A. Hommens

University of Münster, Muenster, North Rhine-Westphalia, Germany

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Publications (4)14.75 Total impact

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    ABSTRACT: The purpose of this study was to determine the relative impact of various predictors responsible for the variability in treatment outcome after guided tissue regeneration (GTR) in intraosseous periodontal defects. 30 patients with chronic periodontitis and at least one intraosseous periodontal lesion (> or =4 mm) were enrolled. Following full-mouth scaling, GTR using polylactic acid membranes was performed at one site in each patient. Main periodontal pathogens, defect morphology, membrane exposure and smoking habit were assessed as predictor variables. Alveolar bone level change served as the primary outcome variable in a multiple regression analysis. After 12 months, the 29 patients completing the study showed alveolar bone changes ranging from 4 mm bone gain to 1 mm bone loss (mean: 1.6+/-0.4 mm gain). Active smoking (beta-weight:-0.49, P=0.003) and persistence of subgingival infection with P. gingivalis (P.g.) (beta-weight:-0.25, P=0.11) were associated with poor treatment outcome. Deep initial intraosseous defects (beta-weight: 0.32, P=0.045) were associated with favorable treatment outcome, and membrane exposure had no impact on bone gain. Active smoking was the strongest predictor variable negatively affecting alveolar bone gain following GTR in the treatment of periodontal defects. It was followed by a positive influence of a deeper intraosseous defect and by a negative effect by persistent subgingival infection of P. gingivalis. The relative impact of these factors may be useful in assessing the prognosis of GTR in intraosseous periodontal defects.
    Journal Of Clinical Periodontology 04/2003; 30(4):368-74. · 3.69 Impact Factor
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    ABSTRACT: Objectives: The purpose of this study was to determine the relative impact of various predictors responsible for the variability in treatment outcome after guided tissue regeneration (GTR) in intraosseous periodontal defects.Patients and methods: 30 patients with chronic periodontitis and at least one intraosseous periodontal lesion (≥4 mm) were enrolled. Following full-mouth scaling, GTR using polylactic acid membranes was performed at one site in each patient. Main periodontal pathogens, defect morphology, membrane exposure and smoking habit were assessed as predictor variables. Alveolar bone level change served as the primary outcome variable in a multiple regression analysis.Results: After 12 months, the 29 patients completing the study showed alveolar bone changes ranging from 4 mm bone gain to 1 mm bone loss (mean: 1.6±0.4 mm gain). Active smoking (β-weight:-0.49, P=0.003) and persistence of subgingival infection with P. gingivalis (P.g.) (β-weight:-0.25, P=0.11) were associated with poor treatment outcome. Deep initial intraosseous defects (β-weight: 0.32, P=0.045) were associated with favorable treatment outcome, and membrane exposure had no impact on bone gain.Conclusion: Active smoking was the strongest predictor variable negatively affecting alveolar bone gain following GTR in the treatment of periodontal defects. It was followed by a positive influence of a deeper intraosseous defect and by a negative effect by persistent subgingival infection of P. gingivalis. The relative impact of these factors may be useful in assessing the prosgnosis of GTR in intraosseous periodontal defects.ZusammenfassungGesteuerte Geweberegeneration mit einer Polylaktat-BarriereTeil II: Prognostische Faktoren für das TherapieergebnisZielsetzung: Bestimmung des relativen Einflusses unterschiedlicher prognostischer Faktoren, die für die Variabilitt der Therapieergebnisse nach gesteuerter Geweberegeneration (GTR) verantwortlich sind.Patienten und Methoden: 30 Patienten mit chronischer Parodontitis und zumindest einem infraalveolren Defekt (≥4 mm) wurden in die Studie aufgenommen. Nach subgingivaler Instrumentierung aller Zhne wurde GTR-Therapie mit Polylaktat-Barrieren an einer Stelle pro Patient durchgeführt. Die Hauptparodontalpathogene, die Defektmorphologie, Membranfreilegung und Rauchverhalten wurden als prognostische Faktoren erfasst. Die Vernderung des Alveolarknochenniveaus diente als Hauptzielkriterium in einer multiplen Regressionsanalyse.Ergebnisse: Nach 12 Monaten zeigten die 29 Patienten, die die Studie beendeten, Alveolarknochenniveauvernderungen, die von 4 mm Knochengewinn bis 1 mm Verlust reichten (Mittelwert: 1,6±0,4 mm Gewinn). Aktives Rauchen (β-Gewicht:−0,49, P=0,003) und Persistenz einer subgingivalen Infektion mit P. gingivalis (P.g.) (β-Gewicht:−0,25, P=0,11) waren mit einem schlechten Therapieergebnis assoziiert. Tiefe properative infraalveolre Defekte (β-Gewicht: 0,32, P=0,045) waren mit einem guten Therapieergebnis assoziiert, whrend Membranfreilegung keinen Einfluss auf den Knochengewinn hatte.Schlussfolgerungen: Aktives Rauchen war der strkste prognostische Faktor, der die knöcherne Auffüllung nach GTR-Therapie parodontaler Defekte negativ beeinflusste. Es wurde gefolgt von einem positiven Einfluss tieferer infraalveolrer Defekte und von einem negativen Einfluss einer persistierenden subgingivalen Infektion mit P. gingivalis. Der relative Einfluss dieser Faktoren könnte nützlich für die Abschtzung der Prognose von GTR-Maßnahmen in infraalveolren parodontalen Defekten sein.RésuméRégénération tissulaire guidée par une barrière en acide polylactiquePartie II: Prédicteurs influençant les conséquences du traitementObjectifs: Cet article se propose de déterminer l’impact relatif de divers prédicteurs responsable de la variabilité des conséquences des traitements après régénération tissulaire guidée (RTG) dans les lésions parodontales intra-osseuses.Patients et méthodes: 30 patients présentant une parodontite chronique et au moins une lésion parodontale intra-osseuse (≥4 mm) ont été enrolés. Après un détartrage complet, une RTG fut réalisé avec des membranes en acide polylactique sur un site de chaque patient. Les principaux pathogènes parodontaux, la morphologie du défaut, l’exposition de la membrane et le tabagisme furent décrétés comme variables prédictives. La modification du niveau de l’os alvéolaire a servi de variable de conséquence primaire dans une analyse de régression multiple.Résultats: Après 12 mois, les 29 patients inclus dans l’étude présentaient des modifications de l’os alvéolaire allant de 4 mm de gain osseux à 1 mm de perte osseuse (moyenne: 1.6±0.4 mm de gain). Le tabagisme actif (β-weight:−0.49, P=0.003) et la persistance de l’infection sous-gingivale par P. gingivalis (P.g.) (β-weight:−0.25, P=0.11) étaient associés à des résultats de traitement faible. Des lésions initiales intra-osseuses profondes (β-weight: 0.32, P=0.045) étaient associées avec des conséquences thérapeutiques favorables, et l’exposition de la membrane n’avait aucune incidence sur le gain osseux.Conclusion: Le tabagisme actif était la variable prédictive la plus forte qui affectait négativement le gain d’os alvéolaire site à un traitement de lésions intra-osseuses par RTG. Il était suivi par l’influence positive de la profondeur de la lésion et par l’effet négatif de la persistence de l’infection sous-gingivale par P. gingivalis. L’impact relatif de ces facteurs peut être utile dans la définition d’un pronostic pour la RTG des lésions parodontales intra-osseuses.
    Journal Of Clinical Periodontology 03/2003; 30(4):368 - 374. · 3.69 Impact Factor
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    ABSTRACT: The purpose of this study was to assess the dynamics of bacterial colonization in intra-osseous defects following guided tissue regeneration (GTR) therapy using a resorbable barrier. In each of 30 patients, one intra-osseous defect was treated with GTR using a polylactic acid membrane (Guidor). Plaque samples were taken from the defect site, other teeth and mucous membranes following initial therapy (baseline), and at 3, 6 and 12 months after periodontal surgery. Additionally, samples were taken from the defect sites at 1, 2 and 4 weeks. Actinobacillus actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), and Bacteroides forsythus (B.f.) were detected by polymerase chain reaction (PCR). Supportive periodontal therapy was performed at 3-month intervals. In the 29 patients completing the study, the assessed microflora was detected in 3 (A.a.), 13 (P.g.) and 14 (B.f.) defect sites at baseline, in 2 (A.a.), 2 (P.g.) and 2 (B.f.) following surgical debridement, and in 6 (A.a.), 10 (P.g.) and 22 (B.f.) at 12 months. Defect site colonization following GTR therapy was significantly correlated with presurgical colonization at other assessed teeth (A.a. and P.g.: tau = 0.45 and 0.66, respectively; P < 0.001), or on mucous membranes (B.f.: tau = 0.44, P < 0.001). The colonization of periodontal pathogens at sites treated by GTR may correlate with the intra-oral presence of these pathogens before surgery. If colonization of GTR sites by periodontal pathogens is to be prevented, intra-oral suppression/eradication of these pathogens may be required before surgery.
    Journal Of Clinical Periodontology 01/2003; 30(1):19-25. · 3.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objectives: The purpose of this study was to determine the relative impact of various predictors responsible for the variability in treatment outcome after guided tissue regeneration (GTR) in intraosseous periodontal defects. Patients and methods: 30 patients with chronic periodontitis and at least one intraosseous periodontal lesion (≥4 mm) were enrolled. Following full-mouth scaling, GTR using polylactic acid membranes was performed at one site in each patient. Main periodontal pathogens, defect morphology, membrane exposure and smoking habit were assessed as predictor variables. Alveolar bone level change served as the primary outcome variable in a multiple regression analysis. Results: After 12 months, the 29 patients completing the study showed alveolar bone changes ranging from 4 mm bone gain to 1 mm bone loss (mean: 1.6±0.4 mm gain). Active smoking (-weight:-0.49, P=0.003) and persistence of subgingival infection with P. gingivalis (P.g.) (-weight:-0.25, P=0.11) were associated with poor treatment outcome. Deep initial intraosseous defects (-weight: 0.32, P=0.045) were associated with favorable treatment outcome, and membrane exposure had no impact on bone gain. Conclusion: Active smoking was the strongest predictor variable negatively affecting alveolar bone gain following GTR in the treatment of periodontal defects. It was followed by a positive influence of a deeper intraosseous defect and by a negative effect by persistent subgingival infection of P. gingivalis. The relative impact of these factors may be useful in assessing the prosgnosis of GTR in intraosseous periodontal defects.
    Journal Of Clinical Periodontology 01/2003; 30(4):368-374. · 3.69 Impact Factor

Publication Stats

22 Citations
14.75 Total Impact Points

Institutions

  • 2003
    • University of Münster
      • Department of Periodontology
      Muenster, North Rhine-Westphalia, Germany
    • University of Tuebingen
      Tübingen, Baden-Württemberg, Germany