Biomedical subjects
Publications and source records attributed to David L Hoexter.
Gingival recession, exposure of the tooth's root, is undesirable and, in many situations, contrary to normal physiology. Today's root coverage is predictable. With the use of an acellular dermal matrix membrane (Fasciablast), we can achieve a new blood supply and predictable coverage, with no second surgical procedure. Youth, esthetics and physiology are restored.
Responding to the patient's uncomfortable reaction following certain periodontal surgery procedures, notably the sensitivity to temperature and touch, has been a source of frustration to both the practitioner performing the surgery as well as the patient. This case demonstrates the placement of an easily applied desensitizing paste (Duraphat) at the time of surgery, which enables the patient to avoid uncomfortable sensitivity after the dressing has been removed and allows the patient to return to good oral hygiene practices quickly, thereby avoiding new accumulation of bacteria. It also prevents further periodontal destruction, which is the purpose of the periodontal treatment. This presentation and diagrammatic explanation demonstrate placing this topical paste during the surgery, just before suturing. This particular paste is easy to place, and ease of placement is not inhibited by moisture in the affected area. The desensitizing effect for the immediate postoperative period provides comfort for the patient and helps to maintain trust between the dentist and the patient.
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One of the many problems facing surgeons is finding adequate bone sites for implant support. Without adequate bone, there can be implant failure or poor esthetic results. By using guided tissue regeneration (GTR) membranes and bone grafting materials, implants may be placed into immediate extraction sites and areas with large osseous defects with an expectation of long-term positive results. These concepts are illustrated by comparing the results of a ten-year follow-up evaluation of a patient lacking healthy bone at the implant site with another case in which the implant site had bone of acceptable morphology and density, with both cases showing similarly good results.