This evening I had a presentation at my dental laboratory with NobelBiocare. The title of the lecture was Zirconia vs PFM Restorations. The speaker, Dr. Thomas Williams showed several examples of less than ideal soft tissue health that resolved with changing to porcelain fused to zirconia restorations. What is the general observations of others on WebDental regarding this subject? Are all ceramics and even composite restorations more biocompatible thna PFM's? Please understand that as a dental technician I don't have the daily opportunity for intraoral observations of my own. Follow to see full course description.http://dickermandental.com/" target="_blank">
There is a lot of research indicating that cast PFMs are horribly dirty/ toxic to tissue, in many cases. They simply are no longer needed, a very tired technology. Today, the only considerations should be all-ceramic or Captek. There is no longer any reason to use a cast PFM, perhaps for a metal occlusal, but Captek can be made with a metal island.
Zr has been shown to be biocompatible. Captek is the only material that has been shown to actually reduce the bacterial count below that of non restored teeth. Research at Forsythe found at least a 71% reduction in bacterial count when Captek restored teeth were compared to non restored teeth in the same mouth. Other research points out that all-ceramics harbor the same bacterial count as non restored teeth.
Oral-body inflammatory connected to medical-dental practice
October 22, 2009
BOSTON, Massachusetts--The science behind why a diseased mouth puts one at a higher risk for heart attacks and strokes ,along with recent new evidence showing improvements in oral health having a positive impact on reducing atherosclerosis or plaque in arteries, is leading more dentists and physicians to become aware of how this may possibly affect their patient's general health and medical conditions.
Dr. James McAnally, CEO of Big Case Marketing, a marketing and case acceptance consulting firm for dentists with advanced clinical training, recently interviewed Dr. Neil Gottehrer, periodontist and a dental authority on the oral-body inflammatory connection about this new emerging science that links dental to medical health.
He illustrates that simple screening tools are available for dentists to use and how they can effectively communicate the dentist's findings to the physician who may or may not be aware of this connection.
Dr. Gottehrer also recently delivered an address to the Academy of General Dentistry on the subject and co-wrote a guide entitled Evaluation & Management of the Oral Body Inflammatory Connection with Dr. Marvin Slepian, a cardiologist. The guide was also discussed during the interview.
Dr. Gottehrer stated, "The immense power we have as dentists to impact not just our patient's oral condition but their entire general state of health is becoming clearer in the science when it comes to reducing whole body inflammatory side effects from dental conditions. As more physicians and dentists become fully aware of this and understand that there are treatment protocols shown to diminish or eliminate gum disease for the long term, we're going to start seeing many more patients having healthier lives medically because of what happens in the dentist's office. We're probably entering one of the most exciting phases that dentistry has ever seen."
As part of the discussion, Drs. McAnally and Gottehrer revealed ways to communicate effectively between the dental office and the physician's office regarding two blood tests that help reveal whether oral disease is having effects beyond the mouth into the circulatory system and how treatment by the dentist and dental hygienist can directly impact these substances suspected of contributing to whole body disease.
"Typically evident in most patients with dental disease who were also recorded as exhibiting the biological markers on a blood test, require some type of periodontal care and often times tooth replacement with dental implants or the use of Captek periodontal crowns if they have dental crowns next to the gums," said Dr. Gottehrer.
In a part of the presentation, Dr. McAnally discussed that the Medical-Perio Physician Referral & Marketing Program is now available from Big Case Marketing for general dentists, periodontists, oral surgeons, and prosthodontists that allows an easy facilitation of the physician-dentist relationship.
"This is really a comprehensive medical watchdog for patients because overall they become healthier as a result of the interaction of all physicians involved. Simply put, if we improve the referral relationship process between family practice physicians and cardiologists and the dentist so that medical patients with serious medical conditions receive appropriate dental treatment to reduce dental disease's effects on their systemic health then the dental patients receive the proper monitoring and attention for systemic medical issues based on what the dentists see back in the physician's office.
For some dental specialists, this referral model will enhance their relationship with physicians and their referring dentists," stated Dr. McAnally.
The Medical-Perio Physician Referral & Marketing Program for dentists who are concerned about the oral-body inflammatory connection includes:
* A practice Fast Start introduction for the doctor and staff
* A dedicated Web site called "Heart-Line" for the patient and physician
* The scientific rationale and journal articles for the dentist and physician
* Clinical protocol manuals and administrative protocols for the dental team
* Inoffice clinical forms, physician referral forms and how to use them
* Hygienist update and referral information with instruction on the appropriate periodontal treatment protocols including hygienist referral systems targeting the physician and cardiology offices
* Discussion of compensation surrounding referrals
* Instruction on how to plan an oral-body inflammatory connection to cancer screening day including print advertisements, public service radio announcements, and press releases
* Physician-dentist-patient referral communication letters and forms, faxes for the physician and cardiologist office, prewritten practice newsletter pieces related to the new science, local physician and cardiology contact information for the dentist, direct mailers for cardiologists & family physicians letting them know the availability of this service
* Tracking systems for patients, case acceptance training, staff phone training and monitoring, and practice consultation to help implement the program
Dr. McAnally added, "Even with the free guide most dentists aren't quite sure how to discuss these topics with the physician or go about implementing any of it so they can help patients given the amount of detail and complexity that it requires which is exactly why we developed this comprehensive program. The dentist or specialist with advanced training related to gum disease and dental implants including the forward thinking generalist, all of whom realize that medical-dental health is going to be the next big thing, are the ones who will take the initiative to be on the forefront of something that really effects their patient's overall health. These are the doctors who will be involved with this."
ChaseHealthAdvance financing options, a division of Chase Card Services of JPMorgan Chase, is offering a complimentary copy of Dr. Gottehrer's guide upon enrollment to interested, dentists or physicians by calling (888) 388-7633.
Barry Trexler, senior vice president of sales and marketing for ChaseHealthAdvance, stated, "At ChaseHealthAdvance, we are pleased to have been the sponsor of the printing for this guide. Our patient financing product can help more patients accept the treatments their healthcare providers prescribe to them by breaking up treatment costs into more manageable monthly payments. Also, we give all approved patients a credit line of at least $5,000 which allows more get the care they need.
OK. Yes, this is definitely consistent with the literature and our limited clinical observations. I would be curious to hear from our restorative colleagues.
Dr. Williams showed multiple cases where he replaced PFM's with PFZ's with favorable tissue response. The photographic documentation was quite compelling. In a similar vein Captek which is 88% AU and 9% Pt has also claimed very favorable tissue response vs PFM's.
Ira,
This is interesting. It is my understanding that the tissue response to Zirconia is excellent. As surgeons, we do not often see the final result unless the patient is on recall. I assume that Dr. Williams said that the soft tissue response to a porcelain fused to zirconia restoration is different (increased inflammation) than the response seen with straight zirconia, or high noble gold alloy PFM restorations. Please elaborate.
Comments
Zr has been shown to be biocompatible. Captek is the only material that has been shown to actually reduce the bacterial count below that of non restored teeth. Research at Forsythe found at least a 71% reduction in bacterial count when Captek restored teeth were compared to non restored teeth in the same mouth. Other research points out that all-ceramics harbor the same bacterial count as non restored teeth.
Dental Economics
Volume 14 Issue 2
March, 2009
Oral-body inflammatory connected to medical-dental practice
October 22, 2009
BOSTON, Massachusetts--The science behind why a diseased mouth puts one at a higher risk for heart attacks and strokes ,along with recent new evidence showing improvements in oral health having a positive impact on reducing atherosclerosis or plaque in arteries, is leading more dentists and physicians to become aware of how this may possibly affect their patient's general health and medical conditions.
Dr. James McAnally, CEO of Big Case Marketing, a marketing and case acceptance consulting firm for dentists with advanced clinical training, recently interviewed Dr. Neil Gottehrer, periodontist and a dental authority on the oral-body inflammatory connection about this new emerging science that links dental to medical health.
He illustrates that simple screening tools are available for dentists to use and how they can effectively communicate the dentist's findings to the physician who may or may not be aware of this connection.
Dr. Gottehrer also recently delivered an address to the Academy of General Dentistry on the subject and co-wrote a guide entitled Evaluation & Management of the Oral Body Inflammatory Connection with Dr. Marvin Slepian, a cardiologist. The guide was also discussed during the interview.
Dr. Gottehrer stated, "The immense power we have as dentists to impact not just our patient's oral condition but their entire general state of health is becoming clearer in the science when it comes to reducing whole body inflammatory side effects from dental conditions. As more physicians and dentists become fully aware of this and understand that there are treatment protocols shown to diminish or eliminate gum disease for the long term, we're going to start seeing many more patients having healthier lives medically because of what happens in the dentist's office. We're probably entering one of the most exciting phases that dentistry has ever seen."
As part of the discussion, Drs. McAnally and Gottehrer revealed ways to communicate effectively between the dental office and the physician's office regarding two blood tests that help reveal whether oral disease is having effects beyond the mouth into the circulatory system and how treatment by the dentist and dental hygienist can directly impact these substances suspected of contributing to whole body disease.
"Typically evident in most patients with dental disease who were also recorded as exhibiting the biological markers on a blood test, require some type of periodontal care and often times tooth replacement with dental implants or the use of Captek periodontal crowns if they have dental crowns next to the gums," said Dr. Gottehrer.
In a part of the presentation, Dr. McAnally discussed that the Medical-Perio Physician Referral & Marketing Program is now available from Big Case Marketing for general dentists, periodontists, oral surgeons, and prosthodontists that allows an easy facilitation of the physician-dentist relationship.
"This is really a comprehensive medical watchdog for patients because overall they become healthier as a result of the interaction of all physicians involved. Simply put, if we improve the referral relationship process between family practice physicians and cardiologists and the dentist so that medical patients with serious medical conditions receive appropriate dental treatment to reduce dental disease's effects on their systemic health then the dental patients receive the proper monitoring and attention for systemic medical issues based on what the dentists see back in the physician's office.
For some dental specialists, this referral model will enhance their relationship with physicians and their referring dentists," stated Dr. McAnally.
The Medical-Perio Physician Referral & Marketing Program for dentists who are concerned about the oral-body inflammatory connection includes:
* A practice Fast Start introduction for the doctor and staff
* A dedicated Web site called "Heart-Line" for the patient and physician
* The scientific rationale and journal articles for the dentist and physician
* Clinical protocol manuals and administrative protocols for the dental team
* Inoffice clinical forms, physician referral forms and how to use them
* Hygienist update and referral information with instruction on the appropriate periodontal treatment protocols including hygienist referral systems targeting the physician and cardiology offices
* Discussion of compensation surrounding referrals
* Instruction on how to plan an oral-body inflammatory connection to cancer screening day including print advertisements, public service radio announcements, and press releases
* Physician-dentist-patient referral communication letters and forms, faxes for the physician and cardiologist office, prewritten practice newsletter pieces related to the new science, local physician and cardiology contact information for the dentist, direct mailers for cardiologists & family physicians letting them know the availability of this service
* Tracking systems for patients, case acceptance training, staff phone training and monitoring, and practice consultation to help implement the program
Dr. McAnally added, "Even with the free guide most dentists aren't quite sure how to discuss these topics with the physician or go about implementing any of it so they can help patients given the amount of detail and complexity that it requires which is exactly why we developed this comprehensive program. The dentist or specialist with advanced training related to gum disease and dental implants including the forward thinking generalist, all of whom realize that medical-dental health is going to be the next big thing, are the ones who will take the initiative to be on the forefront of something that really effects their patient's overall health. These are the doctors who will be involved with this."
ChaseHealthAdvance financing options, a division of Chase Card Services of JPMorgan Chase, is offering a complimentary copy of Dr. Gottehrer's guide upon enrollment to interested, dentists or physicians by calling (888) 388-7633.
Barry Trexler, senior vice president of sales and marketing for ChaseHealthAdvance, stated, "At ChaseHealthAdvance, we are pleased to have been the sponsor of the printing for this guide. Our patient financing product can help more patients accept the treatments their healthcare providers prescribe to them by breaking up treatment costs into more manageable monthly payments. Also, we give all approved patients a credit line of at least $5,000 which allows more get the care they need.
This is interesting. It is my understanding that the tissue response to Zirconia is excellent. As surgeons, we do not often see the final result unless the patient is on recall. I assume that Dr. Williams said that the soft tissue response to a porcelain fused to zirconia restoration is different (increased inflammation) than the response seen with straight zirconia, or high noble gold alloy PFM restorations. Please elaborate.