October 2007
|
Early Communication
of an Ongoing Safety Review
Bisphosphonates:
Alendronate (Fosamax, Fosamax Plus D),
Etidronate (Didronel), Ibandronate (Boniva),
Pamidronate (Aredia), Risedronate (Actonel,
Actonel W/Calcium), Tiludronate (Skelid), and
Zoledronic acid (Reclast, Zometa)
This information reflects FDA’s current analysis
of available data concerning these drugs.
Posting this information does not mean that FDA
has concluded there is a causal relationship
between the drug products and the emerging
safety issue. Nor does it mean that FDA is
advising health care professionals to
discontinue prescribing these products. FDA is
considering, but has not reached a conclusion
about whether this information warrants any
regulatory action. FDA intends to update this
document when additional information or analyses
become available.
Publications in a recent issue of The New
England Journal of Medicine have raised the
question about the association of atrial
fibrillation with the use of bisphosphonates.
FDA has reviewed some safety data and requested
additional data to further evaluate the risk of
atrial fibrillation in patients who take
bisphosphonates.
An article and an accompanying letter to the
editor in the May 3, 2007, issue of The New
England Journal of Medicine describe
increased rates of serious atrial fibrillation
(defined by the authors as life-threatening or
resulting in hospitalization or disability) in
two different studies of older women with
osteoporosis treated with the bisphosphonates,
Reclast and Fosamax. In both studies, more
women who received one of the bisphosphonates
(Reclast-1.3% or Fosamax-1.5%) reportedly
developed serious atrial fibrillation as
compared to women who received placebo (Reclast
study-0.5%, Fosamax study-1.0%). In both
studies, the rates of all atrial fibrillation
(serious plus nonserious) were not significantly
different between groups treated with
bisphosphonate versus placebo.
What does FDA know about this concern?
The FDA reviewed spontaneous post-marketing
reports of atrial fibrillation reported in
association with oral and intravenous
bisphosphonates and did not identify a
population of bisphosphonate users at increased
risk of atrial fibrillation. In addition, as
part of the data review for the recent approval
of once-yearly Reclast for the treatment of
postmenopausal osteoporosis, the FDA evaluated
the possible association between atrial
fibrillation and the use of Reclast. Most cases
of atrial fibrillation occurred more than a
month after drug infusion. Also, in a subset of
patients monitored by electrocardiogram up to
the 11th day following infusion, there was no
significant difference in the prevalence of
atrial fibrillation between patients who
received Reclast and patients who received
placebo.
Atrial fibrillation is a heart rhythm
disorder common in individuals 65 years old and
older, the same age range of many of the
patients studied in the article published in
The New England Journal of Medicine. Upon
initial review, it is unclear how these data on
serious atrial fibrillation should be
interpreted. Therefore, FDA does not believe
that healthcare providers or patients should
change either their prescribing practices or
their use of bisphosphonates at this time.
This early communication is in keeping with
FDA’s commitment to inform the public about its
ongoing safety reviews of drugs. FDA is seeking
additional data to allow for an in-depth
evaluation of the atrial fibrillation issue for
the entire class of bisphosphonates. It may
take up to 12 months to complete the evaluation
at which time FDA will communicate the
conclusions and any resulting recommendations to
the public. Moreover, FDA is continuing to
monitor spontaneous post-marketing reports of
atrial fibrillation reported in patients who
have taken bisphosphonates.
Bisphosphonates are a class of drugs used
primarily to increase bone mass and reduce the
risk for fracture in patients with
osteoporosis. Bisphosphonates are also used to
slow bone turnover in patients with Paget’s
disease of the bone and to treat bone metastases
and lower elevated levels of blood calcium in
patients with cancer. There are 7 FDA-approved
bisphosphonates: alendronate (Fosamax, Fosamax
Plus D), etidronate (Didronel), ibandronate
(Boniva), pamidronate (Aredia), risedronate
(Actonel, Actonel W/Calcium), tiludronate (Skelid),
and zoledronic acid (Reclast, Zometa).
The FDA urges both healthcare professionals
and patients to report side effects from the use
of bisphosphonates to the FDA's MedWatch Adverse
Event Reporting program.
Date created: October 1, 2007 |
|
September 2007
Please remember to be
in prayer for those who are protecting us in the military. Be
sure to thank them, we
owe our freedom to them!
Stress May Leave
Your Mouth a Mess
Stress may play a role in the development of
periodontal diseases
A literature review saw a
strong relationship between stress and periodontal
diseases; 57% of the studies included in the
review showed a positive relationship between
periodontal diseases and psychological factors such
as stress, distress, anxiety, depression and
loneliness. Patients who minimize stress may be at
less risk for periodontal disease.
Researchers speculate that the
hormone cortisol may play a role in the possible
connection between stress and periodontal diseases.
A
study in the July issue of the JOP
found that increased levels of cortisol can lead to
more destruction of the gums and bone due to
periodontal diseases. It is well known that
periodontal diseases left untreated can ultimately
lead to bone loss or tooth loss.
“Individuals with high stress
levels tend to increase their bad habits, which can
be harmful to periodontal health. They are less
attentive to their oral hygiene and may increase
their use of nicotine, alcohol or drugs. Patients
should seek healthy ways to relieve stress through
exercise, balanced eating, plenty of sleep and
maintaining a positive mental attitude.
Patients should to also keep in
mind their “pocket size guide” to periodontal
health; periodontal probing depths of one to
two millimeters with no bleeding are not a
concern but probing depths of three and four
millimeters may need a more in depth cleaning
called scaling and root planing. Probing depths in
excess of 5mm may require more advanced treatment
and patients should talk to their dental specialist.
www.perio.com Journal of Periodontology
(JOP) August 2007 |
|
New CPR Promises Better Results by Compressing
Abdomen, Not Chest"
WEST LAFAYETTE, IN -- September 6, 2007 -- A biomedical engineer at
Purdue University has
developed a new method to perform cardiopulmonary resuscitation that
promises to be more
effective than standard CPR because it increases nourishing blood
flow through the heart
by 25% over the current method. A new technique is desperately
needed because
conventional CPR has a success rate of 5% to 10%, depending on how
fast rescuers are able
to respond and how well the procedure is performed. For every one
minute of delay, the
resuscitation rate decreases by 10%. "In other words, at 10 minutes,
the resuscitation is
absolutely ineffective," said Leslie Geddes, Showalter Distinguished
Professor Emeritus
in Purdue's Weldon School of Biomedical Engineering. "Any medical
procedure that had that
low a success rate would be abandoned right away. But the
alternative is not very good,
either: Don't do CPR and the person is going to die." Geddes has
developed the first new
CPR alternative, called "only rhythmic abdominal compression," or
OAC-CPR, which works by
pushing on the abdomen instead of the chest. "There are major
problems with standard
CPR," Geddes said. "One is the risk of breaking ribs if you push too
hard, but if you
don't push hard you won't save the person. Another problem is the
risk of transferring
infection with mouth-to-mouth breathing." The new CPR method
eliminates both risks,
Geddes said. Findings will be detailed in a research paper appearing
this month in the
[American Journal of Emergency Medicine, published by Elsevier Inc.
The paper was
authored by Geddes and his Purdue colleagues Ann E. Rundell,
assistant professor of
biomedical engineering, biomedical engineering doctoral student
Aaron Lottes, and basic
medical sciences graduate students Andre Kemeny and Michael Otlewski.
In standard chest-compression CPR, which has been in practice since
the 1960s, the
rescuer pushes on the chest and blows into the subject's mouth twice
for every 30 chest
compressions. However, the risk of infection is so grave that many
doctors and nurses
often refuse to administer mouth-to-mouth resuscitation. In one
1993 study of 433 doctors
and 152 nurses, 45% of doctors and 80% of nurses said they would
refuse to administer
mouth-to-mouth resuscitation on a stranger.
"This is the real world that nobody knows about, and it's a sobering
thought," Geddes
said.OAC-CPR eliminates the need to perform mouth-to-mouth
resuscitation.The American Heart Association requires that rescuers
administering CPR push with enough force to depress the chest 1 and
a half to 2 inches at a rate of 100 times per minute.
"To depress the chest 1.5 to 2 inches takes 100 to 125 pounds of
force," Geddes said. "So
you have to push pretty hard and pretty fast, and two people are
needed to perform it
properly. One blows up the lungs and the other compresses the chest.
And when the one
who's compressing the chest gets tired, they change positions."
OAC-CPR requires only one rescuer.Instead of two breaths for
every 30 chest compressions, the new procedure provides a breath for
every abdominal compression because pushing on the abdomen depresses
the
diaphragm toward the head, expelling air from the lungs. The release
of force causes
inhalation.
Researchers have known since the 1980s that pushing on the abdomen
circulates blood
through the heart. The idea was originated by Purdue nursing
doctoral student Sandra
Ralston, Geddes said."She made the remarkable observation that if
you pushed on the abdomen after each chest
compression you could double the CPR blood flow," he said. "So I
started thinking, what
would happen if you just pushed on the abdomen and eliminated chest
compression entirely?"
The procedure provides a new way to effectively perform "coronary
perfusion," or pumping
blood through the heart muscle, which is critical for successful
resuscitation because
the heart muscle is nourished by oxygenated blood, Geddes
said."Unfortunately, in standard chest-compression CPR, blood
sometimes flows in the wrong direction, which means the coronary
blood flow goes backward, bringing de-oxygenated blood back into the
heart muscle," Geddes said. "This retrograde flow reduces the
likelihood of resuscitation."
Findings showed that OAC-CPR eliminates this backward flow. The
Purdue researchers compared coronary artery blood flow during
standard chest-compression CPR with the flow resulting from only
abdominal compression CPR.Findings showed that using the new method
and pushing with the same force recommended for standard CPR
provided 25% more blood flow through the heart muscle without
retrograde
flow in the coronary arteries.
The researchers followed the standard recommended by the American
Heart Association,
pushing with 100 pounds of pressure 100 times per minute."With OAC-CPR,
you really don't have to press as hard or as often, but we followed
the American Heart Association standard to avoid possible criticism
from people who could have said we didn't observe the standard,"
Geddes said.
Another benefit of OAC-CPR is that it eliminates rib fractures,
which are commonly caused
by compressing the chest. Rib fractures cause the chest to recoil
more slowly, but
effective CPR requires that rescuers wait until the chest recoils
fully before
compressing.
Geddes created a wooden "pressure applicator" that resembles a
scaled-down version of a
baseball home plate. It is contoured so that it can be used to
compress the abdomen
without pushing on the ribs. However, a rescuer could push with the
hands to perform the
procedure if no applicator were available.Abdominal organs contain
about 25% of the total blood volume in the body."You can squeeze all
of that into the central circulation when you press on the abdomen,"
Geddes said.Whether the procedure gains widespread acceptance
depends on whether other researchers
can duplicate the results."In research, you publish data and then
the scientific community looks at the data and
tries to duplicate it to verify that it works," said Geddes, who was
awarded the National
Medal of Technology from President George W. Bush in a White House
ceremony on July 27.
It is the nation's highest honor for technological innovation.
Up To Top
|
Temporal Arteritis: Don't Let This
Disease Fool You
|
|
Could your
reoccurring headache be a sign of a much
more severe disease? Older
individuals who experience variable
signs, symptoms, and pain in the head
and jaw could be suffering from temporal
arteritis, a disease characterized
by inflammation in and damage to the
walls of various blood vessels.
Headaches typically are the
characteristic feature in 60 percent of
temporal arteritis cases.
Though the cause is
unknown, dentists who encounter
patients with puzzling complaints that
are not explained by oral and physical
findings may encourage their patients to
take additional steps in order to
properly diagnose this disease.
Patients with temporal arteritis should
be referred for medical evaluation and
treatment before serious complications
occur such as sudden blindness.Temporal
arteritis is a disease that usually
affects individuals older than 70 and
increases in frequency with age.” Women,
however, are three times more likely
than men to suffer from this disease.
Signs of Temporal
Arteritis:
It is recommended
that if the clinical symptoms
suggest the possibility of temporal
arteritis, the patient should be
referred to a physician for
sedimentation or a C-reactive
protein (CRP) test. Both are
blood test designed to detect the
amount of CRP released in the blood
due to the inflammation of blood
vessels.
January/February 2007
issue of General Dentistry,
James Allen, MD,
|
|
|
Up To Top
August
2007
|
Human Papilloma Virus (HPV) Vaccines
May Decrease Chances of Oral Cancer
|
|
The Centers for Disease
Control report that nearly 25 million women
are infected with some form of the Human
Papilloma Virus (HPV). Of those, more
than three million are thought to have one
of the four strains known to cause cases of
cervical cancer and genital warts.
HPV is linked to
oropharyngeal cancer and may be linked to
oral cancers as well, and vaccines that
have been developed to treat HPV might
decrease the risk of these cancers. It
has been found that oral and oropharyngeal
squamous cell carcinoma (OOSCC) have been
linked to high-risk HPV strains, the same
strains that cause cervical cancer.Recently,
a vaccine was developed to treat patients
with HPV against cervical cancer, and this
could have an effect on women’s oral health.
More than 100 strains of HPV
have been identified, they have been shown
to cause other benign and malignant
disorders, which now include those in the
mouth. Nearly 30,000 new cases of oral
and oropharyngeal cancer are reported each
year. It’s possible that oral and
oropharyngeal cancers could be reduced if
vaccination were more widespread; however,
additional research is needed.
Additional research could
result in a comprehensive test for dentists
at patients’ semiannual visits. However, a
dentist can perform a head and neck exam
to detect early signs, despite the lack
of a specific test. A possible connection
between HPV and oral cancers, and the
stronger link to oropharyngeal cancers, is
even more of an indicator that patients
should visit the dentist twice a year to
identify irregularities early.
Visiting the dentist on a
regular basis is an important factor in the
detection of any oral health complication.
Taking preventive measures is especially
important, and your dentist can check for
early signs of oral cancer.
Oral Health Tips for Women:
 |
Keep your dentist
informed about changes in oral health.
|
|
Visit the dentist
regularly, which will help them to
detect changes in the mouth.
|
|
Ask your dentist to take
a full medical history to determine if
you are at risk for certain problems.
|
|
Ask your dentist to
perform a complete a head and neck exam
to detect early signs of certain
conditions |
May/June
issue of General Dentistry, James J.
Closmann, BS, DDS,(AGD). |
|
|
Up To Top
July 2007
|
ADA
Affirms Benefits of ADA-Accepted
Antimicrobial Mouth Rinses and Toothpastes,
Fluoride Mouth Rinses
Recently, the ADA’s
Council on Scientific Affairs highlighted
the oral health benefits of other
ADA-Accepted products such as
antimicrobial mouth rinses and toothpastes
that can help prevent and reduce plaque and
gingivitis, and fluoride mouth rinses that
can provide extra protection against tooth
decay over that provided by fluoride
toothpaste alone. Gingivitis is an
inflammation of the gums caused by the
accumulation of plaque along the gum line.
It is important to note
that the ADA’s daily oral hygiene
recommendations have not changed—people
should still brush twice a day with an
ADA-Accepted fluoride toothpaste; clean
between their teeth daily with an
ADA-Accepted floss or ADA-Accepted
interdental cleaner; eat a balanced diet and
limit between meal snacks; and visit their
dentist regularly for professional cleanings
and oral examinations.
Antimicrobial mouth rinses and toothpastes
Antimicrobial mouth rinses
and toothpastes reduce the bacterial
count and inhibit the bacterial activity in
dental plaque that can cause gingivitis,
an early, reversible form of periodontal
(gum) disease. ADA-Accepted antimicrobial
mouth rinses and toothpastes have
substantiated these claims by demonstrating
significant reductions in plaque and
gingivitis.
Fluoride mouth rinses
Fluoride mouth rinses are
used to help reduce and prevent tooth
decay. Clinical studies have
demonstrated that use of a fluoride mouth
rinse in addition to fluoride toothpaste can
provide extra protection against tooth
decay over that provided by fluoride
toothpaste alone. The use of fluoride
mouth rinse is not recommended for children
six years of age and younger because they
may swallow the rinse. Consumers should
always check the manufacturer’s label for
precautions and age recommendations and talk
with their dentist about the use of fluoride
mouth rinse. ADA.org
Up To Top
|
|
|
June 2007
Infective Endocarditis
New guidelines for prevention of infective endocarditis were
released by the American Heart Association April 19. The AHA and ADA
now recommend that fewer dental patients with heart disease receive
antibiotic prophylaxis before dental procedures to prevent the heart
infection called infective endocarditis (IE). The guidelines were
developed by a group appointed by the AHA that included experts in
infectious disease and cardiology and members representing the ADA.
The guidelines were endorsed by the Infectious Diseases Society of
America and the Pediatric Infectious Diseases Society.
After reviewing relevant scientific literature from 1950-2006, the
group concluded that bacteremia resulting from daily activities is
much more likely to cause IE than bacteremia associated with a
dental procedure. In addition, only an extremely small number of IE
cases might be prevented by antibiotic prophylaxis, even if
prophylaxis is 100% effective. Based on these conclusions,
antibiotic prophylaxis is now recommended before dental procedures
only for patients with underlying cardiac conditions associated with
the highest risk of adverse outcome from IE, such as patients with
artificial heart valves, a history of endocarditis, certain serious
congenital heart conditions and heart transplant patients who
develop a problem with a heart valve. For more details
see ADA.org
Up To Top
May 2007
Perio & Your Heart
|
91% of patients with coronary
artery disease suffered from moderate to severe
periodontitis, compared to 66% in non-cardiac patients.
|
|
Patients with severe
periodontal disease are nearly 3 times more likely to have a
cardiac incident. |
|
Periodontal disease is an
independent risk factor for cerebral ischemia in men and
younger subjects. |
National
Women’s Health Week May 13-19, 2007
|
Reality TV has provided
the general public with a glimpse into the
world of cosmetic dentistry with shows like
“Extreme Makeover”—and people like the
“quick-fix” they see. One of these quick
fixes is a resin appliance (known as a
clip-on smile or snap-on teeth),
designed to fit over the teeth to create an
esthetically appealing smile. People want a
quick, inexpensive, non-invasive way to have
what they perceive as a Hollywood smile.
Snap-on teeth are being used by many
patients to obtain a beautiful smile.
Benefits of using
snap-on teeth:
| A dentist can
determine whether or not a patient can
tolerate a permanent cosmetic dental
treatment, such as the placement of
veneers. |
| Provide
patients with the opportunity to see how
their teeth will look before choosing a
more permanent solution. |
| Patients with special
needs (i.e. those who fear the dentist
or who are medically compromised and
should not undergo long, stressful
procedures) may also benefit from the
use of snap-on teeth. |
Snap-on teeth, however,
are not appropriate for all patients:
| Those with
protrusive teeth, removable teeth, or
who are not interested in improving
their dental health are not good
candidates for the appliance.
|
| Patients need to be
aware that snap-on teeth are temporary
and may need to be replaced often.
|
| The product is
limited to the patient’s natural bite,
occlusion, and smile-line. |
The fix is temporary;
patients are going to need a permanent
solution. The snap-on product, if used in
the proper patient case, can be a safe,
inexpensive, and effective temporary
procedure, however, the patient can’t have
unrealistic expectations; they need to know
their smile will not look like Julia
Roberts.
Items to note before you
quick-fix:
| Quick-fix dentistry
is just that, a “quick fix.” Treatment
done is temporary and is meant to
be a stepping stone to a more permanent
solution. |
| When approaching your
dentist about snap-on teeth, be sure to
discuss dental needs you should consider
before opting for a cosmetic solution,
such as decay and periodontal problems.
|
| The overall look of
snap-on teeth is dictated by a patient’s
bite, occlusion, and smile-line (the
front part of the teeth that is only
visible when someone smiles).
|
| Cosmetic dentistry is
about creating an esthetically appealing
look. You may, however, be able to get a
better cosmetic look with crowns or
veneers rather than using the temporary
snap-on teeth. |
January 2007 issue of
AGD Impact |
|
|
Up To Top
April
2007
In honor of those serving in
Iraq:
Oral Fitness Resources and Fact Sheets
| Fast Facts |
Oral Cancer in the United States
2007 Estimates
| New cases: |
30,990 |
| Deaths per year: |
7,430 |
| Five-year relative survival rate for
localized stage: |
82% |
| Five year relative survival for all
stages combined: |
59% |
|
|
A simple
toothache can be fatal.
That is the sobering message a
12-year-old Maryland boy left when, after his dental
problems went untreated, he succumbed to a severe brain
infection.
Deamonte Driver's life could
have been spared if his infected tooth was
simply removed — a procedure costing just
$80.However, the Driver family faced
obstacles with Medicaid, poverty, and access
to resources, resulting in an easily
preventable health problem turning deadly.In
the end, Driver endured two surgeries and
weeks of hospital care totaling about
$250,000 in medical bills. Sadly, it was too
late to save the boy, and he passed away on
Feb. 25. "Unfortunately, this is more
common than we'd like it to be," says Sally
Cram, a practicing periodontist in the
Washington, DC area. "A lot of children
don't get dental care."
In fact, data from the
Centers for Disease Control cites tooth
decay as one of the most common chronic
infectious diseases among U.S. children.
By the age of 11,
approximately half of children have decay,
and by the age of 19, tooth decay in the
permanent teeth affects about 68 percent of
adolescents.For
children in low-income families, like the
Drivers, there is nearly twice the risk for
untreated tooth decay."I think it is
probably the least covered of our health
benefits across the nation," she adds.
While this lack of care is
a known problem, there are a number of
issues that stand in the way."The dentist
doesn't break even," says Cram. In fact,
experts say the low rates Medicaid offers
to cover dental services are less than what
it costs the doctor to do the actual
treatment
People seem to think "teeth
are not a big deal," says Cram. But it's not just
about your mouth. "Infections
in your teeth and mouth can lead to more problems,"
she points out. When a cavity goes untreated for months
or years, the decay eats into the center of the
tooth, and eventually enters the nerves and blood
vessels. From there, bacteria get into the blood
stream and can travel virtually anywhere. By taking
advantage of basic preventative services — like
cleanings and filling cavities — people can drastically
reduce their chances for severe dental disease. And with
the benefit of Medicaid funding, a tremendous amount of
budget funds could be saved in the long run. Across the
board, education on the benefits of prevention is the
most important that can be done. "It's sad that a child
has to die for people to wake up," says Cram. "We need
to stop putting our heads in the stand and start working
together — it takes education
Up To Top
New Women's Oral Health
Issues by American Dental Association:
Women's Dental Health Issues 2007
Effects of Soft Drink Consumption on
Nutrition and Health: A Systematic Review and Meta-Analysis
In a meta-analysis of 88 studies, we examined the
association between
soft drink consumption and nutrition and health outcomes.
We found clear associations of soft drink intake with
increased energy intake and body weight. Soft drink
intake also was associated with lower intakes of milk,
calcium, and other nutrients and with an increased risk
of several medical problems (e.g., diabetes).
Study design significantly influenced results:
larger effect sizes were observed in studies with
stronger methods (longitudinal and experimental vs
cross-sectional studies). Several other factors also
moderated effect sizes (e.g., gender, age, beverage
type). Finally, studies funded by the food industry reported
significantly smaller effects than did non–industry-funded
studies. Recommendations to reduce population soft drink
consumption are strongly supported by the available
science.
Lenny R. Vartanian, PhD,
Marlene B. Schwartz, PhD and Kelly D. Brownell,
PhD The authors are with the
Department of Psychology, Yale University, New Haven, Conn.
Correspondence: Requests for reprints should be sent to Kelly D.
Brownell, PhD, Department of Psychology, Yale University, PO Box
208205, New Haven, CT 06520-8205 (e-mail: kelly.
brownell@yale.edu
).
Up To Top
March
2007
Dr. Peterson's Father Died of
Lung Cancer this
month.
February 2007
Oral Wounds Heal Slower in Women and Older Adults
Wounds in the mouth heal more slowly in women and
older adults, a new study at the University of Illinois at
Chicago reveals.
`While wounds to the skin heal more quickly in women than in
men, our study suggested the opposite is true for healing of
wounds inside the mouth,' said Dr. Phillip Marucha, head of
periodontics at the UIC College of Dentistry.We discovered
that, regardless of age, men's mouth wounds heal faster than
women's.'
Older women were at the highest risk for delayed healing,
their wounds closing half as slowly as younger men, Marucha
said. The findings of the study, he said, could have important
implications for surgical practices.
`There are an increasing number of surgical procedures being
performed in older populations,' Marucha said. `A greater
emphasis needs to be placed on accelerating the healing process.
Discovering the reasons behind these age and sex differences
will help us improve treatment, and postsurgical recovery times
may be reduced.'
The study consisted of creating a small, standardised circular
wound, half the diameter of a pencil, between the first and
second molar of 212 male and female volunteers aged 18 to 35
years and 50 to 88 years. The wounds were videographed at the
same time for seven consecutive days to assess closure.
Testosterone may help mouth wounds heal faster in men,
said Christopher Engeland, research assistant professor at UIC
and lead author of the study.It's a potent anti-inflammatory
hormone that is abundant in saliva,' he said. Women are
generally more prone to inflammatory diseases, such as
rheumatoid arthritis, Engeland said. In skin, women's wounds
heal faster than men's in part because inflammation causes them
to close faster.
`The more inflammation a person has inside the mouth, the slower
wounds appear to heal,' Engeland said. `We were surprised to
learn that oral wounds heal more slowly in women than in men.
It's one of the few times in the field of healing where men have
an advantage over women.This indicates that the healing process
in skin and mouth tissues is different in some fundamental way
not previously expected.'
[www.smile-on.com Friday 2nd February 2007]
Up To Top
Periodontal disease,
cancer may be linked in men
|
By Jennifer Garvin |
A new study reports that
men with a history of
periodontal disease
could have an increased risk of developing
pancreatic cancer.
The study, conducted by
researchers at the Harvard School of Public
Health, the University of San Juan and the
Dana-Farber Cancer Institute, reviewed more
than 51,000 male health professionals
between the ages of 40 and 75. During a
16-year follow-up period between 1986 and
2002, 216 men developed pancreatic cancer.
After adjusting for age,
smoking history, diabetes, obesity, diet and
other potentially confounding variables, the
researchers concluded that men with a
history of periodontal disease had a 63
percent increased risk of pancreatic cancer
compared to men without a history of
periodontal disease.
The researchers presented
their findings at the 2006 Frontiers in
Cancer Prevention Research meeting in
Boston, hosted by the American Association
of Cancer Research.
While the prospective
cohort study provides a long-term
statistical association between periodontal
disease and pancreatic cancer, it does not
establish a definitive cause-effect
relationship between the two conditions.
The summary of this study
is among the latest in research findings
posted regularly on ADA.org in the "Science
in the News" section.
For more information about
the link between pancreatic cancer and
periodontal disease, visit,
www.ada.org/prof/resources/topics/science_perio_pancreatic.asp.
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Dental DNA bank
starts up at UOP
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The University of
Pittsburgh School of Dental Medicine has
pioneered a new approach to clinical
research with its Dental Registry and DNA
Repository—possibly the world's first dental
DNA bank.
The program, which started
the initial collection of cases in September
2006, seeks clinical information and a
biological sample from those seeking
treatment at the dental school. Patients
who sign up are asked for saliva samples and
permission to look at their medical and
dental charts for use in future research
projects.
The project, which has 200
registrants, is the brainchild of Dr.
Alexandre Vieira, the program's director and
a professor of oral biology at the school.Dr.
Vieira said he believes the project is
"revolutionary" because "it eliminates the
need for further institutional review board
evaluations for projects seeking to use data
from the registry."
Any time a research
project deals with human subjects or
identifiable information from humans, the
project must be evaluated and approved by
the local institutional review board or
ethics in human research committee, said Dr.
Vieira.
This project was designed
so that any future investigation using data
or samples from the registry will not be
classified as human research since
researchers will not be in touch with the
subjects. In other words, he said,
participants are protected beyond the
regular standards because their samples are
blind to the investigators."We have 85
percent compliance—the majority of people we
approached to participate in the study said
yes," he said.
For more information,
visit
www.dental.pitt.edu/vieira_lab/dental_registry.php |
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January 2007
Using
Software to Screen Panoramic Radiographs for Osteoporosis Risk
Assessment
According to new research from the University
of Manchester, image analysis software is under development for
measuring mandibular cortical width in digitized panoramic
radiographs as a potential screening test for osteoporosis. The
study received online coverage from
WebMD
and other news agencies. However, the technology still has some way
to go. As the researchers acknowledge in the study, there is
diagnostic potential for panoramic radiographs in the early
detection of osteoporosis, but the technologies are still under
investigation to determine the precise threshold for minimizing
false positives.
Osteoporosis is a
systemic skeletal disorder characterized by low bone mass and
fragility, especially for postmenopausal women. Although the
condition affects women primarily, it also occurs in men and is
commonly associated with a decrease in bone mineral density. The
condition has several modifiable risk factors, including smoking,
inadequate dietary calcium and estrogen deficiency.
Previous research
has also reported an association between osteoporosis and tooth
loss, along with alveolar bone loss. Based on current estimates,
over 10 million Americans over the age of 50 have osteoporosis, and
nearly 34 million individuals are at risk.1
The new study, published in the online edition of
the journal
Bone
2,
was performed as part of a three-year evaluation called the
OSTEODENT project, which recruited 652 women aged 45 to 70 from four
European centers, based in Greece, Belgium, Sweden and England. The
research team developed analytical software, based on active shape
modeling, to measure the width of the mandibular cortex on digitized
panoramic radiographs. The researchers looked specifically at
mandibular cortical width because of its reported correlation with
bone mineral density at the hip, lumbar spine and forearm, three
common areas of osteoporotic bone fracture.
Results from the computerized evaluation of
panoramic radiographs were compared to a standard method of
diagnosing osteoporosis: dual energy X-ray absorptiometry (DXA) of
the hip, spine or femoral neck. With DXA scans, 140 women were
identified as having osteoporosis at one of the three measurement
sites. By comparison, the software evaluation of panoramic
radiographs identified over half of the 140 women whose osteoporotic
status was confirmed with DXA scans. The research team claimed that,
with further refinement, more at-risk individuals could be
identified using their software-based screening test for skeletal
osteoporosis.
Because the diagnostic accuracy of cortical
width measurements is less than perfect, the dental panoramic
radiograph would not be taken for osteoporosis screening per se, but
could be evaluated for osteoporosis if the radiographs were exposed
for dental purposes. The researchers also caution that radiographic
measurements cannot be used as the sole basis for referral, and that
the patient's medical history must be evaluated before undertaking
further referral or investigation.
Footnotes
1 U.S. Department
of Health and Human Services. Bone Health and Osteoporosis: A Report
of the Surgeon General. Rockville, MD: U.S. Department of Health and
Human Services, Office of the Surgeon General, 2004. Available at: “http://www.surgeongeneral.gov/
library/bonehealth/content.html
“.
Accessed January 10, 2006 .
2 Devlin H, Allen
PD, Graham J, Jacobs R, Karayianni K, Lindh C, van der Stelt PF,
Harrison E, Adams JE, Pavitt S, Horner K. Automated osteoporosis
risk assessment by dentists: as new pathway to diagnosis. Bone 2006
Dec 21; [Epub ahead of print]. ADA 1.07
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Check out the latest dental news for 2006 at:
Dental News 2006 |
