Biomedical subjects

G Pini Prato

Publications and source records attributed to G Pini Prato.

At least 19 recordsLinked to original sources

PubMed2005

Osteonecrosis of the jaws in periodontal patients with a history of bisphosphonates treatment.

BACKGROUND/AIM: Osteonecrosis of the jaws is being increasingly reported in patients with bone metastasis from a variety of solid tumours and disseminated multiple myeloma receiving intra-venous bisphosphonates. The signs and symptoms that may occur before the appearance of clinical evident osteonecrosis include changes in the health of periodontal tissues, non-healing mucosal ulcers, loose teeth and unexplained soft-tissue infection. A series of nine periodontally involving patients showing osteonecrosis of the jaws that appeared following the intra-venous use of bisphosphonates is reported. MATERIAL AND METHODS: Nine consecutive patients with osteonecrosis of the jaws were prospectically studied. Patients' past medical histories and the drugs that they had received for their malignant disease were systematically documented. Clinical, histopathological and radiographic features and proposal for treatment modalities of osteonecrosis are also reported. RESULTS: Of the nine patients (six women and three men) observed, all had osteonecrosis in the mandible; two had maxillary involvement as well. All nine patients had a history of extraction of periodontally hopeless teeth preceding the onset of osteonecrosis. In two patients, the lesions also appeared in edentulous areas spontaneously. All the patients had received intra-venous bisphosphonates as treatment for their disseminated haematological neoplasms or metastatic bone disease. The duration of bisphosphonate therapy at presentation ranged from 10 to 70 months (median: 33 months). CONCLUSIONS: Jaw osteonecrosis appears to be associated with the intra-venous use of bisphosphonates. Dental professionals should be aware of this potentially serious complication in periodontal patients receiving long-term treatment with bisphosphonates.

Aged↗

PubMed2002

Viral etiology of gingival recession. A case report.

Herpes simplex virus-type I (HSV-1) is responsible for both primary and recurrent infections of the oral mucosa. The aim of this case report is to show how HSV-1 may cause periodontal damage such as gingival recession. A 26-year-old male patient presented in a private office for the treatment of gingival recessions. He reported that the recessions had appeared suddenly with marginal inflammation of the gingiva and vesicle formation; within a few hours, the gingival tissue had been completely destroyed. The lesions were accompanied by pain, fever, and regional lymphadenopathy. Two weeks later, the patient returned complaining of a recurrence accompanied by pain and lymphadenopathy. The following day, the patient's condition had worsened and the depth of the recession had increased. A biopsy was taken for histological examination. A free epithelial-connective tissue graft was performed. Histological and direct immunofluorescence examinations confirmed the herpetic origin of the lesion. Eight months after surgery, a new herpetic lesion was detected in correspondence to the gingival margin of the first lower right premolar; therefore, acyclovir was prescribed. After 1 week, the antiviral therapy was completely successful; the gingival lesion disappeared, and no recession of the soft tissue margin was observed. Based on these clinical features, diagnosis of gingival recession induced by HSV-1 must be carried out at an early stage to establish a successful therapy.

Acyclovir↗

PubMed2001

Coronally advanced flap procedure: is the interdental papilla a prognostic factor for root coverage?

BACKGROUND: This study was designed to verify if the dimension of the interdental papilla may be a prognostic factor for the clinical outcome of the coronally advanced flap (CAF) in the treatment of gingival recessions. METHODS: Thirty-three Miller Class I recessions were treated in 33 patients using the CAF procedure. Two types of measurements were performed: 1) clinical measurements (probing depth, recession depth, width of keratinized tissue, clinical attachment level) were recorded at baseline and 3 months after surgery and 2) all recessions were photographed and transformed into computer images. A specific software allowed recording of both linear and square measurements. The following digital measurements were recorded at baseline: 1) base, height, and area of the mesial and distal papillae adjacent to the involved tooth and 2) width/depth of the recession and the area of the exposed root surface of the involved tooth. The residual recession area, if any, was recorded 3 months after surgery. The digital measurements of the height and of the area of the papilla were used in statistical analysis (multiple linear regression and logistic regression) to evaluate a possible correlation with root coverage (mm2) and/or with complete root coverage. RESULTS: Root coverage was not significantly correlated to the papilla area (P= 0.3692) or to papilla height (P= 0.0968). The complete root coverage was not correlated to the papilla area (P= 0.3181), but it was correlated to papilla height (P= 0.0499). CONCLUSIONS: This study indicates that the root coverage following CAF procedure is not significantly correlated to papilla dimension. However, complete root coverage is significantly more frequent in sites with lower height of the adjacent papilla.

Adult↗

PubMed2001

Retrospective evaluation of the influence of the interleukin-1 genotype on radiographic bone levels in treated periodontal patients over 10 years.

BACKGROUND: A difference in genetic susceptibility to plaque accumulation has been advocated to explain different responses to periodontal therapy. The purpose of this study is to assess the role of the interleukin-1 (IL-1) polymorphism on the rate of bone and tooth loss in non-smoking periodontally treated patients during maintenance. METHODS: Sixty consecutive non-smoking patients (mean age 46.8 +/- 5.0) with moderate to severe periodontitis, treated and maintained for over 10 years were selected. At baseline (T0), radiographic evaluation (cemento-enamel junction [CEJ]-root apex, CEJ-bottom of defect mesial and distal, CEJ-bone crest mesial and distal, crown-root ratio) was performed. All patients received scaling and root planing; 36 patients then underwent surgical therapy. Subsequently, all patients were enrolled in a periodontal maintenance program with recall visits every 3.4 +/- 1.0 months for at least 10 years. At the latest recall visit (T2) the same radiographic measurements evaluated at baseline were taken and a DNA sample for IL-1 genetic susceptibility testing was collected and sent for analysis. RESULTS: Twenty-three of the 60 patients (38.3%) were IL-1 genotype positive. A total of 52 teeth (3.3%) out of 1,566 were lost due to periodontitis between T0 and T2; 28 of 957 (2.9%) in the IL-1 genotype negative group and 24 of 609 (3.9%) in IL-1 genotype positive group. The mean variation in bone defect level (DeltaBD) averaged -0.04 mm in IL-1 genotype negative patients and 0.01 mm in IL-1 genotype positive patients. The mean variation in bone crest level (DeltaBC) averaged -0.24 mm in IL-1 genotype negative patients and -0.28 mm in IL-1 genotype positive patients. However, a few patients showed significant differences in response to therapy based on initial bone levels and genotype. IL-1 negative patients who showed minimal initial bone loss responded to the therapy better than the IL-1 positive patients. IL-1 positive patients with severe initial bone loss showed a better response to the therapy than IL-1 negative patients. CONCLUSIONS: On average, there were no significant differences related to IL-1 genotype in tooth loss after 10 years in a non-smoking, well-maintained periodontal population. On an individual patient basis, the IL-1 genotype, in combination with the initial bone level, seems useful at the beginning of therapy for predicting bone level variation.

Adult↗

PubMed2000

Mucogingival interceptive surgery of buccally-erupted premolars in patients scheduled for orthodontic treatment. I. A 7-year longitudinal study.

BACKGROUND: Mucogingival interceptive therapy in patients with buccally erupting teeth is performed to prevent the ectopic permanent tooth from developing periodontal lesions. The keratinized tissue entrapped between the erupting tooth and the deciduous tooth is retained to maintain a satisfactory width of the gingiva for the permanent tooth. The aim of the present study on buccally-erupted premolars scheduled for orthodontics was to evaluate the keratinized tissue width 3 months, 2 years, and 7 years subsequent to mucogingival interceptive therapy and orthodontic treatment. METHODS: Twenty-nine patients participated. Three different surgical techniques were used according to specific indications. Eight patients were treated with double pedicle flaps (DPF), 10 patients with apically positioned flaps (APF), and 11 with free gingival grafts (FGG). RESULTS: The amount of keratinized tissue on the treated (test) sites was not significantly less than on the control (untreated) sites showing normally erupting premolars at all observation periods. All 3 surgical procedures appeared to be effective in saving the keratinized tissue for the permanent tooth. Preoperative periodontal parameters such as gingival width, probing depth, and bleeding on probing significantly influenced the outcome 3 months after surgery (P <0.01). CONCLUSIONS: Mucogingival interceptive surgery is an effective approach to conserve the keratinized buccal gingiva of ectopically erupting premolars.

Adolescent↗

PubMed2000

Mucogingival interceptive surgery of buccally-erupted premolars in patients scheduled for orthodontic treatment. II. Surgically treated versus nonsurgically treated cases.

BACKGROUND: The aim of this 2-year longitudinal study was to compare the width of keratinized gingiva after orthodontic therapy for buccally erupting premolars that had been pretreated by extraction of deciduous teeth alone versus interceptive mucogingival surgery. METHODS: In 8 patients (aged 9 to 12 years) who presented with bilateral buccal eruption of homologous teeth (premolars), one side was randomly treated with extraction of the deciduous molar and mucogingival surgery (test site), while the other side was treated only by extraction of the deciduous molar (control site). All of the subjects underwent orthodontic treatment with fixed appliances. RESULTS: At the baseline visit prior to any treatment, there was no significant difference between the mean amount of keratinized gingiva at test sites (3.06 mm) and control sites (2.93 mm). Two years later, upon completion of orthodontic treatment, there was a significant difference between test (2.93 mm) and control (1.37 mm) sites in the mean width of keratinized tissue. In the control (untreated) group, 2 sites exhibited 1 mm of gingival recession after orthodontic treatment. CONCLUSIONS: Mucogingival interceptive surgery is an effective technique to maintain keratinized tissue in correspondence with buccally-erupted teeth.

Bicuspid↗

PubMed2000

Coronally advanced flap procedure for root coverage. Flap with tension versus flap without tension: a randomized controlled clinical study.

BACKGROUND: This clinical controlled study was designed to measure the tension of coronally advanced flaps (CAF) performed to treat shallow gingival recessions and to compare the recession reduction (Rec Red) achieved in a test group (flaps with tension) and in a control group (flaps without tension) 3 months after surgery. METHODS: Eleven patients, aged 22 to 41 years, with high levels of oral hygiene (full mouth plaque score <20%) were selected for the study. Each patient showed 2 bilateral Miller Class I maxillary or mandibular gingival recessions located on homologous teeth. A total of 22 recessions were treated. The recession depth at the right site was similar to that at the left site (difference < or =1 mm). For each patient, the 2 recessions underwent CAF procedure in the same surgical session. Before suturing, the residual tension (FTens) of both right and left flaps was measured with a dynamometer. Then, one site was randomly assigned to the test group and the contralateral site to the control group. In the test site the flap was sutured. In the control site the flap was further relaxed, the tension was measured again, and the flap was sutured. RESULTS: In the test group (with tension) the initial mean recession depth was 2.82 +/- 0.64 mm and mean FTens was 6.5 g, while in the control group (without tension) the initial mean recession depth was 2.68 +/- 0.81 mm and mean FTens was 0.4 g. Three months later, the test group showed a mean recession reduction of 2.18 +/- 0.60 mm, a mean percent root coverage of 78 +/- 15%, and complete root coverage was achieved on 2 teeth (18%). In the control group the mean recession reduction was 2.32 +/- 0.81 mm and mean percent root coverage was 87 +/- 13%. Complete root coverage was obtained on 5 teeth (45%). The difference of recession reduction between the test and control group was not statistically significant (P = 0.3911). In the test group, linear regression analysis showed a statistically significant association between recession reduction and both recession depth at baseline (P= 0.0001) and mean of the 3 tensions recorded on the test side (MFTens) (P = 0.0009). CONCLUSIONS: This study shows that minimal flap tension does not influence recession reduction after 3 months when shallow recessions are treated by means of CAF. In the test group (with tension), the statistical analysis suggests that the higher the flap tension, the lower the recession reduction.

Adult↗

PubMed1999

Long-term clinical outcomes of abutments treated with guided tissue regeneration.

STATEMENT OF PROBLEM: Guided tissue regeneration (GTR) is an efficacious and predictable treatment modality for deep intrabony defects around natural teeth and abutments. However, long-term prognosis of abutments treated with regeneration has to be proven. PURPOSE: This study investigated the long-term stability of clinical outcomes obtained with regeneration in strategically important abutments. MATERIAL AND METHODS: Sixteen deep intrabony defects around strategically important abutments in 16 patients were treated according to the principles of GTR. After completion of initial periodontal therapy and placement of long-term provisional fixed partial dentures, nonresorbable membranes were applied. Membranes were removed after 6 weeks. All patients remained in a supervised recall program. Final fixed partial dentures were placed 1 year after surgery. Clinical outcomes were evaluated at 1 year and then 4 to 8 years after surgery. RESULTS: Clinical attachment level gains of 5.3 +/- 1.8 mm, reductions in pocket depth (6.1 +/- 2 mm), and increases in the percentage of radiographic bone support (31% +/- 18%) were observed at 1 year. At long-term follow-up visits, clinical attachment levels remained stable with respect to 1 year (-0.1 +/- 0.6 mm; P =.4). The percentage of radiographic bone support slightly increased as compared with 1 year (1% +/- 3%, P =. 04), and pocket depths (0.8 +/- 0.8 mm, P =.004). CONCLUSIONS: This study indicated that tooth support can be gained with GTR and maintained over time in patients recalled regularly.

Adult↗

PubMed1999

Mucogingival deformities.

The presence of mucogingival deformities often have an impact on patients in terms of esthetics and function. The variety of the conditions makes it difficult to place gingival and alveolar mucosa deformities under a single definition. Mucogingival deformities, as defined in this paper, may be congenital, developmental, or acquired defects. These may occur around natural teeth or implants and in edentulous ridges. They may be localized to soft tissues or be associated with defects in the underlying bone. They may show different degrees of severity and extension. A classification of mucogingival deformities should provide a method for identifying the different conditions in order to improve diagnosis, etiologic identification, research, treatment, and insurance evaluation.

Gingiva↗

PubMed1998

Generalizability of the added benefits of guided tissue regeneration in the treatment of deep intrabony defects. Evaluation in a multi-center randomized controlled clinical trial.

BACKGROUND: Several studies have shown that GTR therapy of intrabony defects results in significantly better outcomes than access flap alone. Most of the available data, however, have been produced in highly controlled research environments by a small group of investigators. Generalizability of results to different clinicians and different subject populations has not been evaluated so far. METHODS: This parallel group study involved 143 patients recruited in a practice-based research network of 11 offices in 7 countries. It was designed to evaluate: 1) the applicability of the documented added benefits of GTR in the treatment of intrabony defects to different populations, and 2) the generalizability of the expected results to different clinicians. GTR was compared to access flap alone. Defects, one in each patient, were accessed with a previously described papilla preservation flap in both the test and control group. In addition, GTR sites received application of a bioabsorbable poly-D,L-lactide-co-glycolide membrane. A stringent plaque control regimen was enforced in all patients during the 1-year observation period. Outcomes included gains in clinical attachment (CAL) and reductions in probing depth. RESULTS: Observed gains in CAL were 2.18 +/- 1.46 mm for access flap and 3.04 +/- 1.64 mm for the GTR-treated group. The treatment-associated difference was statistically significant (P = 0.03) after correcting for both center effect and defect anatomy. Among the various centers, a 1.73 mm difference in CAL gain was observed. This is a clinically relevant amount, which underlines the significance of center variability in the outcome of periodontal surgical procedures. A frequency distribution analysis of the obtained CAL gains indicated that GTR treatment of deep intrabony defects decreased, with respect to the access flap control, the probability of obtaining only a modest attachment gain at 1 year. Conversely, CAL gains of 4 mm or more were observed in more than 40% of GTR-treated defects and in less than 20% of the controls (P < 0.0001). CONCLUSIONS: These data indicate that GTR therapy of deep intrabony defects performed by different clinicians on various patient populations resulted in both greater amounts and improved predictability of CAL gains than access flap alone.

Absorbable Implants↗

PubMed1996

Guided tissue regeneration versus mucogingival surgery in the treatment of human buccal recessions. A 4-year follow-up study.

The 4-year follow-up results of a clinical trial are reported. The clinical results of the treatment of buccal recession were analyzed comparing the outcomes of a guided tissue regeneration (GTR) procedure with nonresorbable membranes and a 2-step mucogingival procedure consisting of a coronally-positioned free gingival graft in two groups of 25 patients each. The final root coverage was 73.07% in the test group (GTR) and 72.3% in the control group (mucogingival surgery). In the test group, statistically significant recession reduction, probing depth reduction, clinical attachment level gain, and increase of keratinized tissue width were observed. In the control group the results were similar except for probing depth, which did not vary significantly. At the end of the 4-year follow-up period, the average periodontal conditions did not differ between the 2 groups, with the exception of the keratinized tissue width. This was obviously greater in the control group, where a free gingival graft had been carried out. Recessions > or = 5 mm had a greater root coverage after GTR treatment. In both groups, the periodontal parameters remained stable between 18 months and 4 years after surgery, indicating remarkable stability; the only exception was a significant increase in the keratinized tissue width in the test group. When the changes between the baseline and the 4-year follow-up were compared, the average reduction in the recession was similar in the two groups while probing depth reduction and clinical attachment level were greater in the GTR group.

Adolescent↗

PubMed1996

Periodontal regeneration of human intrabony defects with bioresorbable membranes. A controlled clinical trial.

The purpose of this controlled clinical trial was to compare the clinical efficacy of 3 treatment modalities in the treatment of deep interproximal intrabony defects. Thirty-six (36) defects in 36 patients were randomly assigned to 1 of 3 treatment groups by blocking to prognostic variables. The test was treated with bioresorbable membranes positioned coronal to the interproximal bone crest; the second group (membrane control) was treated with conventional non-resorbable (ePTFE) barrier membranes applied coronal to the alveolar crest; the third group (flap Control) was treated with an access flap procedure (MWF). No differences were observed in terms of baseline oral hygiene and defect characteristics among the 3 groups, indicating that the blocking approach was effective. A stringent infection control program was enforced for 1 year. The results indicated that: 1) at 1 year all treatment modalities resulted in clinically significant improvements in clinical attachment levels (CAL) and reductions in probing depths; 2) a statistically significant treatment effect (P < 0.0001, ANOVA) was observed comparing the test (4.6 +/- 1.2 mm), the membrane control (5.2 +/- 1.4 mm), and the flap control groups (2.3 +/- 0.8 mm) in terms of CAL gain; 3) differences in terms of CAL gain between the test (bioresorbable) and the membrane control (ePTFE) groups were not statistically significant (P = 0.19, t-test); 4) both the test and the membrane control groups gained significantly more CAL at 1 year than the MWF group (P < 0.0001, t-test). CAL gains > or = 4 mm were observed in 83.3% of cases in both GTR groups, while CAL gains of this magnitude were not detected in the MWF group. We concluded that clinically significant CAL gains can be obtained with GTR procedures using both bioresorbable and non-resorbable membranes. Patients' morbidity, however, was lower in the group treated with bioresorbable membranes.

Adult↗

PubMed1996

The modified papilla preservation technique with bioresorbable barrier membranes in the treatment of intrabony defects. Case reports.

A new surgical approach for interproximal regenerative procedures has been utilized in conjunction with bioresorbable barrier membranes in the treatment of deep intrabony defects. The purpose of this study was to test the effectiveness of the modified papilla preservation technique in obtaining and maintaining primary closure of the interdental space over bioresorbable membranes. Ten patients (10 sites) with optimal plaque control were treated according to the modified papilla preservation technique. Baseline probing attachment level and probing pocket depth were 10.1 +/- 1.9 mm and 8.9 +/- 2.4 mm, respectively. The intrabony component of the defects was 6.5 +/- 1.7 mm. Polylactic acid barrier membranes were positioned just coronal to the interproximal bone crest. Primary closure over the membranes was obtained in 100% of the cases. In two cases only a slight dehiscence of the interproximal tissues was observed after 2 weeks. Healing was uneventful in all the treated sites. Probing attachment level gains of 4.5 +/- 0.9 mm and a probing pocket depth reduction of 5.8 +/- 2.3 mm were observed at 1 year. It can be concluded that the modified papilla preservation technique is a suitable alternative for interproximal regenerative procedures in conjunction with bioresorbable barrier membranes.

Adult↗

PubMed1996

Guided tissue regeneration of deep intrabony defects in strategically important prosthetic abutments.

This study reports the clinical outcomes obtained in a longitudinal cohort of 23 patients treated by guided tissue regeneration for strategically important teeth compromised by the presence of deep intrabony defects. After completion of initial periodontal therapy and placement of a provisional fixed partial denture, a nonresorbable e-PTFE membrane was applied to isolate the defect. Changes in probing attachment level, probing pocket depths, and radiographic bone support were evaluated 12 months after removal of the membrane. Clinically and statistically significant improvements in outcome measurements were observed: a probing attachment level gain of 5.3 +/- 1.7 mm, a reduction in probing pocket depths of 6.1 +/- 2 mm, and an increase in the percentage of radiographic bone support of 31% +/- 18%. The results obtained were highly reproducible with 91.3% of the cases resulting in probing attachment level gains of 4 mm or more. The evidence provided in this investigation indicates that guided tissue regeneration can predictably increase the functional support, and possibly improve the prognosis of strategically important abutments. Guided tissue regeneration therapy should, therefore, be one of the options discussed in treatment planning for complex periodontal-prosthetic cases.

Adult↗

PubMed1995

Interproximal free gingival grafts after membrane removal in guided tissue regeneration treatment of intrabony defects. A randomized controlled clinical trial.

The purpose of this controlled clinical trial was to compare the efficacy of two surgical approaches to protect the regenerated tissue following membrane removal in guided tissue regeneration (GTR) treated intrabony defects. Twenty-eight (28) defects, one each in 28 patients were randomly assigned after placement of the membrane to one of two treatment groups by blocking to prognostic variables. The test group received free gingival grafts on the interproximal regenerated tissue. In the control group the surgical flaps were coronally positioned over the regenerated tissue. The two groups were well balanced with respect to all prognostic variables. The results indicated that: 1) similar amounts of regenerated tissue were obtained in the two groups at membrane removal (7.6 +/- 2.8 mm, test; 8.3 +/- 2.3 mm, control); 2) a significantly greater amount of probing attachment level gain was observed in the test group (5.0 +/- 2.1 mm, test; 3.7 +/- 2.1 mm, control). This study indicated that placement of free gingival grafts on the interdental regenerated tissue further improves the clinical outcome of GTR in deep intrabony defects.

Adult↗

PubMed1995

Periodontal regeneration of human intrabony defects with titanium reinforced membranes. A controlled clinical trial.

The purpose of this controlled clinical trial was to compare the clinical efficacy of 3 treatment modalities in the treatment of deep interproximal intrabony defects. Forty-five (45) defects in 45 patients were randomly assigned to 1 of 3 treatment groups by blocking to prognostic variables. The test group was treated with titanium reinforced membranes positioned just apical to the cemento-enamel junction and the modified papilla preservation technique; the second group received conventional expanded polytetrafluoroethylene (ePTFE) barrier membranes applied at the alveolar crest; the third group was treated with an access flap procedure. The groups were well balanced with respect to all prognostic variables. During the 1-year observation period, patients were subjected to a stringent infection control program including: professional tooth cleaning every week for the first 6 weeks (all groups) and in the 4 weeks following membrane removal (guided tissue regeneration groups), then at monthly intervals (all groups). The results indicated that: 1) all treatment modalities resulted in clinical and statistically significant improvements in clinical attachment level (CAL) and probing depths (PD) at 1 year; 2) a significantly greater amount of CAL gain (P = 0.0003, analysis of variance) was observed in the test group (5.3 +/- 2.2 mm) with respect to both the ePTFE group (4.1 +/- 1.8 mm) and the flap control group 2.5 +/- 0.8; 3) in the test group the 1 year CAL (4.7 +/- 1.8 mm) was located more coronally than the baseline position of the interproximal alveolar crest (5.9 +/- 2 mm; P = 0.003, t test).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Periodontal regeneration of human infrabony defects. I. Clinical measures.

A series of investigations was undertaken to evaluate the extent and predictability of periodontal regeneration with barrier membranes in deep infrabony defects. This study reports the clinical outcomes in terms of probing attachment level (PAL) gains, probing pocket depth (PPD) reduction, and recession (REC) of marginal gingiva. Forty deep 1, 2, and 3-wall combination infrabony defects treated with membranes were evaluated 1 year postoperatively following a strict plaque control regimen (mean plaque score = 6.1%, bleeding score = 4% at 1 year). A PAL gain of 6.1 +/- 2.5 mm along with a PPD reduction of 5.9 +/- 2.5 mm were observed. A PAL gain of 2 mm or more was detected in almost 90% of the treated sites. No site lost attachment. Residual PPD was 3 mm or shallower in 95% of the sites. It is concluded that treatment of deep infrabony defects according to the principles of guided tissue regeneration and a strict plaque control regimen represents an efficacious and predictable treatment alternative.

Adolescent↗

PubMed1993

Periodontal regeneration of human infrabony defects. II. Re-entry procedures and bone measures.

This paper evaluates the osseous healing response of 40 infrabony defects treated with guided tissue regeneration. The selected sites presented with deep periodontal lesions with a 1-, 2-, and 3-wall combination infrabony component of 6.1 +/- 2.5 mm. Baseline intrasurgical clinical measurements were compared with intrasurgical clinical measurements obtained at the 1 year surgical re-entry. A significant regeneration of bone of 4.3 +/- 2.5 mm was observed, along with a 0.4 +/- 1.9 mm resorption of the alveolar bone crest, which resulted in a 4.7 mm reduction of the original infrabony defect. Almost 90% of the sites showed a bone gain of 2 mm or more, while no site lost supporting bone; 73 +/- 31.2% of the original defect was filled with bone. The 3- and 2-wall components were filled 95 +/- 6.2% and 82 +/- 18.7% of their original depth, respectively; however, the 1-wall component was filled only 39 +/- 62.4%. It is concluded that treatment of infrabony defects according to the principles of guided tissue regeneration and a strict plaque control regimen resulted in clinically significant and highly predictable bone regeneration.

Adolescent↗