[Show abstract][Hide abstract] ABSTRACT: Several bone grafting materials have been used in sinus augmentation procedures. Bio-Oss (deproteinized and sterilized bovine bone) has shown to have osteoconductive properties and no inflammatory or adverse responses have been published. In spite of these successful results, histologic data regarding bone augmentation using Bio-Oss in humans is scarce. The purpose of this study was to analyse the amount of Bio-Oss ossification in a case of maxillary sinus augmentation, recording and comparing histomorphometric data 8 months, 2 and 10 years after surgery. This long-term histologic evaluation of retrieved specimens has been performed, comparing histomorfometric measures at different times. Eight months after surgery we observed in 20 different thin sections of the specimen a mean amount of bone tissue (including medullar spaces) of 29.8% (and 70.2% of Bio-Oss) +/- 2.6. At 2 years the bone tissue increased to 69.7% + 2.7 and 10 years after surgery it was 86.7% +/- 2.8. The comparison of the means for each time has shown a highly significant increasing trend in bone formation associated with Bio-oss resorption: at 8 months, 2 and 10 years.
[Show abstract][Hide abstract] ABSTRACT: The purpose of the present multicenter clinical trial was to compare the efficacy of two different procedures in the treatment of infrabony defects: guided tissue regeneration (GTR) with nonresorbable membranes and enamel matrix derivative (EMD).
Six centers participated in this study. Ninety-eight patients with an interproximal infrabony defect were selected. All patients were treated with an initial phase of scaling and root planing, and at the study's baseline the selected defects presented a value of probing depth (PD) > or =6 mm with an infrabony component > or =4 mm. Forty-nine patients were treated with GTR procedures (using ePTFE membranes (Gore-Tex W.L. Gore and Associates, Flagstaff, AZ, USA)) and forty-nine with EMDs (Emdogain (U Biora AB Malm, Sweden)). The efficacy of each treatment modality was investigated through covariance analysis.
The patients were reevaluated at one year postop. Probing attachment level (PAL) gain and PD reduction were analyzed. In the Emdogain group the PAL before surgery (PAL 0) and the PD before surgery (PD 0) were respectively 9.9+/-1.4 and 8.5+/-1.6 mm. The PAL gain and the PD reduction at 1 year postsurgery were respectively 4.1+/-1.8 and 5.3+/-1.9 mm. The group of patients treated with membranes showed that PAL 0 and PD 0 were respectively 8.9+/-1.9 and 8.1+/-1.9. The PAL gain was 4.3+/-1.9 mm and the PD reduction was 5.6+/-1.5 mm. The mean PAL gain expressed by percentage (PAL gain/PAL 0) for the group treated with EMD was 41%, while it was 48% for the group treated with GTR. Results from our analysis suggest that there is no statistically significant difference between GTR and EMD treatments in terms of PAL gain, PD reduction and recession variation. Applying the regression model to a group of patients with a PAL 0 > or =8 mm, we observed a better clinical outcome in terms of PAL gain (difference of 0.3 mm) in patients treated with the GTR procedure compared to those treated with EMD. Covariance analysis showed a strong correlation in both groups of patients between PAL gain and full mouth bleeding score, and between PAL gain and defect morphology and depth.
[Show abstract][Hide abstract] ABSTRACT: Some life styles and systemic pathologies represent risk factors for the periodontal disease. Cigarette smoking in particular increases the speed of progression of periodontitis. Other conditions such as diabetes mellitus, presence of genetic markers and some bacteria are significantly correlated with the periodontal disease.
[Show abstract][Hide abstract] ABSTRACT: The purpose of this case report is to present an unusual endoperiodontal lesion on tooth 46 in an 8-year-old child. The absence of any carious process and the presence of the typical radiographic aspect of an infrabony defect, led us to consider the periodontal aetiopathogenesis. In spite of all this, an accurate periodontal probing of all the teeth and the use of the pulp tester for teeth 46 and 36 led us to diagnose properly a truly endodontic lesion. The endodontic treatment of the involved tooth achieved the complete healing of the lesion.
Der Zweck dieses Fallberichtes ist die Darstellung einer ungewöhnlichen endoparodontalen Läsion an Zahn 46 bei einem 8 Jahre alten Kind. Die Abwesenheit jeglicher kariösen Läsion sowie das typische röntgenologische Bild eines infraalveolären Defekts führten ursprünglich zur Annahme einer parodontalen Ätiopathogenese der Läsion. Nachdem die Erhebung von Sondierungsparametern an allen Zähnen nur an Zahn 46 erhöhte Werte und Sensibilitätstests an Zahn 46 eine im Vergleich zu Zahn 36 verzögerte Reaktion ergeben hatten, wurde die Diagnose einer primär endodontalen Läsion gestellt. Allein die Wurzelkanalbehandlung von Zahn 46 führte zu einer vollständigen Ausheilung des Defektes.
Le but de ce rapport de cas était de présenter une lésion endo-parodontale inhabituelle sur une 46 chez un enfant de 8 ans. L’absence de tout processus carieux et la présence d’un aspect radiographique typique d’un défaut intra-osseux nous a conduit à considérer une étio-pathogènie parodontale. En dépit de tout cela, un sondage parodontal précis de chaque dent et l’utilisation d’un pulp-tester sur les dents 46 et 36 ont permis de diagnostiquer vraiment une réelle lésion endodontique. Le traitement endodontique des dents impliquées entraîna la guérison complète de la lésion.
[Show abstract][Hide abstract] ABSTRACT: The purpose of the present study was to compare the efficacy of 3 different surgical procedures in the treatment of infrabony defects: guided tissue regeneration (GTR) with non-resorbable membranes, Widman modified flap (WMF) and enamel matrix derivative (EMD).
30 patients with an infrabony component > or = 4 mm were selected. 10 were treated with expanded polytetrafluorethylene (ePTFE (Gore - Tex W. L. Gore and Associates, Flagstaff, AZ, USA)) membranes, 10 with WMF and 10 with enamel matrix derivatives (Emdogain (U Biora AB Malm, Sweden)). The efficacy of each treatment modality was investigated through regression analysis. Probing attachment level (PAL) gain, probing depth (PD) reduction and gingival recession (REC) variation were analyzed.
Both Emdogain (enamel matrix derivative) and ePTFE treatment show significant better results as compared to the WMF procedure in which there were no significant changes in PAL gain and PD reduction at baseline and 1 year after surgery.
Results from our analysis suggest that there is no statistically significant difference in PAL gain between GTR and EMD. The clinical outcomes of this pilot study may be of little significance, considering the small number of patients, but it has provided an important base for a controlled clinical trial (with a larger number of patients) which is currently in progress.