International Journal of Periodontics & Restorative Dentistry, 5/2020
DOI: 10.11607/prd.4566, PubMed ID (PMID): 32926005Pages 749-e758, Language: English
This investigation was designed to evaluate the long-term effectiveness of human placental allograft in root coverage procedures in terms of clinical and esthetic outcomes. Thirteen patients with 28 maxillary or mandibular recession defects > 4 mm deep were reexamined at 6 months and 5 years postoperatively. Overall, mean percentage of root coverage decreased from 65.58% ± 16.45% to 49.75% ± 19.40% with a greater stability of the gingival margin in the mandible. At 5 years, 18 sites maintained at least 2 mm of keratinized tissue. Gingival color and texture blended well with adjacent soft tissue area in 78.6% of treated sites.
International Journal of Periodontics & Restorative Dentistry, 4/2020
DOI: 10.11607/prd.4647, PubMed ID (PMID): 32559030Pages 487-496b, Language: English
The aim of this retrospective study was to evaluate long-term clinical and radiologic outcomes of submerged and nonsubmerged guided bone regenerative treatments for peri-implantitis lesions. Strict methods of implant-surface decontamination and detoxification were performed. Data on clinical probing depth, soft tissue measures, and marginal bone level that were documented by comparative radiographs were obtained from 45 patients, for a total of 57 implants prior to treatment and at the latest follow-up. The average followup period was 6.9 years (range: 2 to 21 years). Analysis of implant-based data revealed a success rate of 70.2% for a total of 40 implants. Recurrence of periimplantitis was observed on 9 implants, and 8 implants were removed. The regenerative procedures, under a strict periodontal control, were effective in the treatment of moderate to advanced peri-implantitis lesions.
International Journal of Periodontics & Restorative Dentistry, 1/2020
DOI: 10.11607/prd.4523, PubMed ID (PMID): 31815978Pages 95-102, Language: English
This retrospective study evaluated the long-term response of periodontal tissues and survival rate of teeth with advanced attachment loss and pathologic migration in 21 periodontitis patients treated with combined periodontal and orthodontic treatment. All anterior migrated teeth were in function at the end of 10 to 15 years of maintenance. Residual probing depths and clinical attachment levels improved after treatment and remained stable through the follow-up. A total of 55 hopeless teeth were lost during active therapy, as well as 6 molars over the course of the supportive periodontal therapy (for nonperiodontal reasons). In highly compliant patients, all migrated teeth with initial unfavorable prognosis showed long-term clinical stability.
International Journal of Periodontics & Restorative Dentistry, 2/2019
DOI: 10.11607/prd.3337, PubMed ID (PMID): 30794260Pages 245-251, Language: English
The present case series evaluated three-dimensional volumetric bone tissue changes and new bone formation in severely resorbed extraction sockets augmented with Bio-Oss collagen and a covering collagen membrane in nine chronic periodontitis patients. Healing was by secondary intention. After 12 months of healing, the augmentation procedure appeared not only to compensate for bone remodeling but also appeared to repair a significant portion of the buccal wall. The mineralized tissue filled the 91.49% ± 6.77% of the maximum volume for regeneration. Overall, a mean of 49.6% new bone, 27.1% residual graft material, and 23.3% connective tissue were detected.
International Journal of Periodontics & Restorative Dentistry, 1/2019
DOI: 10.11607/prd.3278, PubMed ID (PMID): 29677225Pages 97-105, Language: English
This case series evaluated bone dimensional changes following the application of an occlusive titanium barrier on severely resorbed fresh extraction sockets to achieve bone regeneration. Six extraction sites with buccal bone loss were filled with a xenograft and covered with a titanium plate fixed by two miniscrews and left intentionally exposed. No infection occurred. After 4 months of healing, sufficient hard tissue had formed to allow implant insertion. Mean vertical bone gain was 7.3 ± 2.2 mm at the buccal side and 4.2 ± 1.2 mm at the lingual side. The average bone width augmentation was 23 ± 1.0 mm. At 24 months, all implants were clinically successful. Based on these preliminary findings, occlusive titanium barriers without primary closure may be successfully used in immediate alveolar reconstruction procedures.
International Journal of Periodontics & Restorative Dentistry, 5/2018
DOI: 10.11607/prd.3003, PubMed ID (PMID): 29513774Pages 673-680, Language: English
This case series evaluated the healing of deep intrabony defects treated with a combination of enamel matrix derivative and autologous particulate bone harvested from the buccal and lingual/palatal cortical plate with a Piezosurgery device. A total of 15 defects with a predominantly one- or two-wall component were consecutively treated in 15 patients with advanced chronic periodontitis. In all selected sites, the three-wall component was ≤ 25% of the total defect depth. Clinical and radiographic parameters were recorded at baseline and 12 and 24 months postoperatively. All defects showed favorable clinical and radiographic outcomes at the 24-month follow-up. The probing depth reduction was 4.4 ± 1.6 mm, and more than 50% of the defects presented clinical attachment level gain of at least 5 mm. The bone fill was 3.1 ± 1.6 mm.
International Journal of Periodontics & Restorative Dentistry, 3/2018
Online OnlyDOI: 10.11607/prd.3495, PubMed ID (PMID): 29813142Pages e33-e40, Language: English
The aim of this pilot in vitro study was to evaluate material wear and temperature variations after using conventional rotating bur and piezosurgical insert for osseous resective surgery in bovine bone blocks under physiologic irrigation. Wear evaluation was carried out by measuring cutting time, and wear mechanisms were analyzed by scanning electron microscopy. Time analysis showed greater material wear and higher heat production with the piezoelectric insert. However, temperatures remained below values of clinical concern even after a cutting time of 20 minutes. Conversely, bone surface appeared irregular in shape with bone debris and signs of thermal damage on the bur-drilled surface, probably due to the more traumatic action of the diamond-coated bur.
The International Journal of Oral & Maxillofacial Implants, 2/2018
DOI: 10.11607/jomi.5684, PubMed ID (PMID): 28817739Pages 373-382, Language: English
Purpose: The primary aim of the study was to describe a novel technique to evaluate volumetric hard tissue dimensional changes after ridge augmentation procedures. The secondary aim was to apply this newly developed measuring method to compromised alveolar sockets grafted with a slowly resorbing biomaterial covered with a collagen membrane.
Materials and Methods: Eleven patients (6 men and 5 women, mean age 52.7 ± 8.3 years) requiring extraction of one hopeless tooth for severe periodontitis in the maxillary anterior area were consecutively treated with a ridge augmentation procedure. All experimental sockets showed advanced buccal bone plate deficiency and were grafted with deproteinized bovine bone mineral with 10% collagen covered with a collagen membrane. Sockets healed by secondary intention. Three-dimensional volumetric alveolar bone changes were calculated by superimposing cone beam computed tomography scans obtained before and 12 months after the augmentation procedure.
Results: After 12 months, the alveolar mineralized tissue filled 91.20% ± 7.96% of the maximum volume for regeneration. The augmentation procedure appeared not only to compensate for bone remodeling in most alveolar regions but also to repair a significant portion of the buccal wall. The most significant ridge width changes occurred 1 mm apical to the bone crest (2.33 ± 1.46 mm, P < .001).
Conclusion: Within present limitations, this radiographic measuring methodology can be a useful tool to evaluate changes in socket volume. A ridge preservation technique performed with collagenated bovine bone and a collagen membrane was able to improve ridge shape and dimensions in compromised alveolar sockets.
Keywords: alveolar process, bone substitutes, cone beam computed tomography, periodontitis, regenerative medicine
International Journal of Periodontics & Restorative Dentistry, 1/2018
DOI: 10.11607/prd.3425, PubMed ID (PMID): 29240205Pages 51-58, Language: English
The present case series aimed to explore the potential clinical benefits of the application of dental pulp stem cells (DPSCs) in the regenerative treatment of deep intrabony defects. A total of 11 isolated intrabony defects in 11 chronic periodontitis patients were accessed with a minimally invasive flap and filled with DPSCs loaded on a collagen sponge. A tooth requiring extraction for impaction or malpositioning was used as an autologous source for DPSCs. An average clinical attachment level gain of 4.7 ± 1.5 mm associated with a residual mean probing depth (PD) of 3.2 ± 0.9 mm and remarkable stability of the gingival margin was observed at 1 year. Complete pocket closure (PD ≤ 3 mm) was achieved in 63.6% of the experimental sites. Clinical outcomes were supported by the radiographic analysis showing a bone fill of 3.6 ± 1.9 mm.
International Journal of Periodontics & Restorative Dentistry, 5/2017
Online OnlyDOI: 10.11607/prd.3189, PubMed ID (PMID): 28817128Pages 245-252, Language: English
The aim of this study was to histologically examine any epithelial cell inclusions in submerged subepithelial connective tissue graft (SCTG) after clinical healing was achieved. A total of 16 patients with Miller Class I or II gingival recessions were consecutively treated with a bilaminar procedure. At 2 months after surgery, a gingival tissue specimen was harvested from all SCTG-treated sites and stained with hematoxylin-eosin. The histologic evaluation revealed connective tissue in active reorganization without epithelial inclusions in 14 of the 16 tissue specimens. In the remaining 2 specimens, epithelial islands were observed deep in the connective tissue. In one case they developed in a solid cystic space, while in the second case they were strictly integrated in the lamina propria. Complete recession coverage was obtained in 14 of the 16 treated defects, with a mean root coverage of 95.1% ± 14.2% at 12 months.