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Dentist files suit to protect reputation

STORY BY EILEEN KELLEY (Week of October 31, 2013)

An island dentist is seeking a $1 million judgment against an Alabama woman, accusing her of defaming him when she fired off two emails to Florida officials last year calling him part of a “disrespected” group of dentists still using a controversial technique that the state frowns upon.

Raymond Della Porta Sr. had one year to stew over the e-mails and last month he fought back, hiring attorney Leo Desmond to take on the defamation case.

Della Porta said he lost $90,000 out of pocket because a member of a watchdog group to which the Alabama woman belongs contacted Florida investigators in 2009 and notified them that he admitted to violating state guidelines when he said in a newsletter he had performed more than 5,000 Sargenti root canal procedures.

The Swiss procedure, developed in the 1950s, uses a paraformaldehyde paste in root canals. Some have embraced Angelo Sargenti as a savior to dentistry, claiming the procedure saves teeth and can be easily done by general dentists – not just licensed endodontists.  But when the the Sargenti paste comes in contact with water, itturns to formaldehyde, an ingredient used in  alming fluid.

“If the paraformaldehyde paste extrudes beyond the root tip, it will emit formaldehyde, which can erode the surrounding bone, destroy nearby connective tissues, and lead to numbness, paresthesias  (feelings of pins and needles), jaw pain and infection of the maxillary sinus,” wrote Dr. Stephen Barrett in a piece entitled “Be Wary of Sargenti Root Canal Treatment” for Dental Watch.

Florida considers the Sargenti procedure to be “below the acceptable minimum standard of care” and disciplinary action can be taken if a dentist is found guilty of negligence by failing to meet state standards.

None of Della Porta’s patients complained to the Florida Dental Board, although two agreed to talk to investigators when the probe was launched in 2010. Those two patients were contacted randomly out of 110 that Della Porta performed Sargenti root canals on between Jan. 1, 2008 and Nov. 30, 2009. In a settlement agreement, Della Porta was charged in a one-count administrative complaint.

In the agreement, Della Porta vowed never to do the controversial procedure again. The state also ordered him to the pay out-of-pocket costs for the two patients or their insurance companies. He also was fined and ordered to pay more than $6,000 in fees after a May 2012 dental board hearing, according to state records request by Vero Beach 32963.

Della Porta then found a new lawyer – one of many he has hired since the state began investigating him – former Assistant Attorney General Edwin Bayo, who previously represented the Florida Dental Board among other state groups.

“…Under these fairly unique facts, it is respectfully submitted that an accomplished dentist in the twilight of a long unblemished career (which included service in the Armed Forces) deserves an opportunity to be heard on reconsideration,” Bayo wrote in a June 2012 letter to the Florida Department of Health.

In August 2012, some six months after Della Porta signed the original agreement, Bayo got the Florida Dental Board to overturn the final order provided Della Porta continued to refrain from performing Sargenti root canals.

Routinely called Sargenti Paste or Sargenti Cement, the compound also is also known as N2, N2 Universal and RC2B. The Food and Drug Administration has banned interstate marketing of Sargenti-type materials. However, pharmacists can still lawfully prepare these types of pastes for local use in dentistry on a prescription-only basis.

The group that Della Porta is a director of, the American Endodontic Society, has been trying – without success – to win over the FDA since the technique was developed.

“I am always in your corner for this ridiculous controversy (over N2) that has been going on much too long,” wrote Della Porta in a note to fellow members of the American Endodontic Society. That admission, among other things, led to the state investigation and later sanction of Della Porta. “Hopefully even Florida will see the light and recognize what we have been trying to accomplish. Presently I am in my 35th year of using the Sargenti system with over 5,000 cases treated.”

Although a majority of Sargenti-type root canal procedures are performed without incident, there are other cases showing that when the procedure goes bad, it can go terribly bad and lead to chronic infection, multiple surgeries and loss of parts of the jaw and teeth.

Della Porta doesn’t buy the victims’ claims and said in an interview with Vero Beach 32963 last week that he’s been doing the procedure since the early 1970s in spite of six-figure lawsuits across the country including one in Miami.

But Della Porta’s son, also a dentist and his namesake, stopped using the Sargenti technique about eight to 10 years ago, Della Porta, Sr. said.

“He had great success with it, too,” Della Porta said. “He said, ‘Dad they won’t insure me if I am using this stuff and I said, ‘Well then don’t use it.’”

Della Porta also said there was no reason to inform the patient ahead of time about the use of the Sargenti material. The dentist insisted in his interview that poor dentistry, not a poor product, harmed the patients involved in lawsuits.

“If you are properly trained, there is no problem and the material is not toxic like they say it is,”  Della Porta said.

With his record wiped from the state’s licensing data base, but still available through public records requests, Della Porta fought back against the Alabama woman, Lorrie Kruse, who fired off the e-mails and who is herself a victim of a botched Sargenti technique from a dentist in another state.

“Dr. Della Porta was taught during his time in dental school that this material was dangerous and should not be used and he is well aware that the vast majority of the dental industry is strongly against this material and for good reason. His beliefs are held only within a small group of disrespected dentists who continue to make false claims not only about the success of the material but also its status with the FDA,” wrote Kruse.

Now, this defamation case against Kruse – a former aerospace engineer in Alabama before her Sargenti-related injuries – has thrust the local dentist and his practice into the public spotlight.

“I didn’t want to do it,” Della Porta said. “But if she didn’t come at me with an ax, I wouldn’t have come at her with an ax. When you start sending things to the governor and all those people up there, the board of dentistry and try and reopen this thing again, that is kind of a slap in the face.”

Della Porta hoped to persuade Vero Beach 32963 from reporting on the suit as well as his own record when he spoke about a his long-standing practice here.

Della Porta said he also feared for the reputation of son – who has essentially taken over his 36th Street practice – because of the publicity. Something like this “brings people out of the woodwork with people saying, ‘Oh my gosh, I had one of those things done,’” Della Porta said.