Dr.Pirk's Publications

“Effect of analogues of steroid and thyroxine hormones on wound healing in hamsters.”   J. Periodontal Rex. 9: 290-297;  July 15, 1974

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    Study Importance:   The use of anabolic steroids (Durabolin and                           Levothyroxine) accelerated new bone formation in a healing extraction site, the rate of epithelization was only slightly affected.  The more rapid the fill of osseous tissue, the greater the probability for successful periodontal attachment repair.  There are currently a number of biologics  used to accelerate periodontal wound healing.

 

“The interleukin-I genotype as a severity factor in adult periodontal disease.”   J. Clin Periodontal   24:72-77, 1997

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    Study Importance:   A beautiful DNA study to demonstrate the connection between periodontal diseases and genetics.   The first study to identified the IL-1 polymorphism and its importance in severe periodontal disease in humans.  The presence of the genetic trait and smoking 10+ cigarets per day is a significant predictor of severe  periodontal disease,  multiple tooth loss, and a shorter life span.   The genetic defect is present in 30% of our population.

 

“Soft Tissue Management:  Is it a Help or Hindrance in Modern Esthetic and Regenerative Periodontics?”  Texas Dental Journal,  13-17, July 1995

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    Study Importance:  This publication  emphasizes the importance of early diagnosis of periodontal disease and the necessity to differentiate between gingivitis (gum infection) and periodontitis (bone infection).   Also, the application of clinical techniques used to treat gingivitis may not be suitable when applied to treat or maintain a moderate periodontitis.  In fact,  premature and persistent scaling of a periodontitis patient may inhibit future bone and soft tissue regeneration.  Emphasis is placed on the futility of calculus removal in periodontal defects deeper than 5mm and the potential negative  impact on regeneration procedures and soft tissue esthetics.

 

“Outline of standards for evaluating patients for over dentures.”   J. Prosthet. Dent,  141-146February, 1977 

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    Study Importance:  This article suggests the importance of  maintaining the root of a tooth   (when possible)  in the jaw bone to not only support a denture, but preserve the  alveolar ridge.   Teeth with fractured or decayed crowns indicated for extraction without damage to the roots were selected for a “vital implant”.  The non-restorable crown was removed, the root was shortened,  and submerged 1-2 mm below the crest of the ridge and allowed to heal  without root canal treatment.  Ideally,  3-4 submerged roots in a dental arch will  significantly help to  preserve the ridge and allow patients to wear dentures more comfortably.

 

“Host Response Profiles with Treatment of Stable and Generalized Non-responder Periodontitis Patients.”  UT Health Science Center, San Antonio, Interleukin Genetics, Procter & Gamble Co.  1998

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    Study Importance:  Immunologic study to test host response in refractory and severe periodontitis patients.  Results indicate that different immunological responses can occur in the same patient at the same time,  and that these responses remain following therapy.  A number of these host responses increased with successful therapy suggesting they reflect a return to an appropriate local immune regulation that would maintain homeostasis at these sites.

 

“Periodontics: Old Problems, New Perspectives.”  Dental Survey, the Journal of Dental Practice,  February 1976,  69-70

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    Study Importance:   Emphasized when it comes to calculus there are two types;  calculus that forms above the tissue level that is a harmless nuisance,  and that which is deposited below the gingiva  that is the real culprit in the formation of periodontal disease.  More correctly,  calculus  that is below the tissue level  is diagnostic for periodontal disease because it gets its mineral content from the blood vessels in the gingiva,  whereas supra gingival deposit gets its mineral content from saliva.  When  the gum tissue becomes  infected  by bacteria the body produces an inflammatory response, hence the release of minerals into the bacterial plaque with the subsequent development of calculus.  Not all individuals form calculus at the same rate, but we know those who form calculus fast,  have a better prognosis.  The bacteria responsible for rapid calculus formation are alkaline in nature which is a good indicator for general systemic health.      Acidic producing bacteria form very little calculus and that is why some individuals have very little deposit around their teeth;  not always,  but usually their periodontal prognosis is not as good.    Chronic exposure to this below the gum inflammatory reaction can change the root surface that is exposed to the periodontal pocket, this is referred to as the ‘hard tissue lesion’ which usually necessitates a surgical approach to restore health.

 

“The Narrow Microthread Implant Design.”  Insight,  #1:2003

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    Study Importance:  There was a growing body of information that questioned the validity of the coronal portion of an implant surface being smooth. This was based on studies that concluded an almost certain amount of bone die-back to the first thread on the implant did occur with smooth surface implant necks.  Clinicians involved in placement, restoration, and maintenance of dental implants have traditionally viewed the integrity of the crestal  bone at implant head as the single most important criteria of implant stability.  Success in an esthetically sensitive area or an area that demands intense function, is predicated on the long term  positioning of the bone at the neck of the implant.  A total of 43 implants were placed and at 2 year post surgery followup there was little to no die-back around the implant head; this appears to confirm that the micro thread was successful in blocking the downward growth of epithelium and preserving  crestal integrity. It is my opinion that all implant designs would benefit from the microthread  design.