On the occasion of the centennial of the American Academy of Periodontology (AAP) this year, Dr. Kenneth S. Kornman, Editor-in-Chief of AAP’s Journal of Periodontology, together with Paul B. Robertson and Ray C. Williams have worked on a long reading list [pdf] of scientific articles which have shaped modern periodontology. I shall return to the list later.
In a commentary [pdf], they mention Europe’s first University in Bologna in 1088 although they have to concede that,
“[T]he European university model with a focus on science and research emerged later in the 19th century [sic!], original observations in the sciences were presented to members of learned societies became the primary vehicle for discussion and transmission of knowledge, and in the mid 1600s the proceedings of scientific societies, such as the Philosophical Transactions of the Royal Society of London, began publication.”
It is true that the first university in the sense of a higher-learning, degree-awarding institute was founded in Bologna and the word university had even been coined at its foundation. It is nevertheless superfluous to mention that when it comes to medicine at large or, in particular, our roots. The first medical school had been founded already long before in the south Italian city of Salerno. Based on the 9th century dispensary of a monastery, it became famous after the arrival of Constantine the African in 1077, an Arab physician and professor who introduced Arab medicine to Europe which he compiled and translated from Arabic sources. Although he became a Benedectine monk a couple of years after he had arrived in Salerno, his teachings were entirely based on knowledge and skills of Arabic physicians.
The November 2012 EFP and AAP workshop on systemic health and how it is affected by periodontal disease has resulted in the joint publication of a couple of valuable systematic reviews in both Journal of Clinical Periodontology and Journal of Periodontology. I have expressed my strong opinion here on this blog that, in essence, there was not so much new or surprising. That there is strong evidence for minor effects of periodontitis on, say, cardiovascular disease and that diabetes mellitus is affected by periodontal disease while it is a risk factor for gum disease itself has been known for decades. That, what organizers had claimed, there is now a need for intervention studies to show that the risk for cardiovascular events may be reduced, has been questioned on this blog and elsewhere.
I have criticized the workshop’s Manifesto, a press release which reduced the somewhat difficult to digest information to a message for the public (and I include here in particular most of the dental profession whose members may not be able or willing to read through the pages of documents, be it but systematic reviews let alone the original cohort studies). I have also suggested a brief example (based on a gut feeling of a possible risk ratio) in which the most relevant ethical problem of not treating huge cohorts for periodontal disease was mentioned while probably a great number of patients with periodontitis had to be treated successfully (number needed to treat) in order to prevent a single cardiovascular event (if the effect was causal) which renders the whole exercise probably irrelevant.