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Biomedical subjects

S J Meraw

Publications and source records attributed to S J Meraw.

11 recordsLinked to original sources
PubMed2000

Treatment of peri-implant defects with combination growth factor cement.

BACKGROUND: The use of growth factor agents in the regeneration of oral tissues is an area of current investigation. Combinations of growth factors have been used synergistically to improve tissue regeneration. The aim of this study was to determine the effects of a combination growth factor cement (GFC) on guided bone regeneration around dental implants. METHODS: A combination of bone morphogenetic protein-2 (BMP-2), transforming growth factor-beta (TGF-beta), platelet-derived growth factor (PDGF), and basic fibroblast growth factor (bFGF) was used in a bioabsorbable, non-hydroxyapatite, calcium phosphate cement. Five adult hound dogs were used to compare the effects of GFC, plain cement, and control (no cement). The right and left second, third, and fourth mandibular premolar teeth were extracted; the implant osteotomies were prepared; and a uniform circumferential gap was prepared 1.5 mm beyond the width of the implant in the coronal half of the osteotomy for cement placement. Titanium machine-polished dental implants were placed in the prepared sites, and coronal defects were treated according to previously randomized, assigned modality. A bioabsorbable collagen membrane was secured over the control site, and the flaps were closed primarily. The dogs were maintained on a soft diet to avoid soft tissue trauma. The dogs were sacrificed at 3 months. The specimens were sectioned, mounted, and stained with Stevenel's blue and van Gieson's picric fuchsin. The bone-to-implant contact and bone 1 mm peripheral to the implant surface were recorded with a computerized microscopic digitizer. RESULTS: The findings of this study indicate a significant effect of GFC on increased bone-to-implant contact and amount of bone per surface area compared with the other treatment modalities (P <0.0009). Plain cement demonstrated slight but nonsignificant increases compared with the control (P>0.05). CONCLUSIONS: GFC increases bone-to-implant contact and bone surface area within peri-implant defects. Further studies may be beneficial to determine the feasibility of its use for other regenerative applications.

Absorbable Implants↗
PubMed1999

Qualitative analysis of peripheral peri-implant bone and influence of alendronate sodium on early bone regeneration.

BACKGROUND: Alendronate sodium increases alveolar bone density with systemic use. It inhibits osteoclast activity and is thought to result in a net increase in osteoblastic activity. However, little is known about local in vivo use. The purpose of this study was to evaluate the effect of local delivery of alendronate on bone regeneration within peri-implant defects. Peri-implant bone was examined histomorphometrically to evaluate the amount of supporting bone peripheral to the bone-implant interface. METHODS: Six adult hound dogs were evenly divided into 2 groups, with one group receiving alendronate-coated dental implants and the other group serving as controls. Dental implants were placed immediately after extraction of right and left second, third, and fourth mandibular premolars. Forty-eight dental implants were placed (2 types in each dog: 24 hydroxyapatite [HA]-coated and 24 titanium machine-polished [TMP]), for a total of 4 variables. A bioabsorbable collagen membrane was secured over the implants and defects, and the flaps closed primarily. The dogs were sacrificed on day 28. Specimens were sectioned, mounted, and stained with Stevenel's blue and van Gieson's picric fuchsin. The amount of bone adjacent and 1 mm peripheral to the implant surface was recorded with a computerized microscopic digitizer. RESULTS: Locally applied alendronate resulted in significantly increased amounts of bone (P<0.0002, ANOVA) in the peripheral area with both HA and TMP implants. However, the most influential factor in the amount of peripheral bone was the type of implant surface (P<0.0001). CONCLUSIONS: Local application of alendronate is useful in increasing the amount of peripheral peri-implant bone. Also, the amount of supporting bone was not related to the bone-to-implant contact but to the surface characteristics of the implant. The findings of the present study indicate that the evaluation of dental implant-supporting bone should include peripheral bone as well as bone-to-implant interface.

Alendronate↗
PubMed1999

Use of alendronate in peri-implant defect regeneration.

BACKGROUND: Previous studies have demonstrated an increase in bone mass and density with use of systemic alendronate sodium. This agent acts as an inhibitor of osteoclast activity, and is thought to result in more net osteoblastic activity. The objective of this study was to determine the effects of locally applied alendronate sodium on guided bone regeneration around dental implants. METHODS: Six adult mongrel dogs were divided into 2 groups: one group received alendronate-coated dental implants, and the other group served as control. Two types of dental implants were used in each dog: hydroxyapatite (HA)-coated and titanium machine-polished (TMP), for a total of 4 groups. Dental implants were placed immediately after extraction of the right and left second, third, and fourth mandibular premolars; a resorbable collagen membrane was secured over the implants and defects; and the flaps were closed primarily. Fluorescent labels were administered intravenously on days 0, 6, 12, and 22 to measure bone formation rate. Dogs were sacrificed on day 28. The specimens were sectioned and mounted, and bone formation rate was recorded with a computerized microscopic digitizer. Specimens were stained with Stevenel's blue and van Gieson's picric fuchsin. Bone-to-implant contact was recorded with a computerized microscopic digitizer. RESULTS: The results indicated a significant effect of locally applied alendronate (P < 0.0001) with both types of implants (HA and TMP), as well as the HA coating (P< 0.02) on increased bone formation rate. Additionally, alendronate had a significant effect on bone-to-implant contact, with an increase in the TMP model (P < 0.0001) and a decrease in the HA model (P < 0.0001 ). HA coating also had a significant effect on increasing bone-to-implant contact (P < 0.04). CONCLUSIONS: The results indicate that alendronate increases early bone formation rate around dental implants. Additionally, the local application as described resulted in greater bone-to-implant contact with TMP implants.

Alendronate↗
PubMed1998

Dental considerations and treatment of the oncology patient receiving radiation therapy.

As many as 400,000 out of 1 million patients newly diagnosed with cancer may develop oral complications. The trend toward people's maintaining their teeth longer coupled with the rising age of the population suggest that dentists frequently may be treating patients with cancer, and should be informed about aspects of their oncologic care that will affect their oral health. This article highlights some of the important clinical considerations and offers guidelines for treating patients receiving radiation therapy.

Age Factors↗
PubMed1998

A case report. Treating localized refractory idiopathic gingivitis with Superoxol.

The authors describe a case of localized refractory idiopathic gingivitis in a 29-year-old patient that was successfully treated with hydrogen peroxide (Superoxol, Sultan Chemists, Inc.). The gingivitis was refractory to previous oral hygiene measures and was persistent in the face of meticulous oral hygiene. This case illustrates a successful treatment measure for an uncommon clinical challenge.

Adult↗
PubMed1998

Medically induced gingival hyperplasia.

Gingival hyperplasia or gingival overgrowth is a common occurrence in patients taking phenytoin, cyclosporine, or calcium channel blockers. Speech, mastication, tooth eruption, and aesthetics may be altered. Controlling the inflammatory component through an appropriate oral hygiene program may benefit the patient by limiting the severity of the gingival overgrowth. In patients in whom gingival overgrowth is present or may be anticipated, recognition of this condition and referral to a general dentist or periodontist are appropriate steps to management. The physician's awareness of the potential for development of overgrowth and the dental practitioner's role in attempting to prevent or minimize this problem are important aspects. In this article, we discuss the medications associated with gingival hyperplasia and describe appropriate recommendations.

Anticonvulsants↗
PubMedDate not supplied

Analysis of surgical referral patterns for endosseous dental implants.

Endosseous implants have traditionally been surgically placed by oral and maxillofacial surgeons, periodontists, and general practitioners. The purpose of this study was to examine surgical referral patterns for patients receiving implants in the treatment of partial edentulism. The records of 542 patients who received 1,313 implants between 1993 and 1997 were analyzed. Data relative to anatomic area, patient demographics, type of implant system, and any complication encountered were collected. Surgical cohorts were compared using Wilcoxon's rank-sum or chi-square tests, and complication rates were estimated using survival analysis methods. Results indicate no significant difference (P > .05) between cohorts with regard to placement of implants in the anatomic locations of the anterior mandible, anterior maxilla, posterior mandible, and posterior maxilla. Patient demographic information was not statistically different, with the exception of mean patient age, where oral and maxillofacial surgeons have been younger patients (P < .0001). Relatively few complications were seen, with no significant difference in complications rates between cohorts (P > .05). The type of implant system used showed no significant difference with respect to anatomic location or complication occurrence (P > .05). This study indicates that implant surgical referral patterns were similar in this setting between periodontal and oral and maxillofacial surgeons, with the only difference being a tendency to refer younger patients to the oral surgeons.

Adolescent↗
PubMedDate not supplied

Retrospective review of grafting techniques utilized in conjunction with endosseous implant placement.

Bone resorptive patterns may prevent the ideal placement of endosseous implants. Numerous techniques have been described to create a more favorable surgical site for implant placement. This retrospective review was conducted to determine the frequency of need for implant site preparation in an outpatient clinical setting. In addition, different techniques of surgical site preparation were evaluated to determine their frequency of use and surgical outcome. A history review was conducted of all consecutively treated partially edentulous patients between January 1993 and December 1997. This review evaluated the number of implants placed, the age and gender of patient, the type of graft used, and the status of the implant. In all, 542 patients were seen in this time interval, with a total of 1,313 implants placed. Implant site preparation was needed in 4.4% of the patients, with the requirement for grafts occurring more frequently in the maxilla. Implant site preparation is a relatively infrequent requirement in the general population. Grafts are required more frequently in the maxilla than in the mandible. Complications following grafting were relatively infrequent and were not severe.

Age Factors↗
PubMedDate not supplied

Analysis of incidence and associated factors with fractured implants: a retrospective study.

Osseointegrated threaded titanium screw-type implants rarely lose integration after the first year of clinical function. Implant failure can occur for other reasons, with implant fracture being one of the major reasons for late failure. The purpose of the present study was to determine the incidence of implant fracture in completely edentulous and partially edentulous arches and to determine what factors may predispose an implant to a higher fracture risk. A retrospective evaluation of 4,937 implants was performed to determine the incidence of and factors common to fractured implants from a sample of implants placed and restored in one institutional setting. Based on the results of this study, the following observations were made: implants fracture at similar rates in the maxilla as in the mandible (0.6%), implant fractures occur more frequently in partially edentulous restorations (1.5%) than in restorations of completely edentulous arches (0.2%), all observed fractures occurred with commercially pure 3.75-mm-diameter threaded implants, and prosthetic or abutment screw loosening preceded implant fracture for the majority of the implants. More studies would be helpful to further explore the relationship and progression of factors associated with implant fracture.

Dental Implantation, Endosseous↗
PubMedDate not supplied

Early experience with Wide-Platform Mk II implants. Part I: Implant survival. Part II: Evaluation of risk factors involving implant survival.

Part I of this study describes the survival of a wide-platform, wide-diameter implant (Wide-Platform Mk II). Beginning in January 1997, 85 Wide-Platform Mk II implants were placed in the jaws of 63 patients (35 males and 28 females). Male patients experienced 10 implant failures, and female patients lost 9 implants. The mean time of implant follow-up was 286 days (median, 280), with a maximum of 734 days and a minimum of 0 days. Implant loss was 19% in the mandible and 29% in the maxilla. Kaplan-Meier analysis showed a probability of implant failure after 1 year of 0.649 (confidence interval, 0.455 to 0.926) in the maxilla and of 0.751 (confidence interval, 0.616 to 0.915) in the mandible. No apparent relationship was noted between implant survival and implant length. Part II of this study evaluated the association between the survival of a new implant design and a number of potential risk factors. A retrospective chart review was conducted for all patients who received Wide-Platform Mk II implants and who agreed to allow a medical records review for research purposes. Kaplan-Meier survival curves were used to assess the probability of implant survival relative to time. The relationships between implant survival and implant location, history of tobacco use, current tobacco use, sinus grafting, bruxism, and root canal therapy were assessed by Cox proportional hazards modeling. Although the hazard ratio showed an increased risk of implant failure with some factors, particularly a history of root canal therapy in the site of implant placement (hazard ratio 3.2, P = .10), none of the factors were statistically significant. The Wide-Platform Mk II implant used in this population group was associated with a high failure rate, but the failure rate was not related to any specific risk factors reviewed.

Adult↗