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Wood - The Next Bone Graft Material?

One of our members brought the following story from the BBC to my attention. Scientists in Italy have developed a way of turning rattan wood into bone that is almost identical to the human tissue. The team is lead by Dr Anna Tampieri. "It's proving very promising" she says. "This new bone material is strong, so it can take heavy loads that bodies will put on it. "It is also durable, so, unlike existing bone substitutes, it won't need replacing".

In our periodontal and implant practice, we have been using bone grafts for decades to restore normal physiologic bony parameters around teeth, as well as to facilitate ideal dental implant placement and restoration. In our experience, the synthetic graft materials, although successful, have yielded results that are less desirable than the outcomes achieved with autografts, allografts, and xenografts. However, this is very interesting and promising. Time will tell if it will truly be a viable bone graft material. Check it out.

Source: BBC

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To anybody reading this comment - have you been involved restoring an occlusion of a patient suffering from primary ( idiopathic ) failure of eruption. Patient is female 15 years old and pretty. Several attempts to surgically / orthodontically erupt teeth failed, posterior open bite and although upper anterior teeth erupted she shows no teeth at all. Several treatment options available later but interim a problem.A second patient presents with type of amelogenisis / dentinogenisis imperpecta. No clinical crowns present on all teeth. ( flush with gums ). Radiographically the roots appear normal with totally obliterated root canal systems on all teeth ( no feeling at all ). Brother and sister . Brother is 15 years old and no treatment so far. Sister is 18 and failed treatment attempt .Thank you. Any comment will be appeciated. Best wishes to all for 2010 - come to the world cup in SA!!!!!Kind regardsDeon Ferreira
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Industrial Milling of IPS e.max CAD

Dental laboratories across the USA and in Canada can now access an industrial milling partner specializing in the precision milling of IPS e.max CAD and Empress CAD restorations. Using Roeders industrial milling equipment including RC3 robotic automation , Diadem Digital Solutions partners with laboratories who forward their digital scan information and restoration designs. With their industrial precision milling equipment, Diadem and its lab partners can now achieve marginal fits of less than 10 micron accuracy.For more information go to : https://www.youtube.com/watch?v=Uza_plpDHucor www.diadem-ids.com
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With the emergence and growth of CAD/CAM dentistry and fabrication of simple in-office dental restorations, one might regard this as a threat to the dental laboratory technician. However, the experience, expertise, knowledge, and guidance provided by the dental lab technician are critical for successful outcomes for our patients, especially for larger, more sophisticated cases. The lab technician remains a vital member of the dental team from the initial diagnosis to the delivery of the final restoration, as well as during long term maintenance. The importance of this relationship is elaborated upon in an article by Lee Culp, CDT & Lida Swann, DDS. Comments?

Cary Feuerman, DMD

Periodontal Associates

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It seems as though we are learning more about the relationship between periodontal disease and Diabetes every day. Information about the link between the two continues to grow as new scientific literature is published.

A recent study led by Dr. Sheila Strauss, Associate Professor of Nursing and Co-Director of the Statistics and Data Management Core for NYU's Colleges of Dentistry and Nursing, examined data from 2,923 adult participants in the 2003-2004 National Health and Nutrition Examination Survey who had not been diagnosed with diabetes.

Using guidelines established by the American Diabetes Association, Dr. Strauss determined that 93 percent of subjects who had periodontal disease, compared to 63 percent of those without the disease, were considered to be at high risk for diabetes and should be screened for diabetes. Screening could be performed by dentists using a simple glucometer with blood taken from inflamed periodontal pockets.

Dr. Strauss stated, "In light of these findings, the dental visit could be a useful opportunity to conduct an initial diabetes screening -- an important first step in identifying those patients who need follow-up testing to diagnose the disease."

"It's been estimated that 5.7 million Americans with diabetes were undiagnosed in 2007," Dr. Strauss added, "with the number expected to increase dramatically in coming years. The issue of undiagnosed diabetes is especially critical because early treatment and secondary prevention efforts may help to prevent or delay the long-term complications of diabetes that are responsible for reduced quality of life and increased levels of mortality among these patients. Thus, there is a critical need to increase opportunities for diabetes screening and early diabetes detection."

Given the findings of this study, do you think you would incorporate routine Diabetes screening into your daily practice?

Source: The Journal of Public Health Dentistry

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A new study on the surface chemistry of silver-colored, mercury-based dental fillings suggests that the surface forms of mercury may be less toxic than previously thought. In the study, Graham George and colleagues note that amalgam (mercury-based) fillings have been used by dentists to repair teeth for well-over a century. In recent decades their use has become controversial because of concerns about exposure to potentially toxic mercury. However, mercury can potentially exist in several different chemical forms, each with a different toxicity. Prior to this report, little was known about how the chemical forms of mercury in dental amalgam might change over time. Using a special X-ray technique, the scientists analyzed the surface of freshly prepared metal fillings and compared these with the surface of aged fillings (about 20 years old) from a dental clinic. Fresh fillings contained metallic mercury, which can be toxic. Aged fillings, however, typically contain a form of mercury, called beta-mercuric sulfide or metacinnabar, which is unlikely to be toxic in the body. The scientists found that the surfaces of metal fillings seem to lose up to 95 percent of their mercury over time. Loss of potentially toxic mercury from amalgam may be due to evaporation, exposure to some kinds of dental hygiene products, exposure to certain foods, or other factors. The scientists caution that "human exposure to mercury lost from fillings is still of concern." Source: Science Daily, American Chemical Society Photo Credit: American Dental Association
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DENTSPLY ANKYLOS SynCone Overdentures

Our Periodontal Associates study club co-hosted a meeting the other night with Dentsply on the topic of overdentures. The material was expertly presented by Ira Dickerman of Dickerman Dental Prosthetics and Dr. Theo Kapos from Harvard Dental School. In particular, the Ankylos Syncone protocol was reviewed. This seems to be an extremely precise, stable, and cost-effective method for delivery of an implant-supported overdenture prosthesis. It also appears as though the protocol may be modified to support a fixed "hybrid" prosthesis on four implant fixtures. Even though I have been involved with implant dentistry for over 21 years, it is exciting to see new developments and technologies that can have a tremendous impact on improving the quality of life for our patients. Comment or thoughts (especially from our international members)?

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Dental Supplier Friend or Foe

As a rep for a dental supplier I find the relationships between dentists and their reps vary greatly. Some dentists just try and get as much as they can for the least money,while others see their reps as a partner who can help them grow their practice. I am curious how the dentists of webdental feel about their supplier.
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Look Ma, No Mercury in Fillings!

Kent Coulter and his colleagues at Southwest Research Institute in San Antonio have developed a new proof-of-concept dental restorative material under a program funded by the National Institutes of Health that seeks to replace amalgam with other materials. The new fillings are made with a plastic-like material containing zirconia nanoplatelets. Coulter and his colleagues designed a way to make a roll of this material under vacuum. They envision that this material would be lifted from the roll and packed in a dental cavity and then cured -- using an ultraviolet lamp or some other means -- so that it hardens in place without shrinking. It seems like ziconia continues to be a very exciting, useful and beneficial material in dental practice. Comments?

Source: Science Daily

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Be Thankful for Healthy Teeth!

On the eve of Thanksgiving, all dental professionals should be thankful for having the opportunity to "make a difference" and enhance the quality of life for our dental patients on a daily basis. And, our patients should be equally thankful for the healthy teeth that allows them to enjoy the Thanksgiving meal! Congratulations to all of you. Wishing you a very happy and healthy Thanksgiving.
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A Dental Shift: Implants Instead of Bridges

A patient mentioned a great article written by Jane E. Brody in the Health section of the New York Times regarding dental implants as the treatment of choice when compared to fixed bridges. The author unfortunately had experienced failure of a conventional three unit fixed bridge. Fortunately, she has the option of restoring her quality of life with an implant supported crown. In our periodontal practice in Framingham and Newton, Massachusetts, implant dentistry and related procedures represent the bulk of our daily treatment activities. We have placed thousands of dental implants since 1988, with a success rate of greater than 98%. The majority of our cases result from failing root canals, tooth fractures, and recurrent decay. Although conventional tooth-supported three unit bridges still have a viable role in dentistry, it is refreshing to see that the general public is becoming more educated about the most ideal treatment options. Kudos to Jane E. Brody for her article today. Please share your thoughts on this topic.

photo credit: Cary Feuerman DMD

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Mouth Is An Indicator of Overall Health

One day in medical clinics, the big picture of a patient’s state of health may be found in little pictures from the mouth, says Li Mao, MD, a new professor at the University of Maryland Dental School.

The mouth or oral cavity area is an excellent indicator of the whole body’s health, says Mao, who is the chair of the new Department of Oncology and Diagnostic Sciences at the School.

Mao recently joined the Dental School to be at the forefront of a movement to retool dental education, he says, to make dentists practice more within the bigger health care community.

Future lung cancer prevention trials, for example, could soon be designed so that surface tissues inside the cheek could be checked to detect tobacco-induced damage in the lungs, according to a study led by Mao last year published in the journal Cancer Prevention Research.

“We hypothesized that tobacco-induced molecular alterations in the oral epithelium are similar to those in the lungs,” says Mao. “This might have broader implications for using the mouth as a diagnostic indicator for general health.” More..

Source: Newswise

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Oral biologists formulated a mint that fights cavities with an ingredient called Cavistat. Cavistat contains two main components that protect the teeth. First, the amino acid arginine metabolizes certain bacteria, which neutralizes the acid generated by sugars. This raises the pH to help prevent damage to teeth. Cavistat also introduces other chemical compounds that protect against the dissolving of the minerals of the teeth. See the video and read more. Happy Halloween! Source: American Institute of Physics
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Health Care Reform and Dentistry

As the debate lingers on I wonder what effect all proposed legislation will have on dentistry. Will government fund dental insurance like they propose funding insurance short term? If so, they have tall shoes to fill as I think the system works pretty well as it is. I have heard some argue that dentists would actually get more patients and have to do less "free" dental care. On the flip side, I have heard that dentists would HAVE to see more patients in order to make the same pay they do now, because the insurance payouts would be much less per treatment. This is all very confusing and I have not been following it as closely as I should, which is why I ask, how do you think health care reform will impact dentistry?
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Come fly with me...

A new study looks at the highly sophisticated structure of teeth and how this structure could be applied to aircraft and space vehicles of the future. It's been a mystery: how can our teeth withstand such an enormous amount of pressure, over many years, when tooth enamel is only about as strong as glass? Professor Herzl Chai of Tel Aviv University's School of Mechanical Engineering and his colleagues at the National Institute of Standards and Technology and George Washington University gives the answer. The researchers applied varying degrees of mechanical pressure to hundreds of extracted teeth, and studied what occurred on the surface and deep inside them. The study, published in the May 5, 2009, issue of the Proceedings of the National Academy of Science, shows that it is the highly-sophisticated structure of our teeth that keeps them in one piece — and that structure holds promising clues for aerospace engineers as they build the aircraft and space vehicles of the future. Check it out at Science Daily.

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Scientist and Professor Meital Zilberman of Tel Aviv University's Department of Biomedical Engineering has developed a new biologically active "scaffold" made from soluble fibers, which may help humans replace lost or missing bone. The invention, which does not yet have a name, could be used to restore missing bone in a limb lost in an accident, or repair receded jawbones necessary to secure dental implants, says Prof. Zilberman. The scaffold can be shaped so the bone will grow into the proper form. They're also specially developed to release bioactive drugs and proteins in a controlled manner. After a period of time, the fibers can be programmed to dissolve, leaving no trace. Her technology also has potential uses in cosmetic surgery. Instead of silicon implants to square the chin or raise cheekbones, the technology can be used to "grow your own" cheekbones or puffy lips. But Prof. Zilberman says it's far too early to think of such uses. She first started her work in biomaterials at the UT Southwestern Medical Center at Dallas, Texas, and currently is concentrating on various medical applications. One of them intends to make dental implants more effective. She envisions applying the invention to organ tissue regeneration in the future. This sounds extremely promising for dental implant treatment! Comments? Source: Science Daily
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