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

The present investigation was conducted to evaluate the effect of a polylactic acid-citric acid softened membrane barrier during guided tissue regeneration (GTR) surgery on human intrabony defects. Eighteen patients were treated in the study and 16 patients completed the 1-year follow-up. In all, 27 intrabony defects were treated and clinical soft tissue measurements, including probing depth (PD), probing attachment level (PAL), and recession, were recorded. Results of the investigation demonstrated a significant reduction in PD (3.7 mm), a significant gain in PAL (4.2 mm), and a slight increase in recession (1.2 mm).

Guided tissue regeneration has been described as a technique to enhance the regrowth of the periodontal tissues after surgical therapy. Originally, nondegradable materials were used for this purpose, but more recently, degradable materials have been advocated for this purpose. Utilizing an adapted technique in which the material was used as an infill material and barrier membrane, this small study in human subjects has demonstrated radiographically that the defects are filled with a bone-like material over a protracted period. Regeneration of tissues, with bone deposition in infrabony defects, may not be complete as long as 12 months after surgery.

This 14-year longitudinal case study involved the treatment of localized juvenile periodontitis in a male patient commencing at 15 years of age, by scaling and root planing, systemic metronidazole, and subgingival curettage along with supervised maintenance. No other surgery was required. All symptoms disappeared by the end of the active treatment phase, and radiographic evaluation and reduced probing pocket depth measurements showed adequate bone fill to have occurred and be preserved over this period.

The purpose of this study was to determine the effects of a fibrin tissue adhesive material (FAM) on periodontal tissue regeneration. In an in vitro study comparing osteogenic cells with gingival fibroblasts, it was shown that the degradation of FAM adjacent to the osteogenic cells was faster than that adjacent to the gingival fibroblasts. In two in vivo studies in dogs where surgical bony defects were created, it was shown through histometric measurements that in the sites where FAM was applied, more new bone was found than in the control sites. It was concluded that FAM may enhance periodontal tissue regeneration.

Objective: The purpose of this investigation was to compare by scanning electron microscopy (SEM) the surfaces of roots treated with a dentin conditioning agent and other materials that have been used routinely in periodontal therapy for root surface demineralization, namely, citric acid and tetracycline hydrochloride.

Materials and methods: Sixteen freshly extracted human teeth were randomly divided into four equal groups; each tooth was hand scaled and planed prior to root surface conditioning with citric acid, tetracycline hydrochloride, and a dentin bonding conditioner; Tenure Dentin Conditioner (DenMat Corporation, Santa Maria, CA). The last has been used previously in conjunction with a resin-ionomer barrier in cases involving guided tissue regeneration. Root specimens were prepared for scanning electron microscopy and representative micrographs were taken at 1000x and 2000x.

Results: The results of this study indicate that there are morphological similarities between surfaces obtained with the dentin conditioning agent and the other acidic materials that are used routinely in periodontal regenerative therapy.

Conclusions: Root surface demineralization has been shown to remove the smear layer, and provides a surface which is conductive to mechanical adhesion and cellular mechanisms for growth and attachment.

The biological principles of guided tissue regeneration (GTR) and graft materials have become widely used as methods for the treatment of severe osseous defects. An early-onset periodontitis case which includes a 3-year follow-up is presented in this case report, which demonstrates the successful use of an expanded polytetrafluoroethylene barrier membrane (ePTFE; Goretex Periodontal Material) in conjunction with natural coral bone graft (Biocoral 450). The results after 3 years illustrate the potential for regenerative periodontal therapy in combination with appropriate prosthetic procedures where limited success might have been expected.

The purpose of these case reports is to introduce a potential use for a resin-ionomer in guided tissue regeneration. The resin-ionomer is used in a two-fold manner (1) to lute an e-PTFE membrane in place in furcation defects and (2) to act as a barrier itself in furcation and infrabony defects. Clinical observations made in this report indicate that a resin-ionomer barrier may be placed subgingivally without sutures. In addition, the resin-ionomer, given its ability to release fluoride, may serve as a delivery system for local antimicrobial therapy during the initial stages of wound healing. Further studies should be conducted in order to evaluate the potential of the resin-ionomer for the uses described in this article.