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QUOTEQuote: from lagunabb on 9:10 pm on Sep. 30, 2003
Dr Gregg:My beef is that you presented to me (and I assume others) something as data to be trusted when you knew there were problems with that data. Am I now suppose to be able to draw the line where your data can be trusted or not? What is data and what is not?
You have a nice system from what I have read but does that make it OK to knowingly present erroneous data once in a while.
Ok, I see you are going to ignore the science and research I presented in my last post (kinda like you do with Dr. Bornstein’s science), and continue to pick on one case example that seems to justify your continued personal attacks and distractions from the HKS controversy. Nice political science debating strategy, but not especially convincing to your laser science arguements in the written journal that is being created herein.
A single x-ray or patient example is not “data”.
It was in a case study example, not a body of evidence. (The SPIE paper is a body of evidence). It was a comparative x-ray that morphed the before and after images–which to any dentist looks impressive w/o the Emago® comparisons.
It is a bit of a stretch to assign trustworthiness to one x-ray that reports what it reports–visual imagery of bone dentisty changes consistent with other bone density analysis and now histology. If anything, the x-ray in question is now vidicated as well.
It was a clinical case presentation that discussed the clinical parameters of healing along with the radiographic and comparative Emago® x-ray that give the x-ray you question its (really my) credibility.
Here’s some excerpts from the paper regarding the image you inaccurately call erroneous:
Patient was seen at 60 days. The chart records states, “Periapical x-ray of #20 shows periodontal regeneration including PDL and bone. OHI is excellent. BOP is minimal. Patient reports are excellent regarding the subjective and objective symptoms and signs. Patient is using Proxibrush regularly with excellent results.”
Mean Probe Depth Changes (MPDC) are computed by finding the mean of the differences in probing depths from baseline to follow-up. MPDC of tooth #20 at 14 months post-treatment reduced an average of 4.5mm or 50% pocket depth reduction with no recession. The 4.5mm MPDC in this patient is consistent with a 4.5 MPDC for pockets > 8 mm reported in a previous LPT case report of 4 patients(7), and over 1900 probing sites in 42 patients in a retrospective, multi-centered, private practice study(8).
That references this case study with clinical data of a peer reviewed published paper that you failed to mention in response to my last post, or the Dentistry Today article.
And here’s the actual radiographs. To a trained clincian, the 2 dimensional improvement is impressive enough, AND consistent with the 3-D Emago® Gray scale morphed image. It is neither erroneous, nor exaggerated. It gives a 3-D perspective to the 2-D x-rays.
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Figure 2. Pre-Operative x-ray
Figure 3. 14 month post-operative x-ray
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Here’s the exact caption to Figure 4.
Figure 4. Gamma correction of the before and 14 month post-operative x-ray using Emago® software(16). White areas indicate increased bone density. Bone density increases extend circumferentially and 3-dimentionally into the alveolus.
And here’s the text:
The Gamma Correction contrasts(16) in Figure 4 demonstrate the elimination of the mesial and distal bony defect and a marked increase in radiographic density interproximal to teeth number 19, 20, and 21—indeed, throughout the alveolus and into bone.
The problems mentions with the Emago® software were NOT that the data was erroneous, but that it was difficult to pick the 4 separate data points to be the same on each x-ray compared–which caused “noise” in the images, not in their proportion.
The images you selected as representative have the same “noise” as in the Emago® software. (Look at all the flecks of green that any clinican knows can’t be part of the before and after comparison. That sort of noise can be reduced, but not eliminated, as your example illustrates. That doesn’t make the area being examined erroneous or the data false.
Attacking the personal credibility of others, mis-directing the attention of others from the topic of discussion is a often used tactic in this political season. But that should be reserved for politicians. This is a professional website and such antics have no place here.
I have posted the x-rays to the specific challenge to my professional integrity and trustworthiness (again).
We clearly need a dental professional to make the analysis and interpretation and explain why the regeneration of bone in the after x-ray is so impressive. And, then why it is so important that histology was undertaken to validate the radiographic impressions.
Check Mate
Robert H. Gregg, DDS