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PubMed1995

Comparative clinical trial of AMO Vitrax and Healon use in extracapsular cataract extraction.

This randomized, single-masked, multicenter clinical trial, comprising 95 patients enrolled at five sites, evaluated the performance of AMO Vitrax and Healon viscoelastic materials during cataract surgery. Patients were examined preoperatively and at one day, four days, one month, and three months postoperatively. The following measurements were recorded and analyzed: percentage of endothelial cell loss from preoperative to three months postoperative; change in intraocular pressure (IOP) from preoperative to 24 hours postoperatively; postoperative corrected visual acuity; subjective assessment of ability of viscoelastic to create and maintain tissue space; intraocular transparency; ease of evacuation. Three months postoperatively, endothelial cell loss was 4.9% (+/- 8.3%) for the AMO Vitrax group and 6.3% (+/- 10.5%) for the Healon group. One day postoperatively, IOP decreased by 1.6 mm Hg and increased by +1.1 mm Hg, respectively. Postoperative visual acuities were similar between the two groups at three months. Subjective assessment of transparency was higher for Healon. Assessment of tissue space maintenance was similar between the two materials. Healon was rated as slightly easier to evacuate.

Aged↗
PubMed1996

Comparison of viscoelastic substances used in phacoemulsification.

PURPOSE: To evaluate the usefulness of four viscoelastic agents during phacoemulsification: 2% hydroxypropylmethylcellulose (HPMC) (Methocel), 3% sodium hyaluronate with 4% chondroitin sulfate (Viscoat), 1% sodium hyaluronate (Healon), 1.4% sodium hyaluronate (Healon GV). SETTING: Eye Clinic, Kreiskrankenhaus Bad Hersfeld, Germany. METHODS: Two hundred patients, divided into four groups of 50 patients, received one of the viscoelastic substances during phacoemulsification and posterior chamber intraocular lens implantation. Patients were followed for 1 month. Visual acuity and intraocular pressure (IOP) were measured. The following were subjectively evaluated for each viscoelastic: corneal findings, anterior chamber reaction, visibility of intraocular structures and retention time during phacoemulsification, space maintaining ability, and removability and ease of injection. RESULTS: Postoperative IOP and visual acuity were comparable among the four groups. Viscoat tended to trap nuclear fragments and air bubbles during the phacoemulsification procedure, which decreased visibility during surgery. Space maintenance and injection ease were significantly better with Healon and Healon GV. CONCLUSION: The high molecular weight viscoelastics (Healon and Healon GV) performed better as viscosurgical tool during cataract surgery using phacoemulsification.

Chondroitin Sulfates↗
PubMed2003

Orthodontic treatment provided by pediatric dentists.

The purposes of this study were to document orthodontic treatment currently provided by pediatric dentists for comparison with past and future studies and to ascertain variables that influence practitioners' orthodontic treatment patterns. A 25-item survey was mailed to 492 diplomates of the American Board of Pediatric Dentistry. Surveys returned within 16 weeks were included for statistical analysis. The response rate was 73%. Most practitioners spent less than 10% of their practice time providing orthodontic treatment and reported that this would not change in the future. Practitioners who were dual trained in pediatric dentistry and orthodontics spent more time providing orthodontic treatment, although nearly half spent at least 50% of their time providing traditional pediatric dental treatment. Most pediatric dentists provided orthodontic treatment in the primary or early mixed dentition stages. The most common conditions treated were anterior crossbite, ectopic eruption, habits, posterior crossbite, and space maintenance. The most common orthodontic appliances used were fixed rapid palatal expanders and removable Hawley appliances with finger springs. Orthodontic treatment provided by pediatric dentists has decreased since it was last surveyed in 1983 and is not expected to change in the next 5 years.

Chi-Square Distribution↗
PubMed2003

The use of coral nubbins in coral reef ecotoxicology testing.

While there is an urgent demand to establish reliable ecotoxicological assays for reef corals, there has not been yet an available source material that can supply the high number of colony replicates needed for reliable tests. In past experiments, the major obstacle to obtaining as many fragments as possible had been the damage inflicted to donor colonies by pruning. In this paper, we present the application of coral nubbins, a novel source material for coral ecotoxicology assays. Nubbins from the branching Red Sea coral Stylophora pistillata (n>450) were used for evaluating the impacts of water soluble fractions from a crude oil, an oil dispersant and dispersed oil. Coral nubbins (minute coral fragments in the size of one to several polyps) harvested from a single colony are genetically identical to each other, may be obtained in any quantity needed and whenever research activities demand their use. Several dozens of nubbins can be obtained from a single small branch in branching coral species, a procedure that has minimal impact on donor genotypes. Nubbins production is a low cost procedure and requires limited maintenance space. Results of short and long-term acute ecotoxicological tests are revealed and discussed here, indicating the advantageous use of nubbins as ubiquitous coral material for toxicology assays and physiological studies.

Animals↗
PubMed2000

Contribution of the periosteum to bone formation in guided bone regeneration. A study in monkeys.

The periosteum has been referred to as a protective barrier in the regeneration of bone defects. The objective of this study was to determine the contribution of periosteum as a natural barrier to bone formation in guided bone regeneration. Mucoperiosteal flaps were elevated bilaterally on the buccal aspect of the mandibular angle in 5 cynomolgus monkeys. Bleeding was induced by perforating the cortical bone. A hemispherical titanium mesh was fixed over the areas thus creating a void 5 mm in height between the mesh and the bone surface. One one side the mesh was covered with an ePTFE membrane (test side). The contralateral side did not receive further treatment (control side). After 4 month healing, histomorphometric analyses were used to determine the percentage of new bone in the void underneath the mesh, and the ratio between mineralized tissue and marrow spaces in new and old bone. The mean percentage of new bone tissue was 77.2 +/- 7.5% for the test sides and 68.6 +/- 8.4% for the control sides (P = 0.018, t-test). This new bone contained 80.0 +/- 3.6% mineralized tissue in the test group and 82.5 +/- 5.0% in the control group (P > 0.05, t-test). In both groups the newly formed bone exhibited significantly less mineralized tissue than the old bone (P < 0.05, t-test). It is concluded from this study that new bone formation was enhanced by the additional use of an ePTFE membrane under a periosteum-lined mucoperiosteal flap when space maintenance was excluded as a critical factor.

Animals↗
PubMed2003

Comparative analysis of collagen membranes for the treatment of implant dehiscence defects.

Guided bone regeneration (GBR) evolved from the concept of guided tissue regeneration (GTR) and has been used for reconstructing sites with bone deficiencies associated with dental implants. For GBR, the use of absorbable collagen membranes has been increasing, but, at present, scientific information on the use of collagen membranes for GBR is limited. This study was aimed to clinically and histomorphometrically compare two collagen membranes, Bio-Gide(R) and BioMend ExtendTM, for the treatment of implant dehiscence defects in eight mongrel dogs. Implant dehiscence defects were surgically created in edentulous ridges, followed by the placement of three endosseous implants bilaterally in the mandible. Each implant dehiscence defect was randomly assigned to one of three treatment groups: (1) control (no membrane), (2) porcine dermis collagen barrier (Bio-Gide) or (3) bovine tendon collagen barrier (BioMend Extend). Dogs were sacrificed at 4 and 16 weeks (four dogs each) after treatment. Histomorphometric analysis included percentage linear bone fill (LF), new bone-to-implant contact (BIC) and area of new bone fill (BF). The results of the study revealed no significant differences among groups for any parameter at 4 weeks. However, at 16 weeks, more LF, BIC, and BF were noted in the membrane-treated groups than controls. BioMend Extend-treated defects demonstrated significantly greater BIC than control (P < 0.05) at this time point. BIC at 16 weeks was significantly greater than 4-week BIC (P < 0.05). Membrane exposure occurred in 9 out of 15 sites examined, resulting in significantly less LF and BIC than the sites without membrane exposure (P < 0.05). The results of this study indicate that: (1) GBR treatment with collagen membranes may significantly enhance bone regeneration, manifested at late stage (16 weeks) of healing; and (2) space maintenance and membrane coverage were the two most important factors affecting GBR using bioabsorbable collagen membranes.

Absorbable Implants↗
PubMed2001

Gingival recession defects and guided tissue regeneration: a review.

The last decade has seen an increasing number of clinical reports on guided tissue regeneration (GTR) for reconstruction of gingival recession defects. This article reviews the value of GTR in the management of gingival recession defects based on records from such reports. Studies and case-series using nonresorbable and bioresorbable membranes, studies comparing GTR to the subepithelial connective tissue graft (CTG) procedure, and histologic reports of healing following GTR, published in the English language from 1985 to 2000, were identified using a Medline search and were included in the data-base for this review. The Following pre- and post-treatment data were collated and evaluated for each of the reports: gingival recession depth, probing depth, clinical attachment level, and width of the keratinized gingiva. In perspective of the limitations of the studies reviewed, it has been shown that GTR may be used for reconstruction of gingival recession detects. Importantly it has not been shown that GTR provides an added clinical benefit for the patient treatment planned for reconstruction of gingival recession defects. i.e. GTR does not appear to offer a significant advantage over mucogingival procedures such as the connective tissue graft or the advanced flap procedure. It is imperative to recognize inherent technical difficulties associated with GTR including primary would closure and secondary membrane exposure: membrane exposures being negatively correlated to desired clinical outcomes. Also, membrane exposures appear consistently more common in smokers than in non-smokers. It is also imperative to recognize shortcomings and adverse effects including space maintenance and unacceptable foreign body reactions associated with some bioresorbable GTR technologies.

Absorbable Implants↗
PubMed1995

Lateral thinking: the management of missing upper lateral incisors.

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and a consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and to the teeth, including the presenting malocclusion and the effect on the occlusion, are considered. This review considers the possible options: no treatment; orthodontic space closure with canine modification; space maintenance and replacement of the missing tooth with denture, bridge (adhesive and conventional), or implant.

Anodontia↗
PubMed2000

Clinical evaluation of allografts and homografts for restoration of missing tooth structure.

STATEMENT OF PROBLEM: The clinical performance of bonding human tooth fragments to either replace missing teeth or to restore defective teeth is unclear. Prospective studies can help to predict the success of such treatment options. PURPOSE: This study evaluated the feasibility of bonding tooth tissue homografts and allografts either to replace missing teeth or to restore defective teeth, and estimated the success rate of bonded allograft and homograft restorations 3 years after placement. METHOD AND MATERIAL: Twenty clinical cases were treated by bonding tooth fragments or crowns into 6 groups (Gp): Gp1, cervical erosion and abrasion lesions (6); Gp2, incisal edge fractures (4); Gp3, partially destroyed crowns (4); Gp4, teeth placed in a removable prosthesis (2); Gp5, missing tooth with no opposing tooth (2); and Gp6, temporary space maintenance (2). Restorations were examined using USPHS criteria every 2 months and whenever a patient called to report a failure. RESULTS: After a 3-year follow-up, the overall success rate was 80% for the 20 restorations. The 95% confidence interval was 63% to 94%. Four restorations failed by debonding (Gp2 [2]; Gp5 [1]; Gp6 [1]) during the first 4 months. The main cause of failure appeared to be excessive occlusal loading. CONCLUSION: Within the limitations of this clinical study, the results after a 3-year follow-up showed the success rate was not less than 63% for bonded allograft and homograft restorations.

Dental Bonding↗
PubMed2003

Bimodal signal requisite for agonistic behavior in a dart-poison frog, Epipedobates femoralis.

Animal acoustic signals play seminal roles in mate attraction and regulation of male spacing, maintenance of pairbonds, localization of hosts by parasites, and feeding behavior. Among vertebrate signals, it is becoming clear that no single stereotyped signal feature reliably elicits species-specific behavior, but rather, that a suite of characters is involved. Within the largely nocturnal clade of anuran amphibians, the dart-poison frog, Epipedobates femoralis, is a diurnal species that physically and vigorously defends its calling territory against conspecific intruders. Here we report that physical attacks by a territorial male are provoked only in response to dynamic bimodal stimuli in which the acoustic playback of vocalizations is coupled with vocal sac pulsations, but not by either unimodal cues presented in isolation or static bimodal stimuli. These results suggest that integration of dynamic bimodal cues is necessary to elicit aggression in this species.

Agonistic Behavior↗
PubMed2002

Delivery of recombinant human bone morphogenetic protein-2 using a compression-resistant matrix in posterolateral spine fusion in the rabbit and in the non-human primate.

STUDY DESIGN: A rabbit and rhesus monkey model of posterolateral intertransverse process spine arthrodesis was used. OBJECTIVE: To test two new soft tissue compression resistant ceramic/collagen sponge carriers for recombinant human bone morphogenetic protein-2. SUMMARY OF BACKGROUND DATA: After determining that a plain collagen sponge was too compressible for large animals in a posterolateral fusion application, the authors demonstrated good bone induction using biphasic ceramic phosphate granules (60% hydroxyapatite/40% tricalcium phosphate) as the carrier matrix for recombinant human bone morphogenetic protein 2 in rhesus monkeys. A limitation of 60:40 biphasic ceramic phosphate was its slow resorption time caused by the high hydroxyapatite content, making radiographic detection of new bone formation very difficult. METHODS: Adult New Zealand white rabbits (n = 14) underwent posterolateral spine arthrodesis at L5-L6 using 5:95 biphasic ceramic phosphate (5% hydroxyapatite/95% tricalcium phosphate) impregnated Type I collagen sponges (17 x 35 x 2.5 mm, two per side) loaded with 0.86 mg recombinant human bone morphogenetic protein 2. Additional rabbits (n = 14) received 60:40 hydroxyapatite-tricalcium phosphate granules as the carrier for bone morphogenetic protein 2. Adult rhesus monkeys (n = 6) underwent posterolateral arthrodesis at L4-L5 with ceramic/collagen sponge carrier loaded with 9 mg recombinant human bone morphogenetic protein 2 per side. Two monkeys received ceramic/collagen sponges containing 15:85 biphasic ceramic phosphate (15% hydroxyapatite/85% tricalcium phosphate) with two pieces per side; two received sponges containing 5:95 biphasic ceramic phosphate with two pieces per side, and two received sponges containing 5:95 biphasic ceramic phosphate with four pieces per side. The rabbits were killed after 5 weeks and the monkeys after 24 weeks; the spines were evaluated by manual palpation, radiographs, tensile mechanical testing (rabbits only), and histology. RESULTS: The recombinant human bone morphogenetic protein 2 delivered in the 5:95 biphasic ceramic phosphate/collagen sponge achieved fusion in 100% of rabbits and had improved handling properties compared with the biphasic ceramic phosphate granules. Biomechanical results with 5:95 biphasic ceramic phosphate/collagen carrier were comparable to those obtained with the 60:40 biphasic ceramic phosphate granules and superior to those of autogenous bone graft (P < 0.05). The recombinant human bone morphogenetic protein 2 delivered in the 15:85 or the 5:95 biphasic ceramic phosphate/collagen sponge carrier (two pieces per side) induced fusion in nonhuman primates with normal bone histology, less residual ceramic, and more bone in the center of the carrier matrix in comparison with BCO granules alone. The 15:85 biphasic ceramic phosphate/collagen sponge resulted in fusion mass sizes closer to the original size of the matrix implanted than did the 5:95 biphasic ceramic phosphate/collagen sponge, which was considered a desirable feature. The monkeys with 9 mg recombinant human bone morphogenetic protein 2 spread over four sponges per side instead of two had half the effective recombinant human bone morphogenetic protein 2 concentration per sponge and inferior results. CONCLUSIONS: The new compression-resistant biphasic ceramic phosphate/collagen sponge matrices were biologically compatible with recombinant human bone morphogenetic protein 2 bone formation, resulted in biomechanically stiffer fusion masses than autograft, better space maintenance than plain collagen sponges, and improved handling and radiographic resorption properties over the ceramic carriers previously tested.

Animals↗
PubMed2004

Survey of ophthalmic viscosurgical devices.

PURPOSE OF REVIEW: Cataract treatment is evolving, thanks to new phaco systems and innovative surgical techniques. Recent ophthalmic viscosurgical devices (OVDs) play an important role in the development of new approaches to surgery. Knowledge of the new techniques and advances in new OVDs is crucial to performing routine and complicated surgeries. RECENT FINDINGS: Viscoadaptive substances have been introduced as a particular kind of OVD and are distinguished by high viscosity at a low flow rate and a tendency to fracture at higher flow rates, assuming pseudodispersive behavior. The ultimate soft shell technique emphasizes the rheology of viscoadaptive OVDs to perform phacoemulsification procedures, exploiting all the useful properties of these OVDs in terms of space maintenance and tissue protection. Recent studies have highlighted some new and interesting aspects of the use of OVDs. Current reports suggest that the association of lidocaine and OVD seems to be safe and useful in providing anesthesia during cataract surgery. Concern has been expressed in other studies regarding the presence of contaminants, such as endotoxins, which may be responsible for postoperative uveitis-like reactions. Finally, OVDs are widely known to protect the corneal endothelium during cataract surgery. Their role is also assuming relevance in vitreoretinal surgery. SUMMARY: New OVDs and related techniques represent an advancement in cataract surgery.

Biocompatible Materials↗
PubMed2005

Guided bone regeneration at the donor site of iliac bone grafts for future use as autogenous grafts.

BACKGROUND: Autogenous bone grafting is considered the standard in management of bony defects but has some disadvantages, including limited source of graft material, especially in children. This study represents an attempt to regenerate bone at the donor site of iliac bone grafts using the guided bone regeneration principle for future use in multistage bone reconstruction by grafting. METHODS: Critical size defects were created in 24 iliac bones of 12 skeletally mature New Zealand White rabbits. Defects in group 1 (n = 12) were covered with inverted U-shaped resorbable mesh (space maintainer) and polytetrafluoroethylene membranes underneath the periosteum. In group 2 (n = 6), inverted U-shaped resorbable mesh was used alone (positive control). In group 3 (n = 6), neither resorbable mesh nor polytetrafluoroethylene membranes were used (negative control). An unpaired t test was used for comparison between each two groups. RESULTS: Plain radiographs and contact microradiographic studies showed that bone regeneration was significantly higher in group 1 and group 2 than in group 3 (p < 0.001). There was no significant difference between group 1 and group 2 regarding density. CONCLUSIONS: The periosteum acted as an ideal membrane for guided bone regeneration so that the polytetrafluoroethylene membranes could be used only to compensate for the deficient periosteum. Space maintenance was essential for bone regeneration.

Animals↗
PubMed1994

Ectopic eruption of transposed mandibular permanent lateral incisors beneath primary first molars. Case report.

Mandibular permanent lateral incisors showing bilateral transposition and ectopic eruption were seen beneath primary first molars on bitewing radiographs in a female aged 9 years. This report chronicles management of the case during the mixed dentition period. Appropriate space maintenance after extraction of mandibular primary first molars, cuspids and lateral incisors on both sides facilitated eruption and repositioning of the permanent lateral incisors without the need to sever supracrestal gingival fibres.

Child↗
PubMed2002

Factors that modulate the effects of bone morphogenetic protein-induced periodontal regeneration: a critical review.

The healing process initiated by a single molecular species of bone morphogenetic protein (BMP) such as BMP-2 or BMP-7 sets in motion a cascade of cellular events resulting in differentiation of progenitor cells into phenotypes involved in periodontal regeneration. For example, animal studies show that a single dose of recombinant human (rh) BMP-2 increases the rate of normal intramembranous bone formation and enhanced cementum formation during periodontal wound healing. However, the optimal effects of BMPs are modulated by a range of factors that need careful evaluation in clinical studies. These factors include the influence of root conditioning, occlusal loading, BMP dose, and the release characteristics of the carrier as well as the suitability of the model to evaluate the efficacy of BMPs. Each of these factors may affect the rate of BMP-induced osteogenesis and cementogenesis and subsequent periodontal ligament (PDL) formation during the early and late stages of periodontal wound healing. Although BMP-2 initiates stem cells along an osteogenic pathway, the dose may have to be of sufficient concentration to ensure other growth and differentiation factors do not redirect or retard the osteogenic potential of the cell. Understanding when to manipulate the cell's differentiation pathway with the application of single or multiple doses of BMPs at the appropriate concentration is required to optimize the effect of BMPs in periodontal wound healing. Therefore, different release profiles from the same carrier may be particularly important in tissues with mixed cell populations such as in the periodontium, where similar tissues like bone and cementum grow at different rates. Furthermore, treatment of intrabony defects with BMPs are likely to not only require appropriate temporal release of the BMP(s), but also a carrier that can serve as a template for new tissue formation providing space maintenance and supporting the mucoperiosteal flap. Many of these issues have not been adequately addressed from a periodontal standpoint; therefore the purpose of this review is to clarify our current understanding of the factors that are likely to modulate the effects of BMP-induced periodontal regeneration. Moreover, assessing the importance of these factors is essential prior to conducting expensive human clinical trials.

Acid Etching, Dental↗
PubMed2003

The effect of enamel matrix proteins on periodontal regeneration as determined by histological analyses.

BACKGROUND: Therapeutic approaches to periodontal regeneration in the past have utilized bone replacement grafts, growth factors, barrier membranes, or combinations of these approaches. More recently, enamel extracellular matrix proteins have been introduced to stimulate periodontal regeneration. One factor thought to have an impact on the outcome of the regenerative process is the initial size of the periodontal defect. This is particularly the case when using proteins to stimulate regeneration, because the concepts of guided tissue regeneration emphasize the need for space maintenance to allow for selected cell repopulation. The goal of this study was to evaluate periodontal regeneration in intrabony defects of various sizes treated with enamel matrix proteins. METHODS: Periodontal defects ranging in size from 1 to 6 mm were created bilaterally around 3 teeth in the mandibles of baboons. Plaque was allowed to accumulate around ligatures placed into the defects. After 2 months, the ligatures were removed, the teeth were scaled and root planed, and a notch was placed at the base of the defect. On one side of the mandible, neutral ethylene diamine tetracetic acid and enamel matrix proteins were used to treat the defects. The other side served as a control, with neutral ethylene diamine tetracetic acid treatment alone after scaling and root planing. Flaps were sutured and the animals were allowed to heal without oral hygiene procedures. After 5 months, the animals were sacrificed and the teeth were processed for histological evaluation. RESULTS: Periodontal regeneration occurred in all sizes of the periodontal defects. Qualitatively, new cementum, periodontal ligament with Sharpey's fibers, and new bone tissue were observed. In general, enamel matrix protein treatment resulted in greater tissue formation than controls. In many instances, dramatic tissue formation occurred far coronal to the base of the defects. In addition, horizontal bone fill occurred in defects that were initially 4 or 6 mm wide. The resultant width of the periodontal ligament was similar in all defects regardless of the original defect width. The cementum width was slightly greater in the wider (4 and 6 mm) defects compared to the more narrow (1 and 2 mm) defects. When evaluating the combined 1 and 2 mm defects, the height of new cementum with enamel matrix protein treatment was 45% greater than the control, with 31% greater new bone height versus the control. In the combined wider defects (4 and 6 mm), new tissue height was more similar between enamel matrix protein-treated defects and control defects. The results from the wider defects must be interpreted cautiously, because the interproximal bone heights were resorbed more adjacent to the wider defects during the plaque accumulation period and likely limited the potential for regeneration. CONCLUSIONS: The treatment of various sized periodontal defects with enamel matrix proteins stimulated substantial periodontal regeneration. In many cases, dramatic amounts of new cementum, Sharpey's fibers, periodontal ligament, and bone tissue were formed far coronal to the notch at the base of the defect, especially considering the width of the original defects. This periodontal regeneration occurred in the absence of exogenous growth factors, bone replacement grafts, barrier membranes, or their combination.

Alveolar Bone Loss↗
PubMed2001

The importance of drug delivery to optimize the effects of bone morphogenetic proteins during periodontal regeneration.

Bone morphogenetic proteins (BMPs) include a large number of proteins belonging to the TGF-beta superfamily which are characterized by their ability to induce bone and cartilage formation. Since the isolation and purification of BMPs by recombinant technology, the effects of single BMPs can now be evaluated in animal models. Subcutanous placement of a single recombinant BMP, such as recombinant human (rh) BMP-2, in a rat ectopic assay shows recruitment of undifferentiated mesenchymal cells, cartilage formation, followed by replacement with bone, formation of its own bone marrow and physiological bone remodelling. The therapeutic use of recombinant BMPs in the treatment of periodontal disease (destruction of the tooth ligaments, surrounding bone and tooth cementum, the latter of which anchors the ligaments to the tooth surface from the adjacent tooth socket) has attracted considerable interest due to their potent ability to stimulate intramembranous bone formation without an endochondral intermediate. Their predictability in stimulating new bone may provide an alternative that has greater osteogenic potential than autogenous bone, other growth factors and bone substitutes. The biological processes and the potential role of growth factors involved in promoting regeneration are complicated by the involvement of different cell types each with their different growth rates and responses to various stimuli. The major cell types involved in periodontal regeneration include osteoblasts, cementoblasts and fibroblasts. Here, the formation of the new mineralized layers on the tooth and bone surfaces by cementoblasts and osteoblasts respectively are a prerequisite before periodontal ligament formation and attachment by fibroblasts can occur. In this regard, BMPs are likely candidates to stimulate periodontal regeneration because of their ability not only to promote osteogenesis but also to stimulate cementogenesis (new cementum formation). However, understanding when to manipulate each of the various cells differentiation pathway with the application of single or multiple doses of BMPs at the appropriate concentration is dependent upon a suitable delivery system that can be modified in order to optimize its effect during periodontal wound healing. Furthermore, treatment of intrabony periodontal defects with BMPs are likely to not only require appropriate temporal release of the agent, but also adaptation of a carrier that is robust enough to maintain its integrity around the coronal aspect of the root in order to provide space maintenance and support the mucoperiosteal flap. This review evaluates the effects of different delivery systems upon BMP-induced periodontal regeneration.

Animals↗
PubMedDate not supplied

Correction of ectopic eruption of permanent molars utilizing the brass wire technique.

Ectopic eruption of a first permanent molar is a common occurrence in the developing mixed dentition. Proper management is a challenge to the pediatric dentist and is crucial to a healthy occlusion. Non-treatment can result in early loss of the second primary molar, space loss, and impaction of second premolars. Future corrective treatment may be complicated, lengthy, and costly and include: the distalizing and uprighting of the permanent molar by use of headgear and fixed or removable appliances and subsequent long term space maintenance. The brass wire technique is a fairly simple procedure and can be used successfully in moderately and even severely impacted molar cases. This procedure is described in detail with step-by-step guidelines in this paper.

Humans↗