Oral Bacteria May
Influence Joint Failures
The
culprit behind a failed hip or knee replacement may exist in the oral cavity,
according to a new study in the Journal
of Clinical Rheumatology (JCR). DNA testing of bacteria from the fluid that
lubricates hip and knee joints had bacteria with the same DNA as the plaque
from patients with periodontal disease and in need of a joint replacement,
according to researchers from the Case Western Reserve University School of
Dental Medicine (JCR April 2012, Vol.
18, No.3, pp. 117-121).
Working
with University Hospitals Case Medical Center researchers, the dental,
orthopedic, and arthritis researchers suggest the bacteria might be the reason
why aseptic loosening or prosthetic wear causes the artificial joints to fail
within 10 years when no infection appears to be present.
Dr.
Nabil Bissada, Chair of the Department of Periodontics at the Dental School, says
the objective of the study was to see if bacteria like Fusobacterium nucleatum and Serratia
proteamaculans found in patients with periodontal disease were present in
the fluid.
He
and his colleagues studied 36 patients seeking care at the University Hospitals
Case Medical Center for osteoarthritis and rheumatoid arthritis. These patients
had both natural and artificial joints and signs of periodontitis and had
undergone exams where dental plaque was obtained for the study.
The
researchers used polymerase chain reactions and DNA sequence analysis of
specific genes (16S-23S rRNA) to detect bacteria in the plaque and joint fluid.
Five of the 36 patients (14%) showed direct DNA links between the bacteria in
the fluid and plaque from the mouth: one from a rheumatoid arthritis patient
with a failed natural joint, one rheumatoid arthritis patient with a failed
replacement joint, two osteoarthritis patients with failed artificial joints,
and one osteoarthritis patient with a failed natural joint. For more
information, please click here .
UCLA Dental Student
Recounts Experience Surviving Mount Everest
Mr.
Lindley Zerbe had just flown overseas to start his career as a research
scientist at the National University of Singapore after graduating from
Stanford. Then he got an email that would permanently change his career path.
The
university, it said, wanted to send a team of students and staff to the summit
of Mount Everest in celebration of its centennial. “I couldn’t believe what I
was reading,” Mr. Zerbe says. “I knew I had to do it.”
Now
a fourth-year student at the UCLA School of Dentistry, Mr. Zerbe trained for
more than two and a half years in preparation for the expedition in 2005. His
decision to act as the team’s medic, however, altered his fate. The excitement
of applying preventative medicine techniques and helping others spurred Mr. Zerbe
to pursue dentistry upon his return to the United States, he says. One team
member was needed to learn to treat altitude sickness and common injuries on
the climb, and Mr. Zerbe volunteered.
On
the team’s many treks, Mr. Zerbe used leftover supplies to treat patients at
local clinics and hikers from other groups. On a training hike in Pakistan, for
example, he repaired a broken crown for a Polish hiker with extreme mouth pain.
Mr.
Zerbe recounted his journey to the summit in a presentation at the University
of California, Los Angeles (UCLA), School of Dentistry on April 25, 2012, after
encouragement from Dr. Carol Bibb, Associate Dean at the UCLA School of Dentistry.
During
two and a half years, the National University of Singapore whittled a list of
100 candidates down to the five who would tackle Mount Everest. Overnight boot
camp, psychological tests, and training in the mountains of New Zealand resulted
in Mr. Zerbe, a Malaysian, and three Singaporeans becoming the victors. The
climb took the team three months to complete. In the course of the climb, some
experiences were life-threatening, Mr. Zerbe says.
Mr.
Zerbe and the Sherpa traveling with him were completing an acclimatization hike
and heading toward base camp. Mr. Zerbe heard what sounded like a jet engine
behind him and turned to find a 3-foot-wide boulder rocketing over his
footsteps. He ducked behind a ledge, forever thankful his team had opted to leave
their iPods at home in favor of open ears, he says. “That was a moment of sheer
terror,” Mr. Zerbe says. “The small decision not to wear headphones saved my
life.”
Aside
from learning to appreciate his life, Mr. Zerbe says he also learned to appreciate
people’s diversity—an outlook that he hopes to bring into his future dental
practice. His team faced tensions at first due to cultural differences. Mr. Zerbe
says they would often attribute his opinions to the fact that he was an
American, without considering his personal point of view. But a series of talks
and a journey up the world’s tallest mountain soon dissolved a network of
conflicts into strong cross-cultural friendships, he says.
At
UCLA, Mr. Zerbe has contributed much as a leader, says Dr. Ronald Mito, Associate
Dean at the dentistry school. Mr. Zerbe acted as a representative for his class
to the California Dental Association, mentored younger students, and honed his
leadership skills in the Dean’s Leadership Institute.
“Lindley
brings a certain maturity to the dental school family,” Dr. Mito says. “He has
a sense of what it takes to accomplish something the average person would
consider impossible.” For more information, please click here .