PROSTHETIC JOINT REPLACEMENTS

Surgical placement of prosthetic joints is commonly performed to treat the damage associated with degenerative joint disease (DJD)/osteoarthritis. Hip, knee and shoulder replacements are the more common procedures, although some orthopaedic surgeons are now performing prosthetic ankle replacements.  These devices are made of foreign materials (metal and plastic copolymers) with a lot of nooks and crannies in a warm, moist, dark environment. This represents a perfect environment for pathogenic bacteria to flourish. The surgical procedures are done in a sterile operating room environment so the risk of infection during the actual surgery is very low. However, post operatively, there is a risk of secondary joint infection from bacteria of an external source, such as periodontal bacteria. In the event a joint replacement gets secondarily infected, the corrective treatment is very complicated and many times unsuccessful. Usually, antibiotics are not very effective in treating this situation because there is a lack of blood supply in the artificial joint. And antibiotics need a blood supply to reach the end target. So, the realistic goal is to PREVENT secondary infection of the prosthetic joint.

Frequently medical insurance companies require an orthopedic surgeon to refer a patient preoperatively to a dentist for evaluation and treatment of periodontal inflammation/infection before they will pay the orthopedic surgeon to perform the joint replacement. Medical insurance companies are aware that there are better surgical outcomes with fewer expensive complications if the joint replacement surgery is performed in an environment free of periodontal inflammation/infection.

P3 is a dental locally applied antibiotic (LAA) formulation that is effective in preventing and controlling periodontal inflammation at the cellular and molecular levels. This results in better outcomes for prosthetic joint replacement. P3 is a valuable service that you can offer patients in your dental practice.