Journal of Periodontology:
Congratulations and a Criticism

We would like to congratulate Dr. Effie Ioannidou and the Journal of Periodontology. Since she has taken over one year ago, the journal has seen significant improvements, but before we discuss her work, we need to understand the situation she took over. Here at SteinerBio we have been studying bone grafts for 20 years and we recognize fake science in our field. As fake science has flourished in our field for years, we questioned if other areas of fake science existed in the Journal of Periodontology. The previous editor of the journal formed a company to provide genetic tests for a patient’s susceptibility to periodontal disease and other diseases. It has been reported that these tests were worthless and based on junk science.

It is no surprise that the proposed unscrupulous scientific activities of a journal’s editor-in-chief would find its way into their journal. As you read this article by GenomeWeb, you’ll find that those who outed the editor made it clear that this editor was allowed to promote his fake science because dentists do not have a working knowledge of genetics, and that is precisely our point.

Just like genetics, dentists do not have a working knowledge of bone grafts and our profession looks to our journals to give us honest information. However, when the information that makes it into our journals is intentionally false, we have dentists prescribing fake genetic tests and using cadaver bone grafts that harm our patients through no fault of their own.

The body of people who determine what is published in the journal is called the Editorial Advisory Board, which is made up of periodontal professors for what appears to be a lifetime appointment. From our review, the only way you leave this group is by death. So we have the same group of aging professors who appear to approve anything their buddies submit. While that is bad enough, they also appear to reject anything that challenges their bias. This small group has controlled periodontal thought for decades without debate.

In order to entrench their power without debate, the journal expressly refused letters to the editor.

Is there any wonder why periodontal therapy has not improved in 30 years?

When the new editor-in-chief of the Journal of Periodontology was named, we saw this as an opportunity to bring honest science back to the journal. We published an open letter to the new editor sharing not only our criticism, but suggestions to fix the journal:

One important fix was the simple requirement that all statements in articles be referenced, and the peer reviewer be responsible for the legitimacy of the references. In articles published in the journal, none of the statements about the biologic properties of cadaver bone grafts are true and they have no references to support them. We knew if the simple scientific principle of requiring legitimate references was instituted at the journal, no article on cadaver bone grafts could be published and that is exactly what has transpired over the last year since the new editor has been in place. Not only have all of the fake cadaver bone graft studies been eliminated, but much of the other dubious publications have not made it into print.

When the previous editor was in place, the journal published on average 16 articles per month. Under the new editor, the journal is down to 8 articles per month. The institution of scientific rigor has eliminated the 50% of the garbage we railed about in our previous posts.

Another reason the number of articles are down in the journal is that many authors know that they have no chance of publication if they submitted anything that crossed with the bias at the journal. In the past, any lousy cadaver bone graft paper would get published as long as it supported the paradigm. Not only were publications full of misinformation, but you were also prohibited from publishing anything critical of cadaver bone grafts.

When the new editor came on board, she was faced with an aging Editorial Advisory Board that had controlled everything that was published for decades. Just three months into her position as editor, Dr. Effie Ioannidou instituted a rule that stipulated that the Editorial Advisory Board (peer reviewers) serve for 3 years only. This change replaced 97% of the Editorial Advisory Board. Of the approximately 50 members of the board, only 4 members were not replaced. The quality of the articles being published has greatly improved and the new editor deserves all of the credit. We can now read the journal cover to cover without the need to throw it in the trash.

Every dental school in the United states only uses and teaches cadaver bone grafts. Now that they cannot publish in their own journal, they are facing obsolescence. In fact, they have spent decades covering up the damage these material cause in patients and the associated implant failures. In an effort to remain relevant, these professors are making every effort to support their dying technology. A perfect case is one paper that made it past the editor:

Analysis of risk factors for early crestal bone loss in osseointegrated, submerged implants prior to restoration

Journal of Periodontology, Dec 2023

This article evaluated a long list of variables, so it was not your typical cadaver foolishness and we are not going to bore your with our long list of reasons why this goes into the garbage bin, but we will address a few points. First, it is a retrospective study of implants placed at a university over a period of 7 years. They choose 200 implants, but gave us no information on how they selected those implants. The authors studied what happened to the marginal bone between implants submerged at placement and exposure of the implant for the healing abutment. This time period is 3 months. They spent months poring over 7 years of implants doing a retrospective study when they simply could have done a prospective study in a few months, so this study makes no sense. Most retrospective studies are designed to find what the author is looking for. While the authors claim the cases were chosen randomly, strangely in this case they had a 50/50 split between implants with GTR and no GTR. There is no way this is a random occurrence, so it tells us they were looking at grafted sites as their focus. Most retrospective studies have very little value compared to prospective studies, but let’s go to the real bias in this study. While they are explaining away how a well done prospective study got opposite results, they state, “However, several other clinical studies have demonstrated that implants placed in grafted sites exhibited a clinical performance similar to implants placed in native bone in terms of implant survival and marginal bone loss.”

Because we know this is a false statement that exposes their bias, we always look to the references to see how they can support what we know to be a false statement. They referenced two studies to justify this statement.

REFERENCE 1

A randomized clinical trial to evaluate and compare implants placed in augmented versus non-augmented extraction sockets: 3-year results
J Periodontol. 2012 Jul;83(7):836-46.

In this referenced study, the group performed a prospective study to follow a group of implant patients for three years after half had been grafted with a cadaver bone graft and the control group received no graft. One notable exclusion was any molar implants. So these professors are going to spend years of their careers comparing grafted vs nongrafted sites and they are not going to include molar sites?

One thing you cannot do in scientific articles is to include images in the article that were not part of the study. If this is found, the article is quickly retracted for scientific malfeasance. However, in this paper where they supposedly excluded molars, the paper has 12 images all of molars! They reported no data from molar implants of course. These authors may have questionable integrity but they are not stupid. If you were going to submit a paper on implant success rates and not report on the molars, they would have submitted the paper with bicuspid or incisor images to cover up the fact that you are deleting the molar data that they do not want to publish. However, in this paper they say they did not include molars in the study, yet all the images are of molars, so someone is lying. It is more likely that they submitted the paper with the molar data showing a higher failure rate in the grafted sites and because the Journal must protect the cadaver paradigm, it is only reasonable to think that the Journal of Periodontology required the authors to remove the molar data if they wanted the paper published. Those of our readers know exactly why the molar data would need to be removed.

All cadaver bone grafts produce sclerotic bone that never remodels. Because they cannot self-repair like normal bone, the longevity of an implant in sclerotic bone is a function of the amount of load and the frequency of the load. Molars take a much higher load with the highest frequency of load and that is why implants placed in molar sites fail long before incisors or bicuspids. This paper is exactly what we have been railing about with regard to publishing corrupt science at the Journal of Periodontology. Follow the link to scroll through the paper to see the images for yourself.

REFERENCE 2

Clinical and radiographic intra-subject comparison of implants placed with or without guided bone regeneration: 15-year results
J Clin Periodontol. 2017 Mar;44(3):315-325.

The second study was an immediate implant study which had nothing to do with “…implants placed in grafted sites…”.

The current study published in October 2023 which is using false statements and a corrupt reference previously published in the Journal of Periodontology should be retracted. The author of the fake non molar study has had 3 papers retracted due to scientific malfeasance. This paper has been cited 134 times in support of cadaver bone grafts and Dr. Effie Ioannidou needs to take responsibility for this and have this paper retracted before it can continue to mislead our profession.

While the Journal of Periodontology has made great strides to improve their scientific integrity by eliminating cadaver bone graft articles, they are still guilty of having published baseless cadaver studies for decades which has misled the entire dental profession. What the Journal needs to do now is allow the publication of articles that honestly point out how these materials harm our patients. Exposing the corruption associated with cadaver bone grafts has fallen completely on SteinerBio as we are the only authority on bone graft biology. This has not been without a price. In the US, nearly 100% of academia and our lecturers only know how to use cadaver bone grafts and they are now being questioned about what they teach and they do not have the knowledge to respond. Now that they cannot publish in the Journal of Periodontology, they are truly feeling the pressure of their dying technology because their reputations are dying with it.

One response has been from Dr. Mealey, who has devoted his life to counting cadaver bone graft particles. He has listed on Clinicaltrials.gov a study where he plans to mix allograft with a steroid for socket grafting in an attempt to stop the severe inflammation caused by the cadaver bone grafts that results in sclerotic bone and implant failure:

Ridge Preservation With FDBA (Freeze Dried Bone Allograft) Using Dexamethasone vs. Saline
ClinicalTrials.gov ID: NCT065560955

He is wasting his time but at least he recognizes the serious problem his material presents. We don’t know how long this will remain on the website because he is making a false statement to prospective patients in the study that the cadaver bone graft is FDA approved. The FDA has never approved a cadaver bone graft.

We have no interest in being dentistry’s policeman. However, when we see false information published in our journals and we have the knowledge to recognize it, we have a responsibility to our profession and our patients to call it out. We have prevented the continued publication of misleading scientific articles and also played a part in removing most of our prominent professors from the Journal’s Editorial Advisory Board. We have been attacked in every way possible with multiple complaints to the FDA and false social media posts. We defend ourselves by having a perfect safety record, and never having to recall a defective product in all our years in business. We invite you to view our 2-hour short course on bone biology so you can understand what different bone grafts are doing to your patients. If you are having any problems with implant integration and failure, we invite you to support SteinerBio and begin to improve your practice and the care you are providing your patients. As always, for anyone who wants counter anything in this post, we will post your response in full to all recipients.

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American Society for Bone and Mineral Research (ASBMR)

Tissue Engineering and Regenerative Medicine International Society (TERMIS)

American Academy of Implant Dentistry (AAID)

Journal of Periodontology:Congratulations and a Criticism

Journal of Periodontology:
Congratulations and a Criticism