettes they reported smoking.  The authors found that non-smokers had statistically more root coverage than smokers, 98% versus 83%.  The authors conclude that root coverage with connective tissue grafts was negatively influenced by smoking.  Sixty percent of adults over 30 years old have gingival recession, and approximately 25% of adults in the U.S. smoke.  Dr. Newhart surgically treats gingival recession virtually everyday and encourages individuals to stop smoking prior to periodontal surgery.  However, Dr. Newhart feels that smokers can benefit significantly from gingival grafting.

Gingival Squamous Cell Carcinoma: Do Not Delay

Seoane et al (JPerio2006;77:1229-1233) evaluated the total diagnostic time for gingival, tongue, and floor of the mouth carcinomas.  Total diagnostic time is the time interval from when the patient first noticed a change to the time when there was biopsy diagnosis.  The authors studied 59 consecutive oral cases to see if there were differences in diagnostic time for gingival or other carcinomas.  They found no significant difference in the diagnostic time for any of the three cancers.  However, the authors found that by the time gingival cancers were found, these cancers had invaded the adjacent front structures and bone more than the tongue and floor of the mouth cancers.   The authors conclude that due to the early invasion of the adjacent bone tissue of gingival squamous cell carcinomas, early referral and early diagnosis is essential. 

 Beef Up Gums

Ozcelik et al. (JPerio2006;77:1105-1109) studied the effects of anabolic androgenic steroid (AAS) on the gingival tissues in a group of body builders.  The anonymous group of 24 athletes had been using steroids for over a year and the control group of 20 body builders had never used steroids.  The authors measured plaque index, gingival index, gingival thickness, and gingival encroachment.  The authors found that the steroid users had thicker gums and more gingival enlargement than non-steroid users.  The authors concluded that prolonged use of steroids is closely associated with significant levels of gingival enlargement. The authors reference reports that 80% of male body builders use illicit steroids and 4-6% of American youth use steroids.   Dentists should be alert for these changes in the gingiva and the effects of steroids on their patients, especially those that may be at risk for steroid use. 

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.