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Inside Dentistry
March 2008
Volume 4, Issue 3

In the News…

American Academy of Periodontology Focuses on Understanding Inflammation and Overall Health

Over the past decade, research has focused on the role oral health plays in systemic health and specifically, how chronic inflammation may influence various oral diseases, including periodontal disease. As leaders in the treatment of periodontal disease, periodontologists have started to reappraise the current knowledge of inflammation and chronic disease relative to the clinical management of patients with perio-dontal disease.

In an effort to expand and advance this knowledge, the American Academy of Periodontology (AAP), in conjunction with a grant from Colgate, hosted their first-ever workshop on inflammation, “Inflammation and Periodontal Diseases: A Reappraisal,” in Boston from January 28 through 30.

“The purpose of this workshop was to bring experts on inflammation from around the world and across disciplines to address periodontal inflammation, systemic inflammation and diseases, and the possible associations between the two,” explains Dr. Susan Karabin, president of the AAP. “Furthering our understanding of inflammation will allow both the dental and medical communities to better treat their patients.”

Approximately 50 guests, ranging from dentistry to clinical medicine, participated in the workshop based on their field of interest and expertise. This group of experts engaged in discussions on a variety of topics related to inflammation and periodontal disease, including inflammatory response treatment, innate control responses, and implications in other disease states, such as diabetes and cardiovascular disease. These discussions emphasized the importance of controlling inflammation in periodontal therapy by educating periodontists, general dentists, and other members of the medical community about the effect inflammation in the mouth can have on overall health.

Workshop proceedings will be published as a special supplement to the Journal of Periodontology during the third quarter of 2008.

Dental Mercury Use Banned in Norway, Sweden, and Denmark

Norway recently announced a ban on the use of mercury, including dental amalgam, effective January 1, 2008. Sweden announced a similar ban, and dentists in Denmark will no longer be allowed to use mercury in fillings after April 1, 2008.

“These bans clearly indicate that amalgam is no longer needed. There are viable non-mercury filling substitutes that are used every day in the United States,” said Michael Bender, director of the Mercury Policy Project. “By eliminating amalgam use, which is 50% mercury, we can reduce mercury pollution much more efficiently than end-of-the-pipeline solutions.”

In a prepared statement, Norwegian Minister of the Environment Erik Solheim said that the reason for the ban is the risk that mercury from products may constitute in the environment. “Mercury is among the most dangerous environmental toxins. Satisfactory alternatives to mercury in products are available, and it is therefore fitting to introduce a ban,” he said.

The Swedish amalgam ban is for both environmental and health issues, according to authorities. Since the health insurance stopped paying for amalgam restorations in Sweden in 1999, the use has decreased markedly and is now estimated to be 2% to 5% of all fillings.

Danish officials indicate that the reason for banning amalgam is also because composites have become better, and may now be used in many more situations than a few years ago. Teeth will have to be mended with plastic or ceramics. Exceptions to use amalgam may be granted for a certain period after the ban, if dentists apply for it.

“Composite fillings have now become so strong that the Danish National Board of Health says that we can expand the ban to also include amalgam fillings,” said Danish Minister of Health Jakob Axel Nielsen. Authorities noted that when the ban takes effect in Denmark, the present subsidy for amalgam will be changed so that it will instead cover dental fillings of composite material.

NYU Receives $1.5 Million From New York State for Stem Cell Research

New York University (NYU) has received $1.5 million from New York State to continue its work in stem cell research. NYU’s Dean for Science Office within the university’s Faculty of Arts and Science received $553,000 and NYU’s School of Medicine received $999,715. The funding to NYU’s Dean for Science Office will support research conducted by NYU’s Center for Genomics and Systems Biology and NYU’s College of Dentistry.

The grants are part of a $14.5 million funding package under the governor’s stem cell research initiative intended to quickly boost New York State’s biomedical research capability. To be eligible for funding from the stem cell research initiative, an institution must have received at least $1 million in biomedical funding in 2006 from the National Institutes of Health or the National Science Foundation.

NYU’s College of Dentistry is home to an established core group of researchers involved in regenerative medicine. The College of Dentistry’s stem cell initiative uses animal stem cells in “proof of principle” studies in regenerative medicine, with an emphasis on oral and head/neck structures. The program focuses on environmental conditions and molecular mechanisms that will promote skeletal tissue differentiation and organization into tissues. This entails the use of populations of pluripotent cells—cells with more than one potential outcome—committed to the skeletal muscle, bone, and cartilage lineages to engineer these tissues for repair or replacement.

NYU’s School of Medicine’s Helen and Martin Kimmel Center of Stem Cell Biology looks at how stem cells renew themselves and how they interact with specific niches in the body. The New York State grant will make possible the purchase of a high-speed cell sorter to accurately purify the minute populations of stem cells on which such research is based. The Center for Genomics and Systems Biology Center performs research focused on regeneration and embryonic cells. Research is focused on the use of new techniques in systems biology to understand the complex gene networks of stem cells and their differentiation.

In a related story, the NYU College of Dentistry recently unveiled its newest facility, the Paul & Maxine Rosenberg Educational Wing, at a reception and ceremony on December 13, 2007. The Rosenberg Wing, at approximately 8,000 square feet, includes the new 50-seat Professor Emeritus Francis V. Panno Seminar Room for postgraduate students, plus a postgraduate study lounge and locker room, open 24 hours, 7 days a week. The overarching theme in this portion of the facility’s design is providing postgraduate students with a facility dedicated to their specific needs. The Rosenberg Wing also includes an inner suite of offices and workspace for two complete departments—the Ashman Department of Periodontology & Implant Dentistry and the Department of Allied Health Programs.

Dr. Stuart M. Hirsch, associate dean for International Affairs and Development, hosted the event and introduced Dr. Charles N. Bertolami, the Herman Robert Fox dean of the NYU College of Dentistry. Dean Bertolami officially dedicated the facility, saying: “Paul Rosenberg’s enormous talents as an educator, clinician, researcher, and mentor merit this wonderful recognition. Paul has devoted decades of outstanding service to NYU as the director of the Postgraduate Program in Endodontics; as the distinguished professor and chair of the Dr. I. N. and Sally Quartararo Department of Endodontics; and as a former associate dean for Graduate Programs. Moreover, in 1999, Paul was recognized by New York University with its Distinguished Teaching Award, NYU’s highest honor for teaching—a distinction attained only by the finest teachers.”

Clinical professor of endodontics and former NYU alumni trustee, Dr. Ignatius N. Quartararo, spoke of Dr. Rosenberg’s vision for the endodontics department, which has led to its status as a global leader. “Throughout its history, endodontics at NYU has been a pacesetter,” said Dr. Quartararo, “especially its postgraduate program, which consistently ranks among the top programs of its kind in the world, and the credit goes in large measure to Paul.”

Several of Dr. Rosenberg’s former postgraduate students also paid tribute to him. Dr. Eric Bremer, Class of 2000, spoke of Dr. Rosenberg’s impact on his life both as a teacher and a mentor. “Studying with him gave me a course in life issues, as well as in specialty training,” he said. Dr. Pernard Micken, Class of 2007, said, simply, “No one is more deserving of this honor.”

New Study Shows Scientific Support for Laser Procedure in Treating Moderate to Severe Periodontal Pockets

The results of a new peer-reviewed manuscript, published in The International Journal of Periodontics & Restorative Dentistry, demonstrated uniform histologic success in the treatment of moderate to severe periodontal pockets using the patented Laser Assisted New Attachment Procedure™ (LANAP™) developed by Millennium Dental Technologies Cerritos, CA). New connective tissue attachment and regeneration of the cementum was achieved in 100% of the cases in the human histology study using the PerioLase® MVP-7 variable-pulsed Nd:YAG dental laser (Millennium Dental Technologies). Study results suggest the FDA-approved and patented LANAP is a legitimate treatment alternative to conventional scalpel/suture flap surgery.

Led by Raymond A. Yukna, DMD, MS, Director of Advanced Periodontal Therapies, University of Colorado School of Dental Medicine, the study documented consistently positive responses in patients treated with the LANAP. In a split-mouth design, twelve single-rooted teeth with moderate to advanced chronic periodontitis were treated. Six teeth received treatment by LANAP, while the other six control teeth received scaling and root planing only.

After 3 months, 100% of LANAP-treated teeth showed new cementum and new connective tissue attachment, whereas effectively none of the control teeth had any evidence of new attachment or regeneration. There was no evidence of any adverse changes around the LANAP specimens.

“I am quite pleased and encouraged by the results of this study. These positive results support the concept that LANAP can be associated with cementum-mediated new connective tissue attachment and apparent periodontal regeneration of diseased root surfaces in humans,” said Yukna. “Recent years have seen major advancements in periodontal technology, and this study is a successful demonstration of using a free-running pulsed Nd:YAG laser applying the specific LANAP protocol.” The study was the fourth largest prospective comparative human histology project in the entire peer-reviewed, periodontal literature.

“The findings presented in this landmark study are unprecedented and the culmination of nearly two decades of periodontal medicine,” said Delwin McCarthy, DDS, Millennium Dental Technologies co-founder. Robert Gregg II, DDS, co-founder and chief dental officer added, “The publication of this study in a prestigious, peer-reviewed journal adds to the growing body of scientific evidence that LANAP is a complete and effective periodontal disease-treatment protocol that can routinely result in cementum-mediated new periodontal ligament attachment to the root surface in the absence of long junctional epithelium.”

Saliva Test to Detect Breast Cancer Could Be Performed by Dentists, Study Suggests

Researchers at The University of Texas (UT) Health Science Center at Houston can identify and quantify specific protein markers in human saliva to provide an early, non-invasive diagnosis of breast cancer, according to a new study published in the January 10 issue of Cancer Investigation.

The study describes how the onset of breast cancer produces a change in the normal type and amount of proteins in glandular secretions from the salivary glands. The protein profile in a healthy person is altered by the presence of cancer.

Lead researcher Charles Streckfus, DDS, a University of Texas Dental Branch at Houston professor of diagnostic sciences with an expertise in salivary function and molecular epidemiology, collaborated on the groundbreaking study with William Dubinsky, PhD, a biochemist and professor of integrative biology and pharmacology at The University of Texas Medical School at Houston; and Lenora Bigler, PhD, clinical research professor with the UT Dental Branch.

“Why not the dentist?” said Streckfus. “Most folks, especially women and children, visit the dental office way more often than they ever see the physician. Saliva is a non-invasive, quicker way for detection.”

The study is being applied to a “lab-on-a-chip” technology platform developed by biochemists at The University of Texas at Austin. The ultimate goal is to bring this type of diagnostic test, which is capable of detecting the presence of cancer before a tumor forms, into the dental office or other healthcare facilities. The technology aims to improve the ease and effectiveness with which dental professionals and other healthcare providers can provide quick, accurate diagnostic information and physician referrals to their patients.

Dubinsky said saliva holds the codes to many medical secrets. “Saliva is a complex mixture of proteins. We go through a process that compares different samples by chemically labeling them in such a way that we can not only identify the protein, but determine how much of it is in each sample,” said Dubinsky. “This allows us to compare the levels of 150 to 200 different proteins in cancerous versus non-cancerous specimens to identify possible markers for disease.”

In the study, researchers analyzed saliva samples from 30 patients. They found 49 proteins that differentiated healthy patients from those with benign breast tumors and those with malignant breast tumors. These findings suggest that patients can be tested for breast cancer by examining certain protein markers in their saliva during a visit to a dentist’s office or other healthcare facilities.

Streckfus said that being able to chemically distinguish between benign and malignant tumors through a saliva test eliminates possible false-positive results. The supplemental chemical confirmation could allow experts to immediately determine the patient’s next treatment option, whether it is surgery, a biopsy, or further testing.

The McDevitt Group, led by John McDevitt, professor of chemistry and biochemistry at UT Austin, is working with Streckfus and his colleagues to design the diagnostic device, which may eventually be reduced from the size of a refrigerator to a cellular phone. With a working prototype, a dentist can evaluate a patient’s saliva sample in a routine office visit, with no delay for laboratory work.

“Dentistry has entered an exciting new era,” said Catherine M. Flaitz, DDS, dean of the UT Dental Branch at Houston. “On every front, our researchers are exploring links between oral health and the overall health of patients, often with astonishing findings. We’re working to bring those discoveries out of the lab and into the real world of dentists’ and physicians’ offices. We have a special opportunity to collaborate with some of the most talented clinicians and scientists within the world’s largest medical center to evaluate the significance of oral biomarkers for predicting health and disease. It is such a rewarding time to be part of this great profession.”

National Museum of Dentistry Honored for “Distinction in Public Service”

The Dr. Samuel D. Harris National Museum of Dentistry has been honored for Distinction in Public Service by the Friends of the National Institute of Dental and Craniofacial Research (FNIDCR), a nonprofit organization established in 1988 and based in Washington, DC. National Museum of Dentistry executive director Rosemary Fetter accepted the award at FNIDCR’s Annual Gala at the National Press Club in Washington, DC, on December 10, 2007. The event honors contributors to the advancement of oral health and research.

“The National Museum of Dentistry makes the connection between good oral health and a healthy life—on site in Baltimore, online, and nationwide through our traveling exhibitions,” said Fetter. “We are extremely honored to be recognized by the FNIDCR for making an impact on oral health across the country.”

The National Museum of Dentistry, designated by Congress as the official museum of the dental profession, is committed to raising awareness of the importance of oral health in a healthy life. Smile-inspiring hands-on exhibitions encourage good oral health habits and celebrate the heritage and future of dentistry at the museum’s historic location in downtown Baltimore.

The Museum’s Traveling Exhibition program has reached more than 2 million people at children’s and science museums across the country, inspiring visitors of all ages to keep their smiles bright and healthy. The National Museum of Dentistry also shares the power of a healthy smile with children around the world through www.MouthPower.org, an educational Web experience developed in partnership with the American Dental Association.

LSUHSC Dental School Awarded Top National Honor

The School of Dentistry at LSU Health Sciences Center, New Orleans, has been selected as the inaugural academic dental institution recipient of the William J. Gies Award for Outstanding Innovation. The award will be presented by the ADEAGies Foundation at a black-tie celebration on March 29 in conjunction with the 85th American Dental Education Association (ADEA) Annual Session at the Hilton Anatole in Dallas, Texas. Named after William J. Gies, a pioneer in dental education, the William J. Gies Awards for Vision, Innovation, and Achievement recognize contributions to and support of global oral health and education initiatives.

The LSUHSC School of Dentistry is being honored for its innovation in rebuilding dental education in the State of Louisiana following Hurricane Katrina, a critically important endeavor, as the LSUHSC School of Dentistry is the only dental school in the state. Flooding caused by the failure of federally built levees inundated the dental school’s New Orleans campus for weeks, necessitating its relocation to Baton Rouge. With help from the national dental community and Louisiana State University, LSUHSC dental faculty, staff, and students rebuilt a dental school almost from scratch in former research buildings next to a cow pasture on LSU’s South Campus. Facilities included two state-of-the-art teaching clinics, an oral surgery suite, as well as lecture rooms and laboratories. Classes resumed mere weeks after the disaster for students in the DDS, dental hygiene, and dental laboratory technology programs, along with clinical rotations, so students and residents graduated on schedule, on time.

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