1/21. Treatment of furcation defects with DFDBA combined with GTR: human histologic evaluation of a case.The purpose of this study was to evaluate whether regeneration is possible in human furcation defects. Three molars with Class II furcation involvement were included in this study. A notch was placed in calculus in the furcation to serve as a reference point for histologic evaluation. The defects were treated with a demineralized freeze-dried bone allograft combined with a bioabsorbable membrane. At 6 months postoperative, the teeth were extracted with a small piece of tissue from the furcation area. The samples were then processed for histologic evaluation. Regeneration was found in 2 of the 3 samples. This study demonstrated that regeneration is possible in human furcation defects.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/21. Furcation involvement in posterior teeth.This article presents two cases in which different treatments were used for mandibular molars with furcation lesions. In the first case, a conventional amputation treatment of the distal root was performed to save the mesial root as a terminal tooth, which was used as a partial denture abutment. The second case describes a relatively new technique in which a root perforation was filled with graft material (synthetic bioglass) and covered with a resorbable membrane to treat an iatrogenic furcation lesion adjacent to the mesial root. Twelve months after surgery, periapical radiographs of both treated cases showed increased bone density. Follow-up in both cases--30 months in the first case and 12 months in the second--showed no pathological recurrence or clinical dysfunction. Root amputation may provide an alternative to extraction in periodontally involved molars. Synthetic bone replacement materials combined with guided tissue regeneration may also help to correct osseous defects incurred by recent furcation perforations with associated bone loss.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
3/21. Defect morphology: effects on regenerative predictability and membrane selection.In clinical experience, guided tissue regeneration has been associated with complications, which include membrane exposure. The maintenance of a stable blood clot under the membrane is key to a successful regenerative outcome. This requires adequate membrane stabilization, tension-free suturing, and maintenance of a good vascular supply to the defect. Careful selection of defects after a thorough periodontal evaluation and modification of surgical techniques from those used for conventional resective procedures can lead to predictable outcomes for guided tissue regeneration.- - - - - - - - - - ranking = 7keywords = membrane (Clic here for more details about this article) |
4/21. Periodontal regeneration of a class II furcation defect utilizing a bioabsorbable barrier in a human. A case study with histology.This case report describes human histologic data of periodontal regeneration following guided tissue regeneration therapy (GTR) with a bioabsorbable barrier composed of polylactic acid. The tooth that was examined was part of a previously published study of the clinical effects of GTR therapy without the use of bone or bone substitutes on Class II furcation defects. Twenty-five months following the surgical procedure, the tooth was extracted for non-periodontal reasons. During this extraction, the bone within the furcation that was treated in the study was luxated with the tooth. At the completion of the study (month 12), the furcation's vertical probing depth had decreased by 2 mm with a 2 mm gain in clinical attachment. The horizontal furcation measurement decreased by 3 mm. Following extraction, the tooth was prepared for light microscopy and sectioned in the mesial-distal plane. Reference notches were not placed in the tooth at the time of surgery as there were no plans to perform histologic analysis in the study. However, using the buccal root prominences and what we interpreted to be root planing marks on the cementum, we were able to demonstrate that complete periodontal regeneration occurred on the root surface that was exposed to the pocket environment prior to surgery. New alveolar bone, cementum, and periodontal ligament were consistently observed throughout the furcation in the areas that demonstrated clinical attachment gain and a decrease in horizontal probing depth. This case report adds to the accumulating evidence of histologic periodontal regeneration following guided tissue regeneration with bioabsorbable polylactic acid barriers.- - - - - - - - - - ranking = 733.1250503576keywords = periodontal ligament, ligament (Clic here for more details about this article) |
5/21. Treatment of furcation defects with an allograft-alloplast-tetracycline composite bone graft combined with GTR: human histologic evaluation of a case report.The purpose of this study was to histologically evaluate furcation defects in humans treated with an allograft-alloplast-tetracycline composite graft combined with an absorbable membrane for guided tissue regeneration (GTR). Three teeth with Class II furcation involvement on the buccal aspects were included in this study. A notch was placed in calculus during the procedure to serve as a reference point for histologic evaluation. The defects were then treated with an allograft-alloplast-tetracycline composite graft combined with an absorbable membrane for GTR. At 6 months postoperative, the teeth were extracted with conservative block sections and processed for histologic evaluation. Regeneration (new bone, cementum, and connective tissue attachment) coronal to a notch could be seen in one of the three defects treated. In the other two defects, a new connective tissue attachment was demonstrated (new connective tissue attachment into new cementum) in the notch placed in calculus. In this study, regeneration of a furcation defect in a human was documented with histology.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
6/21. Alveolar bone upper growth in furcation area using a combined orthodontic-regenerative therapy: a case report.BACKGROUND: This case report demonstrates orthodontic and regenerative combined therapy in a 49-year-old male whose right maxillary premolar furcation had a bony defect with poor biologic width resulting from extensive subgingival caries. In these advanced interdisciplinary cases, crown lengthening with periodontal surgery alone does not solve the complex clinical problems. We believe that a combined orthodontic and periodontal regenerative combination therapy offers the best option for achieving a predictable outcome. methods: First, regenerative therapy by open debridement with a bioabsorbable synthetic bone graft, bioabsorbable membrane, and minocycline root conditioning was carried out. Eight weeks after initial surgery, orthodontic extrusion was initiated. RESULTS: Radiographs and reentry documentation suggest that the furcation defect associated with poor biologic width was successfully treated. CONCLUSION: This case report demonstrates that orthodontic-regenerative combined therapy can resolve complex clinical problems and enhance predictability.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
7/21. Periodontal regeneration in human Class II furcations using purified recombinant human platelet-derived growth factor-BB (rhPDGF-BB) with bone allograft.This human clinical trial evaluated the clinical and histologic response to recombinant human platelet-derived growth factor-BB (rhPDGF-BB) delivered in bone allograft for the treatment of advanced Class II furcation defects. Three mandibular and one maxillary molar furcation defects were treated: Two received 0.5 mg/mL and two received 1.0 mg/mL rhPDGF-BB, in all cases mixed with DFDBA. Clinical probing depths and attachment levels were obtained presurgically and 9 months postsurgical, after which the teeth and surrounding tissues were removed en bloc. Both concentrations of rhPDGF-BB resulted in substantially improved horizontal (mean 3.5 mm) and vertical (mean 4.25 mm) probing depths and attachment levels (mean 3.75 mm). Histologic evaluation revealed periodontal regeneration, including new bone, cementum, and periodontal ligament coronal to the reference notch. Regeneration was also present coronal to the original osseous crest In one case where an enamel projection extended into the fornix of the furcation, new calcified tissue with new inserting connective tissue fibers was observed over the enamel. This study documented the favorable tissue response to rhPDGF-BB treatment at both the clinical and microscopic levels, provided the first human histologic evidence that new calcified tissue with inserting collagen fibers can occur over enamel projections within furcations, and demonstrated for the first time that complete periodontal regeneration can be achieved in advanced Class II furcation defects using a combination of purified recombinant growth factor and bone allograft.- - - - - - - - - - ranking = 733.1250503576keywords = periodontal ligament, ligament (Clic here for more details about this article) |
8/21. Mandibular bone deficit with a histologic study in man.The aim of this study was that to determine the clinical and histologic results of a new hydroxyapatite, with innovative properties compared with the other alloplastic materials used in the regenerative treatment of grade 3 bony defects of the mandibular furcations in the human. The hydroxyapatite used in our research is characterized by a scarce density and crystallinity, while from a microstructural point of view, the granules have nanometric dimensions (0.05-0.1 microm). The patient reported here by the authors had a grade 3 infrabony defect into a mandibular furcation. The surgical procedure used consists of the creation of a flap, roots planing, the conditioning of the roots with tetracycline HC, the accurate positioning of the granules of the hydroxyapatite in the furcation area, the crown replacing of the flap, and finally the suture of the same. Six months after the insertion of hydroxyapatite, the clinical effect was studied, comparing the variations found in probing the insertion of depth. At the end of the treatment, a block section of the molar was performed, with part of the surrounding soft tissues, whose histologic analysis underlined the moderate and initial formation of bony tissue, periodontal ligament, and radicular cement in the middle and lower portion of the furcation. In light of these results, the authors conclude that the use of this new hydroxyapatite is promising in the treatment of the mandibular furcations in the human, even if it will be necessary to continue to test its effectiveness through more studies.- - - - - - - - - - ranking = 733.1250503576keywords = periodontal ligament, ligament (Clic here for more details about this article) |
9/21. root resorption and ankylosis associated with guided tissue regeneration.BACKGROUND: root resorption and ankylosis have been reported rarely as sequelae to guided tissue regeneration (GTR). The authors describe a clinical case of root resorption following GTR that involved the use of a bioabsorbable membrane. CASE DESCRIPTION: Two years after GTR was performed on a Class II furcation defect, the clinical examination revealed root resorption reaching the pulp chamber. The furcation defect was filled with epithelium and connective tissue, which contained inflammatory infiltrate and fragments of the membrane. The authors also observed areas of the tooth that exhibited points of ankylosis and root resorption. CLINICAL IMPLICATIONS: Clinical trials have reported favorable clinical and histologic results with GTR. However, this case report, along with other case reports and studies in animals, suggests a high risk of root resorption and ankylosis after GTR, which could limit the indications for this technique.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
10/21. Bioactive glass and bioabsorbable membrane in the treatment of a maxillary class II furcation defect: case report with 6-month re-entry.The combination of bone graft materials with guided tissue regenerative procedures has been shown to have predictable positive results in periodontal defects, especially furcations. The following case report will demonstrate a severe class II furcation defect in a maxillary molar that was treated with combination therapy using bioactive glass and a bioabsorbable membrane made of a copolymer of polylactic/polyglycolic acid. Six-month re-entry revealed substantial clinical fill of the furcation defect. Comparison radiographs also demonstrated fill in the region.- - - - - - - - - - ranking = 5keywords = membrane (Clic here for more details about this article) |
| | Next -> |