Download 2010 VFDC

WINTER 2011
VFDJ
VALLEY FORGE DENTAL JOURNAL
2010 VFDC
March 2, 3, 4
Politics and Science:
A Potential Lethal Mix
A New Class of Drugs
called anti-RANKL agents
OUTCOMES
The Official Publication of the Second District Valley Forge Dental Association of Pennsylvania
VFDJ
Dr. Tami Brady
EDITOR
VALLEY FORGE DENTAL JOURNAL
WINTER 2011
EDITORIAL BOARD
Dr. Karin Brian, Dr. Elliott Maser
Dr. John Nase
WEBSITE EDITOR
OFFICERS
Dr. George A. Bullock
PRESIDENT
Dr. Karin D. Brian
PRESIDENT-ELECT
Dr. Charles Incalcaterra
VICE PRESIDENT
Dr. John L. Meci
TREASURER
Dr. Lawrence Montgomery
Dr. Rusty Bullock presents the Second District
Public Service Award to Dr. Bernie Logan at the
2010 Annual Business meeting.
SECRETARY
Dr. Syreta McTavous, Lauren Wolf, Pappy Chhina,
and Joanne Burrell representing the Helping Hands
of Dentistry at the Fall CD event.
Dr. John L. Meci
IMMEDIATE PAST PRESIDENT
Dr. Bernard P. Dishler
FEATURES
PDA TRUSTEE
President’s Message - Dr. George (Rusty) Bullock . . . . . . . . . . . . . . . . . . . . . . 2
Dr. Jeffrey Sameroff
Politics and Science: A Potential Lethal Mix . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Dr. Charles Weber
A New Class of Drugs called anti-RANKL agents - Dr. Richard L.Wynn . . . 6
Dr. Eugene McGuire
PDA SECRETARY
ADA TRUSTEE
PARLIAMENTARIAN
Outcomes - Sandy Roth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Dr. Bruce R. Terry
PDA EDITOR
Ms. Betty J. Dencler
DEPARTMENTS
EXECUTIVE SECRETARY
Classified Advertising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Upcoming Meetings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . back cover
Need to Reach the Second District Valley Forge
Dental Association or the VFDC? . . . . . . . . . . . . . . . . . . . . . . back cover
ALSO IN THIS ISSUE …
2011 VFDC 25th Anniversary Spring Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8–13
Local Happenings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
DKU Continuing Dental Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
PADPAC Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Become a PDA Contact Dentist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Valley Forge Dental Conference 25th Anniversary, March 2-3-4, 2011 . . . inside back cover
ON THE COVER… Photos from the past 24 years of the
Valley Forge Dental Conference.
MEMBER OF
AMERICAN
ASSOCIATION
OF DENTAL
EDITORS
DIRECTORS
Chester-Delaware
Dr. Tami Brady
Dr. Edmund McGurk
Dr. Eric Shelly
Lehigh-Northampton
Dr. Jason Pellegrino
Dr. Brian Straka
Montgomery-Bucks
Dr. Cary Limberakis
Dr. John Pagliei, Jr.
Dr. Nancy R. Rosenthal
Dr. Laurence H. Stone
Dr. Bruce R. Terry
The Valley Forge Dental Journal is the official publication of the Second District Valley Forge Dental
Association of Pennsylvania, 4781 Steeplechase Drive,
Macungie, PA 18062. 1-800-860-3551
Advertising rates are available from, and all advertising materials and correspondence should be sent to
Stickles Associates, P.O. Box 219, Bath, PA 18014.
(610)837-6036. The Second District Valley Forge
Dental Association of Pennsylvania reserves the right
to refuse any advertisements for any reason.
Articles for publication may be sent directly to Dr.
Tami Brady, 293 Watch Hill Rd., Exton, PA 19341. All
material should be typed, double-spaced, on 8.5" x
11" paper. E-Mail: [email protected] .
Classified advertising should be sent directly to the
Editor. Classified rates are $35 for the first 50 words or
less, 50¢ for each additional word.
The Journal is published three times a year: Winter,
Spring & Fall. The opinions expressed in the Journal are
those of the authors and do not necessarily reflect those of
the Association, nor does the appearance of advertisements imply endorsement by the Association.
President’s
Message
Dr. George (Rusty) Bullock
[email protected]
The Senator listened intently as I explained the
PDA’s point of view on the issue. Then, he sat up straight,
leaned forward in his chair and, with a concerned look on his
face said, “This issue is like the camel poking it’s nose under
the side of the tent”. He must have noticed that I looked perplexed after that statement. I was in Harrisburg to educate legislators and advocate for the dental profession regarding regulations affecting the field of dentistry. The Senator, in turn, was
giving me an education regarding the legislative process and the
issue of change. He warned me how issues that begin in a small
way outside of your main focus of activity can grow in importance and someday “come to roost where you live – right in the
center of your home”. He wasn’t talking about workforce
issues, dental therapists or mid-level providers of dental care
but, he might as well have been. His words of wisdom and
insight into what takes place when the “train of change starts
rolling down the tracks” is something I reflect upon when I
think about the future of the dental profession. Recently, the W.
K. Kellogg Foundation announced that it is investing $16 million in community-led efforts in five states, including the neighboring state of Ohio, to establish Dental Therapists programs as
a way to expand access to oral health care in underserved communities. In Ohio, which is “on our doorstep”, the Foundation
is supporting plans to increase awareness of oral health access
issues, establish community coalitions and, educate lawmakers
regarding how dental therapists, as part of an expanded dental
team, can help address shortages in the delivery of dental care
in rural and low income communities.
The president of the ADA, Raymond Gist, DDS responded
quickly to the announcement and news release by the Kellogg
Foundation by issuing the following statement: “The ADA welcomes the Kellogg Foundation to the fight to improve the oral
health of the millions who suffer from its lack. Unfortunately,
the foundation’s recent efforts to address this complex issue
focus exclusively on expanding a single provider model, the
controversial Alaska Dental Health Aide Therapist. The limited
research evaluation conducted by Kellogg did not provide the
robust examination or projectable metrics on which to base
such important policy and public health decisions.”
At this time, Alaska is the only state with an active Dental
Therapist Program. Since 2005, Dental Therapists have been
providing care to Alaska Native Communities. In 2009,
Minnesota enacted a law authorizing Dental Therapists to practice and students are now being trained to enter the workforce
in the near future. How and where the students are being
trained is a very important issue for the dental profession and
the welfare of the public. Will the proposed two years of training for a Dental Therapist take place in a vocational school setting or, will it take place in an institution of higher education
like an accredited dental school?
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VFDJ
WINTER 2011
Presently, other states including Connecticut, New Hampshire,
Maine and California are investigating the merits of establishing
and schooling mid-level dental care providers such as a Dental
Therapist. The Kellogg Foundation’s message being presented to
legislators and the public in those states is that “workforce models that require non-dentists to practice under direct supervision
of an on-site dentist cannot expand access to care to places that
don’t have enough dentists – only the Dental Therapist – working
under general supervision does this”. Is this proposed workforce
model promoting having a dental auxiliary working outside the
dental team and without dentist supervision? Would the Dental
Therapist accept the responsibility for patient diagnosis, treatment and coordination of dental services with less education than
what is required for a practicing dentist? I personally believe it is
very important to support the vocational growth and advancement
of auxiliaries within the dental team who are under the supervision of a dentist. However, I am concerned about the concept of
having the independent practice of mid-level providers without
supervision by a dentist because of issues involving the health
and safety of the public.
It is of paramount importance that you and I take on the
responsibility to educate our legislators and the public that midlevel providers such as Dental Therapists are not professionals
with the same education and training as dentists but, with schooling received in just a shorter amount of time. We should focus
our discussions with our legislators and our patients on specifically informing them about the skill set and inherent characteristics that highly trained dental professionals bring to the delivery
of oral healthcare that is due to their extensive and unique education, beyond the simple mechanical aspects of the job.
In addition, in our discussions we should reinforce the ADA
position that an auxiliary dental team member dedicated to
community education, triage and facilitation of dental encounters and preventive dental care outreach combined with high
level care provided by dentists can be the means to significantly
improve access to quality oral health care.
This past fall the Second District sponsored a very successful continuing education program with the topic of Infection
Control presented by Rella Christensen, RDH, PhD. The meeting was a sell out. Doctors and staff enjoyed a day away from
the office and left the meeting fully informed regarding what
products and practices that are most critical to effective infection control. Spending a day with Rella gave us all insight into
the warmth of her personality, depth of her knowledge in the
dental field and her ability to convey important information in
an effective and efficient manner. Hopefully, in the not too distant future, we will have an opportunity to once again learn
more from this wonderful educator.
At the Fall Continuing Education meeting, Dr Bernadette
Logan received the Second District Service Award. This
award is given to an individual for distinguished and unselfish
service for improving the oral health of the public through personal activities and actions which have reflected great credit
upon the profession of dentistry. Bernie was recognized and
earned this honor because of her many years of service organizing charitable dental programs and providing care for the disadvantaged, especially children.
continued on page 4
VFDJ
WINTER 2011
3
President’s Message… continued from page 2
The Second District has a long history of having members of
the association from each of the three local Dental Societies
give back to their local communities by providing education
and dental care for the disadvantaged. Perhaps, you are one of
the many volunteers who have provided care for the less fortunate during a Give Kids A Smile event (GKAS) held in
February each year during National Children’s Health Month
(NCDHM). NCDHM focuses on providing oral health education to all children through events run by an individual dental
office and local Dental Societies as well as school based educational programs. The GKAS program was developed by the
ADA to provide free chairside education, screening, treatment,
preventive and restorative care to children in need. Now is the
time for you to “gear up” and plan to hold a NCDHM or GKAS
event in 2011! To learn more about how to organize a GKAS
program in your community contact the ADA at
www.ADA.org/GiveKidsASmile. For additional assistance the
Second District NCDHM Chairperson: Dr. David Iglewicz
([email protected]) would be glad to speak with you and
provide more information on how to plan an event or, join in
the fun of an established-on-going program.
It is important to remember that the overlying message of
the GKAS program is that even with the high level of charitable
care delivered by dentists every year, these efforts will never
solve the problem of access to care highlighted by these programs. In addition, the access to care problem is compounded
by the fact that approximately 50% of actively practicing dentists in Pennsylvania are planning to retire within the next 10
years. Unfortunately, the dentist “pipeline” in Pennsylvania is
not adequately developed to repopulate the current workforce,
especially in rural areas. As a result, the issue of access to dental care in Pennsylvania will only grow in importance in the
coming years. With this in mind, the ADA sponsored GKAS
events provide an opportunity to show how much dentists truly
care about the dental health of the public and, hope to influence
legislators and society-at-large, to work with dentistry to
address the myriad of issues related to access to care.
This year the members of Second District will be celebrating the 25th Anniversary of the Valley Forge Dental
Conference. This highly successful conference which began
with the wishful idea and creative vision of Dr Ron Gross in
1984, has developed and grown through the years due to the
hard work and dedication of the members of the Planning and
Steering Committees into what it is today; the premier Dental
Meeting for Continuing Education, not only in Pennsylvania
but throughout the entire tri-state area. The Association’s
Executive Secretary, Ms Betty Dencler has, since it’s inception, played an invaluable role in achieving the success of the
Valley Forge Dental Conference. Over the years she has
worked tirelessly to coordinate the efforts of dental office volunteers, exhibitors and convention staff to produce a professional meeting experience that we are all proud to be associated with. Kudos to Betty for a job well done!
The theme for this year’s conference: “Celebrate, Discover
and Grow Your Practice” is a reflection of the outstanding
opportunity this meeting represents for all of the members of
the Dental Team. Since this is a license renewal year the program includes courses for dentists as well as staff members who
are seeking CE credits. The General Chairman for the conference, Dr Laurence Stone, along with his entire planning committee have arranged for a superlative program with nationally
recognized speakers presenting on topics such as Periodontics
& Lasers, Pharmacology, Endodontics and Communication.
During the scheduled breaks in the Scientific Program you
will have time to visit the spacious exhibit hall. You will have
an opportunity to stock up on supplies at convention prices and
thank the exhibitors for supporting the conference and enhancing the success of the educational meeting by displaying the
newest equipment and products.
Please mark your calendars to join your friends and colleagues
at the party on Thursday evening March 3, 2011 to celebrate the
long term success of the conference and honor the dedicated individuals who have been involved through the years with the planning of the conferences. The “Founding Fathers” of the conference, Dr Ronald Gross, Dr Jerrold Axler and Dr Richard Galeone
will be recognized at this casual fun-filled event.
I am looking forward to seeing you and your Dental Team on
Wednesday, Thursday and Friday March 2-3-4, 2011 at the
Valley Forge Convention Center. Come join in the fun as we celebrate our Silver Anniversary at what promises to be one of the
most outstanding and memorable Valley Forge Dental
Conferences.
CLASSIFIED ADVERTISEMENTS
The Second District Valley Forge Dental Association reserves the right to
accept or decline classified advertisements at its discretion. In addition, the
Association does not inquire into the offers being made nor does it assume
any liability for them.
Classified advertising should be sent directly to the Editor: Dr. Tami Brady,
293 Watch Hill Road, Exton, PA 19341. E-Mail: [email protected].
Classified rates are $35 for the first 50 words or less, 50 cents for each additional word.
4
VFDJ
WINTER 2011
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Politics and Science:
A Potential Lethal Mix?
by Dr. Nevin Zablotsky
See Dr. Zablotsky’s course “Tobacco and Your Patients,
You Can Be a Lifesaver” at the VFDC on Friday, March 4.
The time was the mid 20th century.
The place was the U.S.S.R. The culprit,
Trofim Denisovich Lysenko, a Russian
horticulturist whose scientific theories
and influence shifted research in agricultural genetics causing catastrophic consequences to the Soviet people, and
ultimately the rest of the world. Lysenko
was an advocate of Lamarck’s theory of
evolution by acquired characteristics. As
many of you may recall from your basic
genetics course, Darwin showed that traits
that benefited a species were naturally
selected and passed along. Thus if some
giraffes had longer necks, they would be
better adapted to access more difficult to
reach food supplies, and would flourish.
Ultimately, this trait would be passed
down over many generations, assuring this
genetic pools’ survival. Those giraffes
with shorter necks would ultimately die
off as they could not compete with the
longer necked giraffes. Jean Baptiste
Lamacrk’s theory of evolution stated that
organisms evolved through the acquisition
of traits during their lifetime and that
future generations would then inherit
these new traits. So if you built up your
biceps muscles, and your offspring built
up their biceps, their future generations
would inherit larger biceps. Nice try, but
clearly wrong.
Unfortunately, the combination of bad
scientists and politicians can be a toxic
mix, and in the case of the partnership of
Lysenko and Stalin this sadly proved
true. As Nazi Germany invaded the
Soviet Union during World War Two, the
Soviets were unable to plant their winter
wheat in the Ukraine which had a more
favorable environment. Thus, Lysenko
treated seeds to harsh conditions and
assumed that by hardening them, the next
generations of wheat would then be able
to grow in difficult climates. Stalin was
so enamored with this approach that with
his backing a resolution was passed banning any other biological work that did
not support Lysenko’s approach.
Scientists who disagreed with this “pseudo-science” were arrested and placed in
prison camps. Tragically, the Soviet people saw a decrease in agricultural production, increased famine and starvation, and
the loss of 30 years of research that would
have benefited future generations.1
The “influenza virus” are two words
that have caused widespread fear and
panic throughout the world, and have
sent modern day scientists and Public
Health officials scurrying to come up
with plans to try and prevent a deadly
pandemic. Once again, we can look back
in history and see how the mixture of bad
science and politics proved to be a lethal
mix. The place was Philadelphia, PA.
The year was 1918. The culprits were
Philadelphia’s political boss, Republican
State Senator Edwin Vare, and Dr.
William Krusen, the Director of the
Department of Public Health and
Charities, “a political appointee with no
background and understanding of public
health issues.” 2 The great influenza pandemic had just begun to reach
Philadelphia, and by September 15th,
600 sailors and marines had been hospitalized at the navy hospital which was
then closed due to a lack of beds.
The Liberty Loan parade was to take
place on September 28th, with thousands
of people marching in it, and hundreds of
thousands of spectators lining the parade
route. Despite the alarming increase in
influenza, Dr. Krusen and Senator Vare
elected not to cancel the march, and intentionally downplayed the dangers of keeping the march as scheduled. In fact,
Dr.Krusen insisted that everyone would be
safe. The repercussions of this political
decision were, “that within 72 hours after
the parade every single bed in each of the
city’s 31 hospitals was filled…literally
hundreds of thousands of people in
Philadelphia were falling ill.” 2 Ultimately,
13,000 people would die within a few
weeks time, leaving a swath of devastation. Once again, the combination of poli-
tics, and the ignoring of basic proven scientific principles had grave consequences.
Unfortunately, the present Vermont
legislative session is continuing the mixture of poor science with politics. The
alleged culprit is the amalgam dental
restoration, but the ultimate victim will
be the general public who will lose
access to an excellent, inexpensive dental
material. Now, I realize that I may be
partaking in a bit of hyperbole for effect,
but if you listen to those who have been
bashing “mercury amalgam”, you would
think that we were talking about nuclear
toxic waste. Sound science tells us that
dental amalgam is safe. In fact it has been
safely used for one hundred years as an
effective way of restoring decayed teeth.
Despite all of this, a small but vocal group
of individuals have convinced legislators
that this restoration’s mercury content is
so vile that cadavers should have their fillings removed before they are cremated, to
prevent mercury from being released into
the air. Does documented, reproducible
science support this? There is no doubt
that mercury in certain forms can be dangerous, and I readily agree that it
behooves everyone to eliminate the real
threats. Yet, this does not give the antimercury lobbyists a carte-blanche for
eliminating dental amalgam.
The philosopher George Santayana
stated that “those who cannot learn from
history are doomed to repeat it.” Elected
officials owe the public their due diligence in utilizing accredited scientists
and health care providers to guide them
in legislating sound public health policies. Whether it be avian influenza, global warming, or even a dental restorative
material, the stakes are too high to rely
on pseudo-science and emotion. As for
poor Lamarck, despite making achievements in classifying invertebrates, his
evolutionary theories were rebuffed and
he died in poverty and was buried in a
rented grave.
REFERENCES:
1
2
www.bookrags.com/research/lysenkoism-wog
John M. Barry The Great Influenza 2005
Article originally published in the Vermont State
Dental Society Journal.
VFDJ
WINTER 2011
5
A new class of drugs called anti-RANKL agents may
be associated with osteonecrosis of the jaw
by Dr. Richard L. Wynn
Don’t miss Dr. Wynn’s presentation, “The Pharmacology Update for Dental Professionals”
at the VFDC on Thursday, March 3.
Denosumab represents a new
class of drugs called anti-RANKL
agents that are indicated for treatment
for osteoporosis. It is marketed under the
brand name Prolia and was developed by
the Amgen company. It gained Food and
Drug Administration (FDA) approval
for the treatment of postmenopausal
women with osteoporosis at high risk for
fracture. It is supplied as an injection for
subcutaneous use. The labeling for denosumab (Prolia) states that osteonecrosis
of the jaw (ONJ) , which is generally
associated with tooth extraction and/or
local infection with delayed healing, has
been reported in patients receiving denosumab (Prolia). A dental examination
with appropriate preventive dentistry
should be considered prior to treatment
with denosumab (Prolia) in patients with
risk factors for ONJ such as dental surgery, diagnosis of cancer, corticosteroid
concomitant therapy, or pre-existing dental disease. Good oral hygiene should be
maintained during drug treatment with
denosumab (Prolia).
Denosumab (Prolia) represents the first
of its class of US approvals known as antiRANKL drugs. These agents work by
decreasing bone turnover resulting in a
significant increase in bone mineral density. More on its mechanisms are described
below. It was developed by Amgen, and is
manufactured by Amgen Manufacturing
Limited, a subsidiary of Amgen Inc. It has
also gained approval for marketing in
Europe and Australia. It is approved for
the treatment of postmenopausal women
with osteoporosis at high risk for fracture.
It is supplied as an injection for subcutaneous use. Recently denosumab (Prolia)
has been granted a Food and Drug
Administration ( FDA) priority review designation for the reduction of skeletal related events in advanced cancer patients.
Priority review designation by the FDA is
granted to drugs that offer major advances
in treatment, or provide a treatment where
no adequate therapy exists. Consistent with
priority review guidelines, the FDA will
6 VFDJ
WINTER 2011
target an Agency action within six months
of the application submission date.
Product labeling for denosumab
(Prolia) states that osteonecrosis of the
jaw (ONJ) has been reported in the
osteoporosis trial program in patients
treated with Prolia. That trial program
has been described by Kyrgidis and
Toulis (see below) . It is not known at
this time what the prevalence or incidence of ONJ is in patients receiving
denosumab (Prolia). However, it is suggested that for patients requiring invasive
dental procedures and are exposed to
denosumab (Prolia), clinical judgment of
the treating physician and/or oral surgeon
should guide the management plan of
each patient based on individual benefitrisk assessment. Further, patients who are
suspected of having or who develop ONJ
while exposed to denosumab (Prolia)
should receive care by a dentist or an
oral surgeon. In these patients, extensive
dental surgery to treat ONJ may exacerbate the condition. Discontinuation of
denosumab (Prolia) therapy should be
considered based on individual benefitrisk assessment.
Patient counseling information provided by Amgen advises patients to maintain good oral hygiene during treatment
with denosumab ( Prolia) and to inform
their dentist prior to dental procedures
that they are receiving denosumab
(Prolia). Patients should inform their
physician or dentist if they experience
persistent pain and/or slow healing of the
mouth or jaw after dental surgery.
These labeling statements can be found
at the Amgen Website at:
http://pi.amgen.com/united_states/prolia/
prolia_pi.pdf (Accessed July 24, 2010)
The Kygidis/Toulis report
Kyrgidis A, Toulis KA. Denosumabrelated osteonecrosis of the jaws.
Osteoporos Int DOI 10. 1007/s00198010-1177-6
Kyrgidis and Toulis described the
results of two unpublished randomized
clinical trials of denosumab in cancer
patients with bone metastases. The
results reported that ONJ occurred as
adverse effect cases reported from preliminary results of clinical trials comparing head to head denosumab with zoledronate (a bisphosphonate) for the treatment of bone metastases in patients with
cancer. In one study, 20 out of 1,026
subjects exposed to denosumab were
observed to have developed ONJ and 14
out of 1,020 subjects exposed to zolendronate were observed to have developed
ONJ. In terms of percent incidence, those
cases accounted for 2.0% for denosumab
and 1.4% for zolendronate. In the second study, 10 out of 888 subjects
exposed to denosumab were observed to
have developed ONJ and 11 out of 888
subjects exposed to zolendronate were
observed to have developed ONJ. In
terms of percent incidence, those cases
accounted for 1.1% for denosumab and
1.3% for zolendronate. Because these
were head to head trials, the incidence of
ONJ in the control population was
assumed to be zero.
Both of these trials had current or prior
intravenous or oral bisphosphonate administration in their exclusion criteria; thus
previous exposure to bisphosphonates as a
factor for ONJ in those participants who
received denosumab could be ruled out.
And, since ONJ has not been previously
described to be associated with other
drugs administered to cancer patients, it
can be suggested that these cases of ONJ
were related to denosumab exposure.
Kyrgidis and Toulis suggested that the
medical community may be facing a new
agent that can induce ONJ. Up to now,
ONJ has never been reported to be associated with other pharmaceutical agents,
except bisphosphonates.
The association between denosumab
exposure and ONJ may be related to dosing interval and cumulative doses. In
studies evaluating denosumab in postmenopausal women with osteopenia or
osteoporosis (Anastasilakis et al Expert
Opin Investig Drugs 18:1085-1102) ONJ
was not observed in any of the subjects
exposed to denosumab. Those studies
included a dosing interval longer than 3
months and a cumulative dose of not more
than 210 mg per 6 months. On the other
hand, the results of the two trials that
described the appearance of ONJ in denosumab subjects included a monthly dosing
interval and a dose of 120 mg per month.
In terms of bisphosphonate related ONJ,
ONJ is a much more common event in
patients receiving those agents for the
treatment and prevention of cancer-related
skeletal events compared to patients
receiving bisphosphonates for non-malignancy indications. Kyrgidis and Toulis
suggests that a broad introduction of denosumab into clinical practice would allow
for recognition of the denosumab-related
ONJ adverse effect in a much wider spectrum of prescription indications, including those for non- malignancy.
The following are two case report
describing the appearance of ONJ
in patients exposed to denosumab
(Prolia)
Case report #1
Agbaloo TL et al. Osteonecrosis of the
jaw in a patient on denosumab. J Oral
Maxillofac Surg 2010; 68:959-963
A 65 year-old women presented to
the oral surgery clinic at the UCLA
Dental School with exposed bone in
the posterior mandible of unknown
duration. Her history included multiple
medical conditions including noninsulin dependent diabetes, hypertension and other cardiovascular problems, and a sacral giant cell tumor
(GCT). She was on multiple medications for her medical conditions, none
of which had ever been associated with
ONJ. The GCT was partially resected
in 2005. In 2007 the patient fell and
sustained an L2-L5 fracture. At that
time she was placed on 120 mg denosumab subcutaneous injections weekly
for 3 weeks followed by a 2 week
hiatus, and continued with a single
injection of 120 mg every 4 weeks.
Approximately 2 to 3 years prior to the
clinic visit, the patient reported a 4
month course of alendronate 70 mg per
week “for bone problems”.
The patient’s history along with
clinical and radiographic findings was
consistent with a working diagnosis of
ONJ. The disease was classified as
stage 2 characterized by exposed and
necrotic bone with pain and erythema,
without purulent drainage. The patient
was treated with antibiotics and
chlorhexidine daily rinses. The patient
was seen 2 and 4 weeks after the initial visit, with no change in severity of
bone exposure. After 8 weeks, the
patient had clinically exposed bone
and the condition was diagnosed as
ONJ, and in this case not associated
with bisphosphonate therapy. The
patient was eventually admitted to the
hospital for intravenous antibiotics,
incision and drainage. After surgery,
the infection subsided and the patient
was discharged.
The authors believed that the potent
inhibition of osteoclastic acitivty by
denosumab played a central role in the
development of ONJ in this patient.
Although the patient reported a history of
alendronate use, the short treatment duration (4 months) was unlikely to have
contributed to the ONJ.
Comment by the authors
Denosumab inhibits osteoclastic differentiation and function. As osteoclasts are
the common target of both bisphosphonates and denosumab, potent osteoclastic inhibition appeared to play a central
role in the pathophysiology of ONJ. As
more osteoclastic inhibitors enter clinical
practice to be used in managing disease
associated with increased bone turnover,
the possibility that these agents might
cause ONJ should be anticipated.
Case report #2
Taylor KH, Middelfell LS, Mizen KD.
Osteonecrosis of the jaws induced by
anti-RANK ligand therapy. Brit J Oral
Maxillofac Surg 2010; 48:221-223.
A 60 year old man was referred to
an oral surgery clinic with an ulcerated area of exposed bone in a region
that was discharging pus in the left
mandible. He had a history of laryngeal carcinoma that had been treated
with laser surgery (no radiotherapy)
and metastatic prostatic adenocarcinoma. He had never been prescribed
bisphosphonate medication and he had
completed a course of chemotherapy
of docetaxel and prednisolone. He
was currently participating in a trial
for a phase 3 study of denosumab
comparing it with zolendronate. The
clinical and radiological features of
the lesion were diagnostic of probable
osteonecrosis. The patient was prescribed amoxicillin 500 mg 3 times
daily for a week along with chlorhexidine mouthrinse. The phase 3 trial
records indicated that the patient was
on the denosumab arm of the trial,
and exposure to denosumab was discontinued immediately. Subsequently
he had symptoms associated with nonvital lower left 1, 2 and 3 and those
extracted, and postoperative
chlorhexidine mouth rinses and
amoxicillin 500 mg 3 times daily
prescribed. The necrotic bone
sequestered 12 months later and on
review 15 months after initial presentation. the mucosa had healed and he
had no symptoms. The authors
believed that the patient had
osteonecrosis of the jaw induced by
denosumab treatment.
Mechanism of denosumabtype drugs
Denosumab (Prolia) is a human monoclonal IgG2 antibody that binds selectively to RANKL, a transmembrane or
soluble protein essential for the formation, function and survival of osteoclasts,
the cells responsible for bone resorption.
RANKL is an acronym for Receptor
Activator of Nuclear factor- KB Ligand,
or receptor activator of nuclear factor
kappa-light-chain-enhancer of activated
B cells. Denosumab (Prolia) prevents
RANKL from activating its receptor,
RANK, on the surface of osteoclasts and
their precursors. RANK is an acronym
for Receptor Activator of Nuclear factor
–K B. Prevention of the RANKL/RANK
interaction inhibits osteoclastic formation, function and survival, thereby
decreasing bone resorption and increasing bone mass and strength in both cortical and trabecular bone. Thus denosumab
is classified as an anti-RANKL agent.
As these agents are increasingly used for
treatment of postmenopausal osteoporosis and being investigated for treatment
of metastatic bone disease, it is possible
that the number of cases of osteonecrosis
induced by anti-RANKL treatment will
increase in the future.
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Local Happenings
SUNDAY, JUNE 12, 2011
Join the Lehigh Valley Dental Association
for their annual Day at the Ballpark with
the Iron Pigs (Philadelphia Phillies AAA
team). Admission is $25 per person and
includes admission to the Coca-Cola Park,
a 2-hour ballpark buffet in the PPL picnic
patio area and free soft drinks throughout the
game. This will be a fabulous family event
where children 12 and younger are invited to
run the bases after the game. Tickets will be
given first-paid, first-served and limited to
350. Please contact Jim Chambers at 610437-5534 to purchase tickets. Questions can
be directed to Bill Cherry at 484-893-5000.
All 2nd District members and their families
are invited to attend.
Dr. Robin Harshaw volunteers at the West Chester GKAS event on
November 3, 2010. This event along with the October 22nd event in
Broomall resulted in $25,000 in dental care for 50 indigent children.
Your
The Second District invites you to participate in its First
Local Lobby Day! Schedule a meeting with your state
representative and senator during the week of January 31 to
February 4 in their district offices. PDA will provide you with
talking points on several important legislative initiatives for
the 2011-2012 legislative session.
Once you have arranged your meeting time, please contact
Donald Smith, PDA government relations coordinator, at
(717) 234-5941, ext. 108, or [email protected]. If you have
any questions, please contact Dr. Linda Himmelberger at
(610) 688-2211 or [email protected].
Help shape the future of the dental profession or it will be
shaped for you!
Join us for our first ever Local Lobby Day!
Dr. Bernadette Logan and Dr. Barry Cohen get inducted into the
International College of Dentists at the 2010 ADA Annual
Conference in Orlando.
Pennsylvania Handpiece Repair Specialists
We repair all brands of handpieces
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888.942.4188
VFDJ
WINTER 2011
15
WE REPAIR HAND
PIECES & MORE
For Additional Services & Specials
Visit us @ www.theDentistsHelper.com
or Call 610.532.1700
16 VFDJ
WINTER 2011
OUTCOMES
by Sandy Roth
For more information on Communication Solutions register
for Sandy’s course on Wednesday, March 2 during the VFDC.
No one comes to your practice for
procedures. Rather, they come because
they are experiencing a problem that is
interfering with their quality of life.
Recently I had the opportunity to work
with a small group of dentists and their
teams on the concept of patient outcomes
and how to learn about them more effectively. To introduce this topic to some of you
who might be new to the idea, I’ll begin by
outlining the basic concept of the OutcomeMeans-Prices model which underlies our
work in patient communications.
While many dentists focus their attention primarily on identifying disease and
breakdown and proposing treatments that
will eliminate that disease or restore original function or form, behaviorally sophisticated relationship-based practices understand that patients cannot easily relate to
those issues on which dentists focus in the
way dentists do. These practices make a
distinction between clinical conditions or
findings and patient-identified problems.
This distinction is enormous and must be
understood for a practice to thrive.
I tend to talk about it as software
(patient experienced and identified problems) versus hardware (clinical conditions
or findings). Outcomes are the software of
dentistry - the quality of life issues the
patient wants dentistry to impact in a positive way. This is relatively easy to understand when you pay attention to what
patients say:
“I don’t like the way that looks. That
front tooth is too big and the one behind it
is a different color.”
“The tooth in the back is really sensitive when I eat something cold.”
“I can’t chew on my left side because of
that open space.”
“I’m worried that something is wrong;
things feel different than they did before.
Do you think I have gum disease?”
When you really listen to what patients
are telling you, it quickly becomes clear
that their everyday experiences are what
matter most and what will get their attention. This makes perfect sense. Patients
aren’t academicians or intellectuals about
dentistry; they are people whose mouths
are either working well or not working
well. Practicality is a key factor for almost
everyone and your paying attention to
what is practical for your patients will help
you understand and serve them better.
Thus, asking about and listening to
their stories and tales is an essential component of learning about their dental priorities. When you study what patients
relate, you will often hear a pattern to
their experiential concerns or problems
and they come in only four flavors:
appearance or how things look
comfort or how things feel
function or how things work
peace of mind issues or health,
stability, etc.
Every issue, concern, complaint, want
or need you hear from a patient will fall
into one of those categories. While some
patients will focus on a single issue, many
will often be experiencing several problems that might span two or more of these
categories.
“There are two things that are bugging
me. First, the ugly tooth on the left side
and the sharp corner on the one that is
broken on the upper right.”
Thus, you must be prepared to listen for
the full range of problems and not stop the
conversation too quickly. In most cases, you
will hear symptoms which will lead you to
discover the underlying conditions, but to
the patient, the symptoms are everything.
Patients often need time to believe you
are really interested in learning about
problems as they are experiencing them
because they are so accustomed to dentists jumping in and telling them everything that is wrong and how they intend
to fix it. You can make an enormous difference in how patients see dentistry by
simply creating a time for them to tell you
their story FIRST before you launch into
clinical investigation.
Once you have learned what your patient
is experiencing, you can begin to learn
what you need to know as a clinician:
What condition or finding does the
patient-experienced symptom reflect?
What other conditions or findings
exist that the patient is not yet
experiencing?
What are the causes of these
conditions or findings?
What are the possible treatments for
these conditions or findings?
Notice that I have used the words conditions and findings to refer to the focus of
the clinician and the words symptoms and
problems to describe the patients’ focus.
This is a good way to make the distinction
in your own mind and keep you clear about
the patient’s concern and focus versus your
clinical concern and focus.
Patients come in to have symptoms suppressed and problems resolved. You do provide them this service by focusing on the
conditions that are causing the symptoms
and problems they are experiencing and
your treatment recommendations or solutions must relate directly to what the patient
is experiencing. This is the linkage or relevance that must be established for your
treatment recommendations to make sense
to your patients.
The way you convey what you are
finding upon examination and the causes of those conditions as well as the
treatment you are proposing will determine whether your patient can relate
what you are saying to what they are
experiencing.
Dentists are charged with the following
obligations:
examination
diagnosis
prognosis
treatment recommendations
delivery of care
When your examination is linked and
relevant to what your patient is experiencing....When your diagnosis is linked and
relevant to what your patient is experiencing.... When your prognosis is linked and
relevant to what your patient is experiencing....When your treatment recommendations are linked and relevant to what your
patient is experiencing.... your patients are
more likely to ask you to deliver care than if
your process is neither linked nor relevant.
I have often said that your first job as a
clinician is to learn. Learn from your
patient what you do not yet know and discover what they think, how they feel and
what they want.
Once that is done, you can immerse
yourself in all things clinical. Until that
is done, you are mostly wasting your
time. Put first things first and focus on
OUTCOME.
VFDJ
WINTER 2011
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Why we need PADPAC…and PADPAC needs us!
WE need PADPAC to…
• Serve as our collective voice with legislators and policymakers – there is strength in numbers!
• Promote our legislative agenda
• Help protect our profession from intrusive and burdensome legislation and regulation
PADPAC needs US to…
• Support their efforts with our contributions
• Support their efforts by becoming Contact Dentists
Please go to www.padental.org and access the PADPAC link to make a contribution or find out more about
becoming a Contact Dentist, or call the Pennsylvania Dental Association at (717) 234-5941, and ask for
Marisa Swarney at ext 116.
The following is a list of 2nd District members who have supported PADPAC in 2010.
PADPAC Contributors 2010
ABBOUD-NIEMCZYK, JEANNETTE
AMANN, NATALIE
ANDOLINO, PETER
ANGLE, ANNE
APPELSTEIN, NEAL
ASTOLFI, ANN
AXLER, JERROLD
BARATI, AMIR
BARRON, W.
BEHNAM, SANDRA
BELLET, DAVID
BELLISARIO, JEFFREY
BENTZ, ROBERT
BERGER, JOEL
BLANK, JEFFREY
BLEVINS, ROBERT
BLUMBERG, DANIEL
BODEN, DANIEL
BOLDEN, TASHA
BONNEVIE, DANIEL
BONOMO, MICHAEL
BOSCH, KENNETH
BRADY, TAMARA
BRADY, THOMAS
BRAY, RICHARD
BRENNER, JEFFREY
BRENT, JOHN
BRIAN, KARIN
BRILLMAN, ROBERT
BRUNO, JOHN
BUFFETT, CONSTANCE
BULLOCK, GEORGE
BURKE, TIMOTHY
BURNS, MARY
18 VFDJ
WINTER 2011
BURT, DAVID
BUSHICK, RONALD
CALABRIA, PHILIP
CANTOR, IAN
CAPISTA, JOSEPH
CAPLIN, LAWRENCE
CARBER, ROBERT
CARLIS, IAN
CAROL, MICHAEL
CARR, GEORGE
CERRONE, ANTHONY
CESTONE, MICHAEL
CHERKAS, LEONARD
CHERMOL, THOMAS
CHERNOW, BRUCE
CHESS, GREGORY
CHIAPPA, JULIUS
CHILA, MARIA
CIMINO, SAMUEL
CIVILLICO, NICHOLAS
CLARK, RICHARD
CLEVELAND, WILLIAM
COHEN, BARRY
COHEN, JAY
COHEN, MARVIN
COHEN, PAUL
COHEN, RONALD
CONTORNO, MICHAEL
COOLEY-BENTZ, SARA
CORVINO, DONNA
COSTE, ANDREW
CRIELLY, WILLIAM
CUMMINGS, WILLIAM
DACHOWSKI, MICHAEL
DAROCHA, BARRY
DASTGIR, MAJID
DEAL, WILLIAM
DECROSTA, JEFFREY
DETWILER, ALETA
DI SPIRITO, NEIL
DILLON, THOMAS
DISHLER, BERNARD
DOBROWOLSKI, RODNEY
DOMSKY, SAMUEL
DONAHUE, KENNETH
ECKMAN, JOSEPH
EDGAR, JANE
ELSTEIN, MARK
ESTELLE, RYAN
FARRIS, JOHN
FELDSHER, RENEE
FETTER, KENNETH
FILIDORE, DOUGLAS
FOSTER, BARRY
GALEONE, RICHARD
GALLAGHER, MICHAEL
GALSON, JOHN
GASTON, BYRON
GATLEY, THOMAS
GAZDICK, STEPHEN
GELLER, BRETT
GIACALONE, ANNA
GIULIANI, NICHOLAS
GLASSMAN, BARRY
GLEASON, WALTER
GOGATE-BHUYAN, VARSHA
GOLDMAN, MITCHEL
GOLDSLEGER, JAY
GORDON, DONALD
GORDON, MARSHA
GOULSTON, MICHAEL
GOWDA, RAJEEV
GOYAL, KUNAAL
GRABILL, LAURENE
GRABOWSKI, RONALD
GRADWELL, SCOTT
GREEN, DANIEL
GREEN, DONALD
GREEN, LESLIE
GREENFIELD, ADA
GREGORY, CHRISTINA
GRETZULA, CHAD
GRIBB, LAWRENCE
GROSS, RONALD
GROSSMAN, EDWARD
GRUBB, PHILLIP
GUPTON, SALLY
HANS, ERIC
HARMON, DANIEL
HARSHAW, ROBIN
HARTMAN, JASON
HARTMAN, JEFFERY
HATGES, NICHOLAS
HEIER, RONALD
HELENIAK, STANLEY
HERB, KATHLEEN
HERSHMAN, HAL
HERTZOG, CHARLES
HILL, CHRISTOPHER
HILLYARD, GREGORY
HIMMELBERGER, LINDA
HOFFMAN, DENNIS
HOROWITZ, ALLAN
HOWARTH, STEPHEN
HUGHES, R.
HUNTINGTON, GARY
INCALCATERRA, CHARLES
INGE, ANDREW
INKER, STEPHAN
ISSA, AEJAAZ
JACKSON, W.
JESTER, CRAIG
JOHNSON, WALTER
KASANDER, JEFFREY
KESSLER, LON
KHOURY, RAMI
KIESEL, WILLIAM
KIRCHNER, GEORGE
KIRSCH, ALAN
KIVOWITZ, GEORGE
KLEIN, RONALD
KOSHETAR, JOYCE
KOSTEVA, CHARLES
KRASNER, PAUL
KUN, MICHAEL
LADER, DANIEL
LAMB, JOSEPH
LAMBERT, HAROLD
LANDES, CHRISTINE
LAWRENCE, CHRISTINA
LEISS, JEFFREY
LEMAY, RICHARD
LEPINE, ERIC
LEVIN, LESTER
LIMBERAKIS, CARY
LLOYD, ROBERT
LOFTUS, MICHAEL
LOGAN, BERNADETTE
LOVASCIO, THOMAS
LU, DOMINIC
LUDWIG, PATRICIA
MALONEY, KARL
MANNINO, VINCENT
MARCINCIN, MARYBETH
MARCUS, EDWARD
MARINAKIS, STEVEN
MARKHAM, CECEILIA
MARKOWITZ, GERALD
MASER, ELLIOTT
MATT, JERALD
MAURO, W.
MAYNES, JAMES
MCCORMICK-GRAVEL, MICHAELA
MCCOY, ROBERT
MCDEVITT, PATRICK
MCELHILL-ROTZAL, SUSAN
MCGUIRE, EUGENE
MCGURK, EDMUND
MCMANMON, GEORGE
MECI, JOHN
MEHTA, TARAL
METROKA, DAVID
MIHALAKIS, MARY
MILLER, DONALD
MILLER, GLENN
MILLER, STEVEN
MIRTAJ, JOSEPH
MOHAMED ALI, SAID
MOLL, EVAN
MONTGOMERY, DAVID
MONTGOMERY, JANE
MONTGOMERY, LAWRENCE
MORICONI, E.
MORRIS, SCOTT
MULLEN, KATHLEEN
MULLER, THOMAS
MUMFORD, JAMES
NASE, JOHN
NELSON, RICHARD
NEUMAN, HOWARD
NEUMAN, NEAL
NISSMAN, CHARLES
NORMAN, ROBERT
NYCE, RICHARD
OLENWINE, CYNTHIA
OLINE, JAMES
OPPENHEIM, KENNETH
PAGLIEI, JOHN
PARDINI, CARL
PARKINSON, GRAHAM
PARSONS, MICHAEL
PASALIC, AIDA
PASSERI, LAURI
PATEL, MONA
PELLEGRINO, JASON
PEPE, VINCENT
PETRILLO, MICHAEL
PETRILLO, PATRICK
PFANNENSTIEL, ARNOLD
PIACINE, MARK
PIORKOWSKI, EDWARD
PISKAI, THOMAS
PLOTNICK, SUSAN
PRESENT, STEVEN
PULLIAM, DALLAS
PYKE, L.
RACHIELE, DOMINIC
RADIN, SHERYL
RADOMILE, JOHN
RADOMILE, MARK
RAKOWSKY, LARRY
RANZINO, VINCENZO
RAVA, JOSEPH
REARDON, WILLIAM
RECUPERO, FRANK
RENNEISEN, WARREN
REUTER, PAUL
RICKERT, DAWN
RIGBERG, ANDY
RISLEY, JENNIFER
RISLEY, WALTER
RITROVATO, ROBERT
ROBBINS, JAMES
ROCCO, CARMEN
ROHRBACH, GEORGE
ROKITA, JOHN
ROSEN, JEFFREY
ROSEN, PAUL
ROSENTHAL, NANCY
ROTHER, DONALD
ROTHWELL, RICHARD
SALDIVAR, MERLE
SALIN, MICHAEL
SAMEROFF, JEFFREY
SANDILOS, WILLIAM
SANTUCCI, STEVEN
SATTLER, ROBERT
SAWYER, PATRICK
SAYLES, ERIK
SCHACH, RAPHAEL
SCHAFFER, JOSEPH
SCHARF, JONATHAN
SCHIFF, LAWRENCE
SCHLESINGER, STEVEN
SCHMIDT, JOANNE
SCHNUPP, PAUL
SCHOENLY, BRIAN
SCHWAN, ROBERT
SCHWARTZ, JAY
SHAH, RAJNIKANT
SHELLY, ERIC
SHIPON, NEAL
SHORE, JEFFREY
SHORE, JOSEPH
SHORE, PHILIP
SIDAWI, MARY
SINGER, ROBERT
SLAWEK, STEPHEN
SLOANE, STEVEN
SMEDLEY, LARRY
SMITH, M.
SMITH, STEPHANIE
SNYDER, DAVID
SNYDER, MARK
SOEHREN, STEPHEN
SOLOMON, ROBERT
SPENNATO, ROBERT
SPILLANE, KEVIN
STAIVECKI, JOHN
STEIN, STEVEN
STERNBERG, MIRIAM
STITELER, TERESA
STOLLER, JOHN
STONE, JONATHAN
STONE, LAURENCE
STOUT, ANGELA
STOUT, KENNETH
STRAKA, J.
STRISOFSKY, RICHARD
STROOCK, MICHAEL
SUBERSKA-WEITZ, KATARZYNA
SUMMERS, ROBERT
TAHA, ESSAM
TAUB, HARRY
TEDROW, DONALD
THOMPSON, PETER
TIGHE, PHILIP
TIMIAN, PETER
TOKASZ, MARIE
TOLLEY, E.
TRACHTENBERG, BRIAN
TROLL, RICHARD
TRUBILLA, LARRY
TYMA, MARK
UFBERG, LAWRENCE
UNGER, MARK
URBANO, BARBARA
VENNERI, DOREEN
VEYS, ALBINA
WASLEY, JOEL
WEBER, CHARLES
WEINER, MICHAEL
WEINSTEIN, MARK
WEISS, ADAM
WEISS, KENNETH
WERNER, CHRISTOPHER
WHYTOSEK, JOHN
WILCK, JEROLD
WILDERMAN, BRUCE
WOLF, WENDELL
WORSLEY, JOHN
WYKE, JEANNINE
YELK, BARRY
ZYCK, JEFFREY
VFDJ
WINTER 2011
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Join the Grassroots Network!
Become a PDA Contact Dentist !
The recent state elections have brought unprecedented change to
the Pennsylvania legislative landscape, not unlike the world of
fashion that, according to Heidi Klum, states “one day you are in;
the next day you are out!”
There are a number of new legislators who were elected from
Chester, Delaware, Montgomery, Bucks, Lehigh and Northampton
counties. There also are a number of returning legislators from
our six county regions.
Regardless of whether they are incumbents or newly elected,
Republican or Democrat, male or female, one thing all of the
legislators have in common is that they are not dentists! They do
not have first-hand information concerning what it takes to provide dental health care, or how unfair insurance practices affect
the economics of a practice. The legislators need a dentist they
know and trust to give them factual information on which to base
their decisions.
That is why we need YOU to become a Contact Dentist. Perhaps
you know a state representative or senator, or know someone who
does. Please consider the important role you could play as a
Contact Dentist.
What do PDA Contact Dentists do?
In a nutshell, they act as liaisons between PDA and the state legislature by developing and maintaining a personal relationship with
a representative and relaying PDA’s position on dental-related
issues. In addition, they may attend campaign fundraisers on PDA’s
behalf. And last, but not least, they act as a source of information
and promote participation in this program to other dentists in the
district.
If you are interested in becoming a Contact Dentist or if you would
like more information regarding the importance of our grassroots
outreach, please contact the Second District Government Relations
Chair, Dr. Linda K. Himmelberger at [email protected] or
610-688-2211.
Become a Contact Dentist Today!
Kornberg School of Dentistry
TEMPLE UNIVERSITY ®
Continuing Education Courses
Spring 2011
Wednesday, February 23, 2011
Nitrous Oxide Sedation (Hands On)
Andrea D. Haber-Cohen, MD, DMD,
Stanton Braid, DMD and
Allen F. Fielding, DMD, MD, MBA
Friday, March 4, 2011
Advance Technology Update: Emerging
Options in Materials, Diagnostics,
and Devices for Dentistry
Steven R. Jefferies, MS, DDS, PhD
Wednesday, March 9, 2011
Dental Management of Emergencies and
the Medically Compromised
Gary Jones, DDS and
Allen F. Fielding, DMD, MD, MBA
Saturday, March 12, 2011
Contemporary Treatment Concepts in
Implant Dentistry for the GP
Matthew Palermo, DMD
Friday, March 18, 2011
Non-Surgical Periondontal Therapies:
Advanced Skills for Improved
Clinical Outcomes (Hands On)
Jon B. Suzuki, DDS, PhD, MBA and
Stacy Matsuda, RDH, BS
Wednesday, March 30, 2011
Adoption and Interpretation of 3D
Cone-Beam CT in your Practice
Jie Yang, DDS, MMedSc, MS, DMD
MISCH
International Implant Institute
Refer to TUKSoD website for more info
Dr. Leonard Abrams Distinguished
Speaker Series Lecture
Making Successful Clinical Decisions in
Anterior Esthetic and Implant Therapy:
Success by Design
Henry Salama, DM
Friday, April 1, 2011
Guide to Predictable and Profitable Anterior
and Posterior Esthetic Restorations
(Hands On)
Marvin A. Fier, DDS, FASDA, ABAD
Friday, April 3, 2011
Adoption and Interpretation of 3D
Cone-Beam CT in your Practice
Jie Yang, DDS, MMedSc, MS, DMD
Questions? Call us at 215.707.7541 or visit
www.temple.edu/dentistry/ce
for complete list of 2011 courses.
20 VFDJ
WINTER 2011
VFDJ
PRSRT STD
US POSTAGE
PAID
UPPER DARBY, PA
PERMIT NO #34
VALLEY FORGE DENTAL JOURNAL
4781 STEEPLECHASE DRIVE
MACUNGIE, PA 18062
Have you seen our
new Website?
Visit us @
www.vfdental.org
UPCOMING EVENTS
25th ANNIVERSARY
Valley Forge Dental Conference:
MONTGOMERY-BUCKS DENTAL SOCIETY
Wed., Mar. 2, Thurs., Mar. 3,
and Fri., Mar. 4, 2011
at the Valley Forge Convention Center
Full day CE Events:
DKU FULL DAY CE,
Springfield Country Club, 8:30-4:00
Wed., Feb. 2, 2011 – Dr. Gordon Christensen
Fri., Jan. 21, 2011 – Dr. Christian Stappert
Fri., April 15, 2011 – Dr. Dennis Tarnow
Fri., April 15, 2011 – Drs. Woodell
and Pissaro
Thurs., May 12, 2011 – Dr. Mark Murphy
[email protected]
Monday Evening Meetings:
Location: Normandy Farms, Blue Bell
Day at the Park with the Iron Pigs
Mon., June 20, 2011
Wed., Feb. 2, 2011 – Dr. Gordon Christensen
Mon., Feb. 28, 2011 – Dr. John Martin
Fri., April 15, 2011 – Dr. Dennis Tarnow
Mon., April 25, 2011 – Dr. D. Walter Cohen
Thurs., May 12, 2011 – Dr. Mark Murphy
LEHIGH VALLEY HEALTH NETWORK
Evening CE events – RSVP to Dan Daley:
[email protected]
Wed., Jan. 26, 2011 – Dr. Steve Jeffries
Full Day CE Events
Thurs., Feb. 3, 2011 –
Dr. Gordon Christensen
Wed., Mar. 23, 2011 – Dr. Paul Goodman
Wed., April 6, 2011 – Mr. Hugh Doherty
Wed., May 25, 2011 – Dr. Alan Stark
Wed., May 11, 2011 – Dr. Dennis Tarnow
CHESTER-DELAWARE DENTAL SOCIETY
DKU Events – Contact Dr. Barry Cohen:
Need to Reach the
Second District Valley Forge
Dental Association
or the VFDC?
ONLINE
www.vfdental.org
(Second District)
www.vfdc.org
(Valley Forge Dental Conference)
Contact Tom Howley: [email protected]
LEHIGH VALLEY DENTAL ASSOCIATION’S
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PHONE
1-800-854-8332 VFDC
1-800-860-3551 SD
FAX
1-610-340-2585 VFDC
1-941-358-3034
1-610-395-5669 SD
E-MAIL
MAIL
4781 Steeplechase Drive
Macungie, PA 18062
[email protected]
[email protected]