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PubMed1988

Partial regeneration of periodontal tissues using collagen barriers. Initial observations in the canine.

The capacity of collagen membranes to support guided regeneration of periodontal tissues in the dog was assessed. The mesiolabial, labial and distolabial aspects of the mesial root of the second and third mandibular premolar were surgically exposed in three beagle dogs. Collagen membranes, 0.5 to 0.7 mm thick, prepared from a purified solution of rat-Type I collagen were interposed between the gingival flap and the exposed root surfaces of the right premolars. The left premolars were sham-operated without the use of collagen membranes. Animals were killed one month after surgery. Tissue blocks, including the surgical sites, were removed and prepared for histological and histometric examination. Long epithelial attachment was the modality of healing in the control sites. The apical level of the junctional epithelium was located either at, or close to, the apical level of the defect. The experimental sites exhibited a combination of three healing modalities: (1) partial regeneration of periodontal tissues (new bone, periodontal ligament and cementum) occurred in the apical half of the defect, (2) long epithelial attachment developed in the coronal quarter of the defect and (3) connective tissue adhesion developed between the two. Pocket depth was similar in both the control and experimental sites. Collagen membranes could not be identified at the time of examination. The results indicate that: (1) collagen membranes have the capacity to support regeneration of periodontal tissues and (2) collagen membranes are either incorporated within the healing tissues or degraded by these during the healing process. These findings suggest that collagen membranes may be of value in reconstructive periodontal therapy.

Alveolar Process↗
PubMed1976

Mandibular fractures. I. An analysis of their etiology and location in 286 patients.

Case histories were studied of 286 patients treated for mandibular fractures by the Department of Plastic Surgery in conjunction with the Dental Department at Odense University Hospital between 1964 and 1973. 46.5% of the patients were aged 18-30 years; and 73.4% were male. Mandibular fractures associated with mid-face fractures were most frequently caused by traffic accidents (81%). When the mandible alone was fractured traffic accidents accounted for 50%, while assaults were responsible for 20%. Accidents at work only occurred among the men. Of the 487 mandibular fractures the most frequent site was the condylar process (36%) where half of the fractures in women were localized. Assaults most frequently caused fracture of the angle of the mandible; while falls were most frequently responsible for fracture of the condylar process. The fracture distribution in dentulous and edentulous mandibles differed despite the aetiology being the same.

Accidents, Occupational↗
PubMed1995

Bafilomycin A1 in bone resorption and tooth eruption in dogs.

Tooth eruption depends on bone resorption to form an eruption pathway. We have previously shown that a 2-wk local infusion of bafilomycin A1, an inhibitor of vacuolar H(+)-ATPases in osteoclasts, into the crypts of erupting mandibular premolars in dogs blocks bone resorption during this period and eruption of these teeth is delayed for 8 wk. Here we report the limits of inhibition of resorption that still permit eruption of these teeth. In 3 dogs 10(-6) M bafilomycin was delivered by osmotic minipumps early (18 wk) in eruption to the fourth premolar for 1, 3 or 4 wk. Radiographs taken at weekly intervals thereafter showed that bafilomycin delivery for 1 wk delayed eruption for 3 wk, delivery for 3 wk delayed eruption 9 wk and delivery for 4 wk prevented eruption. These data show that tooth eruption is delayed in direct proportion to the time resorption is blocked, and that this process for dog premolars cannot be blocked for more than 3 wk with 10(-6) M bafilomycin without blocking eruption itself.

Alveolar Process↗
PubMed1976

The effect of dexamethasone in traumatic changes of the periodontium of marmosets (Callithrix jacchus).

The systemic administration of steroid hormone (0.400 mg of Dexamethasone every 2 days), during a 28-day period in marmosets (Callithrix jacchus) produced modifications in the evolution of the experimental periodontal traumatism. The observed changes were osteoporosis and reduction of the periodontal fibers in quantity as well as a reduction of repair process, when compared to the control group that only received the action of the trauma from occlusion.

Alveolar Process↗
PubMed2002

Biological mediators for periodontal and bone regeneration.

In the past 25 years, significant advances in treatment have occurred in the area of periodontal and bone regeneration. Novel regenerative therapies have emerged based on an increased understanding of embryonic development and wound healing at the cellular and molecular level. Two approaches that have demonstrated significant regenerative potential include the administration of enamel matrix proteins and growth and differentiation factors. Current data regarding the use of enamel matrix proteins support their safety and efficacy. The use of recombinant growth and differentiation factors has been validated in preclinical and clinical trials. A new era of regenerative therapies has emerged, using biological mediators combined with scaffold materials to stimulate cellular processes required for the regeneration of oral tissues. The clinical application of these therapies will be to either replace or augment traditional regenerative treatments.

Alveolar Process↗
PubMed2006

Effects of Tissucol and epsilon aminocaproic acid in the healing process following dental extraction in dehydrated rats.

A histological study was conducted of the alveolar bone healing process following tooth extraction of dehydrated rats after the implantation of fibrin adhesive (TISSUCOL) associated to previous irrigation of the wound with a 5% epsilon aminocaproic acid solution (EACA). Seventy two rats were used, divided into three groups receiving different treatments after the surgical procedure. In group I, the gingival mucosa was sutured after extraction of the right upper incisor. In groups II and III, chronic dehydration was produced by water deprivation for 9 days (3 days in the preoperative period and 6 days in the postoperative period). In the animals of Group II, after tooth extraction, the gingival mucosa was sutured in the same way as performed in group I. In group III, after extraction, the dental socket was irrigated with 5% EACA, followed by implantation of the fibrin adhesive (TISSUCOL). The mucosa was sutured in the same way as performed in the other groups. At 3, 7, 15 and 21 postoperative days, the animals were sacrificed in number of 6 for each group. Specimens containing the dental socket were removed and fixed in 10% formalin and decalcified in an equal part formic acid and sodium citrate solution. After routine processing, the specimens were embedded in paraffin for microtomy. We obtained 6 microm semi-serial slices that were stained with hematoxylin and eosin for histological evaluation. The results showed that the water deprivation in the pre- and postoperative periods caused a delay in the alveolar bone healing process. The use of the fibrin adhesive (TISSUCOL) produced an improvement in the fibrinolytic picture caused by dehydration.

Aminocaproic Acid↗
PubMed1999

Guided bone regeneration using titanium grids: report of 10 cases.

In order to ensure an adequate space where new bone can be formed in guided bone regeneration (GBR), most surgeons fill bone defects with biomaterials. In this work we evaluated new bone regeneration in 10 patients using only a blood clot protected with titanium grids and non-resorbable membranes, without any filling material. A manual measurement of the size of the bone defect, using a plastic probe, was performed at 2 surgical steps. After 5 months of treatment, a biopsy was taken from each patient, fixed and embedded in PMMA, examined microradiographically and morphologically to evaluate the newly-formed bone. Our results showed a good repair of the defects by bone regeneration (about 85% overall), high mineral density of new bone around the implants after 5 months, and steady state deposition processes. These results in GBR, without filling material, appear very promising for implantology and reconstructive odontostomatology practice.

Adult↗
PubMed2002

Immunolocalization of a human cementoblastoma-conditioned medium-derived protein.

Little is known about the molecular mechanisms that regulate the cementogenesis process, because specific cementum markers are not yet available. To investigate whether a cementoblastoma-conditioned medium-derived protein (CP) could be useful as a cementum biological marker, we studied its expression and distribution in human periodontal tissues, human periodontal ligament, alveolar bone, and cementoblastoma-derived cells. In human periodontal tissues, immunoreactivity to anti-CP was observed throughout the cementoid phase of acellular and cellular cementum, cementoblasts, cementocytes, cells located in the endosteal spaces of human alveolar bone, and in cells in the periodontal ligament located near the blood vessels. Immunopurified CP promoted cell attachment on human periodontal ligament, alveolar bone-derived cells, and gingival fibroblasts. A monoclonal antibody against bovine cementum attachment protein (CAP) cross-reacted with CP. These findings indicate that CP identifies potential cementoblast progenitor cells, is immunologically related to CAP species, and serves as a biological marker for cementum.

Adult↗
PubMed1995

Primary closure of the cleft alveolus: a functional approach.

The growth and development of the premaxilla in both normal and cleft lip and palate subjects is described and its relevance in surgery of the cleft alveolus discussed. Embryologically, the cleft alveolus results from failure of fusion of the median nasal and maxillary processes. Consequently, ossification centres in the premaxilla and maxilla cannot migrate and unite such that normal growth and development in the territory of the premaxillary-maxillary suture cannot occur. Functional repair of the cleft lip and soft palate encourages spontaneous alignment of the alveolar segments, facilitating the introduction of vascularized periosteum across the bony defect by gingivoperiosteoplasty. Early reconstruction in the region of the premaxillary-maxillary suture encourages a more normal development of the alveolus, particularly in the bilateral cleft subject.

Alveolar Process↗
PubMed1996

Comparison of healed tissues adjacent to submerged and non-submerged unloaded titanium dental implants. A histometric study in beagle dogs.

This study involved histometry of the healed tissues around submerged and nonsubmerged dental implants in beagle dogs. In a split-mouth design, 19 submerged and 19 nonsubmerged commercially pure titanium implants, titanium plasma-sprayed in the bone anchoring part and smooth in the transmucosal portion, were placed in the mandibles of 6 dogs. Oral hygiene was performed 3 times weekly. After 3 months of healing, transmucosal abutments were inserted in the submerged implants. Six weeks after second stage surgery, the dogs were sacrificed and specimens obtained and processed for histology and histometry. Using a light microscope and a digitizing pad, the distance from implant top to mucosa border (DIM), the extent of epithelial downgrowth (ED), the attachment level, (AL), the length of connective tissue contact (CTC) and the distance of the first coronal alveolar bone contact from the implant top (DIB) were measured at the mesial and distal aspects. Means +/- standard deviations for submerged and nonsubmerged implants were calculated, with the dog being the unit of measure. No statistically significant differences between submerged and nonsubmerged implants were found for DIM, CTC and DIB. However, significant differences were observed for ED and AL. This study in beagle dogs indicates that the apical extension of the peri-implant epithelium is significantly greater and the attachment level significantly lower adjacent to submerged implants with second-stage transmucosal abutments than in nonsubmerged, one-stage implants.

Alveolar Process↗
PubMed1977

Diffuse alveolar damage in cats induced by nitrogen dioxide or feline calicivirus.

The ultrastructural morphogenesis of pulmonary lesions was studied in cats exposed to either aerosols of feline calicivirus (FCV) or high concentrations of NO2. Both directly injured alveolar lining cells, particularly type I cells. Necrosis of pneumocytes attended by an acute exudative response in the air exchange tissues was evident from 0 through 24 hours after exposure of cats to NO2 and from 12 through 96 hours after infection with FCV. The reparative process following alveolar injury was characterized by regenerative hyperplasia of type II pneumocytes, proliferation of stromal cells, and infiltration of mononuclear cells. Differences in the lesions produced by NO2 and FCV also were encountered. Endothelial necrosis was detected only after NO2 injury, whereas a marked infiltration of neutrophils and immunocytes was observed only after FCV injury. The FCV/NO2 experimental system in cats is well suited for studies of diffuse alveolar damage of toxic and viral etiology.

Animals↗
PubMed1994

Technetium 99m-MDP scintigraphy of patients undergoing implant prosthetic procedures: a follow-up study.

The clinical evaluation of peri-implant tissue is mainly based on x-rays. In recent years, radioisotope scintigraphy using Tc-99m-MDP (technetium-99m-methylene diphosphonate) proved to be a useful and reliable clinical method for measuring increased metabolic activity at specific sites of the skeletal tissue. Twenty-six (26) patients (26 to 75 years) who were diagnosed for implant prosthetic treatment modality were randomly chosen to participate in this study. Each patient was injected with 20 mCi of Tc-99m-MDP was scanned 2 hours later by gamma-camera for isotope uptake levels in the jaws. Each patient was scanned 1 to 4 times, starting 2 weeks after implant surgery and up to the 40th week postsurgery. Blade and screw type implants using the non-submerged, one-stage technique were placed. Therefore, the prosthetic reconstruction was initiated 2 weeks after implant surgery. In order to compare the different scans we formulated a relative "bone scan index" (BSI). The results of 62 scans were plotted as BSI against time after implant surgery. A mathematical regression analysis of the BSI was also performed. At the initial stage of 2 to 3 weeks after surgery the BSI is high and then gradually declines. While BSI of the implants in the mandible reaches baseline levels after 12 weeks, the BSI in the maxilla reaches baseline only after 20 weeks. On the other hand, there was no difference in BSI with regard to blade or screw type implant. Here we were able to demonstrate that the process is independent of implant modality and depends on the specific metabolic properties of the jaw.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[A practical method for the determination of the available bone height in oral implantology].

This method puts forward a new and quick process to fix the available height of bone in the recipient site of an endosseous implant. With a flexible strip containing a lot of small equidistant gauged steel spheres, we can quickly reckon up the height of bone. The strip having been placed in the mouth, the patient bites it during the panoramic X-ray examination. The diameter of the spheres is known. On the X-ray photography we can easily measure the spheres and then reckon the available height of bone in the recipient site. This method presents many advantages: the anatomical conditions in the recipient site (specially the height of bone) are known very quickly, in case of contra-indication, this method gets the practitioner out of prescribing new X-ray examinations. So we consider that it is an economical process, an X-ray examination is always realizable with the strip. It is an easy work comparing with TDM.

Alveolar Process↗
PubMed1998

Attachment formation following replantation of cultured cells into periodontal defects--a study in minipigs.

Regeneration processes in the periodontium occur by the interaction of different cell populations. It is known that these cells are also capable of forming new periodontal tissue after culture in vitro. The present study investigated whether replanted cultured cells from the periodontium could contribute to attachment formation. Primary cell cultures from alveolar bone and periodontal ligament were obtained from 11 minipigs. Experimentally induced furaction and interdental defects (n = 168) were treated in groups: (a) flap surgery, replantation of alveolar bone cells, and covering of the defects with Teflon membranes (ABC group); (b) flap surgery, replantation of periodontal ligament cells and membranes (PLC group); (c) flap surgery, bone gelatin (carrier material) and membranes (BG group); (d) flap surgery and membranes (NBG group); (e) flap surgery (FS group); and (f) no treatment (NT group). The defects were clinically and histologically (polyfluorochrome labeling) assessed after 10, 30, and 90 days. In the ABC group, initial calcified tissue formation at the roots was apparent after only 8 days. Marked new formation of cementum and alveolar bone and the development of a new attachment were observed after 90 days. In the BG and the NBG groups, wound healing varied depending on membrane healing and the morphology of the defects, which led to significantly poorer and variable results. Similar results were found in the PLC group, although some defects showed extensive cementum and bone formation. Defects in the FS and the NT groups healed largely by epithelialization. The study shows that replantation of cultured alveolar bone cells leads to formation of new cementum and bone, which, in turn, leads to formation of a new attachment. It is likely that the cells stabilize the tissue formation in the defect or on the root surface in the early phase of wound healing and prevent epithelial downgrowth. Results also show that regeneration in the periodontium is determined by the availability of (precursor) cells capable of forming calcified tissues.

Alveolar Process↗
PubMed2006

Cellular, molecular, and tissue-level reactions to orthodontic force.

Remodeling changes in paradental tissues are considered essential in effecting orthodontic tooth movement. The force-induced tissue strain produces local alterations in vascularity, as well as cellular and extracellular matrix reorganization, leading to the synthesis and release of various neurotransmitters, cytokines, growth factors, colony-stimulating factors, and metabolites of arachidonic acid. Recent research in the biological basis of tooth movement has provided detailed insight into molecular, cellular, and tissue-level reactions to orthodontic forces. Although many studies have been reported in the orthodontic and related scientific literature, a concise convergence of all data is still lacking. Such an amalgamation of the rapidly accumulating scientific information should help orthodontic clinicians and educators understand the biological processes that underlie the phenomenon of tooth movement with mechanics (removable, fixed, or functional appliances). This review aims to achieve this goal and is organized to include all major findings from the beginning of research in the biology of tooth movement. It highlights recent developments in cellular, molecular, tissue, and genetic reactions in response to orthodontic force application. It reviews briefly the processes of bone, periodontal ligament, and gingival remodeling in response to orthodontic force. This review also provides insight into the biological background of various deleterious effects of orthodontic forces.

Alveolar Process↗
PubMed2003

Role of the microgap between implant and abutment: a retrospective histologic evaluation in monkeys.

BACKGROUND: It has been hypothesized that a certain width of the peri-implant mucosa is required to enable a proper epithelial-connective tissue attachment and, if this soft tissue dimension is not adequate, bone resorption will occur to ensure the establishment of attachment with an appropriate biological width. The reason for the accelerated bone loss around submerged 2-piece implants in the first year after the restoration is not known, but one possibility is that the gap between components plays a role in this process. Recent studies have shown that for all 2-part implants, the bone crest level changes appeared dependent on the location of the microgap. METHODS: The aim of the present study was a retrospective histologic evaluation in monkeys of the bone response to implants inserted 1 to 2 mm above the alveolar crest (group 1, 15 implants), at the level of the alveolar crest (group 2, 12 implants), or 1 to 1.5 mm below the alveolar crest (group 3, 13 implants). These implants had been early loaded, immediately loaded, and inserted immediately postextraction. RESULTS: In group 1, a 0.13 +/- 0.12 mm bone increase in a coronal direction was seen. In group 2, a 2.1 +/- 0.29 mm vertical bone loss was present. In group 3, a mean 3.6 +/- 0.46 mm vertical bone loss extending in an apical direction was observed. Statistically significant differences were observed between all 3 groups. CONCLUSIONS: Our results confirm data published previously that if the microgap was moved coronally away from the alveolar crest, less bone loss would occur and if the microgap was moved apical to the alveolar crest, greater amounts of bone resorption were present. This remodeling is not dependent on early and immediate loading of the implants or on immediate postextraction insertion.

Alveolar Bone Loss↗
PubMed2000

The spectrum of minimal clefting: process-oriented cleft management in the presence of an intact alveolus.

The minimal cleft lip provides a model for study of the clefting process. Nasolabial embryogenesis can be best understood using the concept of embryonic fields in which midline structures (columella, philtrum, premaxilla, septum, vomer, and ethmoids) develop with paired, fused A fields. Anatomic features of the minimal cleft lip suggest that the actual clefting site is located at the interface between the A and B fields within the lateral piriform wall. Study of the progression of clefting, using this model, places the timing of the clefting event to Carnegie stage 14. The degree to which this initial event affects subsequent fusion of the lateral and medial nasal processes (D and C fields) determines the final morphology of the cleft. Using this model, a rational basis is presented for the surgical management of minimal clefting in its varying manifestations.

Adult↗