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  • 1
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The purpose of the present clinical study was to evalutate the 5-year results of the first 12 implants inserted at the University of Berne in regenerated bone following successful ridge augmentation with the membrane technique. The patients were recalled and examined with clinical and radiographic paramenters routinely utilized in prospective studies with standard implants in non-regenerated bone. Based on clinical and radiographic findings, all 12 implants were considered successfully integrated according to strict criteria of success. The detailed analysis of clinical parameters revealed no differences to results of prospective studies on standard implants in non-regenerated bone. All implants demonstrated ankylotic stability which was confirmed by a mean Periotest value of -2.08. The radiographic analysis showed stable bone crest levels with a mean bone loss between the 1- and 5-year examination of 0.30 mm. However, 2 implants exhibited a bone loss of more than 1 mm between the 1- and 5-year examination. Therefore, the prognosis of these 2 implants seems questionable at the present time. It can be concluded that bone regenerated with the membrane technique reacts to implant placement like non-regenerated bone, since all 12 implants achieved successful tissue integration with functional ankylosis. Furthermore, this bone is also load-bearing, since all 12 implants maintained osseointegration over a 5-year period.
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  • 2
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This report presents 4 cases with 6 implant exposures after the installation of Bråemark System® implants which called for treatment applying the guided bone regeneration technique. A bioresorbable barrier (GUIDOR® Matrix Barrier) was used to cover the defects, 4 defects with and 2 without the support of autologous bone chips. Complete bone filling was found in 4 (2 without and 2 with bone chips) and partial filling in 2 (with bone chips) of the treated defects, as registered at the abutment connection 6–7 months after surgery. Besides its ability to serve as a barrier for guided bone regeneration, it was found that the matrix barrier had the following properties; biocompatibility observed as uneventful tissue healing, malleability facilitating the clinical handling and ability to be resorbed within 6 to 7 months, as evaluated by clinical inspection. The observations of the present case reports indicate that the tested barrier may be used for guided bone regeneration in connection with implant installation. It is advisable, however, to use a supporting material to prevent barrier collapse, although bone regeneration can be achieved in certain situations without such material if the defect morphology is favourable.
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  • 3
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The principle of guided tissue regeneration has been successfully applied for the regeneration of bone in various jaw defects in human. The purpose of this study was to assess the bone volume regenerated using nonresorbable membrane barriers. Nineteen patients with jaw bone defects of various sizes and configurations were included in the study. Combined split-thickness/full-thickness mucosal flaps were elevated in the area of missing bone. The size of the defects was assessed by measuring the distance from a reference line between 2 adjacent teeth (cementoenamel junctions) to the alveolar crest (a) every 2 or 3 mm. In addition, the crestal width was measured. Consequently, the surface of the triangle formed by a and the width of the crest as well as the volume between all triangles were calculated geometrically. Following the placement of Gore-Tex® augmentation material as a barrier, the distance (b) to the top of the membrane from the reference line was assessed, and the maximum possible volume for bone regeneration based on (a-b) and the width of the crest was calculated. At the time of membrane removal (3–8 months later). the same measurements were performed and the percentages of regenerated bone in relation to the possible volume for regeneration determined. In 6 patients in whom the membranes had to be removed early due to an increased risk for infection between 3 and 5 months, bone regeneration varied between 0 and 60%. In 13 patients in whom membranes were left for 6–8 months, regenerated bone filled 90–100% of the possible volume. It was concluded that successful bone regeneration consistently occurred with an undisturbed healing period of at least 6 months.
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  • 4
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this experimental investigation was to compare the effect of using autologous particulate bone grafts with and without a bioresorbable barrier covering for augmentation of the rabbit skull bone. For this purpose, bilateral, circular, 8 mm wide and 1 mm deep skull bone defects were prepared and overfilled with particulate bone grafts. The grafts placed in the test sites were covered with a bioresorbable barrier (Guidor® Matrix Barrier). The grafts placed in the control sites were covered only by the repositioned, cutaneous flap. 12 weeks later, the animals were sacrificed, the experimental sites were defleshed and the height and volume of the augmented bone in the test and control sites were measured clinically. Histologically, morphometrical measurements of the bone tissue were performed in decalcified vertical cross-sections of the experimental sites. Statistically significant differences were found in favour of the coverage of the bone graft particles with the barrier, both with respect to the height and the volume of the augmented bone.
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  • 5
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The aim of the investigation was to evaluate the potential for new attachment formation at various degree III furcation involvements in the beagle dog. 3 differently shaped furcation defects were prepared; one small and one large key-hole defect, and one furcation defect which was part of “circumferential” loss of attachment and bone. 15 beagle dogs were used in the experiments. The furcation defects were surgically created at mandibular premolars in the right and left side of the jaw. Test teeth were subsequently treated according to the GTR principle, while control teeth were treated without the application of membranes. The result from the histological examination of biopsy specimens revealed that GTR treatment may result in complete new attachment at surgically produced “through and through” furcation involvements in dogs. The study, however, also revealed that the size of the furcation defect as well as the shape of the surrounding alveolar bone were factors that determined the outcome of this kind of treatment. The treatment failures were consistently associated with flap recession during healing which resulted in the exposure of the furcation defect.
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The present study was designed to determine the threshold pressure value to be applied in provoking bleeding on probing (BOP) in clinically healthy gingival units. 12 female dental hygiene students volunteered for the study. They were selected on the basis of excellent oral hygiene standards, absence of probing depths 〉 3 mm and absence of caries or dental restorations on smooth and proximal tooth surfaces. Applying a probing force of 0.25, 0.5, 0.75 and 1.0 N in one of the 4 jaw quadrants, respectively, on 2 different occasions with an interval of 10 days, bleeding on probing was assessed. Oral hygiene and gingival conditions were determined using the criteria of the plaque control record and the gingival index. On the basis of the BOP values, obtained using the lowest probing force (0.25 N), the subjects were divided into 2 groups: group 1 (“minimal BOP” value) consisted of 6 subjects yielding practically no bleeding (mean BOP = 0.9%) at both examinations, while the subjects of group 2 (“low BOP” value) had slightly higher BOP% (mean BOP =13.4%). Both groups showed significant increase in mean BOP% with increasing probing force (0.9%-36.1% in group 1 and 13.4%-47.0% in group 2). Regression analysis revealed an almost linear correlation and a high correlation coefficient between BOP% and probing force. The comparison of the regression lines of the 2 groups showed almost identical slope inclination. However, slight differences in slope inclination were found for different sites: approximal sites clearly yielded steeper regression lines than buccal/oral sites. The results of the study demonstrated that the BOP test using uncontrolled forces may result in a proportion of false positive readings and that a strong possibility exists for the traumatization of clinically healthy gingival tissues if a probing force exceeding 0.25N is applied.
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The present retrospective study was performed to evaluate some long-term alterations of the alveolar bone level at periodontal sites with angular and even (“horizontal”) patterns of bone loss. The investigation included 48 patients who, following treatment for advanced periodontal disease, were placed in a maintenance care program which included recall appointments every 3-6 months for a period of 5 to 16 years. The material of the study comprised all teeth at which angular osseous defects (test sites) could be detected in a full-mouth series of radiographs obtained at the end of the active treatment phase. Alterations in the position of the marginal alveolar bone crest and the base of the osseous defect which took place during the maintainance period were assessed by comparing the post-treatment radiographs with a 2nd set of radiographs obtained at the final examination. In the same patients, an equal number of contralateral or neighboring teeth at which bone loss in the radiographs had an even or “horizontal” character were included as controls. The results from the assessments demonstrated that periodontal sites which, following active therapy displayed either angular or “horizontal” patterns of alveolar bone loss underwent, during a 5-16 year period of maintenance, only minor bone level alterations. Additional loss of supporting bone occurred equally frequently at sites with “horizontal” and angular patterns of bone loss. Thus, the findings reported failed to show up sites with angular bony defects as being particularly susceptible to recurrent destructive periodontitis.
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  • 8
    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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  • 9
    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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  • 10
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. The aim of the present clinical trial was to evaluate the effect of different modes of periodontal therapy on patients with moderately advanced periodontal disease and to express the findings in terms of probing pocket depth and attachment level alterations at periodontal sites with different initial probing depths.The material consisted of 16 patients, 35–65 years of age. Following a Baseline examination including assessments of oral hygiene status, gingival conditions, probing pocket depths and probing attachment levels, the patients were subjected to periodontal treatment. A “split-mouth” design approach of therapy was used and the jaw quadrants were randomly selected for the following different treatment procedures: (1) scaling and root planing, (2) scaling and root planing in con junction with a gingivectomy procedure, (3) scaling and root planing m conjunction with an apically repositioned flap procedure without bone recontouring. (4) scaling and root planing in conjunction with an apically repositioned flap procedure including bone recontouring, (5) scaling and root planing in conjunction with a modified Widman flap procedure without bone recontouring and (6) scaling and root planing in conjunction with a modified Widman flap procedure including bone recontouring. The patients were following active treatment enrolled in a supervised maintenance care program including “professional tooth cleaning” once every 2 weeks during a 6-month period of healing, after which a final examination was performed.The investigation demonstrated that active therapy including meticulous subgingival debridement resulted in a low frequency of gingival sites which bled on probing, a high frequency of sites with shallow pockets (〈4 mm) and the disappearance of pockets with a probing depth of 〉6 mm. Between the Baseline examination and the 6-month re-examination, the probing attachment level for initially shallow-pockets remained basically unaltered, but with a tendency of a minor apical shift. This occurred in all 6 treatment groups. For sites with initial probing depths of 4–6 mm and 〉6 mm, there was in all groups some gain of probing attachment. This gain was most pronounced in the initially deeper (〉6 mm) pockets.With the use of regression analysis, the “critical probing depth” (CPD) value (i.e. the initial probing depth value below which loss of attachment occurred as a result of treatment and above which gain of probing attachment level resulted) was calculated far each of the 6 methods of treatment used- A comparison of the CPD-values between the 6 treatment groups did not reveal any major differences.
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