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At least 685 records · Page 38Linked to original sources
PubMed1998

Importance of bone graft quality for implant integration after maxillary sinus reconstruction.

OBJECTIVE: The aim of this study was to determine whether bone quality, as assessed by osteometry and histologic parameters, can be used to predict implant integration in conjunction with maxillary sinus reconstruction. STUDY DESIGN: Twelve patients with severely atrophied maxillary alveolar processes were treated through use of a two-stage surgical reconstructive strategy with implant placement 4 months after bone grafting. Bone biopsy specimens taken from the iliac crest peroperatively and from the sinus inlay sites 1, 2, 4, 6, or 12 months postoperatively were analyzed by light microscopy and osteomorphometry. Bone mineral content was measured by osteometry. RESULTS: Osteometric and osteomorphometric data (trabecular bone volume [%], assessment of chromatin staining, and an osteocyte index) registered for the biopsy specimens were not statistically correlated with implant failure. CONCLUSIONS: Prognostic evaluation of implant survival is difficult. The tested methods did not contribute to the improvement of guidelines for the clinical handling of these patients.

Adult↗
PubMed1989

[Application of granulate hydroxylapatite for mandibular augmentation].

The already known surgical interventions for absolute induction of extensive mandibular atrophy, cannot be suggested as routine standardized methods. Use of Hydroxylapatite-ceramic for restoration of the atrophic alveolar process, shows several advantages; among those, simplicity of the operation use of local anesthesia, as well as very low percentage of unsuccessful interventions are taken into consideration. The clinical results of 102 cases are shown and discussed. Through the addition of H.A. ceramic in the field of preprosthetic surgery, there is a broadening of the spectrum of the therapeutic possibilities of patients with prosthetic problems to be expected.

Alveolar Ridge Augmentation↗
PubMed2002

Functional rehabilitation using orthognathic surgery, bone transplants and implants after irradiation of malignancy in early childhood.

Functional rehabilitation has been carried out in four young patients by use of orthognathic surgery, bone grafting and implants. All four patients had been successfully treated for malignant tumours in the midface during early childhood by use of full dose irradiation. Retarded growth of the maxilla together with missing root formation of permanent teeth prevented the alveolar process to develop. Bimaxillary osteotomies with inlay bone graft have been made in two cases and maxillary osteotomy le Fort I with interpositional and inlay grafting in two individuals. Implants surgery has been made in a second stage surgery. A total of eighteen implants has been inserted and during five years follow-up two implants have been lost (survival rate 90%). All patients have been successfully rehabilitated with fixed bridge prosthesis.

Adolescent↗
PubMed2004

PCT-233, a novel modulator of pro- and anti-inflammatory cytokine production.

Plant extracts have been implicated in various immunoregulatory effects that are poorly understood. Thus, we investigated the modulatory activity of PureCell Complex (PCT)-233, an active molecular complex from mesophyll tissue of Spinacia oleacea on the inflammatory process. Alveolar macrophages (AM) were treated with PCT-233 and/or budesonide, a well-known anti-inflammatory agent, before or after being stimulated with lipopolysaccharides (LPS). Pro- and anti-inflammatory cytokine production, tumour necrosis factor (TNF) and interleukin (IL)-10, respectively, were measured in cell-free supernatants at different times after the treatment. PCT-233 increased unstimulated AM release of both TNF and IL-10, whereas heat- and light-inactivated PCT-233 stimulated only the release of TNF without affecting IL-10 production, suggesting that different mechanisms are involved in the modulation of TNF and IL-10 release by PCT-233. The presence of LPS did not modify PCT-233-stimulated TNF production, but the ratio TNF/IL-10 production by LPS-stimulated AM was reduced significantly in the presence of PCT-233. Pretreatment of AM with PCT-233 and budesonide before LPS stimulation reduced TNF production at both protein and mRNA levels, whereas IL-10 production was increased. Moreover, TNF/IL-10 ratio was reduced further with the combination PCT-233/budesonide. Interestingly, AM treatment with PCT-233 and budesonide 18 h after LPS stimulation did not modulate TNF release significantly but it did increase IL-10 production, and a synergistic effect was observed with the combination PCT-233/budesonide. These exciting data suggest that PCT-233 possesses some anti-inflammatory properties, even when added during the inflammatory process, and could potentiate the effect of other anti-inflammatory agents.

Animals↗
PubMed1999

Localized ridge maintenance using bone membrane.

The immediate placement of a dental implant into a fresh extraction socket has been limited in many instances by the quantity of bone that remains after the extraction. This article presents two clinical cases that demonstrate successful regeneration of alveolar ridges in which there was extensive loss of the buccal plate of bone. This lack of alveolar process impeded the immediate placement of dental implants into fresh extraction sockets. The surgical technique performed in these cases was based on the principles of guided bone regeneration using a demineralized freeze-dried bone membrane. The bone membrane acted as an efficient barrier that excluded the nonosteogenic tissues. Bone formation took place for the placement of endosseous dental implants 8 months after the procedures were initiated. These human clinical cases confirm positive results of previous animal findings.

Adult↗
PubMed1996

Guided bone regeneration for dental implants.

The application of barrier membranes to promote bone regeneration was first described by Hurley et al. (J Bone Joint Surg 1959, 41A:1243-1254) in orthopedic research. However, the clinical potential of this membrane technique was recognized in the early 1980s for periodontal regeneration. Based on promising results in periodontology, researchers started to evaluate the potential of this technique--often called guided bone regeneration (GBR)--to regenerate bone defects in the alveolar process. This review describes the current knowledge of GBR in implant dentistry. Emphasis is placed on the scientific basis of GBR and the various surgical factors necessary to achieve predictable results with GBR procedures. In addition, unanswered questions that require future research are addressed including long-term success rates of dental implants placed in combination with barrier membranes, evaluation of resorbable membranes, and use of bone substitutes or growth factors to enhance bone regeneration in membrane-protected defects.

Alveolar Bone Loss↗
PubMedDate not supplied

Implants in the posterior maxilla: a comparative clinical and radiologic study.

PURPOSE: The aim of this study was to evaluate implants placed according to several methods of sinus floor augmentation. MATERIALS AND METHODS: Forty-eight patients (median age of 62 years, range 23 to 89) had been treated at least 3 years prior to examination with screw-type implants in the posterior maxilla. Depending on the vertical dimension of the residual bone, 1 of 3 surgical procedures had been performed: sinus lift by lateral antrostomy (SL) in 13 patients; osteotome technique (OT) in 18 patients; standard implantation in 17 patients (control). In each patient 1 implant was randomly chosen for analysis (48 implants with a mean observation time of 4.6 +/- 1.4 years). Examination included probing pocket depth (PPD) measurement and radiographic examination. Radiographs were digitized to assess the marginal bone level. Differences between the groups were tested using analysis of variance, the Student t test and the Kruskal-Wallis test. RESULTS: Mean PPD was 3.0 mm for the SL, 3.1 mm for OT, and 3.1 mm for control. The mean radiographic bone level was 1.53 mm for SL, 2.40 mm for OT, and 1.96 mm for control. No statistically significant differences were found between the groups for either of these parameters. DISCUSSION AND CONCLUSION: Clinical examinations as well as radiographically stable bone levels indicated similar biomechanical conditions for prosthetic restorations when applying the 3 surgical procedures tested.

Adult↗
PubMed1997

A bone regenerative approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases.

TEN PATIENTS WHO REQUIRED two or more anterior teeth extractions were utilized in this study. Extraction procedures were carried out with a full thickness surgical flap approach. After flap reflection, teeth were removed with a minimum of trauma to the surrounding bone. Following extraction silicone-based impression techniques were used to produce a model of the alveolar process and small metal pins were placed in the alveolus to be used as fixed points to make measurements of ridge dimensions. One socket was covered with an expanded polytetrafluoroethylene (ePTFE) barrier membrane (experimental site); the other socket was a conventional control. The soft tissue flaps were then mobilized using periosteal releasing incision and the wound closed with ePTFE mattress sutures. Six months following extraction, patients were treated with flap surgery to expose both extractions sites to remove the ePTFE membranes and to measure ridge dimensions using the pins as fixed points. Clinical and model measurements have shown statistically significant better ridge dimensions at experimental sites than at control (P < or = 0.05). Three patients with exposed membranes had similar dimensional changes as controls. Results from this study suggested that this improved technique offers a predictable alveolar ridge maintenance enhancing the bone quality for dental implant procedures and esthetic restorative dentistry.

Alveolar Bone Loss↗
PubMedDate not supplied

Evaluation of bone-implant integration: efficiency and precision of 3 methods.

Computer-assisted planimetry, computer-assisted lineal analysis, and point-counting stereology have been compared with respect to their reproducibility and the time required to analyze bone-implant integration. Sections of 6 threaded dental implants selected from a bone augmentation experiment for their wide range of new bone formation were analyzed by each method 3 times. The bone density and percentage of osseous integration were evaluated at 4 sites around each implant section. It was found that computer-assisted planimetry demonstrated a modest but significantly greater variance (P < .05) in bone density estimates when compared to the computer-assisted lineal analysis and point-counting methods. Computer-assisted planimetry requires a different method of measuring each parameter and separate fields of view to evaluate fields distant from the implant. However, this can all be accomplished with line probes, as in computer-assisted lineal analysis, which extend from the implant surface into the surrounding alveolar bone. Whereas computer-assisted planimetry requires a separate identification of the perimeter of each field to be analyzed (next to and distant from the implant), computer-assisted lineal analysis allows expansion of the field to be evaluated without creating a new field of view. Also, following a limited learning curve, both point-counting and computer-assisted lineal analysis required less time to complete than did computer-assisted planimetry.

Alveolar Process↗
PubMed2005

Human histologic and electromicroscopic analysis with synthetic peptide enhanced hydroxyapatite in the maxillary sinus elevation procedure: a case report.

Elevation of the sinus floor to augment the alveolar process to place implants is an effective treatment. The traditional use of autologous bone implies a secondary donor site and the related morbidity, and, hence, is not readily accepted by many patients. The new graft material, synthetic peptide enhanced hydroxyapatite (PepGen P-15 Flow, Ceramed Dental, Lakewood, CO, DENTSPLY Int.,York, PA), shows the ease in use and ability to generate new bone growth in the sinus elevation procedure. Histologic and electromicroscopic analysis was performed on the new bone formed after the application.

Aged↗
PubMed1997

Preimplant guided bone regeneration in the anterior maxilla.

Guided bone regeneration is a clinical procedure aimed at promoting bone formation at sites where there is severe bone loss. The purpose of this article was to demonstrate reconstruction of deformations of the alveolar process resulting from traumatic injuries to maxillary incisor teeth by guided bone regeneration procedures followed by insertion of dental implants. In both cases, submembranous space-making was stabilized by human demineralized freeze-dried bone. Implant insertion at the sites of bone augmentation resulted in successful restorations. Histologic examination of biopsy samples from the submembranous hard tissue revealed particles of demineralized freeze-dried bone allografts partially surrounded by uninflamed connective tissue and by vital bone adjacent and adhered to the demineralized freeze-dried bone allograft particles.

Adolescent↗
PubMed1998

Oncostatin M is a potent stimulator of alpha1-antitrypsin secretion in lung epithelial cells: modulation by transforming growth factor-beta and interferon-gamma.

alpha1-Antitrypsin (alpha1-AT) plays a key role in lung homeostasis. Although the hepatocyte is considered as the primary source of alpha1-AT, we have previously demonstrated that rat alveolar epithelial type II cells as well as the human A549 cell line synthesize alpha1-AT, suggesting its local production within the lung. In the present study, we showed that oncostatin M, as opposed to interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), or IL-6, is a potent stimulator of alpha1-AT synthesis in the human A549 cell line. The oncostatin M-induced alpha1-AT secretion is modulated by interferon-gamma (IFN-gamma) and transforming growth factor-beta (TGF-beta) at both the protein and mRNA levels. IFN-gamma decreases oncostatin M-induced alpha1-AT secretion. By contrast, TGF-beta in combination with oncostatin M induces a dramatic and synergistic upregulation that is not observed in the HepG2 hepatocyte cell line. Our results suggest that during an inflammatory process, alveolar epithelial cells may contribute to the antiprotease defense within the lung.

Animals↗
PubMed1993

Dental management of fibrous dysplasia.

This report describes two patients with monostotic fibrous dysplasia affecting maxillary alveolar processes. The long-term care for patient ML between ages 6 and 28 years included the transplantation of a premolar and a third molar tooth into the affected area, but the transplanted tooth 14 had to be extracted 6 years later. The patient JW, who presented at age 5 with an asymptomatic swelling in the left deciduous molar and first permanent molar region, was followed for 15 years. Teeth 24, 25, and 26 were developmentally absent. The roots of the deciduous teeth of both patients resorbed normally, and were replaced by tissue with the same radiographic appearance as fibrous dysplasia.

Alveolar Bone Loss↗
PubMed2000

Diffuse but unilateral gingival enlargement associated with von Recklinghausen neurofibromatosis: a case report.

BACKGROUND: An 8-year old girl was referred for diagnosis and treatment to the Department of Periodontology Oral Surgery of the University Hospital of Liège with an unusual clinical situation: a major, non-inflammatory, diffuse but unilateral enlargement of the interproximal, marginal and attached gingiva around all teeth of the right side of both the upper maxilla and mandible, whereas the alveolar process of the left side of upper and lower arches appeared strictly normal. METHOD: The clinical examination showed delayed eruption of some permanent teeth in the 1st and 4th quadrants. Except for its asymmetric occurrence, this gingival enlargement strongly resembled phenytoin-induced enlargement or gingival fibromatosis. This unilateral expression was evocative of a vascular or neurologic pathology. Several large "café-au-lait" spots were found disseminated on the body. Several selective surgical removals of thick gingival caps impairing the eruption of some permanent teeth were performed, and the removed tissues were histologically analyzed. RESULTS: Because of the presence of the large "café-au-lait" spots, a clinical diagnosis of Von Recklinghausen's disease was given and later confirmed several times by the histological analysis of the gingival biopsies. Now, 6 years later, this gingival enlargement due to the development of intra-gingival neurofibromas is stable and all permanent teeth have had a normal eruption, but alveolar bone growth has been partly impaired by the presence of the tumor. CONCLUSIONS: The present case of unilateral diffuse hyperplasia is a unique clinical expression of neurofibromatosis type I, a slowly evolving neurodermic dysplasia.

Cafe-au-Lait Spots↗
PubMed2007

Vertical ridge augmentation with guided bone regeneration in association with dental implants: an experimental study in dogs.

AIM: To evaluate the effect of using guided bone regeneration (GBR) with a titanium-reinforced e-PTFE membrane in alveolar bone defects with titanium implants. MATERIAL AND METHODS: Following extraction of three mandibular premolars and a molar on both sides of the jaw in three dogs, alveolar bone defects (depth: 5-7 mm) were produced. After 4 months, three implants were inserted into each defect to a depth of approximately 4 mm, so that their coronal portion was protruding about 5 mm. Four sides in the dogs were assigned to a test group and the remaining two sides to a control group. The 12 implants in the test group were covered with a reinforced e-PTFE membrane. The space under the membrane was filled with peripheral venous blood from the animal, and the flaps were sutured over the membrane. The six control implants received no membrane before the suturing of the flaps to complete wound closure. The animals were sacrificed after 6 months, and non-decalcified histological specimens of the implants and surrounding tissues were prepared. RESULTS: Histologic and histomorphometric analyses revealed a significantly (Mann-Whitney test; P=0.08) larger amount of bone fill in the test group (mean=57.42%) than in the controls (mean=11.65%), and clinical evaluation of one test site showed that the implants were completely covered with tissue resembling bone. In most of the specimens, bone had grown in height close to, or in direct contact with the membrane. However, the new bone generally was not in direct contact with the implants. Regularly, a zone of dense connective tissue was interposed between the implants and the newly formed bone. CONCLUSION: The formation of even considerable amounts of bone following vertical ridge augmentation with GBR and implants was not accompanied by predictable osseointegration of the implants.

Alveolar Bone Loss↗
PubMed2004

Measuring the efficacy of rhBMP-2 to regenerate bone: a radiographic study using a commercially available software program.

This radiographic study evaluated the efficacy of different concentrations of rhBMP-2 to regenerate bone in alveolar defects in the anterior maxilla. The study was performed using reasonably standardized CT examinations and the Simplant program. The radiographic measurements were further refined by careful standardization of the measured regions of interest. There was a statistically significant difference in bone formation between subjects treated with a concentration of 1.5 mg/mL rhBMP-2 compared with each of the other groups. There was no statistically significant difference in bone volume between any of the other groups. None of the groups showed a loss in bone volume.

Alveolar Bone Loss↗
PubMedDate not supplied

Two-stage maxillary sinus reconstruction with endosseous implants: a prospective study.

The aim of this prospective study was to evaluate the results of 2-stage maxillary sinus reconstruction using titanium implants placed into iliac corticocancellous bone blocks previously grafted to the floor of sinuses. Fifty consecutive patients received 314 Brånemark implants of varying lengths; 202 implants were placed in the grafted bone and 112 were placed in the adjacent anterior maxillary alveolar process, which had received buccal onlay bone grafts. Follow-up time was 9 to 48 months after implant placement, which was accomplished 5 months after bone grafting. Eighty-four percent of the implants were integrated into the grafted sinuses and 75% were integrated into the anterior graft. Six patients (12%) lost implants in strategic positions, leading to secondary implant placement prior to fabrication of fixed prostheses. Thirty-eight patients (76%) received fixed prostheses. Only 5 individuals (10%) attained permanent implant-anchored overdentures. One patient lost all implants. The total implant survival rate (80.9%) and the survival rate of the fixed prostheses (100%) compare favorably with other reports.

Adult↗
PubMedDate not supplied

Maxillary sinus augmentation using mandibular bone grafts and simultaneous installation of implants. A surgical technique.

This paper presents a specific technique for maxillary sinus augmentation and simultaneous placement of implants in partially edentulous patients. In such patients, there is from time to time insufficient interarch distance for any type of onlay grafting. Health, non-smoking patients without previous or present sinus pathology, where the radiological and clinical examination revealed insufficient height and/or width of the remaining alveolar process in the posterior maxillary region, were selected. They were operated on using a mandibular bone graft obtained from the symphyseal region between the mental foramina and placed in the maxillary sinus. The recipient site was prepared by cutting in a rectangular shape the lateral sinus wall into the sinus lining. The bone wall was then separated towards the lateral nasal wall by rotating the inferior portion of the cut sinus wall medially. In the space thus created, the bone graft was placed. Fixtures were installed at the same session. The method described has proved to be uncomplicated to perform under local anesthesia and no major disadvantages for the patient or pre- or postoperative complications have so far been observed.

Alveolar Bone Loss↗