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  • 1
    In: Journal of Periodontology, Wiley, Vol. 83, No. 11 ( 2012-11), p. 1346-1352
    Abstract: Background: The purpose of this retrospective case series study is to identify possible preoperative parameters that could predict postoperative probing depth (PD), clinical attachment level (CAL) gain, or radiographic defect resolution in intrabony defects treated with enamel matrix derivative (EMD). Methods: Sixty‐one chronic periodontitis patients, each contributing a 2‐ or 3‐wall intrabony defect treated with EMD, were included. Clinical parameters recorded included the following: PD; CAL; gingival margin position; supracrestal soft tissue (SST); surgical distances of cemento‐enamel junction (CEJ) to bone crest (CEJ‐BC), CEJ to base of the defect (CEJ‐BD), and BC to BD (BC‐BD); and depth of 2‐ and 3‐wall components. Radiographic parameters recorded included the following: CEJ‐BC, CEJ‐BD, BC‐BD distances, and radiographic defect angle. Postoperative assessments were performed at 12 months. Results: The probability of postoperative PD 〉 4 mm increased 1.6‐fold (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.2 to 2.3) with each 1‐mm baseline PD increase. Baseline PD and surgical CEJ‐BD were statistically significant predictors of CAL gain; the greater the baseline PD (OR = 0.5; 95% CI = 0.3 to 0.8) and bone loss (OR = 0.6; 95% CI = 0.3 to 0.9), the less likely that postoperative CAL gain was ≤3 mm. Smoking and SST were significantly associated with defect resolution; failure to achieve ≥65% defect resolution was six‐fold greater for smokers (OR = 6.5; 95% CI = 1.7 to 24.5) and almost double (OR = 1.7; 95% CI = 1.1 to 2.8) for each millimeter of SST increase. Conclusion: In EMD‐treated intrabony defects, baseline PD predicts both CAL gain and postoperative PD. Smoking and SST are predictors of defect resolution.
    Type of Medium: Online Resource
    ISSN: 0022-3492 , 1943-3670
    Language: English
    Publisher: Wiley
    Publication Date: 2012
    detail.hit.zdb_id: 2040047-0
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  • 2
    Online Resource
    Online Resource
    Wiley ; 1999
    In:  Journal of Clinical Periodontology Vol. 26, No. 1 ( 1999-01), p. 44-48
    In: Journal of Clinical Periodontology, Wiley, Vol. 26, No. 1 ( 1999-01), p. 44-48
    Type of Medium: Online Resource
    ISSN: 0303-6979
    Language: English
    Publisher: Wiley
    Publication Date: 1999
    detail.hit.zdb_id: 2026349-1
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  • 3
    Online Resource
    Online Resource
    Wiley ; 2019
    In:  Periodontology 2000 Vol. 81, No. 1 ( 2019-10), p. 194-208
    In: Periodontology 2000, Wiley, Vol. 81, No. 1 ( 2019-10), p. 194-208
    Abstract: Ideal implant placement may reduce surgical complications, such as nerve injury and lingual cortical plate perforation, and minimize the likelihood of functional and prosthetic compromises. Guided implant surgery ( GIS ) has been used as the means to achieve ideal implant placement. GIS refers to the process of digital planning, custom‐guide fabrication, and implant placement using the custom guide and an implant system–specific guided surgery kit. GIS includes numerous additional steps beyond the initial prosthetic diagnosis, treatment planning, and fabrication of surgical guide. Substantial errors can occur at each of these individual steps and can accumulate, significantly impacting the final accuracy of the process with potentially disastrous deviations from proper implant placement. Pertinent overall strategies to reduce or eliminate these risks can be summarized as follows: complete understanding of the possible risks is fundamental; knowledge of the systems and tools used is essential; consistent verification of both diagnostic and surgical procedures after each step is crucial; proper training and surgical experience are critical. This review article summarizes information on the accuracy and efficacy of GIS , provides insight on the potential risks and problems associated with each procedural step, and offers clinically relevant recommendations to minimize or eliminate these risks.
    Type of Medium: Online Resource
    ISSN: 0906-6713 , 1600-0757
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2027098-7
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  • 4
    Online Resource
    Online Resource
    Wiley ; 2007
    In:  Journal of Periodontology Vol. 78, No. 10 ( 2007-10), p. 2051-2056
    In: Journal of Periodontology, Wiley, Vol. 78, No. 10 ( 2007-10), p. 2051-2056
    Abstract: Background: The subepithelial connective tissue graft (SCTG) is one of the most used and predictable periodontal plastic surgery procedures; reports of late complications are very rare. This article presents an SCTG case with a previously unreported late complication of epithelial origin, and we suggest a potential link between the patient's dermatologic condition and this complication. Late SCTG complications also are reviewed. Methods: A 19‐year‐old female presented with a 3‐mm deep Miller Class I recession defect on the mandibular right central incisor. An SCTG procedure was performed for root coverage, with uneventful initial postoperative healing that resulted in complete root coverage. At 4 months, an asymptomatic solid white discharge was observed at sites along the original graft margin without evidence of inflammation. A month later, the somewhat reduced but still evident discharge was collected and submitted for microscopic examination. Results: Cytologic examination revealed the discharge to be normal epithelial cells, suggesting a proliferative epithelial response. Follow‐up indicated that the discharge was self‐limiting and was no longer present at 9 months after surgery. This unusual late SCTG complication is consistent with reported epithelial invaginations and projections between graft and overlying flap. The patient had acne, a disease whose pathogenesis includes host predisposition to epithelial hyperproliferation; therefore, a possible association of this SCTG complication with the patient's systemic health is proposed. Conclusion: Epithelial cell discharge is a hitherto unreported, self‐limiting, late complication of the SCTG procedure, and a potential association between this complication and the patient's dermatologic condition is suggested.
    Type of Medium: Online Resource
    ISSN: 0022-3492 , 1943-3670
    Language: English
    Publisher: Wiley
    Publication Date: 2007
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  • 5
    Online Resource
    Online Resource
    American Academy of Implant Dentistry ; 2020
    In:  Journal of Oral Implantology Vol. 46, No. 6 ( 2020-12-01), p. 588-593
    In: Journal of Oral Implantology, American Academy of Implant Dentistry, Vol. 46, No. 6 ( 2020-12-01), p. 588-593
    Abstract: The objective of this study is to assess alterations in buccal soft-tissue contour after alveolar ridge preservation (ARP) using either a collagen matrix seal (CMS) or a collagen sponge (CS) as barriers with freeze-dried bone allograft (FDBA). Participants (28 total) were randomly assigned to the CMS group or CS group (14 participants each). The same clinical steps were used in both barriers. Cast models were taken at baseline and 4 months, and both models were then optically scanned and digitally superimposed. Volumetric, surface, and distance-adjusted measurements were calculated to assess buccal soft-tissue alterations. Surface area and volume loss in the CMS group were observed to be 71.44 ± 1189.09 mm2 and 239.58 ± 231.89 mm3, respectively. The CS group showed measurements of 139.56 ± 557.92 mm2 and 337.23 ± 310.18 mm3. Mean buccal soft-tissue loss and minimum-maximum distance loss were less in the CMS group (0.88 ± 0.52 mm and 0.2–2.15 mm, respectively) as compared with the CS group (1.63 ± 1.03 mm and 0.3–3.68 mm, respectively), with no statistically significant difference between the groups (P = .2742). Both alveolar ridge preservation barriers were unable to entirely prevent soft-tissue contour changes after extraction. However, collagen matrix seal application was slightly better in minimizing the amount of soft-tissue reduction compared with the CS.
    Type of Medium: Online Resource
    ISSN: 1548-1336 , 0160-6972
    Language: English
    Publisher: American Academy of Implant Dentistry
    Publication Date: 2020
    detail.hit.zdb_id: 2139588-3
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  • 6
    Online Resource
    Online Resource
    Hindawi Limited ; 2014
    In:  International Journal of Dentistry Vol. 2014 ( 2014), p. 1-10
    In: International Journal of Dentistry, Hindawi Limited, Vol. 2014 ( 2014), p. 1-10
    Abstract: Alveolar ridge preservation (ARP) has been shown to prevent postextraction bone loss. The aim of this report is to highlight the clinical, radiographic, and histological outcomes following use of a bilayer xenogeneic collagen matrix (XCM) in combination with freeze-dried bone allograft (FDBA) for ARP. Nine patients were treated after extraction of 18 teeth. Following minimal flap elevation and atraumatic extraction, sockets were filled with FDBA. The XCM was adapted to cover the defect and 2-3 mm of adjacent bone and flaps were repositioned. Healing was uneventful in all cases, the XCM remained in place, and any matrix exposure was devoid of further complications. Exposed matrix portions were slowly vascularized and replaced by mature keratinized tissue within 2-3 months. Radiographic and clinical assessment indicated adequate volume of bone for implant placement, with all planned implants placed in acceptable positions. When fixed partial dentures were placed, restorations fulfilled aesthetic demands without requiring further augmentation procedures. Histological and immunohistochemical analysis from 9 sites (4 patients) indicated normal mucosa with complete incorporation of the matrix and absence of inflammatory response. The XCM + FDBA combination resulted in minimal complications and desirable soft and hard tissue therapeutic outcomes, suggesting the feasibility of this approach for ARP.
    Type of Medium: Online Resource
    ISSN: 1687-8728 , 1687-8736
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2014
    detail.hit.zdb_id: 2546524-7
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  • 7
    Online Resource
    Online Resource
    Wiley ; 2015
    In:  Clinical Advances in Periodontics Vol. 5, No. 2 ( 2015-05), p. 91-98
    In: Clinical Advances in Periodontics, Wiley, Vol. 5, No. 2 ( 2015-05), p. 91-98
    Abstract: Introduction: Plasma cell gingivitis (PCG) is an unusual inflammatory condition characterized by dense, band‐like polyclonal plasmacytic infiltration of the lamina propria. Clinically, it appears as gingival enlargement with erythema and swelling of the attached and free gingiva and is not associated with any loss of attachment. The aim of this report is to present a rare case of severe generalized aggressive periodontitis (GAgP) associated with a PCG lesion that was successfully treated and maintained non‐surgically. Case Presentation: A 32‐year‐old white male with a non‐contributory medical history presented with gingival enlargement with diffuse erythema and edematous swelling, predominantly around teeth #5 through #8. Clinical and radiographic examination revealed generalized severe periodontal breakdown. A complete blood count and biochemical tests were within normal limits. Histologic and immunohistochemical examination were consistent with PCG. A diagnosis of severe GAgP associated with a PCG lesion was assigned. Treatment included elimination of possible allergens and non‐surgical periodontal treatment in combination with azithromycin. Clinical examination at reevaluation revealed complete resolution of gingival enlargement, erythema, and edema and localized residual probing depths of 5 mm. One year after treatment, the clinical condition was stable. Radiographs indicated improved bone levels and formation of crestal lamina dura. Conclusion: This case report highlights the unusual coexistence of GAgP and PCG, in which non‐surgical treatment with elimination of all possible causes in combination with antimicrobials resulted in elimination of the gingival enlargement and significant improvement of periodontal parameters.
    Type of Medium: Online Resource
    ISSN: 2573-8046 , 2163-0097
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2670204-6
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  • 8
    In: Journal of Periodontology, Wiley, Vol. 87, No. 4 ( 2016-04), p. 416-425
    Abstract: Background: Tooth extractions are followed by significant dimensional changes in the alveolar crest that may preclude implant placement. This randomized, controlled, prospective compares the preservation of soft and hard tissue dimensional changes after alveolar ridge preservation (ARP) using two membranes consisting of collagen matrix (CM) or extracellular matrix (ECM) as barriers over freeze‐dried bone allograft (FDBA). Methods: Standardized clinical and radiographic measurements of soft and hard tissues were recorded by means of a stent before and 4 months after ARP. The surgery entailed sulcular incisions with minimal flap elevation and repositioning without advancement. Results: Of 11 patients in the CM group and 12 in the ECM group who completed the study, gingival thickness (GT) increased from 0.1 to 0.2 mm for both groups along with a 0.5‐mm decrease in the width of keratinized tissue after healing. Reductions in ridge width were most pronounced on the coronal aspect, 1.8 mm for CM and 2.0 mm for ECM, whereas vertical reduction was most pronounced on the buccal aspect, 0.7 to 1.0 mm. Differences between groups were not statistically significant. However, significant correlation for changes in GT ( P = 0.001) and crestal bone width ( P = 0.002) with preoperative buccal plate thickness (BPT) was observed. Conclusions: Both xenogeneic collagen matrices combined with FDBA were effective in maintaining soft tissues and minimizing ridge resorption in all dimensions after ARP. BPT was an important determinant for amount of change in crestal GT and ridge width.
    Type of Medium: Online Resource
    ISSN: 0022-3492 , 1943-3670
    Language: English
    Publisher: Wiley
    Publication Date: 2016
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  • 9
    In: Journal of Periodontology, Wiley, Vol. 87, No. 5 ( 2016-05), p. 493-501
    Abstract: Background: Currently, information available on the exact prevalence and standard therapeutic protocol of peri‐implant diseases is insufficient. The aim of this survey was to investigate the perceived prevalence, etiology, and management of peri‐implant mucositis and peri‐implantitis by periodontists in the United States. Methods: A twenty‐question survey was developed. Periodontists currently practicing in the United States were contacted by an e‐mail that contained a link to access the survey. Results: Two hundred eighty periodontists (79.3% males; 62.9% with 〉 10 years in practice, 75.7% in private practice) completed the survey. Most (96.1%) of the participants were placing implants (58.3% for 〉 10 years and 32.4% 〉 150 implants/year). The majority reported that the prevalence of peri‐implant mucositis and peri‐implantitis in their practices is up to 25% but is higher in the general US population and that up to 10% of implants must be removed due to peri‐implantitis. There was agreement among contributing etiologic factors such as: 1) plaque; 2) smoking; 3) adverse loading; 4) oral hygiene; 5) use of antimicrobial gel/mouthrinse; 6) non‐surgical debridement; 7) use of systemic antibiotics; and 8) 3‐month supportive care for treatment of peri‐implantitis. Significant heterogeneity was recorded in relation to the instruments used for debridement, use and type of surgical treatment, and materials used for regeneration. Only 5.1% believed that treatment is very effective. Conclusions: This survey indicates that peri‐implant diseases are a frequently encountered problem in periodontal practices and that the absence of a standard therapeutic protocol results in significant empirical use of therapeutic modalities and a moderately effective treatment outcome.
    Type of Medium: Online Resource
    ISSN: 0022-3492 , 1943-3670
    Language: English
    Publisher: Wiley
    Publication Date: 2016
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  • 10
    In: Journal of Periodontology, Wiley, Vol. 77, No. 1 ( 2006-01), p. 103-110
    Abstract: Background: The adjunctive use of enamel matrix derivative (EMD) in the surgical therapy of intrabony defects results in improved outcomes compared to surgical debridement alone. However, the role of EDTA root conditioning in EMD therapy has not been investigated. The purpose of this study was to compare the 12‐month outcomes of EMD application with and without EDTA root conditioning in intrabony defect surgical therapy. Methods: Twenty‐eight chronic periodontitis patients, each contributing a 2‐ or 3‐wall intrabony defect (≥4 mm deep and ≥2 mm wide), participated. Patients consecutively received surgical treatment with either EMD alone (first 13 patients) or EMD + EDTA (subsequent 15 patients). Probing depth (PD), clinical attachment level (CAL), and gingival margin position, i.e., recession (REC) were the clinical parameters recorded. Recorded radiographic parameters were the distances from 1) cemento‐enamel junction to bone crest (CEJ to BC), 2) CEJ to base of the defect (CEJ to BD), and 3) BC to BD. Results: Intragroup analysis showed that both EMD alone and EMD + EDTA led to significant PD reduction, CAL gain, and REC increase 1 year postoperatively. Both groups had 〉 60% mean radiographic defect resolution (change in BC to BD). None of the recorded parameters were significantly different between the two groups, either at baseline or postoperatively. Conclusions: These results suggest that clinical and radiographic outcomes of intrabony defect EMD therapy do not depend on the use of EDTA gel root conditioning. The potential contribution of EDTA gel root conditioning to the histological outcomes reported with EMD therapy remains to be determined.
    Type of Medium: Online Resource
    ISSN: 0022-3492 , 1943-3670
    Language: English
    Publisher: Wiley
    Publication Date: 2006
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