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BACKGROUND: The healing potential of platelet growth factors has generated interest in using Platelet-Rich Plasma (PRP) in ridge preservation procedures. A canine study was performed to determine if extraction sites treated with platelet-rich fibrin matrix (PRFM) exhibit enhanced healing compared to sites treated with non-viable materials. METHODS: Four dog's extraction sockets were treated individually with PRFM, PRFM and membrane, Demineralized Freeze-Dried Bone Allograft (DFDBA) and membrane, PRFM and DFDBA, and untreated control. Treatment sequencing permitted clinical and histologic evaluation of healing at 10 days, 2, 3, 6 and 12 weeks. RESULTS: Healing was more rapid in the PRFM and PRFM and membrane sites. By 3 weeks those sockets had osseous fill. Sites containing DFDBA had little new bone at 6 weeks. By 12 weeks those sockets had osseous fill but DFDBA particles were still noted in coronal areas. CONCLUSIONS: PRFM alone may be the best graft for ridge preservation procedures. ADVANTAGES: faster healing, and elimination of disadvantages involved in using barrier membranes.

Changes in alveolar bone height and width following ridge augmentation using bone graft and membranes.

BACKGROUND: Clinical observation suggests the amount of bone height and width created during guided bone regeneration (GBR) to augment alveolar ridges is not retained during healing. A study was designed to determine: 1) whether the amount of osseous structure 4 months postoperatively after GBR was significantly less than the amount surgically created; and 2) if this change was uniform over the area treated. METHODS: Nineteen extraction sites (10 patients) were treated with GBR prior to placing endosseous implants. Allograft (DMFDB) and a bioabsorbable membrane were employed. Standardized measurements were taken of alveolar height and width 1) prior to augmentation; 2) after placement of graft and membrane; and 3) following 4 months of healing. Width measurements were taken 3 mm, 5 mm, and 10 mm from the crest at 3 intervals: the mesio-distal midpoint of the edentulous area and 3 mm mesial and distal to the midpoint. Height measurements were recorded at the mesio-distal midpoint and points 3 mm mesial and distal to the midpoint. RESULTS: Loss in width of supplemented bone after 4 months of healing ranged from 52.1% to 58.0% 3 mm from the crest, 47.6% to 67.4% 5 mm from the crest, and 39.1 % to 46.7% 10 mm from the crest. Loss of augmented height averaged 14. 7% in the center of the edentulous area but ranged from 60.5% to 76.3% 3 mm mesial and distal to the midpoint. CONCLUSIONS: The results indicate significant non-uniform loss of augmented alveolar height and width during GBR healing. The implications of these findings impact preoperative augmentation planning for endosseous implantology.

Histological, clinical, and digital subtraction radiographic evaluation of repair of periodontal defects resulting from mechanical perforation of the chamber floor using ePTFE membranes.

The aim of this study was to test the hypothesis that a biocompatible membrane, when placed between the gingiva and cortical bone in teeth with periodontal defects that occurred following mechanical endodontic perforation, would facilitate greater regeneration than in control sites not treated with guided tissue regeneration. One beagle dog with a healthy periodontium was used in the study. The maxillary right first and second molars and the mandibular left first and second molars acted as the experimental group in which furcation perforations were treated by guided tissue regeneration. The maxillary left and mandibular right first and second molars served as the controls in which furcation perforation lesions were only treated by open flap debridement. Clinical, histological, and standardized radiographic evaluation showed significant differences between the test and control groups. In addition, digital subtraction radiography revealed a gain in alveolar bone height and increased density at all experimental sites, and a loss at all control sites. Histological evaluation showed extensive regeneration of both alveolar bone and connective tissue at experimental sites, but none at control sites. The results of this study suggest that the use of guided tissue regeneration in furcation lesions produced by endodontic perforations will result in significant new bone and connective tissue attachment.

The destructive potential of electrosurgery on the periodontium.

Three cases have been presented illustrating the complications which may arise from the use of electrosurgery. These cases provide clinical evidence of the potential for severe periodontal destruction, a potential that must be weighed carefully by any practitioner who uses an electrosurgical instrument. It is suggested that new scientific studies be initiated to establish basic principles that will eliminate the hazards that now exist in the routine use of electrosurgery.

Periodontal disease associated with preleukemic syndrome.

A case of preleukemic syndrome associated with severe periodontal disease has been presented for the first time. The clinical, radiographic and hematologic findings have been discussed, as well as medical and periodontal therapy.