Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Furcation Defects”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 325 records · Page 18Linked to original sources
PubMed1998

A clinical evaluation of an allograft combined with a bioabsorbable membrane versus an alloplast/allograft composite graft combined with a bioabsorbable membrane. 100 consecutively treated cases.

The purpose of this study was to evaluate and compare the clinical effectiveness of 2 surgical techniques in treating periodontal defects. Both techniques involved tetracycline treatment of a root planed root, grafting the osseous defect with a bone graft, and placement of a bioabsorbable membrane. In group A, the bone graft was a mix of demineralized freeze-dried allograft, tetracycline, and porous hydroxyapatite and in group B, the bone graft was a mix of demineralized freeze-dried allograft and tetracycline. There was a statistically significant increase in recession (group A, 0.7 mm; group B, 0.6 mm), decreases in probing depth (group A, 6.1 mm; group B, 5.6 mm), and gains in attachment levels (group A, 5.4 mm; group B, 5.0 mm). There were no statistically significant differences between the results for either group. The defects associated with furcations and those that were not associated with furcations had similar results, except for the percent attachment gain. Smoking and age (> or =60 years old) could not be associated with results. Defects with > or =10 mm probing depths (PD) had greater PD reductions (group A, 7.7 mm; group B, 7.1) and attachment gains (group A, 6.6 mm; group B, 6.4 mm) than the defects with probing depths less than 10 mm (probing reduction group A, 4.8 mm; group B, 4.5 mm; attachment gain group A, 4.4 mm; group B, 4.0 mm). Both surgical procedures improved the clinical situation. However, neither technique seemed to offer a statistical advantage over the other. The inclusion of porous hydroxyapatite did not improve or diminish the results.

Adult↗
PubMed1995

Effect of cigarette smoking on periodontal healing following GTR in infrabony defects. A preliminary retrospective study.

This retrospective study examined the effect of cigarette smoking on the healing response following guided tissue regeneration (GTR) in deep infrabony defects. 71 defects in 51 patients underwent GTR with teflon membranes. 20 patients (32 defects) smoked more than 10 cigarettes per day, while 31 patients (39 defects) did not smoke. Clinical measurements were available at baseline, at membrane removal and at the 1-year follow-up. The oral hygiene of both groups was good, but smokers had significantly higher full-mouth plaque scores. No significant differences were observed between smokers and non-smokers in terms of % of tissue gained at membrane removal. At the 1-year follow-up, however, smokers gained significantly less probing attachment level than non-smokers (2.1 +/- 1.2 mm compared with 5.2 +/- 1.9 mm). A multivariate model, correcting for the oral hygiene level of the patients and the depth of the infrabony component, indicated that smoking was in itself a significant factor in determining the clinical outcome. A risk-assessment analysis indicated that smokers had a significantly greater risk than non-smokers to display a reduced probing attachment level gain following GTR. It is concluded that cigarette smoking is associated with a reduced healing response after GTR treatment, and may be responsible, at least in part, for the observed results.

Adolescent↗
PubMed1995

Evaluation of the potential of a polylactic acid barrier for correction of periodontal defects in baboons: a clinical and histologic study.

Created periodontal defects in baboons were treated with one of four possible treatment modes: (1) root preparation and Epi-Guide biodegradable polylactic acid barrier, (2) root preparation and Gore-Tex e-PTFE membrane, (3) root preparation only (no barrier), and (4) no root preparation and no barrier (control). Root preparation consisted of hand instrumentation and use of finishing burs. Measurements of gingival recession were recorded from color photographic slides taken weekly for 6 weeks following barrier placement. Block sections were removed from one animal 6 weeks after barrier placement and prepared for histologic evaluation. Significantly more gingival recession was observed at the Gore-Tex sites than at the Epi-Guide sites. There were no significant differences in gingival recession between the Epi-Guide sites and root preparation-only sites or control sites. Both types of barriers were histologically acceptable. At 6 weeks, the Epi-Guide material was present histologically in a partially resorbed state. There was a mild inflammatory reaction in the surrounding connective tissues.

Alveolar Bone Loss↗
PubMed1995

The influence of the design of two different bioresorbable barriers on the results of guided tissue regeneration therapy. An intra-individual comparative study in the monkey.

The aim of the present study was to compare two bioresorbable barriers to evaluate whether differences in design influence the result of guided tissue regeneration (GTR) therapy. Twenty-four (24) plaque exposed, recession type defects in 4 monkeys were treated. Contralateral defects were randomized for test or control treatment. During a healing period of 6 weeks, gingival recession resulting in device exposure occurred at 3 test and 10 control sites. One control barrier was exfoliated. Histologically, 9 of the 12 test barriers were completely integrated with the surrounding tissues. At 3 test sites, epithelium had migrated apically outside the barrier to a level not exceeding one-third of the height of the device. Seven of the 11 control barriers were enclosed by dentogingival epithelium. The adjacent connective tissue exhibited local inflammatory cell infiltrates (ICT). At the remaining 4 control sites, the epithelial downgrowth as well as the adjacent ICT areas were limited to the coronal 1/3 of the device. New attachment; i.e., new cementum with inserting collagen fibers, averaged 2.2 mm and 0.8 mm at the test and control sites respectively (P < 0.01). Based on the results of the present study, it was concluded that a bioresorbable GTR device, designed to prevent epithelial downgrowth along the barrier surface, has a higher potential to promote new attachment formation than a device which does not have this property.

Animals↗
PubMed2001

Subperiosteal and intraosseous connective tissue grafts for pocket reduction: a 9- to 13-year retrospective case series report.

BACKGROUND: Recent histological evidence has documented that grafted palatal connective tissue is capable of forming a new attachment to previously exposed roots in the treatment of gingival recession. No clinical studies have tested the ability of connective tissue that has been implanted beneath the periosteum into periodontal osseous defects to reduce probing depth and increase clinical attachment levels. This study reports the long-term clinical effect of subperiosteal and intraosseous connective tissue grafts on deep periodontal pockets. METHODS: Connective tissue (CT) grafts were placed in 32 periodontal pockets on 27 patients. Grafts were classified into 3 groups. Type I grafts had 50% or more vascular surface contact and were < or = 2.5 mm thick. Type II grafts had 50% or more contact but were > 2.5 mm thick, and Type III grafts had less than 50% vascular contact regardless of thickness. Twelve of 14 Type I sites, 9 of 15 Type II sites, and 3 of 3 Type III sites were analyzed 9 to 13 years following treatment. RESULTS: Clinical attachment level change differed significantly between the graft types on survivor teeth (P < 0.05): Type III had 2 mm loss (95% confidence interval [CI]: 0.4 to 3.6), while Type II and Type I grafts had a 2.7 mm gain (95% CI: 2.0 to 3.4) and 4.3 mm gain (95% CI: 3.3 to 5.2), respectively. Similar substantial differences were presented for changes in probing depth and recession. CONCLUSIONS: This long-term (9 to 13 years) retrospective case-series analysis suggests substantial improvements in periodontal clinical measures for Type I CT grafts in deep periodontal pockets. Randomized trials are required to evaluate this promising procedure.

Adult↗
PubMed1995

Periodontal pathogens on polytetrafluoroethylene membrane for guided tissue regeneration inhibit healing.

This study determined the microbial composition of the apical parts of the expanded polytetrafluoroethylene membrane surfaces facing the gingiva and the tooth in guided tissue regeneration. Microbial and clinical features of 2-to-3 wall periodontal bony defects treated with membranes with and without concomitant use of systemic Augmentin therapy were also determined. 18 patients with 18 study sites participated. 9 patients received systemic 500 mg Augmentin 1 h prior to surgery, and 500 mg TID for 8 days thereafter. 9 patients received no systemic antimicrobial therapy. Microbiological examination was performed 1 h prior to surgery, at the time of membrane removal at week 6, and at 6 months post-surgery. Microbial morphotypes, total viable counts, and the occurrence of selected microbial species were determined by phase-contrast microscopy, selective and non-selective culture, and DNA probes. Study sites were examined for probing pocket depths and attachment levels. At baseline, no microbial or clinical parameter showed statistical differences between groups. At 6 months, the Augmentin group demonstrated a significantly higher (P = 0.032; Student t-test) mean probing attachment gain (36.5% of potential gain to the cemento-enamel junction) than the 9 control patients (22.4% of potential gain). At the time of removal, membranes in the Augmentin group showed significantly fewer organisms than membranes in the control group (52.2 x 10(6) versus 488.6 x 10(6)). Sites free of pathogens on the membrane surface toward the tooth gained the most clinical attachment, even in the presence of various pathogens on the gingiva-facing membrane surface.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

Mathematical coupling can undermine the statistical assessment of clinical research: illustration from the treatment of guided tissue regeneration.

OBJECTIVES: Previous periodontal literature has shown that there is a strong relationship between treatment effects, such as guided tissue regeneration (GTR), and baseline disease severity. However, relating change to baseline values using correlation or regression is methodologically flawed due to mathematical coupling, where the statistical procedure of testing the null hypothesis-that the coefficient of correlation or slope of regression is equal to zero-becomes erroneous. The aim of this study is to investigate if baseline disease severity is genuinely associated with the treatment outcome of intrabony defects using GTR after adjustment for mathematical coupling. In particular, we seek to demonstrate the potential effect that mathematical coupling has in distorting the results from the statistical analyses of trials of dental treatment, using data from the periodontal literature on GTR. The erroneous results arising from the use of simple correlation and regression techniques to analyse this association will be demonstrated, also the methodological flaw where the statistical procedure tests the null hypothesis-that the coefficient of correlation or the slope of regression is equal to zero. METHODS: Three main periodontal journals were electronically and manually searched to extract the data for the clinical outcomes of pocket probing depth (PPD) and lifetime cumulative attachment loss (LCAL) in the studies using GTR. The relationship between clinical outcomes and baseline measurements were reanalysed using Oldham's method and the variance ratio test. RESULTS: The results of these analyses were compared with those from the papers where the authors used the standard approach of correlation or regression. This shows that mathematical coupling caused spurious correlations between baseline disease severity and treatment effect. Ten out of 12 studies for PPD and nine out of 14 for LCAL initially claimed a significant positive relationship; after using either of the more appropriate statistical methods of adjustment, only three correlations in each group of studies remained significant. CONCLUSIONS: Previous evidence suggesting an association between baseline disease severity and treatment effect for GTR is challenged and therefore needs to be critically reviewed. All future clinical research should avoid using mathematically coupled data in correlation or regression analysis. In seeking to examine the bivariate association between baseline and subsequent change, Oldham's method is recommended.

Alveolar Bone Loss↗
PubMed1998

Effects of expanded polytetrafluoroethylene and polylactic acid barriers on healthy sites.

The configuration of the barrier devices to treat interproximal defects by guided tissue regeneration (GTR) necessitates inclusion of healthy adjacent teeth to secure the barriers in place. The purpose of this study was to evaluate the effects of expanded polytetrafluoroethylene (ePTFE) and polylactic acid (PLA) barrier devices on probing depth (PD), clinical attachment level (CAL), and crestal bone height in healthy sites. The study included 30 patients who were in an earlier study which compared the effects of GTR utilizing an ePTFE or a PLA barrier in intrabony defects. Thirty defects were randomly assigned to receive either a PLA (test) or an ePTFE barrier (control) after open flap debridement. The sites in this investigation included those healthy sites in the immediately adjacent non-affected teeth covered by the barriers. CAL and PD were measured at baseline and 12 months. Intrasurgical crestal bone height was recorded at the time of barrier placement and at a 12-month re-entry. Two-sample t-test comparisons of PD and CAL measurements between barrier device covered sites at baseline (PD: ePTFE, 2.32+/-0.51; PLA, 2.59+/-0.74; CAL: ePTFE, 2.71+/-0.66; PLA, 2.59+/-0.65 mm), and at one year (PD: ePTFE, 2.14+/-0.37; PLA, 2.07+/-0.56; CAL: ePTFE, 3.14+/-1.05; PLA, 2.75+/-0.73 mm) were not statistically different (P > 0.05). Paired t-test was utilized to compare changes in PD, CAL, and crestal bone height from baseline to 12 months. A statistically significant reduction in PD was found in the PLA group (delta = -0.52, P = 0.01) while no significant change was found in the ePTFE group (delta = -0.18, P = 0.18). Change in CAL was statistically significant in the ePTFE group (delta = 0.43, P = 0.02) while no significant change was found in the PLA group (delta = 0.16, P = 0.39). Crestal bone height changes from baseline to 12 months were statistically different for both groups (ePTFE, delta = 0.8 mm, P = 0.001; PLA, delta = 0.6 mm, P = 0.001). These resorptive changes, when compared between treatment groups were not statistically different (P > 0.05). In conclusion, the placement of ePTFE or PLA barriers on healthy sites resulted in probing depth reductions and loss of attachment of 0.5 mm or less. Additionally, both groups exhibited less than 1.0 mm of crestal bone resorption.

Adult↗
PubMed1999

Regeneration of periodontal tissues by basic fibroblast growth factor.

Several growth factors (or cytokines) have recently received attention because of their ability to actively regulate various cellular functions of periodontal ligament (PDL) cells and the effects of topical application of such factor(s) on periodontal tissue regeneration has been evaluated. In this study, we examined the role of basic fibroblast growth factor (bFGF) in the wound healing and regeneration of periodontal tissues. Alveolar bone defects (such as 2-wall, 3-wall and furcation class II bone defects) were created surgically in beagle dogs and primates. Recombinant bFGF was topically applied to the artificial bony defects. Six or 8 wk after application, the periodontal regeneration was morphologically and histomorphometrically analyzed. In all sites where bFGF was applied, significant periodontal ligament formation with new cementum deposits and new bone formation was observed in amounts greater than in the control sites. We found it noteworthy that no instances of epithelial down growth, ankylosis or root resorption were observed in the bFGF sites. In vitro studies demonstrated that bFGF enhances the proliferative responses of human PDL cells, which express FGF receptor-1 and -2, but inhibits the induction of alkaline phosphatase activity and mineralized nodule formation by PDL cells. Interestingly, we observed that the mRNA level of laminin in PDL cells, which plays an important role in angiogenesis, was specifically upregulated by bFGF stimulation, but that of type I collagen was downregulated. The present study demonstrates that bFGF can be applied as one of the therapeutic modalities which actively induce periodontal tissue regeneration. The results of in vitro studies suggest that by suppressing the cytodifferentiation of PDL cells into mineralized tissue forming cells, bFGF may play important roles in wound healing by promoting angiogenesis and inducing the growth of immature PDL cells, and may in turn accelerate periodontal regeneration.

Administration, Topical↗
PubMed1998

Anatomic characteristics of the furcation and root surfaces of molar teeth and their significance in the clinical management of marginal periodontitis.

Treatment of periodontitis which involves the furcation area of molar teeth has always been a challenge. Sixty extracted human molar teeth were used for an anatomic study to clarify the possible morphologic factors which may affect the diagnosis, prognosis, and clinical management of periodontally involved teeth. Teeth were embedded in methylmethacrylate and cut in 70 microm cross sections from the cementoenamel junction to the apex. Cervical enamel projection, root and root trunk lengths, root proximities as well as depths of root concavities coronally, apically, and at the furcation roof were measured. Cervical enamel projections were observed in 30% of the teeth examined. The shortest root trunk was found at the buccal aspect of mandibular first molars, permitting furcation involvement at early stages of periodontal disease. The most apically located furcation was found at the distal site of maxillary first molars. Furcation roofs showed severe concavities and complex cementum morphology. Teeth exhibiting cervical enamel projection were found to have deeper root concavities compared to teeth without cervical enamel projection and mesial roots of mandibular molars possessed greater furcal concavities than distal roots. The presence of root concavities complicates the diagnosis of furcation involvement and restricts access of periodontal instruments, resulting in incomplete treatment. Furcation anatomy may also influence the long-term prognosis of the teeth by favoring the retention of bacterial deposits and making oral hygiene procedures almost impossible. The present study shows that knowledge of a tooth's unique anatomic characteristics is a prerequisite for effective periodontal therapy.

Dental Enamel↗
PubMed2006

Periodontal tissue healing following flap surgery using an Er:YAG laser in dogs.

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare periodontal tissue healing following flap surgery using an Er:YAG laser with that of conventional surgery. STUDY DESIGN/MATERIALS AND METHODS: Bilateral premolars with experimentally induced periodontitis in six dogs were treated by periodontal flap surgery. Degranulation and root debridement in the furcation were performed using an Er:YAG laser or curet. At 3 months postsurgery, animals were sacrificed and decalcified specimens were prepared for histological and histometric analysis. RESULTS: Degranulation and root debridement were effectively performed with an Er:YAG laser without major thermal damage and significantly faster than with a curet. Histologically, the amount of newly formed bone was significantly greater in the laser group than in the curet group, although both groups showed similar amounts of cementum formation and connective tissue attachment. CONCLUSIONS: The Er:YAG laser irradiation can be safely and effectively utilized in periodontal flap surgery, and has the potential to promote new bone formation.

Animals↗
PubMed2006

Tissue responses to an experimental calcium phosphate cement and mineral trioxide aggregate as materials for furcation perforation repair: a histological study in dogs.

The aim was to evaluate histologically the inflammatory reactions and tissue responses to an experimental tricalcium phosphate cement (TCP) and mineral trioxide aggregate (MTA) when used as repair materials in furcation perforations in dogs. Perforations were performed in 24 mandibular premolars of six anaesthetised dogs and filled either with ProRoot MTA (grey) or TCP. The root canals were subsequently shaped and filled, and the access cavities were closed with a bonded composite resin. The animals were killed at 12 weeks. After radiological examination, the teeth and surrounding structures were processed for light microscopy. Concerning the grades of inflammation, MTA exhibited significantly better results than TCP (chi-square test according to Pearson). No furcation was free of inflammatory cells. Mild inflammation was observed in nine of twelve cases with MTA and only twice in those with TCP. No significant differences were revealed between MTA and TCP in terms of bone reorganization or deposition of fibrous connective tissue (Mantel-Haenszel chi-square test). The grade of radiological examination corresponded with the grade of inflammation or differed by only one grade plus or minus. Perforations located in the furcation of teeth remain an endodontic and a periodontal problem with an uncertain prognosis, in spite of the promising modern materials applied.

Aluminum Compounds↗
PubMed2006

Radiographic features of vertically fractured endodontically treated mesial roots of mandibular molars.

OBJECTIVE: The purpose of this study was to evaluate the most frequent radiographic appearance of bony lesions around endodontically treated vertically fractured mesial roots of mandibular molars. STUDY DESIGN: For the study, 49 extracted mesial roots with vertical fractures (study group) were evaluated and compared to 52 extracted roots without fractures (control). RESULTS: The "halo" (36.7%) and "periodontal" (28.6%) type radiolucencies were the most typical appearances of periradicular areas around the mesial roots of mandibular molars with vertical root fractures. By itself, bifurcation radiolucency was statistically insignificant (6.1%), however in conjunction with other areas of radiolucency, it was significant (63.3%, P < .0378). No radiolucency (38.5%) and periapical radiolucency (32.7%) were predominant features in the control (nonfractured roots). Amalgam dowel in the coronal part (1-2 mm) of the root was found in 67.3% of the vertically fractured roots (P < .0006). Defined but not corticated (57.2%) or diffuse (32.6%) borders were typical for vertically fractured mesial roots. CONCLUSIONS: The use of significant variables, such as "periodontal" and "halo" bony radiolucencies, bifurcation involvement, and the presence of amalgam dowel, has prediction sensitivity of 77.6% (VRF group) and specificity of 82.7% (nonfractured roots).

Alveolar Bone Loss↗
PubMed2003

Augmentation of an anterior edentulous ridge for fixed prosthodontics with combined use of orthodontics and surgery: a clinical report.

Untreated periodontitis may lead to tooth and tissue loss that can result in diminished masticatory function and esthetic deformities. Combined periodontal/prosthodontic treatment for patients with advanced periodontal disease has been well documented, and treatment results can often be improved with the use of adjunctive orthodontic treatment such as forced eruption. This clinical report describes a method of preprosthetic preparation of an edentulous ridge for a fixed partial denture that incorporates the combined use of orthodontics and surgical ridge augmentation.

Alveolar Bone Loss↗
PubMed1993

Dye ingress in molars: furcation to chamber floor.

An in vitro dye leakage study was performed to determine the incidence of patent furcal accessory canals following exposure of the pulp chamber to 5.25% sodium hypochlorite. One hundred extracted molars were labeled, endodontically opened, and irrigated for 1 h at 5-min intervals. The external furcations were exposed to 0.5% basic fuchsin for 24 h. Patency was determined by dye presence on the chamber floor. Statistical analysis revealed that first and second molars, regardless of arch position or location, demonstrated a patent accessory canal at a rate of 57% +/- 19.6% in the furcal area. It was concluded that accessory canal exposure to 5.25% sodium hypochlorite in the furcal area of molars produced patency which was demonstrable via passive methods--no vacuum or injection pressures were utilized.

Chi-Square Distribution↗
PubMed1995

Redemption of a perforated furcation with a multidisciplinary treatment approach.

A long-standing lesion associated with an undetected perforation of the furca in a mandibular molar was successfully managed using a multidisciplinary treatment approach. The sequence of therapeutic procedures involved conventional endodontic retreatment, an initial orthograde sealing of the perforation, guided tissue regeneration, and a subsequent orthograde resealing of the perforation with Ketac-Endo and Intermediate Restorative Material.

Adult↗
PubMed1997

An in vitro study of furcation perforation repair using calcium phosphate cement.

Furcation perforations created in the pulpal floors of 30 extracted human molars were repaired with either light-cured glass ionomer cement (GI), calcium phosphate cement (CPC), or light-cured glass ionomer cement placed over a CPC matrix (M). After the cement was set, the teeth were immersed in India Ink for 48 h, dried, and sectioned longitudinally. Dye penetration into the furcation repair was independently evaluated by three board-certified endodontists. There was no significant difference in the mean extent of dye leakage among the three experimental groups. The use of CPC, with its enhanced biocompatibility, potential for osteoconduction, and sealing ability, may improve the prognosis of teeth with furcation perforations.

Calcium Phosphates↗