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At least 613 records · Page 34Linked to original sources
PubMed2000

Clinical and microbiologic study of periodontal surgery by means of apically positioned flaps with and without osseous recontouring.

In periodontitis lesions with interproximal craters, periodontal flap surgery with osseous recontouring allows more apical positioning of the soft periodontal tissue than flap surgery without osseous recontouring. The present study determined the clinical and microbiologic responses to periodontal surgery with and without osseous recontouring in adult periodontitis lesions with interproximal craters. In 7 osseous surgery patients, osteoplasty and ostectomy were performed from the lingual/palatal aspect to eliminate interproximal osseous defects and to partly mimic the original alveolar bony transition to neighboring teeth. In 7 nonosseous surgery patients, the surgical flap was adapted to the preexisting osseous level. Clinical monitoring included periodontal probing depth, Plaque Index, gingival bleeding index, and radiographic examination. Samples of the subgingival microbiota were examined. In sites treated with osseous surgery, mean pocket depth was 5.5 mm at baseline, 1.9 mm at 1 month, 2.0 mm at 3 months, and 2.1 mm at 6 months. In sites not receiving osseous recontouring surgery, the corresponding pocket depths were 5.9 mm, 3.1 mm, 3.8 mm, and 4.1 mm. At baseline in the osseous surgery group, Actinobacillus actinomycetemcomitans was recovered from one patient and Porphyromonas gingivalis from 5 patients; posttreatment, these microbiota were not detected in any patient. In the nonosseous surgery group, the presence of A actinomycetemcomitans increased posttreatment, and levels of P gingivalis remained essentially unchanged after therapy. This study suggests that in patients not receiving adjunctive antibiotic therapy, apically positioned flap surgery with osseous recontouring is more effective than apically positioned flap surgery without osseous recontouring in reducing periodontal pocket depth and levels of major periodontal pathogens.

Adult↗
PubMed2000

The use of a bone block graft from the chin for alveolar ridge augmentation.

Periodontal disease and tooth loss often leave the patient with an alveolar ridge that is less than adequate for endosseous implant placement. Alveolar bone grafting offers a clinically successful treatment option to regain all or some of this lost bone. This article describes the use of a bone block from the chin for the augmentation of the alveolar ridge. It relates the clinical techniques to the healing process in an effort to better understand the events involved.

Alveolar Ridge Augmentation↗
PubMed2000

Subpontic osseous hyperplasia: a case report.

Subpontic osseous hyperplasia is an ectopic growth of bone occurring on the edentulous ridge beneath a fixed partial denture replacing a mandibular first molar. A 56-year-old woman experienced an enlargement of the hard and soft tissues beneath the pontic region of a fixed partial denture replacing her mandibular left first molar. Following removal of the fixed partial denture, the bony enlargement was surgically removed, and the bony fragments were submitted for histologic analysis, which demonstrated mature lamellar bone and appositional growth. One year postoperatively, there has been no recurrence of the lesion. The possible etiologies and treatment modalities are reviewed and a rationale for treatment is presented.

Alveolar Process↗
PubMed2000

Gingivoperiosteoplasty in 3-to-5-year-old patients with cleft lip and palate: a preliminary communication.

Closure of the alveolar cleft and the oronasal fistulas was achieved by gingivoperiosteoplasty in 26 patients with unilateral or bilateral cleft of the lip and palate. They were divided in two groups according to whether or not functional cheiloplasty was previously performed (group I comprised 12 patients, group II--14 patients). No systemic pre- or post-surgical orthodontic treatment was administered in both groups. The malocclusions before and after gingivoperiosteoplasty, the postoperative fistulas and the speech were evaluated. Prior to gingivoperiosteoplasty malocclusions were found in 16 children (4 in group I and 12 in group II). After gingivoperiosteoplasty better occlusion was achieved in 6 patients of group II and in 3 of group I. Malocclusions remained in 6 children of group II and in one of group I. Fistulas persisted in 3 children (group II--2, group 1--1). Rhinolalia was found in 7 children of group II and in none of group I. In conclusion, we think that gingivoperiosteoplasty can be performed successfully after eruption of the deciduous teeth, that is between 3 and 5 years of age. The quality of the cheiloplasty and palatoplasty performed prior to it is of great significance. Gingivoperiosteoplasty should be included as a separate surgical stage in the management of total cleft lip and palate.

Alveoloplasty↗
PubMed2000

Crown lengthening to facilitate restorative treatment in the presence of incomplete passive eruption.

Crown-lengthening surgery can be utilized to expose subgingival caries. In this clinical case, a patient presented with incomplete passive eruption in the maxillary anterior sextant. This case illustrates that when incomplete passive eruption is present and restorative treatment is necessary in the maxillary anterior sextant, crown-lengthening surgery not only provides exposure of subgingival caries but can also result in a more esthetic therapeutic outcome.

Adult↗
PubMed2000

Ridge preservation utilizing an alloplast prior to implant placement--clinical and histological case reports.

A calcified copolymer alloplast (Bioplant HTR, Bioplant Inc., South Norwalk, CT) was utilized to fill osseous defects in five patients. Hard tissue cores were obtained from the grafted sites and prepared for biopsy. In one patient, the lining of a soft tissue flap was biopsied 8 months postgrafting. Histological evaluation of the specimens revealed that the copolymer particles placed adjacent to the bony defect walls served as an osteoconductive material in which vital remodeling bone and marrow formed and fused to the surface of the particles. This process of bone deposition and remodeling was present 11 years following grafting.

Adult↗
PubMed2001

The use of plasma-rich growth factors (PRGF) in oral surgery.

The therapeutic objective of utilizing growth factors in oral surgery is to improve upon the body's regenerative capacity. In many situations, the unaided regeneration process is insufficient to allow complete repair of both bone and soft tissues. This article presents two clinical cases that describe different applications of growth-factor preparation applied at the surgical site in order to stimulate regeneration of osseous and epithelial tissues. Both clinical cases demonstrate the therapeutic effectiveness of utilizing the described technique for the incorporation of plasma-rich growth factors as an adjuvant in regenerative procedure.

Alveoloplasty↗
PubMedDate not supplied

Autogenous bone versus beta-tricalcium phosphate graft alone for bilateral sinus elevations (2- and 3-dimensional computed tomographic, histologic, and histomorphometric evaluations): preliminary results.

The aim of this research was to compare 2 different graft materials, beta-tricalcium phosphate (Cerasorb) and autogenous bone, used in the same patient. Bilateral sinus grafting was performed on 4 selected patients; Cerasorb only was used on the experimental side, and autogenous bone only was used on the control side. In all 4 patients, the maxilla was atrophied to such an extent that the reconstruction included not only sinus grafting but also onlay plasty. The procedure was followed by implant placement 6 months later. In addition to routine panoramic radiographs, 2- and 3-dimensional computed tomographic (CT) examinations were performed pre- and postoperatively and after implantation. Information from CTs is necessary when alveolar bone atrophy is extensive, complications appear probable, and in difficult cases, when exact documentation is important. A total of 16 bone biopsies were taken at the time of implant placement. The histologic and histomorphometric results indicated that when the formation of new bone was slow, it was slow on both sides; when it was fast, then it was fast on both sides. Individual patient factors strongly influenced the fates of the various graft materials in the organism. Comparisons of the present results with the findings of other investigators demonstrated that beta-tricalcium phosphate is a satisfactory graft material, even without autogenous bone.

Absorbable Implants↗
PubMed1999

Extraction site--foundation for restorative excellence.

Preservation of the socket site architecture promotes better esthetics, easier prosthetic treatment, and restoration of the alveolar bone for implant or bridge replacement options. The purported simplicity of the simple extraction can be misleading if the bone housing or soft tissues have been ravaged by disease. This article provides guidelines for case selection, patient consultations, selection of appropriate materials, and a step-by-step methodology for completing successful extraction site therapy.

Alveoloplasty↗
PubMed2001

Rapid orthodontics with alveolar reshaping: two case reports of decrowding.

Two case reports demonstrate a new orthodontic method that offers short treatment times and the ability to simultaneously reshape and increase the buccolingual thickness of the supporting alveolar bone. A 24-year-old man with a Class I severely crowded malocclusion and an overly constricted maxilla with concomitant posterior crossbites and a 17-year-old female with a Class I moderately to severely crowded malocclusion requested shortened orthodontic treatment times. This new surgery technique included buccal and lingual full-thickness flaps, selective partial decortication of the cortical plates, concomitant bone grafting/augmentation, and primary flap closure. Following the surgery, orthodontic adjustments were made approximately every 2 weeks. From bracketing to debracketing, both cases were completed in approximately 6 months and 2 weeks. Posttreatment evaluation of both patients revealed good results. At approximately 15 months following surgery in one patient, a full-thickness flap was again reflected. Visual examination revealed good maintenance of the height of the alveolar crest and an increased thickness in the buccal bone. The canine and premolars in this area were expanded buccally by more than 3 mm, and yet there had actually been an increase in the buccolingual thickness of the overlying buccal bone. Additionally, a preexisting bony fenestration buccal of the root of the first premolar was covered. Both of these findings lend credence to the incorporation of the bone augmentation procedure into the corticotomy surgery because this made it possible to complete the orthodontic treatment with a more intact periodontium. The rapid expansive tooth movements with no significant apical root resorption may be attributed to the osteoclastic or catabolic phase of the regional acceleratory phenomenon. Instead of bony "block" movement or resorption/apposition, the degree of demineralization/remineralization might be a more accurate explanation of what occurs in the alveolar bone during physiologic tooth movement in these patients.

Adolescent↗