The Journal of the Western Society of Periodontology/Periodontal abstracts最新文献

The aim of this study is to examine extraction socket implant longevity and peri-implant conditions longitudinally and to compare the outcome with implants placed in intact alveolar bone sites (nonextraction sites) after a time period in function of five years or more. We hypothesize that implants placed into fresh extraction sockets have a long-term rate of success similar to that of conventionally placed implants. Eleven extraction socket implants in eight patients with a follow-up of at least five years were included in this report. The implants were loaded with either single-tooth replacements or three-to-four-unit fixed partial dentures after healing times of four to six months. Intraoral radiographs of the 11 implants were obtained immediately after surgery and upon recall five to seven years after surgery. In addition, the following clinical parameters were evaluated at each implant site five to seven years postsurgery: plaque indices (PT), bleeding indices (BI), probing depths, attachment level (AL), and distance from implant shoulder to mucosal margin (DIM). As a control, 11 implants from a previous long-term study of nonsubmerged implants placed into intact alveolar bone sites by the same clinician were matched by implant location, sex, and age. Initial and long-term follow-up radiographs of the experimental and control groups were scanned into a computer. A computer program designed for radiographic implant analysis was utilized to examine the changes in radiographic bone levels over time in the two groups. After a period of five to seven years, the mean bone loss for the immediate implant group was 0.167 mm, while that of the control group was 0.460 mm. An unpaired t-test resulted in a P value = 0.0563, indicating that the mean change in bone levels between the two groups is not statistically significant. In addition, clinical evaluation parameters (PI, BI, AL, DIM) revealed no significant difference between the two groups. Therefore, it can be stated that in this study the long-term success rate for extraction socket implants is similar to that of conventionally placed implants.

The ultimate goal of periodontal therapy should not be limited to the establishment and maintenance of periodontal health. The potential regeneration of the hard and soft periodontal tissues lost due to disease also should be considered. This case presentation evaluated a new surgical technique for the treatment of a variety of localized bone defects, utilizing porous bone mineral in combination with collagen membrane and resorbable bone pins.

Epidermolysis bullosa (EB) is a group of diseases characterized by the development of blisters or erosions following minor trauma to the skin. Oral findings that have been associated with EB include keratin-filled cysts; blistering of the mucosa, tongue, and lips; perioral carcinomas; ankyloglossia; lingual papilla atrophy; caries; enamel hypoplasia; rapid attrition of the teeth; and obliteration of the oral vestibule. Defects at the basal cell/basement membrane/connective tissue levels correspond to the mutations in basal cell keratins, hemidesmosome components, and type VII collagen, respectively. In a number of types of EB, structural defects in the skin have been shown and genetic mutations determined. Although there are no publications documenting the prevalence of periodontal diseases in patients with epidermolysis bullosa, it is likely that some molecular defects in the basement membrane zone could increase the susceptibility of a patient to periodontal disease, as this has been noted in the related disorder of Weary-Kindler syndrome. Early-onset periodontal disease can be expected to develop in some types of EB patients, even in the absence of common periodontal pathogens, because of a reduced resistance at the junctional epithelial complex.

This study evaluates surface alterations produced on various implant surfaces by an ultrasonic scaler fitted with a nonmetallic tip. Commercially pure titanium and titanium alloy abutments, plasma-coated implants, and hydroxyapatite-coated implants were contacted with the nonmetallic tip for 10 seconds and then evaluated for surface changes by SEM examination. The commercially pure titanium and titanium alloy surfaces showed negligible alterations from the control, thus indicating possible clinical use as a maintenance device. More severe changes were evidenced with the plasma- and hydroxyapatite-coated surfaces.

The purpose of this study was to compare postoperative administration of bupivacaine, a long-acting local anesthetic, with lidocaine, a short-acting local anesthetic, on pain perception and analgesic use following periodontal surgery. Ten male subjects were selected on the basis of having similar bilateral mandibular quadrants with moderate to severe periodontal disease requiring osseous surgery. The study was a matched-pair, double-blind design. Carpules of 2% xylocaine with 1:100,000 epinephrine and 0.5% bupivacaine with 1:200,000 epinephrine were wrapped in opaque tape and placed in separate coded envelopes. At the time of suturing, the quadrant was injected with one Carpule from one envelope. The Carpules from the second envelope were saved for the second surgery, which took place approximately one month later. Subjects were given standardized postoperative instructions and prescriptions for Peridex and Tylenol #3. They were told not to take the analgesic unless pain or discomfort occurred. They were given a self-administered questionnaire and asked to assess pain and/or discomfort 2, 4, 6, 8, 10, and 12 hours after the procedure, the amount of analgesic taken, and time when complete sensation returned. Results showed that the quadrants which received lidocaine maintained postoperative anesthesia an average of 2.47 hours while the Marcaine quadrants had a significantly longer duration of 5.62 hours. A large intra- and intersubject variability was noted in the amount of analgesic taken. The lidocaine group reported an average of 3.70 tablets versus a significantly smaller amount for the bupivacaine group of 1.60 tablets. Throughout all time intervals, the bupivacaine group reported significantly less pain than the lidocaine group. When used at the end of a mandibular periodontal surgical procedure, bupivacaine provides a significantly greater duration of anesthesia, decreased postoperative pain, and a reduction of anesthesia, decreased postoperative pain, and a reduction in the amount of analgesics taken.

Dentine hypersensitivity (DH) is a perplexing clinical entity. There is no doubt that patients self-report discomfort arising from various stimuli, but the highly subjective nature of the condition makes it extremely difficult to evaluate DH objectively. This is particularly true when evaluating the efficacy of desensitizing agents in the clinical trial setting. This paper attempts to provide an overview on clinical trial management to evaluate both in-office and over-the-counter (OTC) desensitizing agents. The importance of correct clinical trial design (type, allocation, blinding) with emphasis on patient selection, sample size, statistical power, duration, choice of positive/negative controls, treatment outcomes, and data collection, will be discussed.

The treatment of dentine sensitivity or cervical dentine sensitivity (CDS) has been in the form of dentifrices, mouth rinses, sealants, and other therapeutic techniques. Claims of efficacy of the "so-called" active ingredients of these desensitizing agents have been made on the basis of the proposed mode of action generally extrapolated from in vitro or animal studies. Evidence from published, well-controlled clinical studies, however, generally has failed to substantiate such claims, although there has been a reported significant reduction in discomfort by subjects participating in these studies. Currently, the most accepted mechanism of intradental nerve activity associated with dentine sensitivity appears to be hydrodynamic in nature, although other mechanisms cannot be eliminated. The concept of tubule occlusion as a method of dentine desensitization is a logical conclusion from the hydrodynamic hypothesis. This paper reviews the present position with regard to the treatment of dentine sensitivity by various desensitizing agents and evaluates their claims of efficacy in the context of available scientific evidence.

A review of the literature was performed related to the frequency of closure of Grade II furcations with various regenerative therapies such as bone replacement grafts (BRG), coronally positioned flaps (CPF), guided tissue regeneration barriers (GTR), or open flap debridement (OFD). Fifty papers involving 1,016 furcations were evaluated. Complete furcation closure was reported only 20% of the time. Clinical change from Grade II to Grade I (partial furcation fill) was found in an additional 33% of the cases. Therefore, general improvement in clinical furcation status has been reported only about 50% of the time. The most effective furcation regenerative therapy was the combination of GTR plus BRG (91% overall positive). Similar overall positive results (88%) were achieved with nondemineralized allogeneic freeze-dried bone plus tetracycline without a barrier. The least effective therapy for regeneration in furcations was OFD (2% complete furcation closures and 13% partial furcation closures). If complete furcation closure is a primary goal of regenerative therapy, that goal would not appear to be commonly met.