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NEW TREATMENT FOR OSSEOUS DEFECTS AVAILABLE
NEWS HERBALS MAY INTERACT WITH ANESTHESIA
Surgical patients who take herbal supplements and do not tell their physicians or dentists may experience complications, said researchers at the American Society of Anesthesiologists, annual meeting in October. “Some herbals can interact with anesthetics and have adverse effects, while others pose potential risks regardless of their interaction with anesthesia,” said Charles H. McLeskey, M.D., chair of anesthesiology and director of perioperative services at Scott & White Memorial Hospital and Clinic of Texas A&M University. “In either case, the potential for harm warrants precautions.” Dr. McLeskey and other researchers from Scott & White Memorial Hospital and Clinic conducted a survey of herbal use among 979 surgical patients and found that 17.4 percent (170) were taking one or more botanical medications or nutraceuticals—supplements not derived from plants. They also found that among the herbal supplement users, 55 percent took only one product, and 45 percent took more than one. The most commonly used herbs of the 40 listed as being used by the subjects were gingko biloba (32.4 percent), garlic (26.5 percent), ginger (26.5 percent), and ginseng and St. John’s Wort (both 14 percent). The nutraceuticals most widely used were glucosamine (17 percent), chromium picolinate (17 percent) and chondroitin (12 percent). Dr. McLeskey said herbals 1698
such as gingko biloba and feverfew may interfere with blood clotting, and kava-kava—an herbal relaxant—may have an additive effect when combined with the sedatives often given to patients before and during surgery. “If patients are taking herbal products and we know about it, we can alter their care, prevent problems and manage complications more easily,” Dr. McLeskey said. He recommends that health care practitioners ask their patients to stop taking any herbal medications two to three weeks before surgery. If that’s not possible, patients should bring all of their medications and supplements in the original containers with them to surgery. “This is important because herbals can contain several ingredients. Patients may not even be aware of what they are consuming,” Dr. McLeskey said. NEW TREATMENT FOR OSSEOUS DEFECTS AVAILABLE
The U.S. Food and Drug Administration granted marketing approval to PepGen P-15 (CeraMed Dental) on Oct. 25 for the treatment of osseous defects resulting from moderate to severe periodontitis. PepGen P-15 is a bioengineered bone replacement graft material. It uses a synthetic peptide that is bound irreversibly to an anorganic bovinederived material similar to that found in human bone. CeraMed Dental says the material promotes attachment of reparative cells from surrounding tissues and facilitates the biomimetic
environment for bone growth. This action starts a sequence of events that lead to bone formation, as well as repair of the periodontal osseous defect, the company says. In a six-month multicenter clinical trial, researchers found that PepGen P-15 was more effective in percent defect fill (72 percent) than demineralized freeze-dried bone allograft, or DFDBA, (51 percent) or surgical débridement (40 percent). They also found that PepGen P-15 was associated with a 1.3 millimeter gain in clinical attachment compared with 0.5 mm for DFDBA and 0.1 mm for surgical débridement. The clinical trial showed that PepGen P-15 also increased clinical predictability. It had an 87 percent response in defects that fill 50 percent or more of the original osseous defect. The need for retreatment in patients treated with PepGen P-15 was 14 percent, compared with 57 percent in patients treated with DFDBA or surgical débridement. CeraMed Dental noted that no product-related side effects were reported for PepGen P-15. PATIENTS, PHYSICIANS WANT TO COMMUNICATE VIA E-MAIL
Although 40 percent of general medicine clinic patients regularly use e-mail, only 14 percent have used it to communicate with their doctors, said University of Michigan Health System researchers in a presentation at Intel’s Internet Health Day II on Oct. 12. Researchers surveyed 320 patients and 75 resident physiContinued on page 1700
JADA, Vol. 130, December 1999 Copyright ©1998-2001 American Dental Association. All rights reserved.
Surgical patients who take herbal supplements and do not tell their physicians or dentists may experience complications, said researchers at the American Society of Anesthesiologists, annual meeting in October. “Some herbals can interact with anesthetics and have adverse effects, while others pose potential risks regardless of their interaction with anesthesia,” said Charles H. McLeskey, M.D., chair of anesthesiology and director of perioperative services at Scott & White Memorial Hospital and Clinic of Texas A&M University. “In either case, the potential for harm warrants precautions.” Dr. McLeskey and other researchers from Scott & White Memorial Hospital and Clinic conducted a survey of herbal use among 979 surgical patients and found that 17.4 percent (170) were taking one or more botanical medications or nutraceuticals—supplements not derived from plants. They also found that among the herbal supplement users, 55 percent took only one product, and 45 percent took more than one. The most commonly used herbs of the 40 listed as being used by the subjects were gingko biloba (32.4 percent), garlic (26.5 percent), ginger (26.5 percent), and ginseng and St. John’s Wort (both 14 percent). The nutraceuticals most widely used were glucosamine (17 percent), chromium picolinate (17 percent) and chondroitin (12 percent). Dr. McLeskey said herbals 1698
such as gingko biloba and feverfew may interfere with blood clotting, and kava-kava—an herbal relaxant—may have an additive effect when combined with the sedatives often given to patients before and during surgery. “If patients are taking herbal products and we know about it, we can alter their care, prevent problems and manage complications more easily,” Dr. McLeskey said. He recommends that health care practitioners ask their patients to stop taking any herbal medications two to three weeks before surgery. If that’s not possible, patients should bring all of their medications and supplements in the original containers with them to surgery. “This is important because herbals can contain several ingredients. Patients may not even be aware of what they are consuming,” Dr. McLeskey said. NEW TREATMENT FOR OSSEOUS DEFECTS AVAILABLE
The U.S. Food and Drug Administration granted marketing approval to PepGen P-15 (CeraMed Dental) on Oct. 25 for the treatment of osseous defects resulting from moderate to severe periodontitis. PepGen P-15 is a bioengineered bone replacement graft material. It uses a synthetic peptide that is bound irreversibly to an anorganic bovinederived material similar to that found in human bone. CeraMed Dental says the material promotes attachment of reparative cells from surrounding tissues and facilitates the biomimetic
environment for bone growth. This action starts a sequence of events that lead to bone formation, as well as repair of the periodontal osseous defect, the company says. In a six-month multicenter clinical trial, researchers found that PepGen P-15 was more effective in percent defect fill (72 percent) than demineralized freeze-dried bone allograft, or DFDBA, (51 percent) or surgical débridement (40 percent). They also found that PepGen P-15 was associated with a 1.3 millimeter gain in clinical attachment compared with 0.5 mm for DFDBA and 0.1 mm for surgical débridement. The clinical trial showed that PepGen P-15 also increased clinical predictability. It had an 87 percent response in defects that fill 50 percent or more of the original osseous defect. The need for retreatment in patients treated with PepGen P-15 was 14 percent, compared with 57 percent in patients treated with DFDBA or surgical débridement. CeraMed Dental noted that no product-related side effects were reported for PepGen P-15. PATIENTS, PHYSICIANS WANT TO COMMUNICATE VIA E-MAIL
Although 40 percent of general medicine clinic patients regularly use e-mail, only 14 percent have used it to communicate with their doctors, said University of Michigan Health System researchers in a presentation at Intel’s Internet Health Day II on Oct. 12. Researchers surveyed 320 patients and 75 resident physiContinued on page 1700
JADA, Vol. 130, December 1999 Copyright ©1998-2001 American Dental Association. All rights reserved.