thegumdr.com > Periodontal
Updates > July 2009
Dr. Rick Newhart Updates
MOM PROJECT
UPDATE
Thank
you for your wide-spread support for the MOM project that will take
place this weekend, July 31-August 1. Dental assistants and
dentists are still needed to volunteer for Saturday afternoon. A
very large outcome is expected. All dental materials and food will be
provided. To register please visit the website www.movhd.com/dental.
A
“WHALE” OF A RESULT!!!
Bianchi and Bassetti reported on a new flap design
for guided tissue regeneration surgery in the anterior region to
regrow bone in periodontal defects. The incision resembles a whale’s
tale and is reflected to the palate through a necessary diastema.
Bianchi grafted his 14 subjects with a bovine mineral graft and a
biosorbable membrane. The clinical attachment level gain, of
approximately 4.5mm was measured after 12 months. They reported
significant improvement in the healing of the bony defects in the
maxillary anterior. No subjects were probed earlier than 12 months.
Dr.
Newhart
feels that this is a great technique
to correct vertical defects in the anterior, provided they have
significant diastemas to allow for mobilization of the flap on the
facial surface.
IJPRD 2009; 29: 153-159
LETS GET
THAT IMPLANT BACK!
Flanagan
reports on a novel method to retrieve displaced dental implants in the
maxillary sinus in a case report on a 45-year-old woman who had an
implant placed in the #3 position. The implant became displaced in the
maxillary sinus and by using a modified Caldwell-Luc technique, Dr.
Flanagan was able to remove the implant via the use of sterile saline
irrigation and a modified suction. His previous attempts to remove the
implant through the osteotomy were unsuccessful.
Dr. Newhart
feels that Dr. Flanagan’s technique appears to
have significant usefulness because it quickly addresses a
complication, which can result from direct sinus elevation.
JOI
Vol 35 2009; 70-74
FILL THAT FURCATION!
Mellonig
completed a histological and clinical evaluation of four patients with
advanced chronic periodontitis in mandibular molar furcations. The
molar furcations were all grade III and were grafted with recombinant
human platelet-derived growth factor-BB, tri-calcium phosphate and a
barrier with a coronally positioned flap. At six months, the teeth
were extracted and histologically evaluated. Mellonig found that one
furcation had closed and all surfaces had generated new attachment and
bone from this technique.
Dr. Newhart
feels that
this is a great technique to try to re-grow bone in Class III
furcations as he uses TCP and platelet rich plasma in his office. Even
a better result could possibly have been obtained by using root
conditioning and a Teflon guided tissue regenerative barrier.
IJPRD
2009; 29: 169-177.
WHAT
CAUSED THAT IMPLANT TO FAIL?
Koldsland
studied 109 volunteers over a 15-year period to determine implant
failure. Interestingly, 18 implants were lost in 10 subjects and
eleven of the implants were lost before the implants were loaded. No
implants were lost after the 10 year time period. Loss of implants was
significantly tied to a history of smoking and periodontal disease.
Implant loss was not affected by age, gender, alcohol habits,
cardiovascular disease, diabetes, osteoporosis or rheumatic fever. He
also found that all late implant losses were proceeded by an early
implant loss, Therefore, the authors conclude that smoking,
periodontitis and prior implant loss are associated with the loss of
additional dental implants.
Dr. Newhart
agrees with
these findings and agrees that some patients may not be good implant
candidates.
JOP
2009; 80: 1069-1075
“BEADS” ARE BETTER
MacDonald reports on a prospective study of 17
implants after 7-9 years, all used to replace maxillary teeth. The
authors found a survival rate of 92.9% but, Interestingly, with
exception of the one implant, there were no changes in crestal bone
loss from 1-9 years on these implants. The papillary index was
highly favorable, suggesting that there was a retention of bone and
the papillae, over the 7-9 year period. Two of the concerns in implant
reconstruction is loss of the papillae and loss of bone around the
implant. This report suggests that with the beaded surface
implants, there can be very minimal bone loss or gum recession
associated with these implants.
Dr. Newhart
does use
these implants in the maxillary posterior areas in cases where he
would like to avoid sinus elevation surgery.
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