Maxiilary sinus augmentation by the crestal approach: radiographic changes in graft height. a 1-year retrospective study

The purpose of this study is to evaluate, radiographically, the change in intra-sinus graft height after implant placement using inorganic mineral bovine bone and the osteotome technique. Thirty-one implants were placed in twenty-five patients with simultaneous sinus lift using the crestal approach and deproteinized bovine bone [[Bio-Oss[registered sing]]. Periapical radiographs were taken immediately after implant placement, after six months [healing period], and after a minimum of six months of loading. Changes of the graft height were evaluated using image analysis software [Image Tool for Windows, version 3, UTHSCA]. The distance between the implant apex and the graft summit was measured along the longitudinal axis of the implant [distance D]. This distance was consecutively measured on radiographs taken immediately after surgery [D0], at second stage surgery [D6], and at follow-up visits [D12]. Only 25 out of 31 implants were included to analyze the variation in the distance D in [D6 and D12]. Statistical analysis showed a significant difference between D0 and D6 [p<0.0001], between D6 and D12 [p<0.002], and between D0 and D12 [p<0.001]. The graft lost 27.4% of its apical height after twelve months. Within the limitations of the present study it was found that the use of deproteinized bovine bone, which has a very slow resorption rate, could not prevent changes in the initially gained intrasinus graft height. However, the reported results showed that its use was beneficial in limiting the loss of the augmented height to a minimum

proteines derivees de la matrice de l'email [Emdogain] dans la regeneration des lesions intra-osseuses paradontales: analyse des resultats

The enamel matrix derivative [EMD] has been introduced in 1997 for the regeneration of intrabony periodontal defects. The aim of the present review is to study its clinical and histological efficacy. Material and methods: 33 clinical trials and 8 histological investigations on the efficacy of EMD in the treatment of intrabony defects have reviewed. A meta-analytic approach has been adopted in analyzing the clinical attachment gain and the gingival recession by weighing the outcomes of each study in relation to the number of treated defects. The weighted mean of the clinical attachment gain amounted to 3.1 mm for 403 compiled defects. Gingival recession amounted to 1 mm for 265 compiled defects. Bone fill of the original defect varied between 0.8 mm and 4.8 mm. Despite the overall efficacy of EMD, a significant variation in clinical outcomes was observed. Histologicaly, of 28 chronic human intrabony defects compiled, 54% presented regeneration, 24% new connective tissue attachment and 25% long junctional epithelium. Considering the variations observed in clinical and histological outcome, further randomized controlled clinical trial with adequate statistical power one needed in orcler to clarify the efficacy and the predictability of the EMD treatment

effect of membrane contamination in guided tissue regeneration on clinical attachment gain/loss

Since the first clinical application of guided tissue regeneration, therapists expressed an immense interest for the technique and hopes for a true solution to the lost periodontal structures were raised. For years, non-resorbable membranes were the most widely used. They seemed to possess the ideal features of a membrane. In the past ten years, research was oriented towards the development of bioresorbable materials. Nevertheless, membrane contamination remains a major problem in regenerative therapy because of its consequences on treatment outcome. This article review will try to compare data concerning rate of exposure and contamination of resorbable and non-resorbable membranes