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150 JADA, Vol. 140 http://jada.ada.org February 2009

GENE THERAPY STOPS

PERIODONTAL DISEASE

DEVELOPMENT

S

cientists at the University of

Michigan, Ann Arbor, haveshown that gene therapy can be

used to stop the development of

periodontal disease, according

to an article published online

Dec. 11 in advance of print pub-

lication in Gene Therapy.

Gene therapy has not been

used in nonlife-threatening

disease. [Periodontal disease] is

more disabling than life-

threatening, said Dr. William

Giannobile, a professor at the

University of Michigan School ofDentistry and the studys princi-

pal investigator. This is so im-

portant because the next wave

of improving medical therapeu-

tics goes beyond saving life and

moves forward to improving the

quality of life.

The preclinical study was a

collaboration with Targeted

Genetics, a Seattle-based

biotechnology company. The

company recently released

human trial results that showed

that the same gene therapy ap-

proach used to stop periodontal

disease had positive effects in

patients with rheumatoid

arthritis. The company tested

127 subjects, who exhibited a

30 percent improvement in pain

relief and gain of function.

People with rheumatoid

arthritis are four times more

likely than others to have perio-

dontitis. Periodontal diseasealso is linked to systemic condi-

tions such as heart disease, bac-

terial pneumonia and stroke,

likely due to the spread of bacte-

ria from the oral cavity to other

parts of the body.

Using gene therapy, the re-

searchers found a way to help

certain cells by using an inacti-

vated virus to create more of a

naturally produced molecule-

soluble tumor necrosis factor

(TNF) receptor. This factor is

underproduced in patients with

periodontitis. The molecule de-livered via gene therapy works

like a sponge to soak up exces-

sive levels of TNF, a molecule

known to worsen inflammatory

bone destruction in patients

with rheumatoid arthritis, joint

deterioration and periodontitis.

The periodontal tissues

were spared from destruction by

60 percent (at four weeks).

If you deliver the gene into

the target cells once, it keeps

producing in the cells for a verylong period of time or potential-

ly for the life of the patient, Dr.

Giannobile said. This therapy

is basically a single administra-

tion, but it could have potential-

ly lifelong treatment effects in

patients who are at risk [of de-

veloping] severe disease

activity.

The next step is additional

safety testing on patients with

periodontal disease, added Dr.

Giannobile.

This research was funded by

grants from the National

Institute of Dental and

Craniofacial Research and the

National Institutes of Health.

STUDY FINDS LINK

BETWEEN ORAL

INFLAMMATORY DISEASES

AND EPSTEIN-BARR VIRUS

A

significant percentage of

dental patients with irre-versible pulpitis and apical peri-

odontitis also have the Epstein-

Barr virus, according to an

article published in the January

issue of Journal of Endodontics.

Although the number of stud-

ies examining the role of

herpesviruses in oral disease

has been increasing, the majori-

ty of studies have focused on

periodontitis, with no systemat-

ic attempt to examine her-

pesvirus in endodontic patients

with varying inflammatory

diseases.Researchers at the School of

Dentistry at Oregon Health &

Science University, Portland,

assessed the presence of human

cytomegalovirus, Epstein-Barr

virus, herpes simplex virus type

1 (HSV-1) and varicella-zoster

virus in 82 endodontic patients,

including patients with irre-

versible pulpitis and apical peri-

odontitis, and compared the re-

sults with those in 19 healthy

patients.The goal of the study was to

determine the potential associa-

tion of herpesvirus with clinical

symptoms, including acute pain

and size of radiographic bone

destruction.

Using a variety of methods,

the researchers found the

Epstein-Barr virus DNA and

RNA in significantly higher per-

centages (43.9 and 25.6 percent,

respectively) in endodontic pa-

tients than in healthy patients

(0 percent). They found human

cytomegalovirus DNA and RNA

in measurable numbers in en-

COMING IN MARCH

dDepth of cure of clear

versus opaque sealants as in-

fluenced by curing regimens

dA healthy weight interven-

tion for children in a dental

setting

dThe Dental Pipeline pro-

grams impact on access dis-

parities and student diversity

Look for this and more in

the March issue of JADA.

JADAPreview

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dodontic patients (15.9 and 29.3

percent, respectively) as well as

in healthy patients (42.1 and

10.5 percent, respectively). The

researchers found herpes sim-

plex virus DNA in low percent-ages of endodontic patients

(13.4 percent), and they found

varicella-zoster virus in only

one endodontic patient.

Although a previous study

examined the incidence of

herpesviruses in cases of apical

periodontitis, this is the first

time irreversible pulpitis has

been analyzed for the presence

of herpesviruses and associated

with Epstein-Barr virus, said

Curt Machida, PhD, professor ofintegrative biosciences and the

principal investigator.

The incidence of irreversible

pulpitis and apical periodonti-

tis, caused by bacteria and pos-

sibly the latent herpesvirus, is

painful and can greatly impair

the bodys natural immune sys-

tem, Dr. Machida said.

Studies such as ours could

someday lead to more effective

treatments [for] inflammatory

diseases of the mouth.

This research was funded by

grants from the American

Association of Endodontists

Foundation, the Oregon Clinical

and Translational Research

Institute, the National

Institutes of Healths (NIHs)

National Center for Research

Resources and the NIH

Roadmap for Medical Research.

COMORBIDITIES AFFECT

SURVIVAL OF PATIENTSWITH HEAD, NECK CANCER

Current estimates for head

and neck cancer survival

are largely inaccurate because

they widely disregard many of

the most common diseases pa-

tients have in addition to their

primary cancer, according to

Jay Piccirillo, MD, a head and

neck specialist at Washington

University School of Medicine,

St. Louis.

Researchers reviewed the

medical records of 183 patientswith squamous cell carcinoma

of the oral cavity, throat and

larynx who were treated in

1997 and 1998 at Barnes-

Jewish Hospital, St. Louis,

which has tracked comorbidities

since 1995. The study was pub-

lished in the October issue of

Archives of Otolaryngology,

Head and Neck Surgery.

Comorbid ailments in these

patients included heart attack,

coronary artery disease, tumorsother than the primary tumor,

psychiatric disease, lung dis-

ease, stroke, diabetes and alco-

hol abuse. Many of these disor-

ders can be traced to smoking or

alcohol consumption, the same

behaviors that may contribute

to the occurrence of head and

neck cancer, said Dr. Piccirillo,

director of the Clinical

Outcomes Research Office at

Washington University School

of Medicine and a professor of

otolaryngology.

The study results showed

that 33 percent of patients with

head and neck cancer developed

new comorbidities or a worsen-

ing of existing comorbid ail-

ments in the time after their

initial diagnosis and treatment.

Patients with severe comorbidi-

ties during the follow-up period

had, on average, a 6.7 times

greater risk of dying.The most common comorbidi-

ties that developed or worsened

after diagnosis were malignant

tumors unrelated to the original

tumor and psychiatric illnesses.

The type of treatment patients

receivedchemotherapy, radia-

tion therapy, surgery or some

combination of thesemade no

difference in the number or

severity of comorbidities.

For decades, we have used a

cancer staging system based on

tumor size, lymph node involve-

ment and whether cancer hasspread to other parts of the

body when estimating a pa-

tients survival while mostly ig-

noring how sick patients are

from other diseases, Dr.

Piccirillo said. In fact, national

databases used to estimate can-

cer survival dont account for co-

morbidities, and as a result, we

dont have very accurate esti-

mates of how long patients are

likely to survive their cancers.

Compiled by Janice Snider, senior editor.

MEETINGS

dThe British Society of

Periodontology will hold its

spring meeting March 13-14 in

Sheffield, England. For more

information, visit www.bsperio.

org.

dThe Thomas P. Hinman

Dental Meeting will be held

March 19-21 in Atlanta. For

more information, contact Ms.

Sylvia Ratchford by phone at

1-404-231-1663, by fax at 1-404-

231-9638 or by e-mail at

[email protected].

The 33rd International

Dental Show will be held March

24-28 in Cologne, Germany. For

more information, visit www.

koelnmesse.de.

dThe Alliance of the American

Dental Association will hold its

annual meeting March 25-28 inBaltimore. For more informa-

tion, contact Ms. Trish Rubik-

Rothstein by phone at 1-312-

440-2865, by fax at 1-312-440-

7494 or by e-mail at

[email protected].

dThe American Student

Dental Association will hold its

39th annual session March 25-


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29 in Louisville, Ky. For more

information, contact Ms.

Meghan Keelean by phone at

1-312-440-2845, by fax at 1-312-


[email protected] How to Practice

Evidence-Based Healthcare

workshop will be held March

30-April 1 in Oxford, England.

For more information, visit

www.cebm.net/

index.aspx?o=1210.

dThe American Association for

Dental Research will hold its

38th Annual Meeting &

Exhibition April 1-4 in Miami.

For more information, contact

Dr. Christopher Fox by phone at1-703-548-0066, by fax at 1-703-


[email protected].

APPOINTMENTS/

ELECTIONS/AWARDS

dDr. Tim S. Trulove,Montgomery, Ala., was installed

as president of the Southern

Association of Orthodontists.

Other officers are Dr. RollandR. Reed, Ocala, Fla., president-elect; and Dr. Rodney Klima,

Burke, Va., secretary-treasurer.dDr. Tonya Volk, Skokie, Ill.,has joined the orthodontics de-

partment at the University of

Illinois at Chicago College of

Dentistry.

CALENDAROF EVENTS

ADA ANNUAL SESSIONS

2009 Sept. 30-Oct. 4, Honolulu2010 Oct. 9-12, Orlando

2009 CONSTITUENT

DENTAL SOCIETY ANNUAL

MEETINGS

Meeting dates are subject to

change. Dentists interested in

attending any of the listed

meetings should contact the

sponsoring organization for

more information.

Alabama Dental Associa-tion, 836 Washington Ave.,

Montgomery 36104-3839,1-334-265-1684, June 9-14,Orange Beach.

Alaska Dental Society,9170 Jewel Lake Road, Suite

203, Anchorage 99502-5381,

1-907-563-3003, May 7-10,Fairbanks.

Arizona Dental Associa-tion, 3193 N. Drinkwater Blvd.,Scottsdale 85251-6491, 1-480-

344-5777, Western Regional

Dental Convention, March

12-14, Phoenix.Arkansas State Dental

Association, 7480 Highway107, Sherwood 72120, 1-501-

834-7650,April 3-4, HotSprings.

California Dental Associa-tion, 1201 K Street Mall,Sacramento 95814, 1-916-443-

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0505, Spring Scientific Session,

May 14-17, Anaheim; FallScientific Session, Sept. 11-13,San Francisco.

Colorado Dental Associa-

tion, 3690 S. Yosemite, Suite100, Denver 80237-1808, 1-303-

740-6900, June 11-14, Vail.Connecticut State Dental

Association, 835 W. Queen St.,Southington 06489, 1-860-378-

1800, May 6-8, Uncasville.Delaware State Dental

Society, The ChristianaExecutive Campus, 200

Continental Drive, Suite 111,

Newark 19713, 1-302-368-7634,

May 14-15, Wilmington.

District of ColumbiaDental Society, 502 C St.,N.E., Washington 20002-5810,

1-202-547-7613,April 16-18,Washington.

Florida Dental Associa-tion, 1111 E. Tennessee St.,Suite 102, Tallahassee 32308-

6913, 1-850-681-3629, June 18-20, Orlando.

Georgia Dental Associa-tion, 7000 Peachtree DunwoodyRoad, Suite 200, Building 17,

N.E., Atlanta 30328-1655,

1-404-636-7553, July 30-Aug.2, Asheville, N.C.

Idaho State Dental Asso-ciation, 1220 W. Hays St.,Boise 83702-5315, 1-208-343-

7543, June 10-13, Boise.Illinois State Dental

Society, 1010 S. Second St.,Springfield 62705, 1-217-525-

1406, Sept. 11-13, Oak Brook.Indiana Dental Associa-

tion, P.O. Box 2467, Indian-apolis 46206-2467, 1-317-634-

2610, May 7-9, Indianapolis.Iowa Dental Association,

5530 W. Parkway, Suite 100,

Johnston 50131, 1-515-986-

5605, May 1-3, Coralville.Kansas Dental Associa-

tion, 5200 S.W. Huntoon St.,Topeka 66604-2398, 1-785-272-

7360, Heart of AmericaDental Symposium, April 16-18, Wichita.

Kentucky Dental Associa-tion, 1920 Nelson Miller

Parkway, Louisville 40223,1-502-489-9121,April 2-5,Louisville.

Louisiana Dental Associa-tion, 7833 Office Park Blvd.,Baton Rouge 70809-7604, 1-225-

926-1986,April 2-4, NewOrleans.

Maine Dental Association,P.O. Box 215, Manchester

04351-0215, 1-207-622-7900,

June 19-20, Rockport.Maryland State Dental

Association, 6410 DobbinRoad, Suite F, Columbia 21045,

1-410-964-2880, Sept. 25-27,Ocean City.

Michigan Dental Associa-tion, 230 N. WashingtonSquare, Suite 208, Lansing

48933-1312, 1-517-372-9070,

April 22-25, Lansing.Minnesota Dental Associa-

tion, 1335 Industrial Blvd.,Suite 200, Minneapolis 55413-

4801, 1-651-646-7454, Star ofthe North Meeting, April 23-25, St. Paul.

Mississippi Dental Asso-ciation, 2630 Ridgewood Road,Suite C, Jackson 39216-4903,

1-601-982-0442, June 12-16,Destin, Fla.

Montana Dental Associa-tion, P.O. Box 1154, Helena59624-1154, 1-406-443-2061,

May 21-22, Great Falls.Nebraska Dental Associa-

tion, 3120 O St., Lincoln68510-1533, 1-402-476-1704,

April 2-4, Omaha.Nevada Dental Associa-

tion, 8863 W. Flamingo Road,Suite 102, Las Vegas 89147-

8718, 1-702-255-4211, July 9-11, Lake Tahoe.

New Hampshire DentalSociety, 23 S. State St.,

Concord 03301, 1-603-225-5961,

May 14-16, Newcastle.New Jersey Dental Asso-

ciation, One Dental Plaza, P.O.Box 6020, North Brunswick

08902-6020, 1-732-821-9400,June 3-5, Atlantic City.

New Mexico Dental Asso-ciation, 9201 MontgomeryBlvd. N.E., Suite 601, Albu-

querque 87111, 1-505-294-1368,

June 11-13, Albuquerque.New York State Dental

Association, 20 CorporateWoods Blvd., Suite 602, Albany

12211, 1-518-465-0044, Semi-Annual Board of GovernorsMeeting, May 28-31,

Saratoga Springs.North Carolina Dental

Society, P.O. Box 4099, Cary27519-4099, 1-919-677-1396,

May 14-17, Myrtle Beach,S.C.

North Dakota DentalAssociation, P.O. Box 1332,Bismarck 58502-1332, 1-701-

223-8870, Sept. 18-20, Fargo.Ohio Dental Association,

1370 Dublin Road, Columbus

43215-1009, 1-614-486-2700,

Aug. 27-30, Columbus.Oklahoma Dental Associa-

tion, 317 N.E. 13th St.,Oklahoma City 73104-2835,

1-405-848-8873,April 23-25,Tulsa.

Oregon Dental Associa-tion, P.O. Box 3710, Wilsonville97070-3710, 1-503-218-2010,

April 2-4, Portland.Pennsylvania Dental

Association, P.O. Box 3341,

Harrisburg 17105-3341, 1-717-234-5941,April 23-26,Hershey.

Rhode Island Dental Asso-ciation, 200 Centerville Road,Suite 7, Warwick 02886-4339,

1-401-732-6833, May 27,Providence.

South Carolina DentalAssociation, 120 Stonemark


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Lane, Columbia 29210-3841,

1-803-750-2277,April 28-May3, Myrtle Beach.

South Dakota DentalAssociation, P.O. Box 1194,

Suite 103, 804 N. Euclid, Pierre57501-1194, 1-605-224-9133,

May 14-17, Sioux Falls.Tennessee Dental Associa-

tion, Suite 300, 660 BakersBridge Ave., Franklin 37067,

1-615-628-0208, May 14-17,Knoxville.

Texas Dental Association,1946 S. IH35, Suite 400, Austin

78704, 1-512-443-3675, May 7-10, San Antonio.

Vermont State Dental

Society, 100 Dorset St., Suite18, South Burlington 05403-

6241, 1-802-864-0115, Sept. 17-18, South Burlington.

Virginia Dental Associa-tion, 7525 Staples Mill Road,Richmond 23228, 1-804-261-

1610, June 18-20,Williamsburg.

Washington State DentalAssociation, 1001 Fourth Ave.,Suite 3800, Seattle 98154,

1-206-448-1914, July 23-24,Seattle.

West Virginia DentalAssociation, 2016-1/2Kanawha Blvd. East,

Charleston 25311, 1-304-344-

5246, July 16-19, WhiteSulphur Springs.

Wisconsin DentalAssociation, 6737 W.Washington St., Suite 2360,

West Allis 53214-4815, 1-414-

276-4520,April 30-May 1,

Wisconsin Dells.Wyoming Dental Associa-tion, P.O. Box 40019, Casper82604, 1-307-237-1186, June18-21, Cheyenne.

Compiled by Jennifer Garvin, senior editor,ADA News, [email protected].

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