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At least 163 records · Page 9Linked to original sources

Potential applications of Erbium:YAG laser in periodontics.

OBJECTIVES: Since lasers were introduced for the treatment of oral diseases, there has been considerable advancement in technology. As a result, numerous laser systems are currently available for oral use. Neodymium:Yttrium-Aluminum:Garnet (Nd:YAG), carbon dioxide (CO(2)) laser and the semiconductor Diode lasers have already been approved by the US Food and Drug Administration for soft tissue treatment in oral cavity. The Erbium:YAG (Er:YAG) laser was approved in 1997 for hard tissue treatment in dentistry and recent studies have reported positive results. This suggests that the Er:YAG laser system is a promising apparatus, which will be able to revolutionize and improve dental practice, in particular periodontal treatment. In this mini-review, we would like to describe the positive characteristics of the Er:YAG laser which indicate its potential as a new treatment modality in periodontics. MATERIALS AND METHODS: Recent findings are summarized briefly to evaluate the potential of the Er:YAG laser for clinical application in periodontics. RESULTS: The Er:YAG laser possesses suitable characteristics for oral soft and hard tissue ablation. Recently, it has been applied for effective elimination of granulation tissue, gingival melanin pigmentation and gingival discoloration. Contouring and cutting of bone with minimal damage and even or faster healing can also be performed with this laser. In addition, irradiation with the Er:YAG laser has a bactericidal effect with reduction of lipopolysaccharide, high ability of plaque and calculus removal, with the effect limited to a very thin layer of the surface and is effective for implant maintenance. CONCLUSION: The Er:YAG laser seems to be an effective tool for periodontal therapy, however, further clinical and basic investigations are required to confirm its clinical application.

Aluminum Silicates↗

Current concepts in the surgical management of the atrophic mandible.

1. For the severely atrophic mandible surgery cannot be considered as a magical panacea. 2. Retention of teeth or tooth roots is important as we are unable to predict the degree of mandibular bone resorption relating to the innate vascular pattern. 3. More emphasis should be given to mylohyoid reduction as described in this paper. 4. A gain in stability by surgery should not be at the expense of retention. 5. Mucosal grafts are more satisfactory than skin grafts. 6. Bone graft augmentation in the future must be considered with great caution. 7. When removing denture hyperplasia which involves the sulcus, every effort must be made to preserve viable mucosa in order to reconstitute a resilient border seal.

Alveolectomy↗

Bony lid approach for apicoectomy of mandibular molars.

Apicoectomy in the lower molar region is indicated in many instances to avoid the need for prosthetic appliances. Nevertheless it is a method sometimes rejected by oral surgeons because of the thickness of the buccal compact bone in the lower molar area leading to extensive bone loss in addition to a restriction of vision and access during the operation. The present study reports twenty-four cases of apicoectomized mandibular molars treated with the bony lid approach which facilitates considerably the apicoectomy procedure. Once part of the buccal compact bone in the periapical area of the molars is removed, favourable conditions are created for the completion of the operation under direct vision of the operational field. The replacement of the buccal compact bone then minimizes the dimensions of the remaining bone cavity.

Alveolectomy↗

Reason and remedy for conflicting reports on comparative effects of steel scalpel and electrosurgical cutting on gingival tissues and alveolar bone.

The fact that electrosurgical cutting is governed by factors that have no influence on steel scalpel cutting is responsible for discrepancies among the results of investigations of the modalities. The investigator's equal expertise in the use of both modalities is a prerequisite for accurate comparative investigations of the effects of electrosurgical and steel scalpel cutting. Eleven specific factors that govern the efficacy and quality of electrosurgical cutting and that can, therefore, ensure consistently reliable histologic results and accurate conclusions have been mentioned.

Alveolectomy↗

Rationale and methods for crown lengthening.

Surgical crown lengthening should not be attempted when tooth fractures extend into the middle third of the root. Excessive bone reduction on the fractured tooth and necessary blending of osseous contours over adjacent teeth may result in mobility or furcation involvement. In addition, the necessary osseous surgery may create precipitous changes in the bony architecture that will be bridged by soft tissues. This results in increased pocket depth and an unhealthy situation. If the tooth in question has a hopeless prognosis or the osseous surgical procedure would create a poor crown-root ratio, furcation involvement, mobility, or esthetic problems, crown lengthening should be avoided. In cases such as these, extraction may be indicated.

Alveolectomy↗

Root morphology--clinical significance in pathogenesis and treatment of periodontal disease.

Root morphology is a seldom considered yet extremely important factor in the treatment of periodontal disease. The shape of the roots may contribute to development of periodontal defects by providing an environment favorable to the retention of plaque. The practitioner should periodically review root morphology and give it appropriate importance during planning and treatment. In this study, teeth with representative root anatomy were sectioned and photographed. The photographs are intended as a visual presentation of various root morphologies and their potential implications in the practice of periodontics.

Alveolectomy↗

Histologic evaluation of the effect of nicotine administration on bone regeneration. A study in dogs.

The objective of this study was to investigate the histometric impact of nicotine on bone regeneration of surgically created alveolar ridge defects in dogs. Sixteen mongrel dogs were used. One defect was surgically created unilaterally in the mandible, and left to heal spontaneously. The animals were randomly assigned to one of the following groups: Group 1--control (n = 8) and Group 2--subcutaneous nicotine administration (2 mg/kg) twice a day (n = 8). After 4 months, the animals were sacrificed and the specimens routinely processed for semi-serial decalcified sections. Bone height (BH), bone width (BW), bone density (BD), and bone area (BA) of the newly-formed bone were evaluated. Intergroup analysis (Mann-Whitney rank sum test) showed that regardless of the presence of nicotine, no significant differences were observed regarding bone width (BW), bone area (BA) and bone height (BH) (p > 0.05). On the other hand, it was demonstrated that nicotine administration significantly influenced the proportion of mineralized tissue within the limits of the newly-formed bone (BD) (p < 0.001). Within the limits of the present study, it can be concluded that nicotine might affect but not prevent bone healing in defects left to heal spontaneously.

Alveolar Process↗

New technique for creating permanent experimental alveolar clefts in a rabbit model.

Alveolar bone grafting is an adjunctive procedure that has become increasingly popular in the rehabilitation of patients with cleft lip and palate. A histologic basis of the performance of bone grafts is required to evaluate properly different grafting materials. This, however, cannot be provided by clinical studies on humans. Therefore, an animal model with a simulated alveolar cleft is needed. A number of animal models has been previously proposed by other investigators. The problems associated with each model are presented and a surgical technique for the creation of permanent alveolar clefts in rabbits is described. Clinical and histologic findings 6 weeks postoperatively confirm the establishment of a 1-cm wide defect with oronasal communication and healthy epithelial lining. This animal model can be efficiently used for the testing of various bone grafting materials.

Alveolar Process↗

Biologic responses of autogenous bone and beta-tricalcium phosphate ceramics transplanted into bone defects to orthodontic forces.

This study was conducted to evaluate biologic responses of autogenous bone (particulate marrow and cancellous bone; PMCB) and beta-tricalcium phosphate ceramics (TCPC) to orthodontic stimuli. Nine dogs served as the experimental animals; three dogs underwent orthodontic tooth movement after grafting, three dogs received PMCB grafting without tooth movement, and three dogs received TCPC grafting without tooth movement. Immediately after extraction of the upper second and/or third incisors, the maxillary alveolar bone was resected bilaterally. Autogenous PMCB obtained from the iliac bone and TCPC were transplanted into each bone defect. Experimental tooth movement was initiated 2 to 4 weeks after the grafting and continued for 9 to 15 weeks. Sectional archwires with open-coll springs were used for distal movement of the upper first incisors into the extraction sites. Oxytetracycline and calcein were employed as bone markers. Sections of grafted areas including the teeth were prepared for light and fluorescence microscopy. The results revealed that both autogenous bone and TCPC presented similar adaptive changes to the original alveolar bone without any external stimuli. TCPC exhibited more prominent biodegradative responses to orthodontic force in association with new cementum formation. Root resorption was also less in the TCPC area than in the PMCB region. It is shown that TCPC is biodegradative in nature and adaptive for remodeling during orthodontic tooth movement. This finding indicates that TCPC may be a better biocompatible alternative to autogenous bone transplanted into bone defects subjected to orthodontic tooth movement.

Adaptation, Physiological↗

Experimental tooth movement into bone induced by recombinant human bone morphogenetic protein-2.

OBJECTIVE: The development of biomaterials for secondary bone grafting to the alveolar cleft, recombinant human morphogenetic protein-2 (rhBMP-2) may have great potential to promote osseous regeneration. The purpose of this study was to investigate the osteoinductive activity of low-dose rhBMP-2 (10 microg/100 microL) and the biological response of newly generated bone to orthodontic stimulation, compared with previous results using high-dose rhBMP-2 (40 microg/100 microL). METHOD: After extraction of the maxillary first premolars, bone defects were surgically created in eight adult beagle dogs using a 5-mm-diameter trepan bar. The rhBMP-2 with a PLGA/gelatin sponge complex (PGS) made of gelatin and polylactic acid polyglycolic acid copolymer was immediately implanted. The osteoinductive activity of rhBMP-2 and tooth movement into the newly generated bone was evaluated based on histological and morphometric examination. RESULTS: Dramatic histological and morphometric differences were found in the time course of bone remodeling between low- and high-dose rhBMP-2. The onset of bone remodeling occurred significantly earlier in low-dose rhBMP-2. During experimental tooth movement, in contrast to high-dose rhBMP-2, with which root resorption occurred, only partial cementum resorption occurred on the pressure side with low-dose rhBMP-2. CONCLUSION: These results indicated that the proper dosage of rhBMP-2 should be determined for successful clinical application.

Absorbable Implants↗