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Periodontics Research Highlight: Dr. John Thousand

Research Newsletter | February 2014

Dr. Thousand and Dr. Powell in Clinic
Dr. Thousand and Dr. Powell in clinic

It’s not uncommon to find Dr. John Thousand in a study room at 6:30 a.m. fervently reading some new study that has just been released in the periodontics field. Dr. Thousand works long hours to be up on the evidence, and prepared for his patients. Thus, it is no surprise that his most current research revolves around creating better patient outcomes.

“One study showed that 80% of cemented implant crowns have periimplantitis,” says Thousand, “The question we are trying to answer is a more precise measurement of how much cement, quantitatively, gets left under the gums following the cementation of an implant crown.” Of course there is also more than one way to seat an implant crown, and Dr. Thousand is thinking that perhaps one procedure would be more effective than another in preventing the leaving behind of excess cement, and thus preventing periimplantitis.

Here is how they are going to measure this: “We’ll get a bunch of dentoforms and have the implant fabricated to fit into one of the dentoform’s sockets. These implants will be milled to a custom depth. Then we will have implant abutments milled, all in the same dimensions, and they will all fit exactly the same for all the dentoforms. Each of these abutments will go the exact same amount subgingival."

After this, Thousand explains, that they will get several residents/dentists, and have each person cement a crown using 1 or 2 techniques. The first technique is similar to the one we use each day to cement a conventional crown, and involves brushing the cement onto the crown itself, and then seating. The second technique is a VPS technique. This technique involves squirting exabite into the crown, and this will give you the shape of the crown. Then you put the crown onto the VPS 1st, remove the excess cement, and then place the crown in the mouth. Things such as working time, maxillary versus mandibular, and other factors will be controlled for. After these crowns are seated, and the cement has dried, Dr. Thousand will be able to unscrew the crowns from the dentoform and measure the surface area of the cement that has been left behind.

Dr. Thousand has already seen the clinical applications of his research. “If you think about it, the teeth that you are cementing crowns on are the most important ones. They are the teeth in the anterior, and the ones that everyone can see.” So, as Dr. Thousand goes onto explain, anything you can do to minimize sub-gingival cement, and thus periimplatitis is beneficial. Though Thousand's current study will not directly connect the residual cement to periimplantitis, several before him have, and this particular study has been done in a few different ways, but never by direct measurement of how much cement is left. The ultimate goal? To find the best technique possible to reduce the prevalence of cement left behind.

Dr. Thousand would like to thank both Dr. Brada and Dr. Powell for their help and support.



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