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- Horváth, Attila, et al.
(författare)
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Histological evaluation of human intrabony periodontal defects treated with an unsintered nanocrystalline hydroxyapatite paste
- 2013
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Ingår i: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 17:2, s. 423-430
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the study was to clinically and histologically evaluate the healing of human intrabony defects treated with open flap surgery (OFD) and application of a new, resorbable, fully synthetic, unsintered, nanocrystalline, phase-pure hydroxyapatite (nano-HA). MATERIALS AND METHODS: Six patients, each of them displaying very advanced intrabony defects around teeth scheduled for extraction due to advanced chronic periodontitis and further prosthodontic considerations, were included in the study. Following local anaesthesia, mucoperiosteal flaps were reflected; the granulation tissue was removed, and the roots were meticulously debrided by hand and ultrasonic instruments. A notch was placed at the most apical extent of the calculus present on the root surface or at the most apical part of the defect (if no calculus was present) in order to serve as a reference for the histological evaluation. Following defect fill with nano-HA, the flaps were sutured by means of mattress sutures to allow primary intention healing. At 7 months after regenerative surgery, the teeth were extracted together with some of their surrounding soft and hard tissues and processed for histological analysis. RESULTS: The postoperative healing was uneventful in all cases. At 7 months following surgery, mean PPD reduction and mean CAL gain measured 4.0 ± 0.8 and 2.5 ± 0.8 mm, respectively. The histological analysis revealed a healing predominantly characterized by epithelial downgrowth. Limited formation of new cementum with inserting connective tissue fibers and bone regeneration occurred in three out of the six biopsies (i.e. 0-0.86 and 0-1.33 mm, respectively). Complete resorption of the nano-HA was found in four out of the six biopsies. A few remnants of the graft particles (either surrounded by newly formed mineralized tissue or encapsulated in connective tissue) were found in two out of the six biopsies. CONCLUSION: Within their limits, the present results indicate that nano-HA has limited potential to promote periodontal regeneration in human intrabony defects. CLINICAL RELEVANCE: The clinical outcomes obtained following surgery with OFD + nano-HA may not reflect true periodontal regeneration.
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| 2. |
- Horváth, Attila, et al.
(författare)
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Histologisk evaluering af humane intraossøse parodontale defekter behandlet med en usintret nanokrystallinsk hydroxyapatit pasta
- 2013
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Ingår i: Tandlægebladet. - : Dansk Tandlægeforening. - 0039-9353. ; 117:1, s. 12-13
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Formål Formålet med undersøgelsen var at evaluere den kliniske og histologiske heling af humane intraossøse defekter behandlet med konventionel flapkirurgi (OFD) og anvendelse af en ny, resorberbar, fuldsyntetisk, usintret, nanokrystallinsk, hydroxyapatit (nano-HA ). Materialer og metoder Seks patienter, som hver viste en meget avanceret intraossøs defekt omkring en tand planlagt til ekstraktion på grund af svær kronisk marginal parodontitis og yderligere restaurerende overvejelser, blev inkluderet i undersøgelsen. Efter lokalbedøvelse, mucoperiosteal lapløft, granulationsvævs fjernelse og omhyggelig roddepuration og afglatning med hånd- og ultralydsinstrumenter blev der på roden placeret et mindre boremærke ved den mest apikale tilstedeværelse af tandsten eller ved bunden af defekten (hvis ikke tandsten var til stede); boremærket tjente som reference ved den histologiske evaluering. Efter defektudfyldelse med nano-HA blev lapperne syet ved hjælp af madras-suturer mhp. primær heling. Syv måneder efter regenerativ kirurgi blev tænderne ekstraheret sammen med en mindre del af de omgivende bløde og hårde væv og præpareret til histologisk undersøgelse. Resultater Postoperativ heling var komplikationsfri i alle tilfælde. Syv måneder efter operationen sås der betydelig pochedybdereduktion og klinisk fæstegevinst på 4,0 mm ± 0,8 mm og 2,5 mm ± 0,8 mm, henholdsvis. Den histologiske analyse viste, at helingen hovedsageligt kendetegnede sig ved et lang epitelialt fæste. Begrænset dannelse af ny cement med indlejrede kollagenfibre og knogleregeneration sås hos tre ud af de seks biopsier på op til henholdsvis 0,86 mm og 1,33 mm. Komplet resorption af nano-HA-partikler blev fundet i fire ud af de seks biopsier. Nogle få rester af de implanterede partikler (enten omgivet af nydannet mineraliseret væv eller indkapslet i bindevæv) blev fundet i to ud af de seks biopsier. Konklusion De foreliggende resultater viser, at nano-HA har begrænset mulighed for at fremme parodontal regeneration i humane intraossøse defekter. Klinisk relevans: De kliniske resultater opnået efter kirurgi med OFD + nano-HA afspejler måske ikke ægte parodontal regeneration. Horváth A, Stavropoulos A, Windisch P et al. Histological evaluation of human intrabony periodontal defects treated with an unsintered nanocrystalline hydroxyapatite paste. Clin Oral Investig 2012.
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| 3. |
- Molnár, Bálint, et al.
(författare)
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Treatment of multiple adjacent Miller Class I and II gingival recessions with collagen matrix and the modified coronally advanced tunnel technique
- 2013
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Ingår i: Quintessence International. - : Quintessence. - 0033-6572. ; 44:1, s. 17-24
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To clinically evaluate the treatment of Miller Class I and II multiple adjacent gingival recessions using the modified coronally advanced tunnel technique combined with a newly developed bioresorbable collagen matrix of porcine origin. METHOD AND MATERIALS: Eight healthy patients exhibiting at least three multiple Miller Class I and II multiple adjacent gingival recessions (a total of 42 recessions) were consecutively treated by means of the modified coronally advanced tunnel technique and collagen matrix. The following clinical parameters were assessed at baseline and 12 months postoperatively: full mouth plaque score (FMPS), full mouth bleeding score (FMBS), probing depth (PD), recession depth (RD), recession width (RW), keratinized tissue thickness (KTT), and keratinized tissue width (KTW). The primary outcome variable was complete root coverage. RESULTS: Neither allergic reactions nor soft tissue irritations or matrix exfoliations occurred. Postoperative pain and discomfort were reported to be low, and patient acceptance was generally high. At 12 months, complete root coverage was obtained in 2 out of the 8 patients and 30 of the 42 recessions (71%). CONCLUSION: Within their limits, the present results indicate that treatment of Miller Class I and II multiple adjacent gingival recessions by means of the modified coronally advanced tunnel technique and collagen matrix may result in statistically and clinically significant complete root coverage. Further studies are warranted to evaluate the performance of collagen matrix compared with connective tissue grafts and other soft tissue grafts
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