Associate member of the American Academy of Periodontology

I have been honored with an Associate membership in the Prestigous AAP American Academy of Periodontics.

AAP Meeting in Boston

At the AAP don't forget to catch Ray Yukna on Saturday 1 pm this is the Corp sponsored program. then again you can see him 2pm.

MILLENNIUM DENTAL TECHNOLOGIES

Outstanding Clinical and Human Histologic

Outcomes with the PerioLase® Nd:YAG Laser

Speaker: Raymond A. Yukna

The Laser-Assisted New Attachment Procedure

(LANAP™) using the Nd:YAG laser in a specific

patented protocol has been evaluated as a single

visit treatment of periodontal pockets with the goal

of obtaining new attachment. Clinical success is

supported by human histology showing new

cementum and new connective tissue attachment.

Then Monday at 10:15.

CTS1: LASER APPLICATIONS: AN EVIDENCEBASED

APPROACH TO CLINICAL PRACTICE

10:15 - 11:45 am

Program Track: Treatment of Inflammatory

Periodontal Diseases

Moderator: Timothy P. Walsh

Speakers: Bobby L. Butler, Henry Greenwell,

George E. Romanos, Raymond A. Yukna

Lasers have been used in dentistry for many years.

Historically, lasers have been shown to be used primarily

for soft tissue procedures. The clinical benefits of lasers

have led to FDA clearance for numerous uses of such in

periodontics and implant dentistry.

Educational Objectives:

• Understand different laser wavelengths and their

interactions with hard and soft tissue, including the

applications of varying wavelengths and treatment

protocols to treat periodontitis.

• Discuss tissue biotypes and case selections for open

and closed crown lengthening.

• Demonstrate long-term success for treating failing

implants with lasers.

Laser Gum Surgery

Who Was the First Periodontist?

Who Was the First Periodontist?

Many people have wondered, who was the first periodontist? Upon hearing this question, many have wondered, what is a periodontist? Well, we are going to discuss those questions and many more throughout the course of this article, to the best of our abilities concerning the documented evidence.

We know that periodontal disease has been a problem for people all throughout history. You see, as a specialty, periodontics – the study of periodontal disease, periodontitis, et cetera – has a very long and very full history. That history covers the whole of civilization.

There is evidence that even back in prehistoric times, our ancestors had some problems with their teeth. For example, people in the early Egyptian and Middle Eastern cultures had oral health problems. How do we know this? Well, for one thing, there is written evidence and skeletal remains which show the existence of periodontal disease.

In histories pertaining to ancient Chinese and Indian cultures, there exists evidence of periodontal diseases like scurvy. Within those same histories, there were actually pieces of advice pertaining to the importance of cleaning one’s teeth! The evidence piles up through history, from ancient Greek and Roman to Renaissance Europe. The diseases themselves were well described in the records available, as well treatments and methods of prevention.
However, the first periodontist came quite a bit later – not until the early twentieth century, in fact. Now, it stands to reason that periodontists likely existed before this; they simply were not documented. They may have gone by a different title. Around about 1914, however, all available accounts seem to suggest that Dr. Grace Rogers may have been the first practicing periodontist.
Given the long history of documented periodontal diseases and care, however, it only stands to reason that, in the equally long history of dentistry, other people must have practiced periodontology. We simply do not have the records of those possible forebears.
Disclaimer: If you have or think you might have gum disease or any other health problem, please visit your dentist or periodontist for advice, diagnosis and treatment. This article is for information purposes only and does not intend to provide advice, diagnosis or treatment for any health condition.

Periodontal disease a risk marker for stroke

Periodontal disease a risk marker for stroke.

Men with a history of bone loss due to periodontitis run a higher risk of having a stroke, according to a study in the Annals of Neurology (May 28, 2009).

The potential role of periodontitis in the risk of cardiovascular disease has received much attention in the past decade, and evidence of an association between periodontitis and cerebrovascular disease, especially ischemic stroke, has been stronger compared to other types of cardiovascular disease, the study authors noted.

Although the link has been reported before, their research examined the clinical measures of periodontitis as opposed to self-reports or other assessments not involving periodontal probing, lead study author Thomas Dietrich, D.M.D., of the University of Birmingham School of Dentistry said.

The researchers analyzed data from 1,137 men in the Veterans Affairs Normative Aging Study, an ongoing study that began in the 1960s with healthy volunteers from the greater Boston area. Participants underwent medical and dental exams every three years for an average of 24 years.

A trained periodontist conducted the dental exams, including full mouth radiographs and periodontal probing at each tooth. Cerebrovascular disease was defined as a stroke or transient ischemic attack.

Dr. Dietrich and his colleagues evaluated the incidence of cerebrovascular events in relation to mean radiographic alveolar bone loss (a measure of periodontitis history) and cumulative periodontal probing depth (a measure of current periodontal inflammation).

Bone loss key

Overall, 80 incident cases of cerebrovascular disease occurred during a combined 27,506 person-years, and periodontal bone loss was "significantly associated" with an increased hazard rate of cerebrovascular disease, according to the researchers. They found a stronger effect among men younger than 65 compared to older men.

In comparison, periodontal probing depth was not associated with a significantly increased rate of cerebrovascular disease.

The exact mechanism of the association is unclear, said Dr. Dietrich, noting that both causal and noncausal factors may explain it.

There could be direct or indirect effects of the periodontal infection and inflammatory response, or some people may have an increased proinflammatory susceptibility that could contribute to both cerebrovascular disease and periodontal disease, the authors wrote. Current epidemiologic studies are not able to differentiate between these causal and noncausal pathways, even with perfect control of all established cardiovascular risk factors.

And why was periodontal bone loss significantly associated with an increased hazard rate of cerebrovascular disease, while periodontal probing depth was not?

"This is more consistent with a noncausal mechanism, since treatment of periodontitis or tooth loss would not affect the underlying susceptibility to inflammatory disease," Dr. Dietrich said.

A significant link was found between history of periodontitis as measured by alveolar bone loss and incidence of cerebrovascular disease in men, independent of established cardiovascular risk factors, the authors noted. Furthermore, they found evidence for a stronger association between periodontal bone loss and incidence of cerebrovascular disease among younger men.

"Even if this association was predominantly noncausal, periodontitis could be an important marker of risk for cerebrovascular disease, given its relatively high prevalence and the strength of the association," they concluded.

Large epidemiologic studies using molecular and genetic approaches in various populations are necessary to determine the strength of the association between periodontitis and cerebrovascular disease and to elucidate its biologic basis, they added.

Tooth decay, bleeding gums may herald chronic ills

NEW YORK (Reuters Health) - Our modern dental woes have a lot do to with modern whole-body ills like heart disease and diabetes, according to the author of a review of decades' worth of studies on diet and health.

The culprit in both cases? The so-called fermentable carbohydrates forming the foundation of the modern diet, says Dr. Philippe P. Hujoel of the University of Washington School of Dentistry in Seattle. These include sugars and starchy foods that break down into sugars in the mouth, as well as tropical fruits and dried fruits.

Hujoel argues in the Journal of Dental Research that gum disease and tooth decay should be seen as "alarm bells" that signal a person is at risk of heart disease, diabetes and other chronic health problems.

In recent years, Hujoel argues, fat has replaced fermentable carbohydrates as the enemy, which has led to the promotion of heavy carbohydrate consumption-and in turn the need for dental interventions like sealant and fluoride to prevent tooth decay.

Studies have shown development of gum disease within days of a person upping their sugar intake, which then improves within weeks of a person cutting out carbs. If such high-fermentable carbohydrate diets continue, Hujoel argues, their associated chronic illnesses take hold.

"Clearly, the dental alarm bell has an extremely low threshold for activation; the response occurs in days, weeks or, at most, years, as opposed to the decades it takes for systemic (diseases) to become clinically apparent," he writes.

Hujoel calls for research to investigate the question of whether diets that are good for our teeth are also good for our overall health. If the answer is yes, he adds, "dental diseases could become increasingly regarded as the early marker of adverse lifestyle choices," and could also offer clues to understanding other systemic illnesses such as Alzheimer's disease.

SOURCE: Journal of Dental Research, July 1, 2009.

http://www.reuters.com/article/healthNews/idUSTRE56Q4RM20090727

Certain Oral Bacteria Linked To Obesity

Certain Oral Bacteria Linked To Obesity

Investigators at the Forsyth Institute are focusing on the possible role of oral bacteria as a potential direct contributor to obesity. It seems likely that certain bacterial species could serve as biological indicators of a developing overweight condition.

Researchers J.M. Goodson, D. Groppo, S. Halem and E. Carpino measured salivary bacterial populations of overweight women. Saliva was collected from 313 women with a body mass index between 27 and 32, and bacterial populations were measured by DNA probe analysis. Levels in this group were compared with data from a population of 232 healthy individuals from periodontal disease studies. The median percentage difference of seven of the 40 bacterial species measured was greater than 2 percent in the saliva of overweight women. Classification tree analysis of salivary microbiological composition revealed that 98.4 percent of the overweight women could be identified by the presence of a single bacterial species (Selenomonas noxia) at levels greater than 1.05 percent of the total salivary bacteria. Analysis of these data suggests that the composition of salivary bacteria changes in overweight women.

Of even greater interest, and the subject of future research, is the possibility that oral bacteria may participate in the pathology that leads to obesity. The complete research study is published in the June issue of the International and American Associations for Dental Research's Journal of Dental Research.

Source: Journal of Dental Research

Los Angeles Gum Surgery

AGD panel to discuss perio, heart disease link

AGD panel to discuss perio, heart disease link

The connection between periodontal disease and cardiovascular disease will be the topic of a panel discussion on the growing need for dentists and physicians to collaborate at this week's Academy of General Dentistry (AGD) annual meeting.

Marvin Slepian, M.D., and Neil Gottehrer, D.D.S., will lead an "Oral/Body Inflammation Connection" discussion during the meeting in Baltimore.

"It is critical for all dentists and physicians to collaborate in helping patients reduce inflammation, which can become a target factor for cardiovascular disease," Dr. Slepian stated in a press release.

Information presented during this session will provide dentists with hands-on knowledge regarding how to communicate with physicians to collaborate and create more proactive management periodontal disease treatment plans (including nonsurgical options), which can then improve periodontal and associated physical health by reducing cardiovascular disease.

"This is a landmark course being presented, and I am honored to be holding the discussion with my colleague, Dr. Slepian," Dr. Gottehrer stated in the release. "We hope to provide groundbreaking and useful information to attendees to help them improve the overall health of their patients and to build an increased awareness about the connection between periodontal disease and cardiovascular disease that many, if not most, patients are unaware of."

Along with a panel of seven other doctors, Drs. Gottehrer and Slepian will identify the categories by grade of periodontal disease and the risks of disease to the patient, describe uniform treatment for all stages of both periodontal disease and cardiovascular disease, and suggest a successful hygiene program to improve dental care given to patients.

LANAP Dentist

LANAP in the News

Laser gum surgery Los Angeles

Researchers study link between gum disease and memory loss

Researchers study link between gum disease and memory loss.

The National Institutes of Health (NIH) has awarded a $1.3 million grant to a group of researchers who have found a link between gum disease and memory loss.

The research team includes Richard Crout, D.M.D., Ph.D., an expert on gum disease and the associate dean for research at West Virginia University (WVU) School of Dentistry; gerontologist Bei Wu, Ph.D., a researcher at the University of North Carolina; Brenda Plassman, Ph.D., a specialist in memory research at Duke University; and Jersey Liang, Ph.D., a professor at the University of Michigan.

The team will look at health records of several thousand Americans over many years, according to WVU.

"This could have great implications for health of our aging populations," Dr. Crout stated in a press release. "With rates of Alzheimer's skyrocketing, imagine the benefits of knowing that keeping the mouth free of infection could cut down on cases of dementia."

The research builds on an ongoing study of West Virginians age 70 and older. Working with the WVU School of Medicine, School of Dentistry researchers have given oral exams and memory tests to 270 elderly people in more than a dozen West Virginia counties.

Funded by a $419,000 two-year grant, they've discovered that about 23% of the group suffers from mild to moderate memory loss.

"If you have a gum infection, you'll have an increased level of inflammatory by-products," Dr. Crout noted. "We're looking for markers in the blood that show inflammation to see if there is a link to memory problems. We'd like to go full circle and do an intervention -- to clean up some of the problems in the mouth and then see if the inflammatory markers go down."

Los Angeles Periodontist

Laser periodontal therapy effective alternative to surgery

Laser periodontal therapy effective alternative to surgery

Laser periodontal therapy is an effective alternative to scalpel/suture surgery for treating gum disease, according to a new study in the International Journal of Periodontics & Restorative Dentistry.

Led by Raymond A. Yukna, D.M.D., M.S., the histological split mouth design study looked at twelve single-rooted teeth with moderate to advanced chronic periodontitis. Six teeth were given Laser Assisted New Attachment Procedure (LANAP) using the PerioLase MVP-7 by Millennium Dental Technologies, while the other six received scaling and root planing only.

After three months, all LANAP-treated teeth showed regeneration of root surface (cementum) and new connective tissue attachment (CTA), whereas none of the control teeth effectively showed new attachment or regeneration.

"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 Dr. Yukna in a press release. "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 publication of this study addresses many of the concerns held by the dental community," said Michael Minailo, president and CEO of Millennium Dental Technologies. "With growing demand and continued scientific support, we expect to see significant momentum in 2009."

http://www.drbicuspid.com/index.aspx?sec=nws&sub=rad&pag=dis&ItemId=300317

Patients With Moderate To Severe Periodontitis Need Evaluation For Heart Disease Risk

Additional research is called for and patients with moderate to severe periodontitis should receive evaluation and possible treatment to reduce their risk of atherosclerotic cardiovascular disease (CVD), according to a special consensus paper by editors of The American Journal of Cardiology and Journal of Peridontology in the July 1, 2009 issue of The American Journal of Cardiology, published by Elsevier. Periodontitis, a bacterially-induced, localized, chronic inflammatory disease, destroys connective tissue and bone that support the teeth. Periodontitis is common, with mild to moderate forms affecting 30 to 50% of adults and the severe generalized form affecting 5 to 15% of all adults in the USA. In addition, there is now strong evidence that people with periodontitis are at increased risk of atherosclerotic CVD - the accumulation of lipid products within the arterial vascular wall. The explanation for the link between periodontitis and atherosclerotic CVD is not yet clear, but a leading candidate is inflammation caused by the immune system. In recent years the inflammation is now recognized as a significant active participant in many chronic diseases. Other explanations for periodontitis and atherosclerotic CVD are common risk factors such as smoking,Diabetes mellitus, genetics, mentalanxiety, depression, obesity, and physical inactivity. Regardless of the cause, the expert panel believes that the current evidence is strong enough to recommend that doctors assess atherosclerotic CVD in their patients with periodontitis. The research recommends that patients with moderate to severe periodontitis should be informed that there may be an increased risk of atherosclerotic CVD associated with periodontitis, and those patients with one or more known major risk factor for atherosclerotic CVD should consider a medical evaluation if they have not done so in the past 12 months. "This consensus paper is important because it will draw attention to the fact that patients with periodontitis, especially moderate and severe forms of the disease, can have increased risk for coronary disease," commented to David Dionne, Executive Publisher of The American Journal of Cardiology. Notes: The article is "The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease" by Vincent E. Friedewald, MD, Kenneth S. Kornman, DDS, PhD, James D. Beck, PhD, Robert Genco, DDS, PhD, Allison Goldfine, MD, Peter Libby, MD, Steven Offenbacher, DDS, PhD, MMsc, Paul M. Ridker, MD, MPH, Thomas E. Van Dyke, DDS, PhD and William C. Roberts, MD. It appears in The American Journal of Cardiology, Volume 104, Issue 1 (July 1, 2009) published by Elsevier. Source: Maureen Hunter Elsevier

LANAP in the NEWS

This is Dr Robert Gregg speaking on LANAP with ABC NEWS






LANAP