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PubMed1977

Precocious periodontitis: a clinical entity and a treatment responsibility.

This report has proposed that the term, periodontosis, be discarded and replaced with the term, precocious periodontitis. The literature review has shown that, although the exact causative agents are unknown, certain microbiological reactions do occur and the condition is a periodontitis. The term, precocious periodontitis, has been suggested because the disease entity differs from chronic periodontitis in some of its characteristic features and etiologic factors. Three important local etiologic factors are: (1) contact and eruption of the first molars, (2) occlusal traumatism, and (3) ineffective oral hygiene. The recent literature concerning possible hereditary characteristics, bacteriological findings, and immunological reactions has been cited. The reports presented showing successful results of therapy were selected to illustrate that this condition can have the same prognosis and response to therapy as other similarly involved cases of periodontitis as a clinical entity with a definitive treatment responsibilities.

ABO Blood-Group System↗
PubMed1977

Effect of fluoride on autogenous iliac cancellous bone and marrow transplants in surgically created intrabony pockets in dogs.

The effect of the osteogenic capacity of fluoride on autogenous iliac cancellous bone and marrow transplants was studied in experimentally created periodontal defects. Eight dogs, 2 years old, weighing between 10 to 15 kg each, were used. The right side of the upper jaw served for creation of the experimental (fluoride-treated) pockets and the left side for the control (saline-treated) pockets. Fluoride treatment was carried out by a single topical application of a high concentration of fluoride in the periodontal defects and by application of a low concentration of fluoride to the bone marrow transplants. Intraoral periapical radiographs were taken immediately after implantation, and at time of sacrifice. Changes during bone healing were assessed histologically and by radioopacity measurements. The newly formed bone in the control and fluoride-treated areas did not differ in quality. Radioopacity in the experimental defects was significantly higher in comparison with that found in the control areas. The increase was probably due to greater bone formation in the fluoride-treated defects. The difference decreased with the duration of the healing intervals. Cementum was deposited in both control and experimental sites.

Alveolar Process↗
PubMed1977

Present status of osseous grafting procedures.

Osseous grafting techniques represent one mode of therapy to manage combination pocket-osseous defects. They have their greatest applicability in the intrabony defect although encouraging results have been noted in furcation and suprabony sites. Like all treatment modalities, their usage is dictated by the therapeutic objectives for specific problems and whether their respective advantages and limitations outweigh other management techniques. They are neither a panacea nor an unproven experimental venture. When properly employed, they are a valuable component of currently accepted therapy. When compared with other treatment approaches, the following relative advantages and limitations have been noted with osseous grafts: Advantages 1. Reconstruct lost periodontium. 2. Idealistic therapeutic objective. 3. Reversal of disease process. 4. Increase tooth support. 5. Enhance esthetics. 6. Improve function. Limitations 1. Additional treatment time. 2. Autograft disadvantages. 3. Availability of graft material. 4. Additional postoperative care. 5. Unique postoperative problems. 6. Variations in repair. 7. Longer post-treatment evaluation interval. 8. Predictability. 9. Greater expense. 10. Multistep therapy common. 11. Vulnerability to recurrence.

Alveolar Process↗
PubMed1978

The induction of new bone and cementum formation. IV. Microscopic examination of the periodontium following human bone and marrow allograft, autograft and nongraft periodontal regenerative procedures.

This retrospective study based on histologic evaluations of 100 human block sections and extracted teeth taken from sites treated via bone and marrow autograft, allograft and nongraft regenerative procedures revealed the following findings: 1. Graft procedures yielded new cementum formation in 66 of 79 sites evaluated while nongraft approaches yielded new cementum formation in only 7 of 21 sites. Two of the grafted sites not yielding new cementum were only 14 days duration. 2. Block section evaluation revealed new bone formation in 33 of 39 graft sites and in 7 of 21 nongraft sites. 3. When regeneration did occur, as seen in the block sections, the nature of the new attachment was similar in all graft approaches and was comparable to healthy functioning periodontium. 4. The potential for regeneration of a functional attachment apparatus including new cementum, bone and functionally oriented periodontal ligament has been demonstrated in autograft and allograft approaches. 5. Adverse immune response to bone and marrow allografts could not be detected at a clinical, histologic or chemical level. 6. No ankylosis or root resorption was noted with fresh intra-oral donor material and with frozen iliac autografts or allografts. Root resorption was noted in two cases treated with nongraft methods and in 16 of 275 sites treated with fresh iliac autograft material.

Alveolar Process↗
PubMed1978

Preliminary clinical studies of bioceramic in periodontal osseous defects.

In six patients, porous tricalcium phosphate ceramic (400 to 500 micrometer pore diameter and 50% pore volume) was used to repair naturally occurring periodontal osseous defects. These patients were evaluated clinically, radiographically and hematologically. The clinical evaluation indicated that there was no adverse inflammatory response at the implant site except the anticipated immediate postsurgical trauma. Radiographically, there was a significant increase in bone height with a mean gain of 5.2 mm. Whether or not this gain consisted of bone and/or ceramic is yet to be conclusively determined. The SMA-12 blood chemistry study revealed that no significant change occurred pre- or post-operatively (P less than 0.01). Although the number of patients in our study was limited, the results are very promising. The ceramic is nontoxic to human tissue and repair of the periodontium is most likely obtainable, the desired objective being the restoration of the natural state of the periodontium.

Adult↗
PubMed1978

A method for securing conservative block section in the mandibular anterior region.

A conservative method for removal of histologic block tissue sections has been presented. Its application permits the operator to conserve a portion of lingual alveolar bone in the mandibular anterior region to allow maintenance of a sufficient amount of ridge bone and tissue for construction of a functional and esthetic removable or fixed prosthetic appliance. This block section procedure may be modified to permit more conservation of human tissues in those studies involving human subjects.

Alveolectomy↗
PubMed1979

Lyophilized bone allografts in periodontal intraosseous defects.

Nine patients with 10 pairs of intraosseous periodontal defects were treated. Most of the patients had identical bilateral lesions (referred to as "mirror-image" defects). In each pair, one of the defects was randomly selected and treated as a flap and currettage control whereas the other defect was grafted with freeze-dried cortical powdered allografts of bone. Evaluation was based on radiographs, photographs, and measurements taken during both the initial surgery and at reentry approximately 1 year after transplantation. Control procedures (flap and curettage) demonstrated the same amount of osseous regeneration as that seen with the graft procedure. The amount of osseous regeneration demonstrated with the grafting procedures agreed with previously published studies. Evaluation revealed that (1) an autologous control such as incorporated in the "mirrow-image" design of this study is probably the most valid experimental model available for evaluating the clinical effectiveness of any human periodontal grafting procedures; (2) the effectiveness of freeze-dried cortical powdered bone allografts in human periodontal osseous defects is questionable and needs additional study; and (3) nongrafting procedures may be more effective in generating new attachments or reattachments in human periodontal osseous defects than previously believed.

Alveolar Process↗
PubMed1979

Methods of altering crestal levels. Clinical case reports.

Selected cases have been presented using different techniques to alter crestal levels. Self Regeneration or Autogenous bone grafts have been most successful in cases of three-wall and two-wall infrabony lesions. When a hemiseptal lesion occurs on the mesial of a tooth an uprighting procedure can be accomplished. When there is an adjacent tooth a forced eruption technique using orthodontic forces can be used. A surgical elevation technique has been presented which also has shown positive changes in bony topography.

Adult↗
PubMed1979

Comparison of tricalcium phosphate and frozen allogenic bone implants in man.

As part of their treatment, eight patients with 47 infrabony pockets and horizontal bone defects had 29 tricalcium phosphate and 18 frozen allogenic bone implants placed. One year after surgery the sites were reentered. At the tricalcium phosphate implant sites the average amount of bone apposition was 1.2 mm and pocket depth induction 1.8 mm; 38% of the pockets remained deeper than 3.0 mm. At the allogenic bone sites the average amount of bone apposition was 1.5 mm and pocket depth reduction was 2.0 mm; 22% of the pockets remained deeper than 3.0 mm. The implant materials were well tolerated and there were no complications during the period of the study. Though storage and handling of tricalcium phosphate was simpler, use of allogenic bone led to greater bone apposition and reduction in pocket depth.

Adult↗
PubMed1979

The healing extraction site: a donor area for periodontal grafting material.

In cases of advanced periodontal disease, it is likely that vertical osseous defects will be present and that selected teeth will require extraction. The healing extraction site provides a source of vital osseous grafting material for the treatment of these infrabony defects. The preparation and grafting of the recipient site, as well as the management of the donor area, are described in detail. Three cases are presented which illustrate the efficacy of this type of therapy.

Alveolar Process↗
PubMed1979

Histological assessment of autogenous bone graft. A case report and critical evaluation.

A histological study of the site of a clinically successful bone graft revealed the presence of a downgrowing junctional epithelium between the root surface and the altered graft bone. No new cementum could be seen associated with the osseous autograft, nor was a functional periodontal ligament in evidence adjacent to the grafted bone. It is suggested that the presence of newly formed bone on surgical reentry following bone grafting in periodontal lesions does not necessarily imply that regeneration of the periodontium has occurred.

Adult↗
PubMed1979

Gingival flap-split thickness flap, a combined procedure. Clinical study in humans and dogs.

1. The combined procedure can be performed to handle the two very common periodontal problems (bone defect, high frenum, and/or high muscle insertion) when present in the same area. 2. Healing was uneventful, since only four postoperatory complications were observed in 40 surgeries performed, and none of these complications was in humans. 3. Macroscopically, the surgical area showed normalcy 1 week after the procedure. 4. It is a procedure very easy to perform and shows uneventful postoperative healing. There is no patient discomfort.

Alveoloplasty↗
PubMed1979

Combined orthodontic-periodontal treatment of an infrabony defect. A case report.

A case presentation involving the combined orthodontic-periodontic treatment of a distally inclined mandibular left central incisor with a mesial infrabony defect is reported. Treatment was performed in three phases: (a) the tooth was moved upright (b) periodontal surgery with osseous grafting of the infrabony defect was then performed; and (c) the operative site was reentered 5 months later. The patient was followed and soft and hard tissue changes were documented for 12 months from time of initiation of treatment.

Alveolar Process↗