In a previous post, I have expressed considerable concern about an assumed advertorial in our leading periodontal journal, JCP. Quintessence Publishing was about to launch their fourth installment of “3D” animated, short (each 15-17 min) movies all called Cell-to-Cell Communication, “Oral Health and General Health – The Links between Periodontitis, Atherosclerosis, and Diabetes.” Previous movies have been offered for purchase by QuintPub for a remarkable amount of around $100. Luckily, the new one can now be found on the EFP homepage and accessed by members and non-members for free.
It is remarkable that the prestigious Journal of Clinical Periodontology, founded by Hans Mühlemann and edited for decades by Jan Lindhe, is going to publish a commercial for a Quintessence Publishing and Sunstar production, part of a Quintpub series of DVDs (all called Cell-to-Cell Communication) of short (each runs for about 15 minutes) animated (“3D”) movies. The first installations in this series had been about inflammatory reactions in the periodontium (I had critically reported on its educational value here), periodontal regeneration and osseointegration.
Europerio 8 in London earlier this year saw the world premiere of the 3D video animation, Oral Health and General Health – The Links Between Periodontitis, Atherosclerosis and Diabetes. The movie was produced by Sunstar and Quintessence Publishing and is the fourth in a series commonly called Cell-to-Cell Communications (I had written a critical review about the first installment here; empty knowledge, Matrix-Reloaded style) and the trailer can currently be seen on the EFP website. A pumping heart gets an infarction.
Myocardial infarction. A life-threatening manifestation of a series of inflammatory changes in the walls of the coronary arteries. It is a leading cause of death in the western world. Can periodontitis or other inflammatory processes in the oral cavity contribute to the development of cardiovascular diseases and systemic conditions such as artherosclerosis or diabetes or negatively influence their course?
This is fear mongering and, to say the least, misleading the public by completely ignoring all established risk factors for cardiovascular disease (high blood pressure, high cholesterol, smoking, unhealthy diet, obesity, lack of physical activity) and diabetes as well.
As the German version of The Links will be presented at the big national dental congress in November, authors Stadlinger, Terheyden and Jepsen have published a respective essay in Zahnärztliche Mitteilungen, the German Dental Associations’ biweekly tabloid (scroll to page 38). It is strangely called “Storyboard”; and, as before in the series, biofilm and cells become actors. Apparently, Quintessence goes Hollywood. The article (unfortunately in German) is prominently featured on its cover. A careful review reveals, unsurprisingly, a remarkable mixture of undeniable facts about the well-known pathogenesis of both artherosclerosis and its sequels and diabetes, and wild speculation regarding possible contributions of periodontal pathogens. It once more seems that “visualizing the invisible” may in fact create more confusion than understanding.
Teaching undergraduates the pathogenesis of periodontal disease is not an easy task. It is demanding for students and the teacher as well, who needs to integrate traditional knowledge about pathohistological features of the initial, early, and established lesions in the gingiva which may or may not develop into destructive periodontal disease with an understanding of the more dynamic, non-linear, and hierarchical network of mechanisms which might be modeled as interplay between microbes aggregated in a biofilm on the tooth surface and host reactions which may largely be responsible for periodontal destruction. In the current curriculum, for instance, I could only dedicate one hour didactic teaching on the topic which is, of course, a true challenge. Accordingly, learning goals [pdf] had been formulated which are not very explicit.
A new series of DVDs has been commenced by Quintessence Publishing on Cell-to-Cell Communications, and the second volume which follows Osseointegration is dedicated to Inflammatory Reactions. You may see the trailer when clicking here. As the preface by the two authors, H. Terheyden and B. Stadlinger, tells it was Alexander Ammann, “communication expert” and managing director of QuintPub, who had the original idea and who had “recognized the benefits of three-dimensional video animations for the visualization of complex biological relationships.”
Even at the microscopic scale of our body cells, the seemingly confusing communication networks and information flows can be made comprehensible by novel digital technologies. The human mind seems hardly able to comprehend biological networks as a whole. The protagonists of these networks are cells that communicate with each other via messenger molecules. Controlling our bodily functions – exemplified by inflammation and regeneration and periodontal disease – is not a hierarchical [sic] and monocausal process. Rather, a more successful descriptive model for these phenomena is that a host of interconnected control loops and equilibriums to be maintained.
Quintessence Publishing had “enlisted the assistance of InterActive Systems, Berlin, a group of video animation artists with a biological background.” Amazingly, authors mention that a “clear-cut distinction between the innate and adaptive immune system [had to be] made mainly for the purpose of didactic clarity, while in actual reality they overlap.”
An explicit aim of the series on Cell-to-Cell Communication was “to instill in students and other audiences a fascination with science.” Well, at least in that QuintPub failed gravely. Both bacteria and host cells are displayed all whitish-opaque making it difficult to differentiate them. While any dental student is soon familiar with a bewildering variety of different bacteria, be it gram-negative or -positive cocci, curved and straight rods, motile rods, filaments and fusiforms, and, in particular spirochetes, InterActive’s animation seem to have short rods in mind, sometimes roused by flagellated creatures which resemble those targeting heroes in Matrix Reloaded. Spirochetes, which may account for the majority of microorganisms in dental biofilm, seem to miss completely.