Dr. Rick Newhart Updates

MORE ROOTS, LESS BONE

Huang et al. (JPerio2007;78:1485-1490) studied the effect of an extra third distal lingual root on mandibular molars in relationship to periodontal attachment loss in molars with the standard mesial and distal roots. They examined 127 patients with 332 mandibular first molars. The researchers checked for bleeding, pocket depth, gingival recession, and periodontal attachment loss.  The authors found that greater probing depth and attachment loss occurred at the distal-lingual sites of molars with the additional third root!  Unilateral distal-lingual roots were found in 8.5% of the molars and bilateral distal-lingual roots were evident in 14.1% of the molar teeth.  The authors state that the present of a distal-lingual root may contribute to periodontal attachment loss.  Dr. Newhart feels this is clinically relevant and that the presence of a distal-lingual root should be checked in all of our periodontal patients.  This area should be identified early on in therapy as a site that will require extra plaque control and is at risk for further periodontal breakdown. 

STANNOUS FLUORIDE OR TRICLOSAN, WHICH IS BEST?

Athena Papas et al. (JPerio2007; 78:1505-1514) studied the effect of a Triclosan copolymer toothpaste versus as stannous fluoride for the prevention of cavities and periodontal disease over a two-year period in medication-induced Xerostomic patients.  A total of 344 subjects were measured for caries and attachment loss over the two-year period.  At the end of the one-year treatment phase both groups showed significant decreases in pocket depths, increases attachment gain, and remineralization of root surfaces.  The results showed stannous fluoride and triclosan toothpastes to be virtually identical in efficacy for this high-risk group for periodontal disease and caries. 

BISPHOSPHONATE OSTEONECROSIS OR UNTREATABLE BONE NECROSIS

At the Blennerhassett Dental Society Meeting on September 21, 2007 Dr. Doug Damm presented the latest ADA guidelines in standard of care regarding patients on bisphosphonate therapy and those planning to have bisphosphonate therapy. The ADA website has a web-link meant to provide updated information www.ada.org/prof/resources/topics/osteonecrosis.asp.

Dentists and other medical professionals encouraged to review this site.  Physicians should be aware of the guidelines for intravenous bisphosphonate therapy.  Dental guidelines for these patients include delaying bisphosphonate therapy for one month to allow for the elimination of all oral infection, removal of all large tori, and the establishment of a 3-month recall cleaning program with their regular dentist.  After IV bisphosphonate therapy has begun, all evasive dental procedures should be avoided.  Splinting of teeth with excessive mobility is recommended, along with endodontics for hopeless teeth, as opposed to extraction. All elective surgical procedures are contra-indicated after IV bisphosphonate therapy has begun, including the removal of impactions and tori, periodontal surgery, or placing implants. The practioner is encouraged to review the ADA website.    

  MOTORIZED FLOSSING!

Hague and Carr (JPerio2007; 78:1529-1537) evaluated the efficacy of a flossing device called the Ultra Flosser produced by the William Getgey Company of Cincinnati , OH . The Ohio State University study was a 10-week, two-treatment period crossover designed trial. One hundred two patients were divided into three groups of non-flossers, manual flossers, and automated flossers.  The efficacy of the different flossing methods were evaluated over the 10-week trial.  The authors found that the automated flossing device was found to be significantly more effective in removing interproximal plaque in all areas of the mouth compared to manual floss at days 15 and 30. Dr. Newhart is excited about this automated flossing device, which uses a vacillating motion, because it may motivate or assist some patients in flossing. 

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.