Clinical evaluation of Bio-Oss: a bovine-derived xenograft for the treatment of periodontal osseous defects in humans.

The purpose of this study was to compare the bovine derived xenograft (BDX) Bio-Oss to demineralized freeze dried bone allograft (DFDBA) in human intrabony defects. 17 healthy patients with no systemic disease with moderate-severe periodontitis (7 males, 10 females; aged 34-67), were treated. Surgically, defects were included only if the intraosseous defect depth was >3.0 mm. Final selection included 30 defects. The sites were randomly assigned treatment with DFDBA or BDX. Soft tissue and osseous defect measurements were taken the day of surgery and 6 months post-operatively at re-entry. Average baseline PD, CAL, and surgical defect depth for the DFDBA group were not statistically different from the BDX group. No adverse healing response occurred. The results showed a statistically significant improvement in PD and AL for both materials at 6 months in 26 defects (4 defects did not respond to therapy). Soft tissue measurements for the DFDBA group included PD reduction of 2.0+/-1.3 mm, and AL gain of 2.6+/-1.6 mm, while the BDX group showed a PD reduction of 3.0+/-1.7 mm, and AL gain of 3.6+/-1.8 mm. Osseous measurements showed bone fill of 2.4 mm (46.8%) for the DFDBA group and 3.0 mm (55.8%) for the BDX group. Defect resolution was 59.4% for the DFDBA group and 77.6% for the BDX group. Statistical analysis revealed there was no statistical difference between the 2 materials in all measurements.

Drug-induced gingival overgrowth.

Certain anticonvulsants, cyclosporine, and a variety of calcium channel blockers have been shown to produce clinically and histologically similar gingival enlargements in certain susceptible patients. These drugs appear to be similar with respect to their pharmacologic mechanism of action at the cellular level. The primary target tissue is the most essential difference among them. Therefore it is tempting to speculate that these agents may act similarly on a common secondary target tissue, such as gingival connective tissue, and cause a hyperplastic response. This tissue reaction may involve a disturbance of calcium ion influx into specific cell populations with a resulting alteration in collagen metabolism and other host cell response mechanisms. A connection between ion exchange, folate uptake, collagenase activation, and bacterial inflammation may exist. Until a more effective approach can be developed from future research results, treatment should continue to emphasize plaque control, professional debridement, and resective gingival procedures to improve function, esthetics, and access for home care.