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  • 1
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this study was to explore the possibility of creating bone tuberosities on the mandibular ramus in rats, using a rigid, occlusive. Teflon capsule. The experiment was carried out in 30 rats. The mandibular ramus was exposed bilaterally. On the test side, the periosteum was left covering the lateral surface of the ramus. On the contralateral side (control). the periosteum was elevated from the lateral surface together with the flap. A hemispherical, Teflon capsule was then placed to face the periosteum or the bone surface with its open part before closure of the wound. The healing periods comprised 7–120 days. Histological analysis demonstrated increasing bone fill in the test specimens from 7 to 60 days, and a limited further increase was observed from 60 to 120 days. In the control specimens, limited bone fill was seen within the first month after surgery, but substantial amounts of new bone were produced from 30–120 days. At 120 days, the mean amount of bone obtained in the test specimens was 56%(range 39%-71%) of the total space created by the capsules, and it was 52%(range 32%-85%) in the controls. The amount of newly formed bone was equivalent to a 5–6 times increase of the original width of the mandibular ramus. These findings indicate that a secluded space created by an occlusive barrier adjacent to existing bone or periosteum may be filled out with bone tissue. This may have a great clinical impact in cranial and maxillofacial surgery.
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  • 2
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: Aim: To examine in a discriminating capsule model whether denaturation of demineralized bone matrix (DBM) by heating may influence bone formation.Materials and methods: DBM was produced from the long bones of rats. Half the portion of DBM was denatured by heating in distilled water for 20 min at temperatures between 70°C and 90°C. Prior to the study, the destruction of the osteoinductive properties of the DBM was confirmed in three rats following intramuscular implantation. Thirty, 4-month-old, male albino rats of the Wistar strain were used in the study. Following surgical exposure of the mandibular ramus, a hemispherical Teflon capsule (internal diameter=5.0 mm) was placed, with its open part facing the lateral aspect of the ramus. On one side (test side), the capsule was loosely packed with denatured DBM, while on the contralateral side, serving as control, the capsule was loosely packed with the same amount of non-denatured DBM. After healing periods of 30, 60, and 120 days, groups of 10 animals were killed and 40–70 μm thick undecalcified sections of the capsules were produced. Three sections from each specimen, representing the mid-portion of the capsule, were subjected to histological analysis and computer-assisted planimetric measurements.Results: Increasing amounts of newly formed bone were observed in both test and control capsules during the experimental period. At 4 months, the new bone formed in the control capsules occupied 46.7% of the cross-sectional area of the capsules, while it was only 19.1% in the test capsules (P〈0.05).Conclusion: Denaturation of DBM by heating significantly reduces bone formation by guided tissue regeneration.
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  • 3
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract New attachment procedures were performed in 80 three-wall intrabony defects produced adjacent to incisors and canines in monkeys. Following a reverse bevel incision, rnucoperiosteaS flaps were raised on the buccal and lingual aspect of 40 intrabony defects, AH soft tissue was removed from the defects and following transplantation of autogenous bone grafts, the tissue flaps were replaced and sutured. On the buccal and lingual aspect of another 40 intrabony defects a split flap procedure was performed. Granulation tissue was removed from the defects and following transplantation of autogenous bone grafts, the defects were covered with free palatal grafts.The animate were sacrificed (o yield observation periods from 0 to 42 days. After de-caicification of the specimens and embedding in paraffin, 8-μm serial sections were cut and stained. The epithelium on the full thickness flap seemed almost unaffected by the surgical procedure and had migrated between 0.2 mm and 2.0 mm along the root surface during the first week of healing. The epithelium on the transplants degenerated almost completely within the first week after surgery and epithelial migration along the root surface was not observed until after 10–12 days.These results indicate that the migration of epithelium during the postoperative phase of new attachment attempts can be retarded by covering the defects with free palatal grafts instead of full thickness flaps.
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  • 4
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The purpose of the present study was to examine the effect on periodontal regeneration of preventing bacterial contamination of the membrane material following the guided tissue regeneration procedure (GTR). Periodontal dehiscence defects were surgically produced in 2 monkeys. In each monkey, 8 of these defects were submerged after resection of the crowns of the teeth and a teflon (Gore-Tex Periodontal Material®) or a polyglactin (Vicryl Mesh®) membrane was adjusted to cover the defect and the exposed root surface. 4 defects on non-crown resected teeth were treated with either a teflon or a polyglactin membrane positioned with the coronal border approximately 2 mm below the margin of the covering tissue flap. Following 6 months of healing, the animals were sacrificed. Histological evaluation of the specimens revealed that roots which were kept completely covered during the healing period demonstrated new connective tissue attachment and bone formation corresponding to 67–100% of the length of the initial defect depth, whereas the amount of new connective tissue attachment and bone on non-submerged roots ranged between 30–59% and 11–31%, respectively. It seems reasonable to anticipate that it is bacterial contamination of the membrane material which jeopardizes the formation of new connective tissue attachment but in particular bone formation following the GTR-procedure.
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  • 5
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The present investigation was designed to evaluate the regenerative potential of the periodontal tissues in degree TIT furcation defects at mandibular molars using a treatment procedure based on the principle of guided tissue regeneration. The patient sample included 21 patients, 26–65 years of age, who presented periodontal lesions in the right and left molar regions including “through and through” furcation defects. After an initial examination, each patient was subjected to a series of full-mouth scaling and root planing. 2–3 months later, they were recalled for a baseline examination. The furcation-involved molars were randomly assigned in each patient to either a test or a control treatment procedure. The test procedure included the elevation of muco-periosteal flaps at the buccal and lingual aspects of the molars. Granulation tissue was removed and the exposed root surfaces were debrided and planed. The width and the height of the entrance openings to the furcation defects were assessed. A teflon membrane was adjusted to cover the entrances to the defects (buccal and lingual) and was retained in the manner described by Pontoriero et al. (1988). The flaps were repositioned on the outer surface of the membrane and secured by sutures which were removed after 10 days. Following surgery, the patients were instructed to rinse the mouth twice daily for 4 weeks with chlorhexidine gluconate. The membranes were removed after a healing period of 1–2 months. A surgical procedure identical to the test procedure was performed in the control tooth regions with the exception of the placement of membranes. During a 6-month period after surgery, the patients were maintained in a plaque control program including professional tooth cleaning every second week. At the end of this period, all patients were re-examined. The results of this re-examination demonstrated that out of 21 “through and through” furcation defects treated with the GTR therapy, 8 healed with complete closure of the defect. An additional 10 defects had become partially healed and only 3 defects were after a healing period of 6 months still open. In the control group, none of the previous “through and through” defects had healed with complete closure. 10 control defects were partially filled and 11 remained open. The potential for regeneration of periodontal tissues in furcation defects of varying dimensions is discussed.
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  • 6
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The present clinical trial was designed to evaluate the regenerative potential of the periodontal tissues in degree II furcation defects at mandibular molars using a surgical treatment technique based on the principles of guided tissue regeneration. The patient sample included 21 subjects. 22–65 years of age. The patients selected had periodontal lesions in the right and left molar regions including advanced periodontal tissue destruction within the interradicular area. After an initial examination, each patient received a series of full-mouth scalings and root planings. 2–3 months later, they were recalled for a baseline examination including assessment of plaque, gingivitis, probing depths and probing attachment levels. The furcation involved molars were randomly assigned in each patient to either a test or a control treatment procedure. The test procedure included the elevation of mucoperiosteal flaps at the buccal and lingual aspect of the alveolar process. The inner surface of each flap was carefully curetted to remove epithelium and granulation tissue. The root surfaces were scaled and planed. A teflon membrane was adjusted to cover the entrance of the furcation area and the adjacent root surfaces as well as a portion of the alveolar bone apical to the crest. The flaps were repositioned and placed on the outer surface of the membrane and secured with interdental sutures which were removed after 10 days of healing. Following surgery, the patients were instructed to rinse the mouth twice daily with chlorhexidine gluconate. A second surgical procedure was performed after a healing period of 1–2 months to remove the teflon membrane. A procedure identical to the one used at the test teeth was performed at the control tooth regions with the exception of the placement of the teflon membrane. After 3 and 6 months of healing, the test and control sites were examined using the same parameters that were studied at baseline. The findings from the investigation demonstrated that treatment of degree II furcation defects at mandibular molars using a technique in compliance with the principles of guided tissue regeneration at most sites resulted in the disappearance of the anatomical defect. More than 90% of the sites treated with the GTR technique showed complete resolution of the furcation problem. Conventional therapy reached the same treatment goal in less than 20% of the cases treated.
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  • 7
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The use of enamel matrix proteins (EMD) has been recently introduced as a new treatment alternative for periodontal regeneration. However, no histological studies are available investigating the effect of EMD in the treatment of degree III furcation involvements.Objectives: The aim of this study was to evaluate the healing of mandibular degree III furcation involvements histologically following treatment with guided tissue regeneration (GTR), EMD and a combination of EMD and GTR.Material and Methods: Degree III furcation involvements were surgically created at the teeth 36, 37, 46, 47 in three monkeys (Macaca fascicularis). Spontaneous healing of the defects was prevented by placing impression material into the defects. After 6 weeks, full-thickness flaps were elevated at the buccal and lingual aspect of the experimental teeth. Following removal of all granulation tissue from the furcation defects, scaling/root planing and conditioning of the root surfaces with 24% EDTA gel, the defects were treated with one of the following treatment modalities: (i) EMD, (ii) GTR or (iii) a combination of EMD and GTR. The defects serving as control did not receive any treatment, except from complete coverage with coronally displaced flaps. After 5 months of healing, the animals were killed and perfused with 10% buffered formalin for fixation. The experimental teeth with surrounding tissues were dissected free, decalcified in EDTA, dehydrated and embedded in paraffin. 8 μm thick histological sections were cut and stained and subsequently examined under the light microscope.Results: The histological analysis revealed that with GTR or combined EMD and GTR treatment, new attachment formation (new cementum with inserting collagen fibers) had occurred on almost the entire circumference of the furcation and new bone was almost filling the defect in the situations where the membrane was not exposed. The sites treated only with EMD exhibited new attachment and new bone formation to a varying extent, while the control sites presented only limited new attachment and bone formation.Conclusion: The results provided histological evidence suggesting that both GTR and EMD may result in true periodontal regeneration, and suggest that this type of healing might be favored by such treatments in comparison with flap surgery.
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  • 8
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Enamel matrix proteins (EMD) have recently been introduced in regenerative periodontal treatment. However, no histological data are yet available concerning the effect of treating intrabony periodontal defects with EMD, and no histological comparisons have been made comparing the result of treatment of intrabony defects with EMD with that of the treatment with guided tissue regeneration (GTR).Aim: Therefore, the aim of the present study was to evaluate histologically in monkeys the effect of treating intrabony defects with EMD, GTR or combined EMD and GTR.Method: Intrabony periodontal defects were produced surgically at the distal aspect of teeth 14, 11, 21, 24, 34, 31, 41 and 44 in 3 monkeys (Macaca fascicularis). In order to prevent spontaneous healing and to enhance plaque accumulation metal strips were placed into the defects. After 6 weeks the defects were exposed using a full-thickness flap procedure. The granulation tissue was removed and the root surfaces were debrided by means of hand instruments. Subsequently, the defects were treated using one of the following therapies: (i) GTR, (ii) EMD, or (iii) combination of EMD and GTR. The control defects were treated with coronally repositioned flaps. After 5 months, the animals were sacrificed and perfused with 10% buffered formalin for fixation. Specimens containing the defects and surrounding tissues were dissected free, decalcified in EDTA and embedded in paraffin. 8 μm thick histological sections were cut and stained and subsequently examined under the light microscope.Results: In the control specimens, the healing was characterized by a long junctional epithelium and limited periodontal regeneration (i.e., new periodontal ligament, new cementum with inserting connective tissue fibers and new bone) in the bottom of the defect. The GTR-treated defects consistently presented periodontal regeneration when the membranes were not exposed whereas the sites treated only with EMD presented regeneration to a varying extent. The combined therapy did not seem to improve the results.Conclusion: It can be concluded that all 3 treatment modalities favor periodontal regeneration.
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  • 9
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. The aim of the present study was to investigate whether oxytalan fibers are formed in the regenerated human periodontal ligament. 6 patients, each of them exhibiting an advanced intrabony defect, were treated with a bioresorbable membrane according to the GTR-principle. Following a healing period of 6 months, the teeth were extracted together with their surrounding soft and hard tissues and subsequently fixed in 10% buffered formalin. Following decalcification in EDTA, the specimens were embedded in paraffin and 8-μm histological sections were cut in the mesio-distal direction, parallel to the long axes of the teeth. The sections were stained with hematoxylin and eosin, or with the oxone-aldehyde-fuchsin-Halmi staining method and examined in the light microscope. A regenerated periodontal ligament containing newly-formed oxytalan fibers was observed in all specimens. Many of them inserted into the newly formed cementumon the root surface. It is concluded that oxytalan fibers are formed de novo in human regenerated periodontal ligament tissue.
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  • 10
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    ISSN: 1600-0765
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This study describes the cross-sectional findings on dental plaque, calculus, gingivitis, loss of attachment, periodontal pockets and tooth loss in a population of adult Tanzanians aged 30–30 years. In all age groups more than 90% of all tooth surfaces exhibited plaque and 50–50% exhibited calculus deposits. Both plaque and calculus deposits were more extensive in the older age groups whereas gingival bleeding affected 30–30% of the surfaces in all age groups. Less than 35% of all surfaces exhibited a loss of attachment ≥4 mm and less than 10% had a loss of attachment exceeding 6 mm. Loss of attachment was accompanied by recession of the marginal gingiva and pockets deeper than 3 mm were present on less than 10% of all surfaces. The mean number of teeth present ranged from 23.9 in the oldest to 29.5 in the youngest age group. An interesting finding was that relatively few individuals accounted for most of the loss of attachment and periodontal pockets found in the study. Therefore, in future epidemiologic studies more emphasis should be put on the identification of these particularly susceptible subpopulations.
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