Dental India Newsletter
dated 7th August 2005... Choice of 22000 dentists
Forward this newsletter to your friends... Let them click here to
receive FREE newsletters
Please send your comments and suggestions on this
newsletter
Visit www.dentalindia.com , the premium
dental site
|
Implant case with a
rubber dam
Warning On Methamphetamine Growing Bone For Grafts In Vivo Oral Bacteria Point To Cancer Diagnosis |
Please furnish
following details to receive
FREE magazines/brochures/Articles/CDs
(Those who already responded need not send the
details again)
Name: Dr
Name of the spouse
if he/she is a dentist)
Speciality:
Mailing address:
Postal pin code:
Tel no with STD code:
Cell Number:
Pl mail these details to praba@vsnl.com
Here’s the first case I did in June. He’ll be coming back to test the torque soon. Healing went extremely well.
Here’s the first case I did in June. He’ll be coming back to test the torque soon. Healing went extremely well.
I performed the entire implant procedure with a rubber dam slit across four teeth so I could maintain a relative perspective. The buccal root popped out easily. The palatal root I basically drilled out with a #6 surgical length round bur.
The bone was incredibly dense for a maxilla. I had to keep redirecting the twist drills mesially and buccally to keep my ideal alignment. I used a 4.3 X 15mm replace select straight implant.
I screwed a 5mm healing cap.
I’m being very selective with cases and choosing primarily maxillary bicuspids requiring little if any bone augmentation. One thing I think I’m very good at is putting precisely in the cross hairs where they’re supposed to go. Endodontists are good at that kind of precision. TDO is a great communication tool for relaying information back and forth in planning. I’ll post another one I just did last week that I buried. The root was extremely long but it’s very easy to extract these teeth with a scope and a dam.
Terry - ROOTS
Friday 5th August 2005
Warning On Methamphetamine
The American Dental Association wants more dentists and patients to understand the devastating effects the illegal drug methamphetamine has on oral health, a condition known by some as ‘meth mouth’.
In addition to numerous threats to overall health, methamphetamine users risk rampant tooth decay in a distinctive pattern on the smooth front surface of the teeth and the spaces between the front teeth, the ADA reports.
Methamphetamine users' teeth have been described as ‘blackened, stained, rotting, crumbling or falling apart’. Often, the teeth cannot be saved and must be extracted.
The causes of methamphetamine-related tooth decay include:
• the acidic nature of the drug,
• the way the drug reduces the amount of protective saliva around the teeth,
• the craving the drug induces for high calorie carbonated beverages,
• the tendency of users to grind and clench their teeth, and
• the long duration of the drug (12 hours versus one hour for cocaine), which leads to long periods of time when users are not likely to brush and floss their teeth.
According to the 2003 National Survey on Drug Use and Health, 12.3 million Americans aged 12 and older had tried methamphetamine at least once in their lifetimes (5.2 percent of the population), with the majority of past-year users between 18 and 34 years of age.
Dental professionals who suspect patients may be using methamphetamine can:
• Complete a comprehensive oral examination that includes taking a thorough dental and medical history
• Attempt to educate the patient about the profound negative effects the drug can have on oral health
• Refer the patient to such resources as physicians or drug counselling services
• Use preventive measures such as topical fluorides
• Encourage the patient to drink water instead of sugar-containing carbonated beverages
• Be cautious when administering local anaesthetics, sedatives, or general anaesthesia, nitrous oxide or prescribing narcotics because of potential drug interaction
• Take opportunities to educate patients about the risks associated with methamphetamine or any illicit drug use
Warning On Methamphetamine
The American Dental Association wants more dentists and patients to understand the devastating effects the illegal drug methamphetamine has on oral health, a condition known by some as ‘meth mouth’.
In addition to numerous threats to overall health, methamphetamine users risk rampant tooth decay in a distinctive pattern on the smooth front surface of the teeth and the spaces between the front teeth, the ADA reports.
Methamphetamine users' teeth have been described as ‘blackened, stained, rotting, crumbling or falling apart’. Often, the teeth cannot be saved and must be extracted.
The causes of methamphetamine-related tooth decay include:
• the acidic nature of the drug,
• the way the drug reduces the amount of protective saliva around the teeth,
• the craving the drug induces for high calorie carbonated beverages,
• the tendency of users to grind and clench their teeth, and
• the long duration of the drug (12 hours versus one hour for cocaine), which leads to long periods of time when users are not likely to brush and floss their teeth.
According to the 2003 National Survey on Drug Use and Health, 12.3 million Americans aged 12 and older had tried methamphetamine at least once in their lifetimes (5.2 percent of the population), with the majority of past-year users between 18 and 34 years of age.
Dental professionals who suspect patients may be using methamphetamine can:
• Complete a comprehensive oral examination that includes taking a thorough dental and medical history
• Attempt to educate the patient about the profound negative effects the drug can have on oral health
• Refer the patient to such resources as physicians or drug counselling services
• Use preventive measures such as topical fluorides
• Encourage the patient to drink water instead of sugar-containing carbonated beverages
• Be cautious when administering local anaesthetics, sedatives, or general anaesthesia, nitrous oxide or prescribing narcotics because of potential drug interaction
• Take opportunities to educate patients about the risks associated with methamphetamine or any illicit drug use
Growing Bone For Grafts In
Vivo
An international team of biomedical engineers has demonstrated for the first time that it is possible to grow healthy new bone reliably in one part of the body and use it to repair damaged bone at a different location.
The research, which is based on a dramatic departure from the current practice in tissue engineering, is described in a paper titled In Vivo Engineering of Organs: The Bone Bioreactor to be published online next week by the Proceedings of the National Academy of Sciences.
‘We have shown that we can grow predictable volumes of bone on demand,’ said V. Prasad Shastri, assistant professor of biomedical engineering at Vanderbilt University who led the effort. ‘And we did so by persuading the body to do what it already knows how to do.’
‘This research has important implications not only for engineering bone, but for engineering tissues of any kind,’ added co-author Robert S. Langer, Institute Professor at the Massachusetts Institute of Technology and a pioneer in the field of tissue engineering. ‘It has the potential for changing the way that tissue engineering is done in the future.’
The current approach currently used by orthopaedic surgeons to repair serious bone breaks is to remove small pieces of bone from a patient’s rib or hip and fuse them to the broken bone. They use the same method to fuse spinal vertebrae to treat serious spinal injuries and back pain. Although this works well at the repair site, the removal operation is extremely painful and can produce serious complications. If the new method is confirmed in clinical studies, it will become possible to grow new bone for all types of repairs instead of removing it from existing bones. For people with serious bone disease, it may even be possible to grown replacement bone at an early stage and freeze it so it can be used when it is needed, said Prasad.
Despite the fact that living bone is continually growing and reshaping, the numerous attempts to coax bone to grow outside of the body have all failed. Recent attempts to stimulate bone growth within the body have had limited success but have proven to be extremely complex, expensive and unreliable.
Shastri and his colleagues took a new approach that has proven to be surprisingly simple. They decided to take advantage of the body’s natural wound-healing response and create a special zone on the surface of a healthy bone in hopes that the body would respond by filling the space with new bone. The approach lived up to their highest expectations. Working with mature rabbits, a species with bones that are very similar to those of humans, the researchers were delighted to find that this zone, which they have dubbed the ‘in vivo bioreactor,’ filled healthy bone in about six weeks. And it did so without having to coax the bone to grow by applying the growth factors required by previous in vivo efforts. Furthermore, they found that the new bone can be detached easily before it fuses with the old bone, leaving the old bone scarred but intact.
‘The new bone actually has comparable strength and mechanical properties to native bone,’ said Molly Stevens, currently a reader at Imperial College in the United Kingdom who did most of the research as a post-doctoral fellow at MIT. ‘And since the harvested bone is fresh, it integrates really well at a recipient site.’
Long bones in the body are covered by a thin outer layer called the periosteum. The layer is a little like scotch tape: The outside is tough and fibrous but the inside is covered with a layer of special pluripotent cells which, like marrow cells, are capable of transforming into the different types of skeletal tissue. So Shastri and his collaborators decided to create the bioreactor space just under this outer layer.
They created the space by making a tiny hole in the periosteum and injecting saline water underneath. This loosened the layer from the underlying bone and inflated it slightly. When they had created a cavity the size and shape that they wanted, the researchers removed the water and replaced it with a gel that is commercially available and approved by the FDA for delivery of cells within the human body. They chose the material because it contained calcium, a known trigger for bone growth. Their major concern was that the bioreactor would fill with scar tissue instead of bone, but that didn’t happen. Instead, it filled with bone that is indistinguishable from the original bone.
The scientists intend to proceed with the large animal studies and clinical trials necessary to determine if the procedure will work in humans and, if it does, to get it approved for human treatment. At the same time, they hope to test the approach with the liver and pancreas, which have outer layers similar to the periosteum.
An international team of biomedical engineers has demonstrated for the first time that it is possible to grow healthy new bone reliably in one part of the body and use it to repair damaged bone at a different location.
The research, which is based on a dramatic departure from the current practice in tissue engineering, is described in a paper titled In Vivo Engineering of Organs: The Bone Bioreactor to be published online next week by the Proceedings of the National Academy of Sciences.
‘We have shown that we can grow predictable volumes of bone on demand,’ said V. Prasad Shastri, assistant professor of biomedical engineering at Vanderbilt University who led the effort. ‘And we did so by persuading the body to do what it already knows how to do.’
‘This research has important implications not only for engineering bone, but for engineering tissues of any kind,’ added co-author Robert S. Langer, Institute Professor at the Massachusetts Institute of Technology and a pioneer in the field of tissue engineering. ‘It has the potential for changing the way that tissue engineering is done in the future.’
The current approach currently used by orthopaedic surgeons to repair serious bone breaks is to remove small pieces of bone from a patient’s rib or hip and fuse them to the broken bone. They use the same method to fuse spinal vertebrae to treat serious spinal injuries and back pain. Although this works well at the repair site, the removal operation is extremely painful and can produce serious complications. If the new method is confirmed in clinical studies, it will become possible to grow new bone for all types of repairs instead of removing it from existing bones. For people with serious bone disease, it may even be possible to grown replacement bone at an early stage and freeze it so it can be used when it is needed, said Prasad.
Despite the fact that living bone is continually growing and reshaping, the numerous attempts to coax bone to grow outside of the body have all failed. Recent attempts to stimulate bone growth within the body have had limited success but have proven to be extremely complex, expensive and unreliable.
Shastri and his colleagues took a new approach that has proven to be surprisingly simple. They decided to take advantage of the body’s natural wound-healing response and create a special zone on the surface of a healthy bone in hopes that the body would respond by filling the space with new bone. The approach lived up to their highest expectations. Working with mature rabbits, a species with bones that are very similar to those of humans, the researchers were delighted to find that this zone, which they have dubbed the ‘in vivo bioreactor,’ filled healthy bone in about six weeks. And it did so without having to coax the bone to grow by applying the growth factors required by previous in vivo efforts. Furthermore, they found that the new bone can be detached easily before it fuses with the old bone, leaving the old bone scarred but intact.
‘The new bone actually has comparable strength and mechanical properties to native bone,’ said Molly Stevens, currently a reader at Imperial College in the United Kingdom who did most of the research as a post-doctoral fellow at MIT. ‘And since the harvested bone is fresh, it integrates really well at a recipient site.’
Long bones in the body are covered by a thin outer layer called the periosteum. The layer is a little like scotch tape: The outside is tough and fibrous but the inside is covered with a layer of special pluripotent cells which, like marrow cells, are capable of transforming into the different types of skeletal tissue. So Shastri and his collaborators decided to create the bioreactor space just under this outer layer.
They created the space by making a tiny hole in the periosteum and injecting saline water underneath. This loosened the layer from the underlying bone and inflated it slightly. When they had created a cavity the size and shape that they wanted, the researchers removed the water and replaced it with a gel that is commercially available and approved by the FDA for delivery of cells within the human body. They chose the material because it contained calcium, a known trigger for bone growth. Their major concern was that the bioreactor would fill with scar tissue instead of bone, but that didn’t happen. Instead, it filled with bone that is indistinguishable from the original bone.
The scientists intend to proceed with the large animal studies and clinical trials necessary to determine if the procedure will work in humans and, if it does, to get it approved for human treatment. At the same time, they hope to test the approach with the liver and pancreas, which have outer layers similar to the periosteum.
Oral Bacteria Point To
Cancer Diagnosis
Scientists from the Forsyth Institute have identified three species of oral bacteria whose elevated levels can be positively associated with increased incidence of oral squamous cell carcinoma, a discovery that could facilitate development of a saliva-based diagnostic test for this deadly form of cancer, reports the American Dental Association.
‘Finding bacteria associated with oral squamous cell carcinoma encourages us to hope that we have discovered an early diagnostic marker for the disease,’ said Dr. Donna Mager, assistant member of the staff in Forsyth’s Department of Periodontology and Molecular Genetics. ‘If future studies bear this out, it may be possible to save lives by conducting large-scale screenings using saliva samples.’
Nearly 30,000 Americans will be diagnosed with oral or pharyngeal cancer this year, according to the American Cancer Society. Ninety percent of oral cancer lesions are oral squamous cell carcinomas (OSCC), the Forsyth team noted, with a five-year survival rate of 54 percent despite advances in surgery, radiation and chemotherapy.
For their study, the Forsyth investigators collected unstimulated saliva samples from 229 cancer-free subjects and 45 subjects with OSCC and evaluated the samples for their content of 40 common oral bacteria using the checkerboard DNA-DNA hybridisation method.
Of the 40 types of bacteria tested, three species — Capnocytophaga gingivalis, Prevotella melaninogenica and Streptococcus mitis — were elevated in the saliva samples from the subjects with OSCC. The investigators obtained similar findings when they controlled for gender, age and smoking history.
‘Those results led us to hypothesise that the three species could serve as diagnostic indicators for OSCC,’ Dr. Mager said. ‘And, in fact, we found that elevated salivary counts of the three bacteria correctly identified 80 percent of individuals with oral cancer and 83 percent of controls.’
One possible explanation for the results is that oral cancer may change the oral ecology, allowing the three species of bacteria to colonise more rapidly, the investigators noted. However, they said the possibility that the bacteria may be causally associated with development of OSCC cannot be ruled out.
If the findings of the study can be replicated, the Forsyth team envisions development of a simple saliva test to diagnose OSCC administered in large screenings and analysed by a diagnostic centre with results returned within days.
But in the meantime, Dr. Mager noted she ‘cannot overemphasise’ the importance of patients getting examined for signs of oral cancer at least once a year.
The findings of the Forsyth investigation are available online in the paper, ‘The salivary microbiota as a diagnostic indicator of oral cancer: A descriptive, non-randomised study of cancer-free and oral squamous cell carcinoma subjects,’ published in the Journal of Translational Medicine.
The study was funded by the National Institute of Dental and Craniofacial Research and conducted in collaboration with the Dana Farber Cancer Institute and Massachusetts General Hospital
Scientists from the Forsyth Institute have identified three species of oral bacteria whose elevated levels can be positively associated with increased incidence of oral squamous cell carcinoma, a discovery that could facilitate development of a saliva-based diagnostic test for this deadly form of cancer, reports the American Dental Association.
‘Finding bacteria associated with oral squamous cell carcinoma encourages us to hope that we have discovered an early diagnostic marker for the disease,’ said Dr. Donna Mager, assistant member of the staff in Forsyth’s Department of Periodontology and Molecular Genetics. ‘If future studies bear this out, it may be possible to save lives by conducting large-scale screenings using saliva samples.’
Nearly 30,000 Americans will be diagnosed with oral or pharyngeal cancer this year, according to the American Cancer Society. Ninety percent of oral cancer lesions are oral squamous cell carcinomas (OSCC), the Forsyth team noted, with a five-year survival rate of 54 percent despite advances in surgery, radiation and chemotherapy.
For their study, the Forsyth investigators collected unstimulated saliva samples from 229 cancer-free subjects and 45 subjects with OSCC and evaluated the samples for their content of 40 common oral bacteria using the checkerboard DNA-DNA hybridisation method.
Of the 40 types of bacteria tested, three species — Capnocytophaga gingivalis, Prevotella melaninogenica and Streptococcus mitis — were elevated in the saliva samples from the subjects with OSCC. The investigators obtained similar findings when they controlled for gender, age and smoking history.
‘Those results led us to hypothesise that the three species could serve as diagnostic indicators for OSCC,’ Dr. Mager said. ‘And, in fact, we found that elevated salivary counts of the three bacteria correctly identified 80 percent of individuals with oral cancer and 83 percent of controls.’
One possible explanation for the results is that oral cancer may change the oral ecology, allowing the three species of bacteria to colonise more rapidly, the investigators noted. However, they said the possibility that the bacteria may be causally associated with development of OSCC cannot be ruled out.
If the findings of the study can be replicated, the Forsyth team envisions development of a simple saliva test to diagnose OSCC administered in large screenings and analysed by a diagnostic centre with results returned within days.
But in the meantime, Dr. Mager noted she ‘cannot overemphasise’ the importance of patients getting examined for signs of oral cancer at least once a year.
The findings of the Forsyth investigation are available online in the paper, ‘The salivary microbiota as a diagnostic indicator of oral cancer: A descriptive, non-randomised study of cancer-free and oral squamous cell carcinoma subjects,’ published in the Journal of Translational Medicine.
The study was funded by the National Institute of Dental and Craniofacial Research and conducted in collaboration with the Dana Farber Cancer Institute and Massachusetts General Hospital