Stability and biological activity of epoietin beta in parenteral nutrition solutions.

The aim of this in vitro study was to determine stability and biological activity of epoietin (Epo) beta in a parenteral nutrition solution over 24 h. Epo beta was added to the parenteral nutrition solution which was administered through intravenous tubing and a Posidyne Neo filter. Samples were collected after 0, 4, 12, and 24 h. The Epo concentrations were measured before and after filter passage by an ELISA assay. The Epo biological activity was determined in the UT7/Epo cell line. The Epo concentration in the parenteral nutrition solution remained stable for 24 h. However, 35% of the Epo was adsorbed by the filter. The samples collected induced proliferation of UT7/Epo cells. These results suggest that Epo can be administered in parenteral nutrition solutions, but the dosage would need to be increased when a filter is used.

A meta-analytic, quantitative assessment of osseointegration establishment and evolution of submerged and non-submerged endosseous titanium oral implants.

Two implant placement methods are used in oral implantology: submerged (S, two-stage surgical procedure) and non-submerged (NS, one-stage surgery). However, a quantitative assessment of their influence on implant osseointegration, summarising the whole present experience, is not directly possible, owing to the lack of normalisation of the published results. To overcome this difficulty, selection criteria have been applied to the latter in a process of a meta-analysis of specialised literature, in order to authorise a pooled treatment with an adequate statistical method. Survival life tables are established (up to 15 and 10 years respectively for S and NS implants placed in normal situations) for extended samples (13049 S and 5515 NS implants). Early (before loading) failure rates and 95% confidence level ranges of cumulative implant survival rates are shown. For both categories, the quality of the placement stage remains critical to ensure optimal osseointegration behaviour. Both categories match current survival requirements, but with a quite different behaviour over time. NS implants, while osseointegrating better initially, are subject to causes of osseointegration loss, which persist over a longer period of time. Implant design characteristics (including the type of surface) seem to be more relevant than the placement procedure for the implant's behaviour. This is in agreement with recent histological and preliminary clinical results, and should be confirmed by further studies.

Regeneration of bone graft donor sites.

When crestal volume is greatly insufficient for the placement of dental implants, bone grafting is usually the most reliable ridge augmentation procedure. The grafts are most often taken in parietal or mandibular symphysis regions. Though not too noticeable, it seems contra-indicated and even potentially dangerous to leave zones like the cranium to repair spontaneously. Guided bone regeneration techniques have shown their ability to regenerate new bone under difficult conditions in jaws. Their use in bone graft donor sites is simple and the results are consistent. This report shows that 2 types of resorbable membranes are equally as efficacious in terms of new-bone formation.

Resorption rates of 2 commercially available bioresorbable membranes. A histomorphometric study in a rabbit model.

The respective resorption rates of recently commercialized collagen versus polylactic acid-citric acid ester membranes were compared. 16 rabbits were implanted with 2 mm x 4 mm pieces of membrane of both types in the alveolar mucosa just apically to the incisors on either side of the mouth. 1 animal was sacrificed on day 0, just after the operation. The others were sacrificed at 1, 2, 3, 5, 7, 9 and 12 weeks. The specimens were prepared for histologic examination. Observations showed that the cross-linked collagen membranes induced severe inflammation and were resorbed within 2 weeks. The polylactic acid-citric acid ester polymer barriers produced a much more moderate infiltrate and were still not totally resorbed at 12 weeks. Although resorption rates in the rabbit may not be similar to those observed in humans, it seems that the durability of the polymer barrier is more adequate for guided tissue regeneration than the cross-linked collagen.

Synthetic extracellular matrix supports healing of mucogingival surgery donor sites.

Palatal donor sites are commonly used in periodontal surgery. Their healing speed determines the patient's comfort. This may be enhanced by the use of collagen sponges, supplemented with various components of the extracellular matrix, which display chemotactic properties and enhance the proliferation and synthesis activity of fibroblasts. A collagen-based dressing supplemented with such extracellular matrix components, including chondroitin 4 sulfate, heparan sulfate, and fibronectin was used, in an attempt to facilitate the healing of donor sites in 10 periodontal patients. Immunohistological techniques were used on biopsy samples from the margin of these volunteer's healing donor sites to appreciate tissue reconstruction around the synthetic material. Our results indicate a fast epithelial growth, neovascularization, and spatial organization of the new matrix. Limited and topographically selective inflammatory reactions, characterized by polymorphonuclears and mononuclear cells seen near the wound's margin, could be responsible for the production of soluble factors supporting reconstruction.

An analysis of the community periodontal index of treatment needs. Studies on adults in France. V. Presentation of CPITN data in cross-tabulations.

A total of 1005 subjects were examined using the CPITN and DFT indices. CPITN data were modified in their presentation in order to be suitable for cross-tabulation. Two different methods were considered. One, described previously by Roland et al. (1984), classified subjects according to the combination of their highest CPITN score and the mean of the highest scores of every nonedentulous sextant. The other consisted of multiplying the above mentioned mean by the individual's highest CPITN score. A critical analysis of the methodology showed that the two number system developed by Roland et al. (1984) was impractical. The new method provides a linear array of values from 0 to 16. Very little overlapping of values was observed, which means that a relatively precise periodontal condition is characterised by each value. With this transformation the CPITN can be used as an index that quantifies periodontal conditions instead of treatment needs.

Analysis of the Community Periodontal Index of Treatment Needs--study on adults in France. IV. The significance of gingival recession.

A total of 1005 persons were examined using the CPITN criteria which were recorded for every tooth. All the teeth were also measured on both their buccal and lingual aspects to assess the amount of gingival recession. The combination of pocket depth and gingival recession was computed using a specially written program: 93.8 per cent of the teeth had 1 mm or less gingival recession; 82.5 per cent of the teeth with gingival recession did not present pockets; 26.6 per cent of all subjects had at least one tooth with gingival recession of 2 mm or more but only 9.9 per cent had at least one tooth with 2 mm or more gingival recession and a periodontal pocket.

[Evaluation of time needed to treat periodontal conditions classified according to the C.P.I.T.N. index]. / Evaluation du temps nécessaire pour traiter les états parodontaux classés selon l'indice C.P.I.T.N.

A questionnaire was sent to 623 members of the "French Society of Periodontology" with a view to assessing the time necessary to provide instructions concerning hygiene, carry out root planing, surgery on 3.5 to 5.5 mm pockets, surgery on pockets of 6 mm or more, and to ensure maintenance. 282 responses were received from the practitioners and were computer analysed. The time required for instructions concerning hygiene was estimated to be approximately 15 mn. This information was usually repeated 4 times. It was determined that scaling and root planing require an average of 29.19 mn per sextant. The surgical interventions for 3.5 to 5.5 mm and 6 mm or more pockets are estimated to last an average of 77.03 and 107.36 mn respectively. Finally, the assessment of the time necessary for maintenance of the whole mouth was 30 to 60 mn, with an average of 45.11 mn. A quarterly check-up was recommended by 48.9% of the practitioners. The treatment of complex cases requires much more time, and maintenance is indispensable in order to avoid relapse. A plaque control programme undertaken sufficiently early might avoid long treatment stages.

An analysis of the Community Periodontal Index of Treatment Needs. Studies on adults in France. III--Partial examinations versus full-mouth examinations.

1005 persons were examined using the Community Periodontal Index of Treatment Needs. Presence or absence of every clinical sign was registered for each tooth. A specially written program computed CPITN values corresponding to full mouth or partial examinations. Results compare the prevalence and treatment needs obtained through either full mouth or partial examinations. Cross tabulation analysis of the number of cases detected by full mouth and partial examinations shows differences in detection rates of 23.5 per cent for deep pockets, 17.6 per cent for moderate pockets, 13.4 per cent for calculus, 3.2 per cent for bleeding and 53.0 per cent for health. When determining treatment needs using the partial examination procedure approximations of the number of subjects needing hygiene education and scaling are acceptable but the evaluation of the number of individuals needing complex therapy is greatly underestimated. The CPITN is most accurate using full mouth examinations.

Comparison of gingival index and sulcus bleeding index as indicators of periodontal status.

Although the gingival index and sulcus bleeding index have been widely used as indicators of periodontal status, there is some disagreement among investigators as to their meaning and significance. A clinical study was undertaken to monitor the occurrence of gingival bleeding, oedema, and change in colour in subjects with and without periodontal disease, and it was found that the combinations of these clinical symptoms often did not correspond exactly with an index score. It is therefore suggested that any study of periodontal disease should be based on fundamental criteria, such as bleeding or oedema, rather than on composite indices.