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1.
Braz. dent. j ; 24(3): 204-212, May-Jun/2013. tab, graf
Article Dans Anglais | LILACS | ID: lil-681873

Résumé

Intrabony periodontal defects present a particular treatment problem, especially in patients with generalized aggressive periodontitis (G-AgP). Regenerative procedures have been indicated for this clinical situation. The aim of this study was to compare treatment outcomes of intrabony periodontal defects with either anorganic bone matrix/cell binding peptide (ABM/P-15) or guided tissue regeneration (GTR) in patients with G-AgP. Fifteen patients, with two intrabony defects ≥3 mm deep, were selected. Patients were randomly allocated to be treated with ABM/P-15 or GTR. At baseline and at 3 and 6 months after surgery, clinical and radiographic parameters and IL-1β and IL-6 gingival fluid concentrations were recorded. There was a significant probing pocket depth reduction (p<0.001) for both groups (2.27 ± 0.96 mm for ABM/P-15 group and 2.57 ± 1.06 mm for GTR group). Clinical attachment level gain (1.87 ± 0.94 mm for ABM/P-15 group and 2.09 ± 0.88 mm for GTR group) was also observed. There were no statistically significant differences in clinical parameters between the groups. The radiographic bone fill was more expressive in ABM/P-15 group (2.49 mm) than in GTR group (0.73 mm). In subtraction radiographs, the areas representing gain in density were 93.16% of the baseline defect for ABM/P-15 group versus 62.03% in GRT group. There were no statistically significant differences in inter-group and intra-group comparisons with regards to IL-1β and IL-6 quantification. Treatment of intrabony periodontal defects in patients with G-AgP with ABM/P-15 and GTR improved significantly the clinical outcomes. The use of ABM/P-15 promoted a better radiographic bone fill.


Defeitos periodontais infra-ósseos representam um desafio particular no tratamento, especialmente em pacientes com periodontite agressiva generalizada (PAg-G). Procedimentos regenerativos tem sido indicados para esta situação clínica. O objetivo deste estudo foi comparar os resultados do tratamento de defeitos periodontais infra-ósseos com associação de matriz óssea inorgânica bovina com o P-15 (MOI/P-15) ou regeneração tecidual guiada (RTG) em pacientes com PAg-G. 15 pacientes com PAg-G, com pelo menos dois defeitos periodontais infra-ósseos (profundidade de sondagem ≥4 mm e componente infra-ósseo ≥3 mm) foram selecionados. Os pacientes foram aleatoriamente alocados para serem tratados com MOI/P-15 ou RTG. No exame inicial, e aos 3 e 6 meses após a cirurgia, os parâmetros clínicos e radiográficos e as concentrações de IL-1β e IL-6 no fluido gengival foram registrados. Houve uma redução significativa profundidade de sondagem (p<0,001) para ambos os grupos (2,27 ± 0,96 mm para o grupo MOI/P-15 e 2,57 ± 1,06 mm para o grupo RTG). Um ganho no nível clínico de inserção (1,87 ± 0,94 mm para o grupo MOI/P-15 e 2,09 ± 0,88 mm para o grupo RTG) também foi observado. Na comparação entre grupos, não houve diferenças estatisticamente significativas nos parâmetros clínicos. O preenchimento ósseo radiográfico foi mais expressivo no grupo MOI/P-15 (2,49 mm) do que no grupo RTG (0,73 mm). Na análise radiográfica, as radiografias de subtração apresentaram ganho médio de área radiopaca em relação ao defeito inicial de 93,16% para grupo MOI/P-15, contra 62,03% para o grupo RTG. Na análise das citocinas, não foram observadas diferenças estatisticamente significantes nas comparações intra e entre os grupos. O tratamento de defeitos infra-ósseos com MOI/P-15 ou RTG em pacientes com PAg-G, em um período de 6 meses, levou a melhoras nos parâmetros clínicos. O uso de MOI/P-15 levou a um maior preenchimento radiográfico.


Sujets)
Adolescent , Adulte , Humains , Jeune adulte , Parodontite agressive/chirurgie , Résorption alvéolaire/chirurgie , Trame osseuse/transplantation , Collagène/usage thérapeutique , Régénération tissulaire guidée parodontale/méthodes , Fragments peptidiques/usage thérapeutique , Processus alvéolaire , Densité osseuse/physiologie , Études de suivi , Exsudat gingival/composition chimique , Interleukine-1 bêta/analyse , /analyse , Membrane artificielle , Perte d'attache parodontale/chirurgie , Poche parodontale/chirurgie , Technique de soustraction , Lambeaux chirurgicaux/chirurgie , Résultat thérapeutique
2.
Int. j. odontostomatol. (Print) ; 5(3): 279-286, dic. 2011. ilus
Article Dans Espagnol | LILACS | ID: lil-612102

Résumé

Se describe el tratamiento periodontal en un defecto óseo situado mesial a la pieza 2.3 y distal a la pieza 2.2, mediante la terapia combinada de derivado de la matriz del esmalte (DME) y aloinjerto óseo mineralizado. Se valoró la zona afectada y se planeo su abordaje quirúrgico para la terapia combinada. Seis meses después del tratamiento se observó una reducción significativa en la profundidad al sondeo y ganancia en los niveles de inserción, así como el relleno óseo del defecto en la evaluación radiográfica. Los resultados reafirman la efectividad del DME y el aloinjerto óseo mineralizado en la terapia regenerativa periodontal.


We describe the periodontal treatment in a bone defect located mesial to the 2.3 tooth, using combination therapy of enamel matrix derivate (EMD) and mineralized bone allograft. We evaluated the affected area and planned their surgical approach to combination therapy. Six months after treatment it showed a significant reduction in probing depth and gain in attachment levels and bone filling of the defect in the radiographic evaluation. These results confirm the effectiveness of the EMD and the mineralized bone allograft in periodontal regenerative therapy.


Sujets)
Humains , Femelle , Adulte d'âge moyen , Résorption alvéolaire/chirurgie , Protéines de l'émail dentaire/usage thérapeutique , Transplantation osseuse/méthodes , Régénération osseuse , Association thérapeutique , Perte d'attache parodontale/chirurgie , Résultat thérapeutique
3.
Article Dans Anglais | IMSEAR | ID: sea-140063

Résumé

Objective : To use the periosteum as a barrier in treatment of buccal Grade II furcation defects of lower molars. Materials and Methods : This technique was performed on 12 patients with bilateral buccal Grade II furcation defects of lower molars. On a random basis, one furcation defect of each pair was selected for the control group and other for the experimental group. Debridement was done in the defect area in both groups. In the control group, after debridement, mucoperiosteal flap was sutured back. In the experimental group, after reflection of the mucoperiosteal flap, a portion of the periosteum along with a layer of connective tissue (periosteal membrane) was incised and mobilized in the defect area for defect coverage as a barrier, and then the periosteal membrane and mucoperiosteal flap were fixed with suture, respectively. Horizontal dimension of the furcation defect was the primary outcome measure. Gingival index, probing attachment level (PAL), and vertical dimension of furcation defect were the secondary outcome measures. Clinical parameters were registered at baseline and at 6 months. Results : Every clinical parameter was improved by surgery. Significant gain in PAL as well as horizontal and vertical dimensions of the furcation defects was found. Conclusion: This periosteum displacement technique is effective for the treatment of buccal Grade II furcation defects of lower molars.


Sujets)
Adulte , Tissu conjonctif/transplantation , Débridement/méthodes , Études de suivi , Anomalies de furcation/classification , Anomalies de furcation/chirurgie , Régénération tissulaire guidée parodontale/méthodes , Humains , Mâle , Maladies mandibulaires/chirurgie , Adulte d'âge moyen , Molaire/chirurgie , Muqueuse de la bouche/chirurgie , Perte d'attache parodontale/classification , Perte d'attache parodontale/chirurgie , Indice parodontal , Poche parodontale/classification , Poche parodontale/chirurgie , Périoste/transplantation , Lambeaux chirurgicaux , Techniques de suture , Résultat thérapeutique
4.
Article Dans Anglais | IMSEAR | ID: sea-140062

Résumé

Background: The present study was aimed at comparing the clinical effectiveness of two regenerative techniques - platelet rich plasma (PRP) + bone graft (HA + β TCP) versus bone graft (HA + β TCP) + normal saline in the treatment of periodontal intrabony defects. Materials and Methods: Ten patients diagnosed with chronic periodontitis were enrolled in a randomized split mouth clinical trial. Following phase I therapy the sites were randomly assigned to the test group - PRP + bone graft (HA + β TCP) and control group - saline + bone graft (HA + β TCP). Clinical parameters recorded at baseline and 6 months included plaque index, probing pocket depth, relative attachment levels, and relative gingival margin levels. Hard tissue evaluation was done using digital radiography to evaluate the image intensity and therefore the radioopacity of a desired region of interest in the intrabony defect. Pre- and postoperative comparisons were made between the treatment groups at 6 months. Results: Test group sites showed a significantly higher reduction in pocket depth compared to control group sites. Test group sites showed a significantly higher amount of radioopacity in the regions of interest, indicative of better graft remodeling, compared to control group sites. Conclusion: (HA + β TCP) bone graft appears to be a beneficial material in the treatment of human periodontal intrabony defects. When combined with platelet-rich plasma there is a significantly higher reduction in probing pocket depth, higher gain in attachment levels and higher amount of radio-density seen in the intrabony defects.


Sujets)
Adulte , Résorption alvéolaire/classification , Résorption alvéolaire/chirurgie , Processus alvéolaire/imagerie diagnostique , Matériaux biocompatibles/usage thérapeutique , Densité osseuse/physiologie , Remodelage osseux/physiologie , Substituts osseux/usage thérapeutique , Parodontite chronique/chirurgie , Indice de plaque dentaire , Femelle , Études de suivi , Gencive/anatomopathologie , Humains , Hydroxyapatites/usage thérapeutique , Mâle , Adulte d'âge moyen , Perte d'attache parodontale/classification , Perte d'attache parodontale/chirurgie , Poche parodontale/classification , Poche parodontale/chirurgie , Plasma riche en plaquettes/physiologie , Études prospectives , Radiographie rétrocoronaire , Radiographie numérisée dentaire , Chlorure de sodium , Jeune adulte
5.
Article Dans Anglais | IMSEAR | ID: sea-139994

Résumé

Background: Mucoperiosteal flap surgery stimulates varying amounts of alveolar bone loss due to accelerated osteoclastic activity [Regional Accelerated Phenomenon (RAP)]. Alendronate sodium inhibits osteoclastic activity and is thought to result in a net increase in osteoblastic activity. We undertook a preliminary study evaluating the effect of adjunctive use of topically delivered bisphosphonate alendronate (ALN) along with regenerative bone graft material in the treatment of periodontal infrabony defects. Materials and Methods: Fifteen patients with two-walled or three-walled infrabony defects were selected. In each patient, the infrabony defect of one side of arch was designated as group A (control site) and received hydroxyapatite (HA) bone graft material, while the infrabony defect on the contralateral side of same arch was designated as group B (test site) and received HA + 200 μg drug solution of ALN. Results: Both the groups exhibited a highly significant reduction in probing depth and gain in clinical attachment level and linear bone fill at the end of 24 weeks. Comparative evaluation between the study groups revealed a statistically nonsignificant reduction in probing depth (P=0.128 NS ) and mean gain in attachment level (P=0.218 NS ). However, there was a statistically significant gain in linear bone fill (P=0.040*) in group B as compared to group A. Conclusions: The results suggest that use of ALN along with graft material led to enhanced linear bone fill at the surgical site. This research provides a clue that bone-targeting properties of bisphosphonates can be harnessed along with regenerative materials to potentiate osseous regeneration.


Sujets)
Adulte , Alendronate/usage thérapeutique , Résorption alvéolaire/imagerie diagnostique , Résorption alvéolaire/chirurgie , Processus alvéolaire/anatomopathologie , Processus alvéolaire/imagerie diagnostique , Agents de maintien de la densité osseuse/usage thérapeutique , Substituts osseux/usage thérapeutique , Parodontite chronique/anatomopathologie , Parodontite chronique/chirurgie , Durapatite/usage thérapeutique , Femelle , Études de suivi , Régénération tissulaire guidée parodontale/méthodes , Humains , Mâle , Adulte d'âge moyen , Ostéoclastes/effets des médicaments et des substances chimiques , Perte d'attache parodontale/anatomopathologie , Perte d'attache parodontale/chirurgie , Poche parodontale/anatomopathologie , Poche parodontale/chirurgie , Méthode en simple aveugle , Résultat thérapeutique
6.
Article Dans Anglais | IMSEAR | ID: sea-139926

Résumé

Background: Experimentation confirmed the conclusion that bone allografts, like other tissue and organ allografts, are immunogenic. These immune responses cause resorption of allograft, thus lowering the bone formation capacity of the graft. An attempt has been made in this study to prevent immune reactions and achieve enhanced regeneration of allograft-demineralized freeze-dried bone matrix by incorporating it with an immunosuppressive drug Cyclosporine-A (CsA) in the treatment of human periodontal infrabony defects. Materials and Methods: Fifteen patients showing clinical evidence of almost bilateral infrabony defects requiring bone grafting procedures were selected. In each patient, the infrabony defect of one side of the arch was designated as Group A (control site) and the infrabony defect of the contralateral side of the same arch was designated as Group B (test site). Results: On comparative evaluation of the two groups (by Student t-test), the mean values of reduction in probing depth (P=0.81 NS ) and gain in clinical attachment level (P=1.00 NS ) of Group B were found to be greater than that of Group-A, but the differences were statistically non-significant. The mean linear bone fill (P=0.010 ** ) of Group B was also detected to be higher than that of Group A, and the difference was found to be statistically significant. Conclusion: Increase in linear bone fill in Group B signifies the role of CsA in augmenting the regenerative potential of allograft by eliminating immune reactions.


Sujets)
Adulte , Résorption alvéolaire/imagerie diagnostique , Résorption alvéolaire/chirurgie , Trame osseuse/transplantation , Régénération osseuse/physiologie , Parodontite chronique/chirurgie , Ciclosporine/administration et posologie , Ciclosporine/usage thérapeutique , Femelle , Études de suivi , Lyophilisation , Humains , Immunosuppresseurs/administration et posologie , Immunosuppresseurs/usage thérapeutique , Mâle , Adulte d'âge moyen , Perte d'attache parodontale/chirurgie , Poche parodontale/chirurgie , Méthode en simple aveugle , Lambeaux chirurgicaux , Conservation de tissu , Transplantation homologue
7.
J. appl. oral sci ; 18(4): 379-384, July-Aug. 2010. ilus, tab
Article Dans Anglais | LILACS | ID: lil-557108

Résumé

OBJECTIVES: This study assessed the bone density gain and its relationship with the periodontal clinical parameters in a case series of a regenerative therapy procedure. MATERIAL AND METHODS: Using a split-mouth study design, 10 pairs of infrabony defects from 15 patients were treated with a pool of bovine bone morphogenetic proteins associated with collagen membrane (test sites) or collagen membrane only (control sites). The periodontal healing was clinically and radiographically monitored for six months. Standardized pre-surgical and 6-month postoperative radiographs were digitized for digital subtraction analysis, which showed relative bone density gain in both groups of 0.034 ± 0.423 and 0.105 ± 0.423 in the test and control group, respectively (p>0.05). RESULTS: As regards the area size of bone density change, the influence of the therapy was detected in 2.5 mm² in the test group and 2 mm² in the control group (p>0.05). Additionally, no correlation was observed between the favorable clinical results and the bone density gain measured by digital subtraction radiography (p>0.05). CONCLUSIONS: The findings of this study suggest that the clinical benefit of the regenerative therapy observed did not come with significant bone density gains. Long-term evaluation may lead to a different conclusions.


Sujets)
Adulte , Animaux , Bovins , Humains , Adulte d'âge moyen , Implant résorbable , Résorption alvéolaire/chirurgie , Protéines morphogénétiques osseuses/usage thérapeutique , Traitement d'image par ordinateur/méthodes , Membrane artificielle , Technique de soustraction , Résorption alvéolaire , Densité osseuse/effets des médicaments et des substances chimiques , Trame osseuse/transplantation , Substituts osseux/usage thérapeutique , Collagène , Durapatite/usage thérapeutique , Études de suivi , Régénération tissulaire guidée parodontale/instrumentation , Régénération tissulaire guidée parodontale/méthodes , Perte d'attache parodontale/chirurgie , Poche parodontale/chirurgie , Radiographie rétrocoronaire , Lambeaux chirurgicaux , Résultat thérapeutique
8.
Braz. dent. j ; 21(1): 60-67, Jan. 2010. ilus, tab
Article Dans Anglais | LILACS | ID: lil-552356

Résumé

This case series evaluated the clinical performance and patient-centered outcomes after a minimally invasive surgical technique (MIST) associated with enamel matrix protein derivative (EMD), for the treatment of intra-bony defects. Twelve patients presenting teeth with probing depth >5 mm and bleeding on probing associated with radiographic evidence of intra-bony defect were treated by MIST associated with EMD. Clinical parameters were measured at baseline, 3 and 6 months. Patient perception during the intraoperative period and during the first postoperative week was evaluated. The use of MIST with EDM promoted significant improvements in clinical parameters, minimal pain/discomfort and maximum esthetics satisfaction. Within of limits of the present study, it could be shown that MIST combined with EMD for the treatment of intra-bony defects promotes satisfactory clinical and patient-centered outcomes.


O objetivo deste estudo foi avaliar os resultados clínicos e centrados no paciente após abordagem cirúrgica minimamente invasiva (CMI) associada à aplicação das proteínas derivadas da matriz do esmalte (PDE) no tratamento de defeitos infra-ósseos. Doze pacientes apresentando um sítio com profundidade de sondagem >5 mm e sangramento à sondagem , associado à evidência radiográfica de defeito infra-ósseo, foram tratados com CMI e aplicação das PDE. Os parâmetros clínicos foram avaliados imediatamente antes do procedimento e após 3 e 6 meses. A percepção de dor e desconforto do paciente durante o período trans-cirúrgico e ao longo da primeira semana de pós-operatório, bem como a satisfação estética 6 meses após o tratamento, foram avaliadas por meio de questionários. Os resultados mostraram que o uso da CMI associada à aplicação de PDE promoveu melhoras estatisticamente significantes nos parâmetros clínicos, mínima dor e desconforto e máxima satisfação estética aos pacientes. Dentro dos limites do estudo, foi demonstrado que a associação de CMI e PDE, no tratamento de defeitos infra-ósseos, é capaz de promover satisfatórios resultados clínicos e centrados no paciente.


Sujets)
Femelle , Humains , Mâle , Adulte d'âge moyen , Résorption alvéolaire/chirurgie , Protéines de l'émail dentaire/usage thérapeutique , Régénération tissulaire guidée parodontale/méthodes , Satisfaction des patients , Attitude envers la santé , Processus alvéolaire/anatomopathologie , Parodontite chronique/chirurgie , Indice de plaque dentaire , Dentisterie esthétique , Études de suivi , Hémorragie gingivale/chirurgie , Récession gingivale/chirurgie , Complications peropératoires , Interventions chirurgicales mini-invasives , Hygiène buccodentaire , Complications postopératoires , Douleur postopératoire/étiologie , Perte d'attache parodontale/chirurgie , Poche parodontale/chirurgie , Lambeaux chirurgicaux , Résultat thérapeutique , Col de la dent/anatomopathologie
9.
Article Dans Anglais | IMSEAR | ID: sea-139777

Résumé

Background : Calcium phosphate cements (CPC) are apparently good candidates for periodontal treatment by virtue of their biocompatibility, mouldability and osteoconductivity. However, the clinical efficacy in this regard has not been established. This study is aimed at the evaluation of the efficacy of a formulation of CPC in healing human periodontal intraosseous defects in comparison with hydroxyapatite ceramic granules. Materials and Methods : In this clinical study, 60 patients with periodontal defects were divided into 2 test groups and 1 control group. The defect sites in the test groups were repaired with CPC and hydroxyapatite ceramic granules (HAG). Debridement alone was given in the control group. The progress was assessed at 3, 6, 9 and 12 months observation intervals through soft tissue parameters (probing depth, attachment level and gingival recession). Results: CPC showed significantly better outcome. Probing depth reduction values of CPC, HAG and Control at 6 months were 5.40 ± 1.43, 3.75 ± 1.71 and 2.90 ± 1.48, and those at 12 months were 6.20 ± 1.80, 4.5 ± 1.91 and 2.95 ± 1.73. Clinical attachment gain values of CPC, HAG and Control at 6 months were 5.15 ± 1.50, 3.45 ± 1.96 and 2.25 ± 1.52, and those at 12 months were 5.80 ± 2.02, 3.55 ± 2.06 and 2.30 ± 1.78, In both cases the P value was <0.001 showing high significance. The gingival recession over 12 months, for the CPC group is lesser than that in the HAG group and the value for the control group is marginally higher than both. Soft-tissue measurements were appended by postoperative radiographs and surgical re-entry in selected cases. Conclusions: Calcium phosphate cement is found to be significantly better than hydroxyapatite ceramic granules. The material could be considered as a "barrier-graft".


Sujets)
Implant résorbable , Adulte , Résorption alvéolaire/imagerie diagnostique , Résorption alvéolaire/chirurgie , Matériaux biocompatibles/usage thérapeutique , Ciments osseux/usage thérapeutique , Substituts osseux/usage thérapeutique , Phosphates de calcium/usage thérapeutique , Céramiques/usage thérapeutique , Débridement , Détartrage dentaire , Durapatite/usage thérapeutique , Femelle , Études de suivi , Récession gingivale/chirurgie , Régénération tissulaire guidée parodontale/méthodes , Humains , Mâle , Adulte d'âge moyen , Ostéogenèse/physiologie , Perte d'attache parodontale/chirurgie , Poche parodontale/chirurgie , Parodontite/chirurgie , Curetage sous-gingival , Lambeaux chirurgicaux , Résultat thérapeutique , Jeune adulte
10.
Braz. oral res ; 21(3): 241-246, 2007. tab
Article Dans Anglais | LILACS | ID: lil-458597

Résumé

The objective of this split-mouth, double-blind, randomized controlled trial was to compare the clinical effect of treatment of 2- or 3-wall intrabony defects with open flap debridement (OFD) combined or not with enamel matrix proteins (EMP). Thirteen volunteers were selected with one pair of or more intrabony defects and probing pocket depth (PPD) > 5 mm. All individuals received instructions regarding oral hygiene and were submitted to scaling and root planing. Each participant received the two treatment modalities: test sites were treated with OFD and EMP, and control sites received only OFD. After 6 months, a significant reduction was observed in PPD for the EMP group (from 6.42 ± 1.08 mm to 2.67 ± 1.15 mm) and for the OFD group (from 6.08 ± 1.00 mm to 2.00 ± 0.95 mm) (p < 0.0001), but with no significant difference between groups (p = 0.13). A significant gain in relative attachment level (RAL) was observed in both groups (EMP: from 13.42 ± 1.88 mm to 10.75 ± 2.26 mm, p < 0.001; OFD: from 12.42 ± 1.98 mm to 10.58 ± 2.23 mm, p = 0.013), but with no significant difference between groups (p = 0.85). Gingival recession (GR) was higher in the EMP group (from 1.08 ± 1.50 mm to 2.33 ± 1.43 mm; p = 0.0009) than in the OFD group (from 0.66 ± 1.15 mm to 1.16 ± 1.33 mm; p = 0.16), but this difference was not significant (p = 0.06). In conclusion, the results showed that OFD combined with EMP was not able to improve treatment of intrabony defects compared to OFD alone.


O objetivo deste estudo clínico controlado, randomizado, duplo-cego, tipo boca-dividida foi comparar o efeito clínico do tratamento de defeitos infra-ósseos de 2 ou 3 paredes com retalho de espessura total (RET) associado ou não com a proteína da matriz do esmalte (PME). Treze voluntários com 1 par ou mais de defeitos infra-ósseos foram selecionados com profundidade clínica de sondagem (PCS) > 5 mm. Todos receberam instruções de higiene bucal, raspagem e alisamento radicular. Cada participante recebeu os dois tipos de tratamento: o lado teste foi tratado com RET e PME, e o lado controle recebeu somente RET. Após 6 meses, foi observada uma redução significante na PCS para o grupo PME (de 6,42 ± 1,08 mm para 2,67 ± 1,15 mm) e para o grupo RET (de 6,08 ± 1,00 mm para 2,00 ± 0,95 mm) (p < 0,0001), mas não houve diferença significante entre os grupos (p = 0,13). Um ganho significante de nível clínico de inserção relativo (NCIR) foi observado em ambos os grupos (PME: de 13,42 ± 1,88 mm para 10,75 ± 2,26 mm, p < 0,001; RET: de 12,42 ± 1,98 mm para 10,58 ± 2,23 mm, p = 0,013), mas não houve diferença significante entre os grupos (p = 0,85). A retração gengival (RG) foi maior para o grupo PME (de 1,08 ± 1,50 mm para 2,33 ± 1,43 mm; p = 0,0009) do que para o grupo RET (de 0,66 ± 1,15 mm para 1,16 ± 1,33 mm; p = 0,16), mas essa diferença não foi significante (p = 0,06). Concluiu-se que o tratamento de defeitos infra-ósseos com RET associado à PME não mostrou resultados melhores que o uso de RET sozinho.


Sujets)
Adulte , Femelle , Humains , Mâle , Résorption alvéolaire/traitement médicamenteux , Résorption alvéolaire/chirurgie , Régénération osseuse/effets des médicaments et des substances chimiques , Débridement , Protéines de l'émail dentaire/pharmacologie , Lambeaux chirurgicaux , Association thérapeutique/méthodes , Indice de plaque dentaire , Méthode en double aveugle , Protéines de l'émail dentaire/usage thérapeutique , Études de suivi , Récession gingivale/traitement médicamenteux , Récession gingivale/chirurgie , Perte d'attache parodontale/traitement médicamenteux , Perte d'attache parodontale/chirurgie , Racine dentaire/effets des médicaments et des substances chimiques
11.
Braz. oral res ; 18(2): 116-120, Apr.-Jun. 2004. graf
Article Dans Anglais | LILACS | ID: lil-363260

Résumé

O objetivo deste estudo foi investigar a relação entre medidas clínicas e radiográficas durante a terapia de manutenção periodontal e a confiabilidade de medidas clínicas periodontais repetidas para o diagnóstico precoce de destruição periodontal de lesões de furca classe II. Dezoito lesões de furca classe II em molares inferiores foram incluídas neste estudo. Radiografias padronizadas e medidas do nível clínico de inserção vertical (NCI-v) e da profundidade de sondagem (PS) foram obtidas imediatamente antes do tratamento cirúrgico e aos 6, 12, 18 e 24 meses após a cirurgia. Um total de 72 pares de radiografias foram subtraídos após correção das distorções geométricas e de contraste, e a altura de ganho/perda óssea (AO) (em mm) foi medida. Não houve correlação estatisticamente significante entre NCI-v e AO. Houve uma correlação estatisticamente significante entre redução na PS aos 24 meses e aumento na AO aos 18 meses (r = 0,5, p < 0,05). Os resultados deste estudo sugerem que medidas clínicas e radiográficas refletem diferentes características da reparação e destruição periodontais e medidas clínicas longitudinais repetidas do NCI-v não são confiáveis para o diagnóstico precoce de destruição periodontal em lesões de furca classe II.


Sujets)
Humains , Anomalies de furcation , Régénération tissulaire guidée/méthodes , Perte d'attache parodontale , Radiographie dentaire/normes , Résorption alvéolaire , Résorption alvéolaire/chirurgie , Débridement , Études de suivi , Anomalies de furcation/chirurgie , Modèles linéaires , Perte d'attache parodontale/chirurgie , Parodontite , Parodontite/chirurgie
13.
Rev. Soc. Odontol. La Plata ; 15(29): 9-14, mayo 2002. ilus, tab
Article Dans Espagnol | LILACS | ID: lil-317830

Résumé

En los últimos años, la estética ha jugado un papel fundamental en el éxito de la periodoncia y la implantología. Las recesiones gingivales, la falta de encía insertada, o la presencia de agujeros negros entre dientes o coronas eran tratados por técnicas quirúrgicas como colgajo desplazado apical, injerto gingival libre, injerto de tejido conjuntivo o subepitelial, etc. En esta publicación mostraremos una membrana preparada para el tratamiento de todas estas afecciones. Dicha membrana proviene de piel obtenida de banco humano y a través de un proceso de purificación se elimiman sus componentes celulares dérmicos, obteniendo así una membrana formada por colágeno y membrana basal totalmente biocompatible. Es utilizada para la cobertura de recesiones, aumento de encía insertada y lograr cierre primario entre colgajos que no se contactan, tanto en periodoncia como en implantes. Sus ventajas son: evitar el sitio dador del paladar, tratar recesiones múltiples y no reabsorberse, sino integrarse a los tejidos. Este caso clínico muestra el aumento de encía insertada y el cubrimiento de recesiones múltiples en dientes anteroinferiores


Sujets)
Humains , Mâle , Adulte , Implants dentaires , Derme , Membrane artificielle , Maladies parodontales , Matériaux biocompatibles , Collagène/usage thérapeutique , Gencive/chirurgie , Dentisterie esthétique , Perte d'attache parodontale/chirurgie , Racine dentaire/chirurgie , Racine dentaire/traumatismes , Récession gingivale/chirurgie , Lambeaux chirurgicaux
14.
Rev. Fac. Odontol. Univ. Antioq ; 13(1): 79-88, jul.-dic. 2001. ilus, graf
Article Dans Espagnol | LILACS | ID: lil-318401

Résumé

Este estudio clínico aleatorizado pretende determinar la efectividad de dos procedimientos utilizados para cubrir las recesiones marginales gingivales, el injerto gingival libre (IGL) y el injerto submucoso de tejido conjuntivo (ISTC). Se realizaron 18 cirugías: nueve de IGL y nueve de ISTC, en cinco pacientes con recesiones bilaterales, con un promedio de edad de 34,5 años , en buena condición de salud bucal. Se evaluó el porcentaje de cubrimiento radicular, el nivel clínico de unión, la estética periodontal, el uso de la tetraciclina (HCL) y la molestia postoperatoria. Adicionalmente, se diseñó un índice de estética periodontal. Ninguno de los procedimientos mostró diferencias estadísticamente significativas en el porcentaje de cubrimiento radicular, con una P=0.0719. El IGL cubrió un 52.3 por ciento y el ISTC un 67.9 por ciento. Se ganó inserción clínica favorable, siendo significativa la diferencia con un valor P=0.00. Al comparar la estética periodontal, se presentaron diferencias con un valor P=0.0117, mostrando un comportamiento excelente y bueno de 88,9 por ciento para el ISTC y bueno en un 22.2 por ciento para el IGL. Este estudio comprobó que el sitio más molesto es el paladar, el IGL es una cirugía más dolorosa, el ISTC presenta un mejor comportamiento clínico que el IGL, y la tetraciclina no representa beneficios adicionales


Sujets)
Humains , Mâle , Adolescent , Adulte , Femelle , Adulte d'âge moyen , Tissu conjonctif , Gencive/transplantation , Récession gingivale/chirurgie , Colombie , Dentisterie esthétique , Palais mou , Perte d'attache parodontale/chirurgie , Indice parodontal , Racine dentaire/anatomopathologie , Répartition aléatoire , Essais contrôlés randomisés comme sujet , Interprétation statistique de données , Lambeaux chirurgicaux , Tétracycline
15.
In. Galan Júnior, Joäo; Namen, Fátima Maria. Dentística restauradora: o essencial para o clínico. Säo Paulo, Santos, 1998. p.189-94, ilus.
Monographie Dans Portugais | LILACS, BBO | ID: lil-250266
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