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At least 127 records · Page 7Linked to original sources
PubMed1994

The effect of occlusal loss on normal and pathological temporomandibular joints: an animal study.

The effect of unilateral posterior malocclusion on temporomandibular joint intra-articular pathology was studied in sheep. In Group I, osteoarthritic changes were induced in the left temporomandibular joint by gentle scraping of the articular surface (Ishimaru and Goss, 1992). Group II had the same procedures as Group I, with concurrent extraction of all the left maxillary posterior teeth. Group III had a different osteoarthritic precondition in the left temporomandibular joint, allowing synovial fluid to contact the condylar marrow (Ishimaru et al., 1992). Group IV had the same procedure as Group III, with concurrent extraction of all the left maxillary posterior teeth. Group V had unilateral maxillary molar teeth extraction in the left side. At 3 months, the animals were sacrificed and the joints examined histologically. There were no significant differences between normal control joints and those with unilateral tooth extraction (Group V). Similarly the degree of osteoarthritic change was the same between Groups I and II. Significant differences (p < 0.05) were seen between Groups III and IV with tooth extraction increasing the osteoarthritic effects. Hence it was concluded that in sheep, malocclusion had no effect on the normal temporomandibular joint and on one type of experimental osteoarthritis, but accelerated osteoarthritic change in another model.

Alveolectomy↗
PubMed1996

Detection of peri-implant bone changes with axial tomosynthesis.

Tuned aperture computed tomography was used to assess bone defects at implant sites that are normally obscured in conventional periapical projections. Titanium implants were placed in incisor, premolar, and molar areas of an edentulous dry human mandible. The alveolar crest adjacent to each implant was circumferentially grooved with progressively larger round burs (no. 1/4 to no. 6). After each increment of bone removal, axial tuned aperture computed tomography slice images were produced. From these, digital subtraction images were generated with incremental and baseline slices. A panel of eight dentists reviewed randomized pairs of images that showed defects that differed by a single bur size. Images were masked to limit observation to mesial, distal, facial, or lingual regions. Observers accurately identified larger lesions in 76% of the unsubtracted tuned aperture computed tomography images and in 90% of the subtracted images. Logistic regression analysis suggested significant differences as a result of lesion size (p < 0.036) and imaging modality (p < 0.020).

Alveolar Process↗
PubMed1997

Bone regeneration with a calcium sulfate barrier.

OBJECTIVES: Bone defects are a challenge for the dental clinician. As widely accepted in guided tissue regeneration, physically halting soft connective tissue proliferation into bone allows for bone regeneration. This concept is the "osteopromotion principle." The aim of this study was to assess the osteopromoting effect of calcium sulfate as a barrier. STUDY DESIGN: Forty male Sprague-Dawley rats were used. Mucoperiosteal flaps were raised bilaterally at buccal and lingual aspects of the mandible to expose the angles. Next, 5 mm through-and-through bony defects were created bilaterally. On the test side, sterile medical grade prehardened calcium sulfate disks were applied both lingually and buccally to cover the defect. The control side defects were left uncovered. All flaps were sutured closed. Observation times were 3, 9, 18, and 22 weeks. RESULTS: Histologic analysis demonstrated that at 3 weeks all test sites showed partial or complete bone healing. Similar findings were reported for all observation times. The control group showed no bone growth at 3 and 9 weeks and partial bone healing at 18 and 22 weeks. CONCLUSIONS: This study indicates that calcium sulfate barriers can exclude connective tissues, allowing bone regeneration during healing.

Alveolar Process↗
PubMed1998

Alveolar bone formation at dental implant dehiscence defects following guided bone regeneration and xenogeneic freeze-dried demineralized bone matrix.

The present study evaluated rate and extent of alveolar bone formation in dental implant dehiscence defects following guided bone regeneration (GBR) and implantation of xenogeneic freeze-dried demineralized bone matrix (xDBM). A total of 16 titanium plasma-sprayed (TPS) and 16 hydroxyapatite-coated (HA) titanium cylinder implants were inserted in 4 mongrel dogs following extraction of the mandibular premolar teeth. Four implant sites per jaw quadrant (2 TPS and 2 HA implant sites) were prepared into extraction sockets in each dog. Buccal alveolar bone was removed to create 3 x 5 mm dehiscence defects. Two jaw quadrants in separate animals received GBR, GBR + xDBM, xDBM (control), or gingival flap surgery alone (GFS; control). Thus, four conditions were available for each implant type (TPS or HA): GBR, GBR + xDBM; xDBM and GFS. The animals received fluorescent bone labels to allow observations of rate and extent of bone formation. Animals were sacrificed at 12 weeks postsurgery and block sections were harvested for histologic analysis. There were no apparent histologic differences between TPS and HA implant defects. GBR and GBR + xDBM resulted in almost complete bone closure of the dental implant dehiscence defect. Rate of bone formation appeared higher following GBR alone. Extent of bone formation appeared somewhat greater following GBR + xDBM; however, delayed. xDBM alone did not adequately resolve the bony defect. In conclusion, GBR results in rapid, clinically relevant bone closure of dental implant dehiscence defects. Adjunctive implantation of xDBM does not appear to significantly improve the healing response in the model used.

Alveolar Process↗
PubMed2002

Tensile strength, histological and immunohistochemical observations of periodontal wound healing in the dog.

This study was designed to study wound strength at the dentine/connective tissue interface and at the bone/connective tissue interface following full thickness flap surgery. Flaps of uniform dimension were outlined in four young adult beagle dogs using a standardised double bladed knife and vertical incisions 10 mm apart, which extended 8 mm apical to the gingival margin. Bone was removed from half the sites (eight sites in each dog), giving 32 flaps replaced on dentine and 32 sites on bone. A tensile force was applied using a microprocessor force gauge at 1, 2, 3, 7, 10, 14, 21, and 28 days. Mean tensile strengths were markedly weaker for the dentine/flap interface. At 7 days the value for flaps to dentine was 1.82 N, in contrast to 5.08 N for flaps replaced on bone. Inflammatory cell counts tended to fall markedly at 3 days for both modalities, but were higher for the dentine/flap modality at all time points. Fibroblast density peaked at 7-14 days but did not vary with type of flap over the time points studied. The amounts of fibrin were greater for the dentine/flap interface at all time points but decreased for both flap types as time progressed. Collagen type V was localised to the basement membrane and blood vessels and tended to show more foci for flaps replaced on dentine. Procollagen levels showed little change over the healing interval for both flap/bone and flap/dentine interfaces. Type III collagen synthesis was at peak levels during the first week. These findings would support efforts to stabilise periodontal flaps at early time points, especially those on dentine.

Alveolar Process↗
PubMed2002

Mandibular bone invasion by gingival carcinoma on dental CT images as an indicator of cervical lymph node metastasis.

OBJECTIVES: To evaluate the significance of mandibular bone invasion by gingival carcinoma revealed by reformatted dental CT images as a prognostic indicator of cervical metastasis. METHODS: Thirty-two patients with squamous cell carcinoma of the lower gingiva were examined by dental CT. Cervical metastases and survival rates of these patients were analysed in relation to their clinical characteristics, histologic grading based on gingival biopsy, and mandibular bone invasion using reformatted dental CT imaging diagnoses prior to surgery. The dental CT images were classified into four types: Class I, no bone invasion; Class II, invasion confined to the alveolus; Class III, invasion extending between the alveolus and the mandibular canal; and Class IV, invasion beyond the mandibular canal. RESULTS: Logistic multivariate regression analysis showed that bony invasion identified on dental CT images was a significant prognostic factor in cervical metastases (P=0.028). The 5-year overall survival rates of Classes I, II, III, and IV were 100% (n=9), 76.2% (n=9), 71.4% (n=7), and 28.6% (n=7), respectively. CONCLUSIONS: The evaluation of mandibular bone invasion using dental CT images is useful as a prognostic indicator of cervical metastasis for patients with gingival carcinoma.

Adult↗
PubMed1995

Uncovering labially impacted teeth: apically positioned flap and closed-eruption techniques.

The purpose of this study was to examine the esthetic and periodontal differences between two methods of uncovering labially impacted maxillary anterior teeth: the apically positioned flap and closed-eruption techniques. The sample consisted of 30 patients who were recalled a minimum of three months after orthodontic treatment of a unilateral labially impacted maxillary anterior tooth. Eighteen of the patients had undergone an apically positioned flap (APF) procedure, and the remaining twelve had undergone the closed-eruption (CE) technique. In the CE group, clinical examination showed less width of attached gingiva on the distal surface and increased probing bone level on the facial surface of the uncovered teeth relative to their contralateral controls. Uncovered teeth in the APF group showed more apical gingival margins on the mesial and facial surfaces; greater crown length on the midfacial surface; increased probing attachment level on the facial surface; increased width of attached gingiva on the facial surface; increased probing bone level on mesial, facial, and distal surfaces; and gingival scarring. Radiographic examination showed shorter roots on the uncovered teeth in both groups. Photographic examination revealed vertical relapse of the uncovered teeth in the APF group. We conclude that labially impacted maxillary anterior teeth uncovered with an apically positioned flap technique have more unesthetic sequalae than those uncovered with a closed-eruption technique.

Adolescent↗
PubMed1996

Alternative donor site for alveolar bone grafting in adults with cleft lip and palate.

Grafting of the alveolar ridge with autogenous bone is an integral stage of contemporary management of complete cleft lip and palate cases. Alveolar bone grafting restores continuity of the dental arch, closes oronasal fistulae, supports the alar base, and facilitates spontaneous eruption of permanent teeth adjacent to the cleft. However, timing of the graft and the selection of materials have been topics of much debate in the literature. This article discusses an alternative donor site in cases where rehabilitation has passed the recommended time. Harvesting bone from the third molar regions allows not only the removal of impacted third molars during the same surgical procedure, but also eliminates the morbidity associated with additional surgical sites such as the ilium or mandibular symphysis. This report should not be interpreted as a recommendation for the use of this alternative site in cases where grafting is carried out within the optimal time period, which is usually in the mixed dentition stage. However, when grafting is necessary in young adults suffering from complete cleft lip and palate, the third molar region may provide another acceptable donor site.

Adolescent↗
PubMed1998

Periodontal conditions following surgical and orthodontic treatment of palatally impacted maxillary canines--a follow-up study.

This follow-up study reports on the periodontal status 1 to 18 years after the completion of orthodontic treatment of unilateral palatally impacted maxillary canines and their adjacent incisors and premolars. Registrations were performed on 42 patients, 19 to 59 years old (mean 35 years) at investigation. An orthodontic pin with eyelet had been placed after exploration of the canine and, in some cases, bone removal. A flap had been raised and resutured after bone removal in 11 cases. The results showed greater mesial probing depth of the canines on the treated side, on the adjacent lateral incisors distolingually, and on the first premolars mesiolingually. Marginal bone level was found to be lower on the distal aspect of the treated canines and adjacent laterals. In general, the results showed a good gingival and periodontal status with slight differences between treated and untreated sides.

Adult↗
PubMed2003

Tissue response to titanium implantation in the rat maxilla, with special reference to the effects of surface conditions on bone formation.

Tissue responses to titanium implantation with two different surface conditions in our established implantation model in rat maxillae were investigated by light and transmission electron microscopy and by histochemistry for tartrate-resistant acid phosphatase (TRAPase) activity. Here we used two types of implants with different surface qualities: titanium implants sandblasted with Al2O3 (SA-group) and implants coated with hydroxyapatite (HA-group). In both groups, bone formation had begun by 5 days postimplantation when the inflammatory reaction had almost disappeared in the prepared bone cavity. In the SA-group, however, the bone formation process in the bone cavity was almost identical to that shown in our previous report using smooth surfaced implants (Futami et al. 2000): new bone formation, which occurred from the pre-existing bone toward the implant, was preceded by active bone resorption in the lateral area with a narrow gap, but not so in the base area with a wide gap. In the HA-group, direct bone formation from the implant toward the pre-existing bone was recognizable in both lateral and base areas. Many TRAPase-reactive cells were found near the implant surface. On the pre-existing bone, new bone formation occurred with bone resorption by typical osteoclasts. Osseointegration around the implants was achieved by postoperative day 28 in both SA- and HA-groups except for the lateral area, where the implant had been installed close to the cavity margin. These findings indicate that ossification around the titanium implants progresses in different patterns, probably dependent on surface properties and quality.

Acid Phosphatase↗
PubMed2003

Surface characteristics of implants influence their bone integration after simultaneous placement of implant and GBR membrane.

The purpose of this study was to evaluate the influence of titanium surface characteristics on bone integration of implants, and to describe the pattern of peri-implant tissue healing after simultaneous implant placement and guided bone regeneration. In four healthy mongrel dogs mandibular premolars were extracted. Two weeks following full mouth prophylaxis and 4 months after extractions, simultaneous membrane and implant surgeries were performed. Efforts were made to produce bony defects with dimensions of 7 x 7 x 7 mm. Into these, 24 standard ITI implants (diameter = 4.1 mm; length = 8 mm) with either a titanium plasma-sprayed (TPS) or a machined surface (MS) were placed. Although implants were inserted 4 mm into cancellous bone, difficulties in achieving optimal primary stability were encountered. All dogs were maintained on a soft diet. Chlorhexidine rinses were performed three times a week. Full mouth prophylaxis was performed every 2 weeks. In the case of membrane exposure, the membranes were removed prematurely (4-6 or 14-15 weeks after surgery). Two dogs were sacrificed at 16 weeks and two at 24 weeks after surgery. Nondecalcified histologic sections were processed and histometric analyses were carried out. When membranes were removed after 4-6 weeks, a vertical bone growth (VB) of 45-61% of the original defect was noted. After membrane removal at 14-15 weeks, similar VB was observed. However, if membranes were left in situ for 24 weeks, VB was between 79% and 96%. In this group of sites, the VB was 66% at 16 weeks and 86% at 24 weeks. Osseointegration in the regenerated bone area ranged from 12% to 32% for the TPS and from 0.0% to 3.6% for the MS implants at 16 and 24 weeks combined. Osseointegration in the pristine host bone area ranged from 16% to 35% for the TPS and from 0.0% to 11% for the MS sites at 16 and 24 weeks. In conclusion, the fraction of implant-bone integration was much higher in the pristine bone compared to that in the regenerated bone. TPS surfaces positively influenced the fraction of osseointegration in comparison to MS surfaces for both regenerated and pristine bone. Furthermore, early membrane removal negatively affected the fraction of bone defect fill.

Alveolar Process↗
PubMed2000

Prospective analysis of secondary alveolar bone grafting using computed tomography.

PURPOSE: This study radiographically evaluated the quantity and quality of secondary alveolar bone grafts from the anterior iliac crest to maxillary alveolar clefts in cleft lip and palate patients with the use of computed tomography. PATIENTS AND METHODS: A 1-year prospective study was conducted by using 14 unilateral and bilateral cleft lip and palate patients. Axial and coronal computed tomography (CT) scans were obtained during the immediate postoperative phase and at 1-year follow-up. RESULTS: This study showed that the average alveolar cleft requires a bone graft volume ranging from 0.9 to 3.6 cm3, with a mean volume of 2.10 cm3. The percentage of bone loss derived from the linear dimensional changes to the alveolar bone graft between the immediate postoperative and follow-up CT scans were as follows: 17.9% in maximal bone height, 29.9% in maximal anteroposterior bone width, and 13.7% in maximal transverse width. As compared with the linear measurements, the volumetric analysis showed a disproportional amount of volume loss equaling 43.7% and 42.5% in the coronal and axial studies, respectively. This showed a total average volume loss of 43.1% at approximately 1 year after the secondary alveolar cleft repair. However, as the canine tooth erupts through the bone graft, it can account for up to 53.4% of the total average volume loss. All 14 patients (17 clefts) showed bone bridging between the alveolar cleft radiographically, with good incorporation and maturation of the bone graft, and no recurrence of the oronasal fistula. CONCLUSION: The CT scan is a valuable radiographic imaging modality to assess and follow the clinical outcome of secondary alveolar bone grafting.

Adolescent↗
PubMed2000

Behavioural measurement of postoperative pain after oral surgery.

The amount and type of postoperative analgesia prescribed depends on the clinician's judgement of the patient's need. Among other factors, this judgement is likely to be based on the patient's behaviour. The primary aim of this study was to investigate the validity of using behavioural measures to provide information about a patient's experience of pain during the early stages of recovery from oral surgery under general anaesthesia. Behavioural measures were not valid measures of acute postoperative pain, which suggests that while clinicians may build a better picture of a patient's experience of pain by including behavioural observation in their range of assessments, they should not rely on them when judging a patient's need for analgesia. The results also show differences between the sexes in their reaction to pain. Significantly more women than men showed signs of pain, despite little difference in self-rating pain scores.

Acetaminophen↗