Steven D. Sherry, DDS, MD John D. Wallace, DDS, MD8315 Walnut Hill Lane | Suite 120 |Dallas, TX 75231 | 214.363.9946

5824 West Plano Parkway | Suite 101 | Plano, TX 75093| 972.733.0414

www.oralsurgerydfw.com

Dear Colleague:

Each year we continue to see growth and development in our practice accompanied by an increase in treatment success. Through this quarterly newsletter, we wish to share with you some of the latest developments in oral surgery and implant dentistry, as well as open communication with your office.

If we can provide any additional information, or if you would like to see an article on a particular topic in our next issue, please do not hesitate to call. We appreciate the trust you place in us by allowing us to participate in the care of your patients.

Regards,

Winter 2013/2014 ~ A Quarterly Update

Dr. Steven D. SherryDr. John D. Wallace

Immediate Occlusal versus Non-Occlusal Loading of ImplantsVogl S, Stopper M, et al.Clin Implant Dent Relat Res. 2013 Sep 30

I mmediate occlusal and non-occlusal loading protocols have been discussed and, despite varying success rates, are considered viable in

selected cases. Preoperative implant planning and intraoperative transfer are essential to the success of implant-supported reconstructions in partially or completely edentulous jaws. This study was performed to compare clinical outcomes of immediate occlusal versus non-occlusal loading of posterior implants. Of 19 patients with 52 screw-type implants replacing mandibular molars or premolars, nine patients with 21 implants were randomized to a study group that

received immediate restorations with occlusal loading, whereas 10 patients with 31 implants were randomized to a control group that received provisional restorations without occlusal loading. Occlusal loading was defined as full loading in maximum intercuspidation. Single-tooth or splinted multiunit restorations were incorporated by screw retention or cementation. Marginal bone defects (MBD), implant survival, and implant success were evaluated 12 months after insertion.

Results found that both groups revealed similar MBD levels consistent with previous reports. No implants were lost (overall survival: 100%) or found to fail (overall success: 100%). No significant intergroup differences were noted for any of the evaluated parameters. Immediate restorations in partially edentulous mandibles demonstrated successful clinical and radiographic 12-month results. Larger long-term prospective studies are needed to confirm the final evidence and predictability of immediate functional loading as a standard treatment concept for partially edentulous jaws.

The Value of Postoperative Visits for Third Molar RemovalInverso G, Desrochers HR, et al.J Oral Maxillofac Surg. 2013 Oct 16 278-2391(13)

The clinical follow-up visit after third molar extraction has been cited as time consuming and of little benefit to patients. Although telephone follow-up has the potential

to add value to the surgical management of third molars, sparse information exists on the financial context of this alternative. The purpose of this study was to show the change in value of third molar extraction with telephone follow-up through 1) measurement of the postoperative complication rate and 2) costs of telephone versus clinical follow-up. Bivariate comparisons were computed to assess for differences in follow-up type. Cost was calculated from a provider's perspective using

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This newsletter is a publication of this office. Its information is intended solely for physicians, dentists and other healthcare providers. It is not intended for use as a replacement for medical advice. For individual situations or conditions, appropriate dental/medical consultation should be obtained.

Steven D. Sherry, DDS, MDJohn D. Wallace, DDS, MD

8315 Walnut Hill Lane • Suite 120 Dallas, TX 75231 Ph: 214.363.9946

5824 West Plano Parkway • Suite 101Plano, TX 75093 Ph: 972.733.0414

micro-costing analysis that quantified cost differences between postoperative telephone and clinical follow-ups. Each visit type was divided into clinical activities and clinicians involved. Cost rates (dollars per minute) were derived for each clinician. Each clinical activity time was multiplied by clinician cost rate to derive an activity-based cost for each activity. Individual activity-based costs were summed to derive the total cost of telephone versus clinical follow-up visit.

Patients who had a telephone follow-up had a similar postoperative complication rate (2.1%) as those who had a clinical follow-up (1.9%). The total cost estimates were $14.26 for telephone follow-up and $63.33 for clinical follow-up. Overall, there was a cost savings of $49.07 per patient, or a 77.4% decrease in cost, when using telephone follow-up. The authors concluded that telephone follow-ups added value to the operative management of patients having third molar extractions by controlling for postoperative complication rate and decreasing cost of care.

A Retrospective Analysis of Clinical Features of Oral Malignant and Potentially Malignant Disorders with and without Oral Epithelial DysplasiaDost F, Lê Cao KA, et al.Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Oct 18. 212-218(13)

Clinical identification of underlying histopathology of oral mucosal lesions (OMLs) remains difficult. The study was undertaken to identify clinical indicators of

underlying histopathology of oral malignant and potentially malignant disorders. All clinical patient records of an oral medicine and pathology clinic over a 12-year period were manually searched. Cases of OMLs with a histopathologic diagnosis of dysplasia (n = 124) and malignancy (n = 27) and a sample of nondysplastic OMLs (n = 109) were analyzed using both univariate and multivariate analysis and odds ratios for an association with clinical characteristics.

A nonhomogeneous clinical appearance was strongly associated with underlying dysplasia in both univariate and multivariate analysis (odds ratio, 4.4). For lesions with homogeneous appearance, dysplasia was associated with lesion location odds ratio, 2.6) and smoking history. The findings in this study suggest that a nonhomogeneous mucosal lesion is a significant independent indicator for underlying oral epithelial dysplasia, with location, size, and color as additional contributing factors.

Amoxicillin Administrations and its Influence on Bone Repair Around Osseointegrated ImplantsGiro G, Witek L, et al. J Oral Maxillofac Surg. 2014 Feb;72(2):305-310

T he objective of this study was to evaluate the influence of 4 different amoxicillin administration protocols on osseointegration of dental implants. Thirty-five Wistar

rats received an implant in the right tibia and were divided into 5 groups (n = 7): the control group (G1), a group that received a single dose of amoxicillin suspension (40 mg/kg) hour before surgery (G2), a group that received amoxicillin suspension 1 hour before surgery and a 10-mg/kg dose every 12 hours for 3 days (G3), a group that received amoxicillin suspension 1 hour before surgery and a 10-mg/kg dose every 12 hours for 5 days (G4), and a group that received amoxicillin suspension 1 hour before surgery and a 10-mg/kg dose every 12 hours for 7 days (G5). The animals were sacrificed by anesthesia overdose 28 days after implant placement. The samples were retrieved for bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) analyses.

Postoperative Visits …continued BIC analysis indicated 3 different statistical groups: G1 plus G2, G3, and G4 plus G5. There was no statistical difference between G1 and G2 or between G4 and G5. G3 presented lower values, with statistical difference for G1 plus G2 and G4 plus G5. Also, a statistical difference was found between G1 plus G2 and G4 plus G5. For BAFO evaluation, no statistical difference was found for the experimental groups. The results of this study suggest that prolonged use of amoxicillin might have a negative effect on bone formation around implants.