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Cavitation surgery options

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Cavitation surgery options

Post  thissucks on Mon Mar 24, 2014 8:46 am

I had my wisdom teeth removed about 15 years ago, and I imagine I probably have some pretty nasty cavitations by now.  With my current rash of health problems, I think it's in my best interest to get those cleaned out as soon as possible, so I'm looking for the most reputable dentist in the U.S. to help me out.  At the moment, I am looking at two possible doctors:

Dr. Alireza Panahpour
http://www.systemicdentist.com/

Dr. Blanche Grube
http://www.drblanchegrube.com/
http://www.centersforhealing.net/index.html

Dr. Panahpour is interesting.  One of our users here, manofmanytrades, saw him and had a good experience with him (more on that here http://immortalhair.forumandco.com/t9616-dental-work-stopped-my-hair-loss).

Dr. Panahpour suggests filling the extraction site with a relatively new substance called Socket Graft Putty to assist with bone formation.  You can read about it here:  http://www.steinerlabs.com/socket_graft.shtml  It is implanted and not removed, and the exact ingredients are not disclosed.  It does appear to contain a drug of some kind.  The company's claim is that all the compounds in it are found in nature, yet are synthetically reproduced and therefore pure.  The thought of implanting foreign substance into my jaw is both intriguing and concerning.  I understand that it may help prevent bacteria from regrowing and also help the bone regenerate properly.  However, it also means that the drug evidently "enters the osteoblasts" and is, presumably, integrated into your bone.  More information on that here: http://www.mouthbodydoctor.com/wp-content/uploads/2013/12/Healing_socket.pdf  My scientific knowledge is limited, so I would love to hear others' thoughts on the subject.

On the other hand, Dr. Grube is championed by the Hal Huggins Alliance.  She evidently follows the Huggins protocol closely and has performed thousands of surgeries.  In that respect, she seems like a safe choice.  Unlike Dr. Panahpour,  I do not think she implants anything to the cavitation site, although I'm looking to confirm this.  However, my understanding is that if you simply clean out the cavitation site and then stitch it back up, the lesion may just become reinfected after surgery and then need to be cleaned out again in the future.  Is this correct?  

Dr. Panahpour used to be on the Huggins list, but now is not.  He told me personally he refuses to pay the $8,000/year fee to be on their list.  Thus, although he follows many of the elements of the Huggins protocol (such as IV Vitamin C), he is not endorsed by them any further.  He actually told me "don't be fooled by that crap."  He referred to many of them as "weekend warriors" who take a few classes but don't actually have the knowledge or experience to be a top surgeon.  He told me that he has paid hundreds of thousands of dollars to stay up to date with the latest research and technology, and that my first question to other dentists should be for them to list the training and certifications they have received.  On his website biography, I noticed that he mentions enriching his education at "highly distinguished schools such as University of Southern California, San Francisco Academy for Advanced Dental Education and New York University," although he doesn't get any more specific than that.

My phone conversation with Dr. Panahpour was quite candid and interesting, although customer service isn't exactly his strong point and his bitterness towards the Huggins Alliance was clear.  After a few minutes he seemed to be quite eager to get off the phone with me, but I'm sure he's very busy.  He did say he usually performs about 4-5 cavitation surgeries per day.  He has also responded to some of my questions via e-mail (albeit with typos, although English may not be his first language).

Both dentists are extremely expensive, and this is a huge life decision to make.  Right now, the socket graft putty seems to be the biggest sticking point (pun intended) - "To putty, or not to putty? That is the question."  Smile  I do not know if there are other factors I should take into consideration, since both dentists have great credentials and share many of the same philosophies.  I would love to hear some thoughts from this board on the subject.

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Re: Cavitation surgery options

Post  ngb on Mon Mar 24, 2014 10:45 am

I would get a 3d cone beam x-ray first to see if you even have a problem and get a few opinions from different dentists to make sure they aren't just taking your money. I had my wisdom teeth removed 10 years ago and the x-ray showed no problems.

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Re: Cavitation surgery options

Post  CausticSymmetry on Mon Mar 24, 2014 10:50 am

thissucks - One question to ask the dentist (how he response might be revealing), which is is this material implanted tested for biological compatibility?

Huggin's methodology is based on immunology, which is the premise that *anything* implanted into bone will cause an autoimmune reaction. The question is will this material be entirely replaced by bone or is there is a chemical tag by the body that will create an immune reaction to the foreign substance. Initially, there is a drug that inhibits the invasion of immune factors so that the infection process can be withdrawn long enough for the new growth factors to be initiated.

However, what happens after that?

I would basically ask the qualifying question. Is there is risk of immune reaction?  Is there is test of this material being biologically compatible?

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Re: Cavitation surgery options

Post  thissucks on Mon Mar 24, 2014 11:46 am

ngb wrote:I would get a 3d cone beam x-ray first to see if you even have a problem and get a few opinions from different dentists to make sure they aren't just taking your money.  I had my wisdom teeth removed 10 years ago and the x-ray showed no problems.

Thanks, I do plan on getting X-rays first.  However, as manofmanytrades explained in one of his posts, the infections sometimes don't show up on the X-ray.  One of his sites didn't show anything, yet the dentist dug out all sorts of nasty stuff.  He even posted a picture of the results.  You can see all the gunk they pull out before you send it off to biopsy.  I don't plan on doing all 4 sites at once, but I'd be willing to open up at least one of the bottom ones just to survey the damage.  

CausticSymmetry wrote:thissucks - One question to ask the dentist (how he response might be revealing), which is is this material implanted tested for biological compatibility?

Huggin's methodology is based on immunology, which is the premise that *anything* implanted into bone will cause an autoimmune reaction. The question is will this material be entirely replaced by bone or is there is a chemical tag by the body that will create an immune reaction to the foreign substance. Initially, there is a drug that inhibits the invasion of immune factors so that the infection process can be withdrawn long enough for the new growth factors to be initiated.

However, what happens after that?

I would basically ask the qualifying question. Is there is risk of immune reaction?  Is there is test of this material being biologically compatible?

Hi CS, thanks for the reply.  Those are some great questions and I wonder if anybody actually knows for sure.  I've read the manufacturer's website carefully (Steiner Laboratories) and this is their company line:

"Everything in Socket Graft Putty is synthetically produced while all of the compounds exist in nature. There are no animal or human products in any of our graft materials. In addition, there is no potential for allergic or inflammatory reactions."

Steiner claims to have done hundreds of these with no complications, and it is FDA approved. (although I know that is irrelevant to you!)  I will definitely call up Dr. Panahpour and ask him your questions and see how he responds.  However, I wonder if he will basically say some variant of the above, and that there is no risk of immune reaction (as per the manufacturer).  I will also try calling Steiner Laboratories and see if I can get more information from them.

What do you think about just cleaning the site out and then stitching it back up?  Any guess on the odds of reinfection?

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Re: Cavitation surgery options

Post  ngb on Mon Mar 24, 2014 12:34 pm

thissucks wrote:
ngb wrote:I would get a 3d cone beam x-ray first to see if you even have a problem and get a few opinions from different dentists to make sure they aren't just taking your money.  I had my wisdom teeth removed 10 years ago and the x-ray showed no problems.

Thanks, I do plan on getting X-rays first.  However, as manofmanytrades explained in one of his posts, the infections sometimes don't show up on the X-ray.  One of his sites didn't show anything, yet the dentist dug out all sorts of nasty stuff.  He even posted a picture of the results.  You can see all the gunk they pull out before you send it off to biopsy.  I don't plan on doing all 4 sites at once, but I'd be willing to open up at least one of the bottom ones just to survey the damage.  

Normal dental x-rays don't always show anything I guess, you have to get a 3d cone beam x-ray. Whoever you go to should order this first and show you where a cavitation is. I got one and the dentist told me nothing was wrong.

https://www.google.com/search?q=3d+cone+beam&espv=210&es_sm=93&source=lnms&tbm=isch&sa=X&ei=AoovU8iVOIfxoATyxYKwCA&ved=0CAkQ_AUoAQ&biw=1024&bih=653

I read that 80% of people get their wisdom teeth out and I'm guessing 95% of people get a tooth pulled at some point in their life. I'm guessing a cavitation is pretty rare. You can probably find a lab and just pay for the x-ray yourself without a dentist. It takes 30 seconds so you can probably negotiate the price down to $100-$200. Send copies of the CD around and see if some dentists will look at it.

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Re: Cavitation surgery options

Post  thissucks on Mon Mar 24, 2014 2:47 pm

ngb wrote:
thissucks wrote:
ngb wrote:I would get a 3d cone beam x-ray first to see if you even have a problem and get a few opinions from different dentists to make sure they aren't just taking your money.  I had my wisdom teeth removed 10 years ago and the x-ray showed no problems.

Thanks, I do plan on getting X-rays first.  However, as manofmanytrades explained in one of his posts, the infections sometimes don't show up on the X-ray.  One of his sites didn't show anything, yet the dentist dug out all sorts of nasty stuff.  He even posted a picture of the results.  You can see all the gunk they pull out before you send it off to biopsy.  I don't plan on doing all 4 sites at once, but I'd be willing to open up at least one of the bottom ones just to survey the damage.  

Normal dental x-rays don't always show anything I guess, you have to get a 3d cone beam x-ray.  Whoever you go to should order this first and show you where a cavitation is.  I got one and the dentist told me nothing was wrong.

https://www.google.com/search?q=3d+cone+beam&espv=210&es_sm=93&source=lnms&tbm=isch&sa=X&ei=AoovU8iVOIfxoATyxYKwCA&ved=0CAkQ_AUoAQ&biw=1024&bih=653

I read that 80% of people get their wisdom teeth out and I'm guessing 95% of people get a tooth pulled at some point in their life.  I'm guessing a cavitation is pretty rare.  You can probably find a lab and just pay for the x-ray yourself without a dentist.  It takes 30 seconds so you can probably negotiate the price down to $100-$200.  Send copies of the CD around and see if some dentists will look at it.  

Thanks for the info about the the 3D-cone, I'll look into it. I think you underestimate the occurrence of cavitations though. According to these 2 sources, cavitations are found in about 75-80% of extraction sites (the links include sources):

http://www.thenaturalrecoveryplan.com/docs/research_docs/2010.07.28.03.27_Cavitations.pdf
http://www.flcv.com/damspr11.html

Sadly, most people that have cavitations go through life unaware that they are even affected. CS, any input on this?

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Re: Cavitation surgery options

Post  manofmanytrades on Mon Mar 24, 2014 3:29 pm

Interesting about the socket graft putty, I wonder if that's the same thing he used with me, although he called it vitamin k compound.  Healing the site is apparently pretty important, which is why I believe he recommended it.  I can't imagine that biological dentists, who of all people should know the dangers of foreign materials in the mouth, would use something that wasnt safe.  But we all know what happens when we assume...

...Honestly the only reason i went to panahpour is that id been making awesome health gains with dr. klinghardt and panahpour was his recommendation.  But that other Dr. looks really good too...Huggins protocols and certifications seem to be pretty good and I would imagine most any biological dentist could do a simple re-excision of an old removal site.  Seems like a pretty basic operation.  FWIW panahpour offered that compound to me as an option, it wasn't something I had to have done, as it cost a little more.  Maybe base the decision on travel convenience and price??

Also, I believe you're probably right about many people having cavitations without being aware of it.  However, it might not hurt to get confirmation before you spend a lot of money on it- Both my ND and panahpour expected me to have panaromic x rays taken, which cost about 100$ through a local dentist (who were very suspicious of why I wanted them since they didn't see anything wrong).  One of Klinghardts dr's at the clinic didn't see anything on the xray and passed over it, months later I returned and saw him and he examined it and found a faint suspicious area on one side.  He 'confirmed' it with muscle testing, and had the operation which found a lot of crap in the jaw.  On suspicion and muscle testing opened the other side and found a bunch there too.  I think maybe it doesnt show up on xrays well because there's still bone in the cavitation, its just necrotic? But if you wanted to confirm it first you might have to call the dentists and ask for a recommendation for Dr's to do an examination, although I would think the dentist should be able to do that too.  The other dr. might be able to do all that in-house.  It is strange to think that this could be so common and that there arent any good diagnostic techniques to test for it...

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Re: Cavitation surgery options

Post  CausticSymmetry on Mon Mar 24, 2014 4:15 pm

Just to mention, X-rays do not pick up jawbone infections. It requires other methods. This is partly why orthodox dentists are still in the dark and just shrug off worries about extractions/cavitations.

http://iaomt.org/intro-articles-biological-dentistry/

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Re: Cavitation surgery options

Post  ngb on Tue Mar 25, 2014 2:38 am

CausticSymmetry wrote:Just to mention, X-rays do not pick up jawbone infections. It requires other methods. This is partly why orthodox dentists are still in the dark and just shrug off worries about extractions/cavitations.

http://iaomt.org/intro-articles-biological-dentistry/

That article doesn't mention anything about x-rays. Are you sure the 3d cone beam x-ray wouldn't see it? I agree that the bitewing and panoramic x-rays might not see anything. I went to a dentist that does these caviation surgeries, got the 3d cone beam x-ray and they said nothing was wrong. They have this equipment in part to find cavitations and I doubt any dentist would just put you under, cut you open 4 times and dig around unless they had some reason to believe your wisdom tooth extractions are infected. If someone goes to a dentist that performs these cavitation surgeries and they don't at least look at a 3d cone beam x-ray I would run because they aren't up on the latest technology.

manofmanytrades,

Did your dentist order a 3d cone beam x-ray or just a normal panoramic x-ray?


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Re: Cavitation surgery options

Post  thissucks on Tue Mar 25, 2014 8:31 am

manofmanytrades wrote:Interesting about the socket graft putty, I wonder if that's the same thing he used with me, although he called it vitamin k compound.  Healing the site is apparently pretty important, which is why I believe he recommended it.  I can't imagine that biological dentists, who of all people should know the dangers of foreign materials in the mouth, would use something that wasnt safe.  But we all know what happens when we assume...

...Honestly the only reason i went to panahpour is that id been making awesome health gains with dr. klinghardt and panahpour was his recommendation.  But that other Dr. looks really good too...Huggins protocols and certifications seem to be pretty good and I would imagine most any biological dentist could do a simple re-excision of an old removal site.  Seems like a pretty basic operation.  FWIW panahpour offered that compound to me as an option, it wasn't something I had to have done, as it cost a little more.  Maybe base the decision on travel convenience and price??

Also, I believe you're probably right about many people having cavitations without being aware of it.  However, it might not hurt to get confirmation before you spend a lot of money on it- Both my ND and panahpour expected me to have panaromic x rays taken, which cost about 100$ through a local dentist (who were very suspicious of why I wanted them since they didn't see anything wrong).  One of Klinghardts dr's at the clinic didn't see anything on the xray and passed over it, months later I returned and saw him and he examined it and found a faint suspicious area on one side.  He 'confirmed' it with muscle testing, and had the operation which found a lot of crap in the jaw.  On suspicion and muscle testing opened the other side and found a bunch there too.  I think maybe it doesnt show up on xrays well because there's still bone in the cavitation, its just necrotic?  But if you wanted to confirm it first you might have to call the dentists and ask for a recommendation for Dr's to do an examination, although I would think the dentist should be able to do that too.  The other dr. might be able to do all that in-house.  It is strange to think that this could be so common and that there arent any good diagnostic techniques to test for it...

Yes that should be what he used with you as well. I know it's just an option, which makes the two different approaches so interesting. One the Huggins approach, and two Panahpour's hybrid approach. I'm leaning towards Panahpour at the moment.

Since it's a quite trip for me off to the west coast, I'm going to first get some x-rays done here and send them off to him so he can check it out. I'm also interested in removing some of my old fillings, so they may show something there as well. Agreed with everything you said. The sad thing is that these types of procedures are still in their infancy. I'd imagine that if every dentist in America offered these services, the technology would move along much more quickly.


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Re: Cavitation surgery options

Post  thissucks on Tue Mar 25, 2014 9:29 am

OK guys, so I got the goods.  I spoke to Dr. Grube's office, Steiner Laboratories (manufacturer of the socket graft putty), and Dr. Panahpour today.

First off, Dr. Blanche Grube's office -

- Will not disclose prices over the phone
- $495 initial consultation fee
- $280 lab fee for blood compatibility testing
- Dr. Grube does not operate "piecemeal" - in other words, she wants to do everything in one operation
- I asked if I could get my fillings removed in one visit, and then come back later to get the cavitations cleaned out, and she said no.

That was about it for that conversation because they want you to come in for the consultation.  I found the last point to be a bit of a red flag.  Is it best to remove the fillings and cavitations all in one sitting?  Seems like quite a load for the body to endure.  I don't know, but I don't like not having the option.  It's clear Dr. Grube's procedure will be both very thorough AND very expensive.

Next, Steiner Laboratories -

I asked them CS's questions about the possibility of immune response.  Here is what they told me:

- It's a calcium phosphate base.
- All the ingredients are "pretty much" found in your body already.  (I'd imagine she said "pretty much" because that excludes the drug)
- I asked if it contains Vitamin K2, and she said yes.
- Full ingredients cannot be disclosed.
- The drug is completely absorbed by the cells, spurs osteogenesis and should leave no chemical tag once it's gone.
- Everything should be absorbed after about 8 weeks, depending on the size of the site.
- No chance of a immune response.
- They've been testing this material since 2006 with great success, and it's far ahead of any competing products on the market.

I know it's the company and I expected those types of answers, but it was still interesting to hear the responses. I will ask Dr. Panahpour the same questions later on, but I spoke to him about other things today.

Finally, Dr. Panahpour -

- I asked him if we could do the fillings and cavitations in one day, since I'm flying in from the northeast.  He said it depends on if there are fillings on both sides.
- I told him I have two on the right and one on the left.  To that he replied that we may need to do two different surgeries, contradicting Dr. Grube's approach.
- He wants to see full-mouth x-rays.  I said I would get them and send them over.
- I asked him if he believed in blood testing for biological compatibility of dental materials.  He replied that he does not.  He said that the blood is like a filter and can change over time.
- He tests for biocompatibility using muscle testing, rather than blood analysis.
- For fillings, he uses safe biomimetic materials such as kevlar, zirconium, and pearl dust.

I am of course paraphrasing all these conversations, but hopefully I'm relaying everything accurately.  

It's interesting to see the differences in opinion over blood testing and of course, the use of bone graft putty.  Would love to hear additional thoughts on this.  I'm leaning towards Dr. Panahpour at the moment, will send him my x-rays and go from there.  However, I know that a consultation with Dr. Grube is still on the table, however it will cost me nearly $800 just to make it through the initial consultation.  IF the consultation is worth it, then price is not an objection, but if it's based on faulty science, then I would obviously prefer to keep my money.  Thoughts?

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Re: Cavitation surgery options

Post  thissucks on Thu Mar 27, 2014 6:01 am

Any thoughts on the use of biomimetic materials such as kevlar, zirconium, and pearl dust for fillings?

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Re: Cavitation surgery options

Post  CausticSymmetry on Thu Mar 27, 2014 9:40 am

thissucks wrote:Any thoughts on the use of biomimetic materials such as kevlar, zirconium, and pearl dust for fillings?  

I have heard good findings on zirconium, but do not know anything in regards to kevlar or pearl dust in this respect.


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Re: Cavitation surgery options

Post  thissucks on Thu Mar 27, 2014 2:28 pm

CausticSymmetry wrote:
thissucks wrote:Any thoughts on the use of biomimetic materials such as kevlar, zirconium, and pearl dust for fillings?  

I have heard good findings on zirconium, but do not know anything in regards to kevlar or pearl dust in this respect.


Thanks CS, I likewise found plenty of positive information online about zirconium, but hardly any on kevlar or pearl dust. They must be on the new side.

What do you think of Dr. Panahpour's rejection of blood testing for biocompatibility, and the substitution of muscle testing in its place?

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Re: Cavitation surgery options

Post  thissucks on Wed Apr 30, 2014 4:00 pm

Going to make an appointment soon. Will keep this thread updated.

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Re: Cavitation surgery options

Post  thissucks on Tue Mar 15, 2016 6:47 pm

I still haven't fixed my teeth. Dr. Grube's exorbitant prices have scared me off thus far, but I'm thinking about finally ponying up the cash for a consultation soon.

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