Clinical comparison of bioabsorbable barriers with non-resorbable barriers in guided tissue regeneration in the treatment of human intrabony defects.

The purpose of the study was to compare the effects of guided tissue regeneration (GTR) with expanded polytetrafluoroethylene (ePTFE) non-resorbable barriers and polylactic acid bioabsorbable barriers in humans with intrabony defects due to periodontitis. Ten patients presented with 2 intrabony defects each. Mucoperiosteal flaps were performed. One of the defects was randomly assigned for placement of the ePTFE barrier over the roots and alveolar bone and the other defect with placement of the polylactic acid barrier. A minimum of 9 months after barrier placement, surgical reentry was performed. The data were evaluated by the Wilcoxon matched-pairs signed-ranks test and the Fisher exact test. Treatment with both types of barriers produced significant changes from baseline for all parameters, except in the ePTFE group for the amount of bony crest resorption (P = 0.055) and in the polylactic acid group for increased recession (P = 0.109). The results showed no significant differences between the barriers for any parameters: probing depth reduction (polylactic acid 2.60 +/- 1.90, ePTFE 2.80 +/- 1.40; P = 1.000); attachment gain (polylactic acid 1.40 +/- 1.43, ePTFE 1.90 +/- 1.29; P = 0.336); increased recession (polylactic acid 0.80 +/- 1.40, ePTFE 1.10 +/- 0.99; P = 0.531); amount of vertical bone fill (polylactic acid 1.60 +/- 1.84, ePTFE 2.00 +/- 2.49; P = 0.984); bony crest resorption (polylactic acid -1.30 +/- 1.06, ePTFE -1.30 +/- 1.63; P = 1.000); depth of bony defect reduction (polylactic acid 2.90 +/- 1.20, ePTFE 3.30 +/- 1.70; P = 0.750); width of bony defect reduction (polylactic acid 2.20 +/- 1.23, ePTFE 2.20 +/- 1.23; P = 0.875); or volumetric changes (polylactic acid 33.50 +/- 19.70 microl, ePTFE 34.00 +/- 18.40 microl; P = 0.750).

Surgical techniques for covering exposed roots.

Each grafting technique described here produced successful root coverage. Predictable root coverage by use of current techniques has increased options for managing gingival recession and associated problems.

Ultrastructural characteristics of a cell line derived from a melanotic neuroectodermal tumor of infancy.

Thin section and freeze-fracture transmission electron microscopy were used to examine and identify the cytoplasmic and membrane structures in a cell line derived from a melanotic neuroectodermal tumor of infancy (MNTI). The cultured cells had a uniform appearance after 70 population doublings characterized by long dendritic processes and evidence of melanin production. The cytoplasm contained numerous melanosomes in various stages of development, vesiculated rough endoplasmic reticulum, microfilaments and uncoated as well as coated vesicles. The membrane specializations included caveoli, coated pits, gap junctions, microfilaments, desmosome-like structures and lamellipodia. The ultrastructural appearance of the cultured MNTI cells was similar to features previously seen in electron micrographs of MNTI tumor specimens. However, correlated freeze-fracture and thin section micrographs permitted further identification of structures previously described. The MNTI cell line represents one of the cell types of the tumor and provides an opportunity for further study of the pathogenesis of this rare tumor.

Standardized portrait photography for dental patients.

Photography is becoming an increasingly important tool in the dental profession. But documentation of orthodontic or orthognathic treatment with pretreatment and posttreatment photographs can be misleading if features on one or both photographs are distorted. The dental photographer must be constantly aware of the importance of standardizing photographic variables when documentation of change is important. Although total reproducibility may not be practical, the photographer can establish a reasonably standardized approach to photographing patients. In this article the authors present the major considerations for frontal and profile facial photographs. Lens selection, camera position, subject distance, and position are all variables to be understood and controlled if accurate reproduction is desired. Numerous frontal and lateral photographs were made with head position, camera position, jaw position, and lens focal length changed to allow assessment of their contribution to the final picture. Using easily recognized facial landmarks, dental photographers can standardize frontal and lateral portraits for more consistent comparison.

A system for insuring success of long-term supportive periodontal therapy.

The article describes a program of supportive periodontal therapy (SPT) for patients who have been treated for periodontal disease. Emphasis is placed on identifying the specific supportive therapy needs of periodontally treated patients as distinct from the needs of patients who are not at risk for periodontal disease. The critical components of SPT for clinical practice are defined and discussed. The parameters necessary for a through clinical and radiographic assessment are outlined. The use of assessment data to direct therapy is explained. Implementation of site-specific therapeutic measures as well as the use of evaluative procedures to assure appropriate long-term care are defined.

The hyperactive child: an update.

The physician is uniquely qualified to manage the multiple facets of attention-deficit hyperactivity disorder. This clinically oriented update reviews the current state of the art regarding diagnosis and management of hyperactive children. Three case reports emphasize the wide variation of clinical problems presented by this frequently occurring disorder of childhood. Epidemiology, differential diagnosis, associated features, neurobiologic mechanisms, treatment, long-term outcome, and attention-deficit disorder in adults are addressed. Although medication is an important tool in the treatment of this condition, follow-up studies confirm the importance of a multimodal treatment approach.

Proximal tooth surface quality and periodontal probing depth.

The proximal tooth surface integrity of 826 patients was correlated with periodontal probing depths. Results show relatively increased probing depths adjacent to restored proximal tooth surfaces, with the greatest probing depths adjacent to overhanging restorations and restorations with recurrent caries. The data confirm the significant tendency of the periodontal condition to deteriorate as a function of decreasing surface quality. Probing depth appeared to increase with the patient's age. Surface condition, however, showed a significant relationship with probing depths in all age groups.

Management of arthrogryposis multiplex congenita. A case report.

Arthrogryposis multiplex congenita is a rare disorder of skeletal muscle development which is characterized by deforming contractures of the joints, but seldom affects the temporomandibular joint. This report reviews the condition and reports the findings and periodontal management of a patient referred with arthrogryposis multiplex congenita which required treatment for severe dilantin gingival hyperplasia.

The acro-osteolysis (Hadju-Cheney) syndrome. Review of the literature and report of a case.

Acro-osteolysis ( Hadju - Cheney ) Syndrome is a rare disorder of bone metabolism characterized by progressive destruction of the distal phalangeal bone, curvature of the spine, aplasia of the facial sinuses, and persistence of the cranial sutures. The purpose of this manuscript is to focus on the description of the oro-facial and dental manifestations of the disorder.

The squiggle-drawing game in child psychotherapy.

The squiggle-drawing game is an adaptation of Winnicott's Squiggle Technique using the story-telling approach of Gardner and Kritzberg. It is a useful technique in obtaining thematic material and communicating through metaphor with latency-age children, who often resist direct questioning about their problems and feelings.