Periodontal clinical investigations : official publication of the Northeastern Society of Periodontists最新文献

This case report concerns the loss of osseous tissue around two hydroxyapatite (HA) Biovent implants, placed in 1993, at sites #30 and #31. The implant in site #31 was positioned with a distal angle, resulting in an ill-fitting prosthesis. This permitted bacterial colonization to set up a periimplantitis. The rough HA coating on the implants further exacerbated the resultant bone loss. In an attempt to rectify the pathology, surgical debridement, antibiotic therapy, bone grafting, and guided tissue regeneration with a barrier membrane were utilized. This case report documents a successful partial repair of osseous housing around these implants.

The present study was planned to assess the capacity of a resorbable collagen membrane enriched with fibronectin to prevent the apical migration of epithelium and to facilitate new attachment and new bone. Experimental osseous dehiscence defects were produced on the bilateral labial aspect of mandibular 2nd, 3rd and 4th premolar teeth in six mongrel dogs. Guided tissue regeneration therapy using collagen membranes, which were rehydrated with fibronectin solution, was performed on one quadrant (group A). In the contralateral quadrant, the same collagen membranes, but rehydrated only with saline (group B), were placed over the bony defects. The third premolar teeth, which were treated by open-flap debridement, served as control (group C). Flaps were positioned slightly coronally and sutured; sutures were removed 10 days later. The dogs were killed 30 days after reconstructive therapy. Tissue blocks containing the experimental and control teeth were excised, demineralized in EDTA, and embedded in paraffin. Histological and histometric evaluation revealed that all groups demonstrated similar effects on preventing the down-growth of epithelium and formation of new cementum and new bone. Collagen membranes were tolerated well within the tissues, and membrane remnants were identified at 30 days. In summary, this study indicated that in this dog model similar healing results could be achieved with a bovine type I collagen membrane with or without fibronectin solution and open-flap debridement.

A case of a central odontogenic fibroma involving the left mandible of a 39-year-old female is presented. The clinical and radiographic appearance, surgical treatment, and histopathologic diagnosis are discussed. With the addition of this case, a total of 68 cases of central odontogenic fibroma have thus far been reported in the English language literature.

This study was undertaken to evaluate the biocompatibility, cellular reaction and resorption characteristics of a type I bovine collagen membrane material either enriched with or without fibronectin solution in vivo using light (LM) and transmission electron microscopy (TEM). Experimental osseous dehiscence defects were surgically produced bilaterally on the labial aspect of the mandibular 2nd, 3rd, and 4th premolar teeth in four mongrel dogs. Collagen membranes rehydrated with fibronectin solution (group FM) and membranes rehydrated with saline (group M) were placed over the bony defects. The third premolar teeth on which the flap operation was performed served as control (group C), with no membrane placed. Flaps were positioned slightly coronally and sutured. Gingival tissue samples and block biopsies were obtained from all experimental and control sites for LM and TEM evaluation at 7 days. For each group, morphometric analysis was performed and the numbers of macrophages in the most coronal area of the free gingiva were counted. Postoperative healing was uneventful during the experimental period, and all membranes remained covered. Light microscopic evaluation revealed similar resorption patterns in the most coronal area of the membranes both enriched with and without fibronectin solution within the first 7 days. The mean numbers of macrophages were higher in experimental groups than in the control group. In TEM evaluation, more excessive intracellular macrophage activity was observed in group M than group FM. As a result of these observations it may be concluded that similar resorption characteristics existed in the most coronal area in both experimental groups with LM evaluation, but with TEM it was observed that the membranes enriched with fibronectin solution were resorbed more slowly at the ultrastructural level.

The purpose of this single-blind, randomized study was to evaluate the clinical efficacy of slow-release tetracycline fibers as an adjunct to initial periodontal therapy in moderate to advanced periodontitis patients who had no periodontal treatment before. A group of 17 patients with at least two sites in each quadrant with probing pocket depths > 5 mm that bled on probing were included in the study. After scaling and root planing, each selected site was randomly assigned to one of two treatment groups: tetracycline fiber therapy and control group. Plaque index, gingival index, bleeding on probing, probing pocket depth, and clinical attachment level were measured at baseline and at 1, 3, and 7 weeks. The change from the baseline of each measurement was studied using analysis of variance with subject and treatment effects and a baseline covariate. Results of this investigation demonstrated that tetracycline fiber treatment as adjunct to scaling and root planing is effective in regard to probing pocket depth reduction and bleeding on probing. On the other hand, fiber application seems to have no beneficial effect on gain of clinical attachment level within limits of this study.

Two cases are presented where teeth initially deemed hopeless and scheduled for extraction were, at the patient's request, treated. The so-called hopeless teeth responded well to regenerative periodontal therapy. This supports findings of previous studies that only on healthy teeth can treatment outcome be predicted with confidence.

This report demonstrates that if an intact avulsed tooth is retrieved, stored carefully and treated, it can be re-implanted successfully, even after more than 42 hours outside the alveolus. The tooth can regain its position as a stable member of the arch, and its osseous and gingival complex can be restored.

This is a case report of two patients, aged 26 and 22, who suffered from congenital hemangioma on their faces and pronounced gingival overgrowth localized parallel to extraoral lesions. Prior to surgical intervention the hygienic conditions were improved in several sessions by means of professional preventive treatment and oral hygiene instructions. Histologic examination of both cases revealed a highly vascularized pattern of pyogenic granuloma. One of the cases was associated with a pregnancy. These patients can be classified as Sturge-Weber syndrome. Postsurgical treatment consisted of efficient plaque control and adequate oral prophylaxis sessions every 3 months. The large gingival overgrowth was not observed to recur in 2 and 4 years, respectively, of follow-up.

The purpose of this study was clinical evaluation of the effectiveness of a composite graft, consisting of demineralized freeze-dried bone and doxycycline hyclate (4:1 by vol.) in combination with a resorbable calcium sulfate barrier in the treatment of Class III furcation involvement. A total of 24 sites in seven patients having adult periodontitis with at least two mandibular molars with class III furcation involvement were randomly allocated into two equal groups. The experimental sites received the composite graft in the furcation area covered by the barrier buccally and lingually. The control sites were treated by surgical debridement only. Baseline preoperative data, including probing depth, clinical attachment level, gingival recession and radiographic bone level, were recorded. During surgery, direct linear and volumetric measurements of the defects were taken. At 12 months postoperatively, all sites were surgically re-entered and all measurements were again recorded. Student's t-test and analysis of variance of the data showed: (1) The experimental sites had a significant (P < .05) gain in clinical attachment while the control sites did not (1.44 + 0.33 mm vs. 0.11 + 0.35 mm); (2) the control sites showed greater (P < .05) gingival recession than the experimental sites (0.93 + 0.43 vs. 0.31 + 0.26); (3) when compared to control sites, the experimental group showed significantly (P < .05) greater vertical defect fill (2.24 + 0.79 mm vs. 0.45 + 0.82 mm) and volumetric fill (37.2% vs. 7.5%). In conclusion, the combined composite graft and resorbable barrier utilized in this study may have a favorable effect on the treatment outcome of mandibular class III furcations 12 months postoperatively when compared to surgical debridement only.