Biomedical subjects

Anton Sculean

Publications and source records attributed to Anton Sculean.

At least 37 records · Page 2Linked to original sources

PubMed2005

Anti-infective therapy with an Er:YAG laser: influence on peri-implant healing.

In addition to conventional treatment modalities (mechanical and chemical), the use of lasers has been increasingly proposed for the treatment of periodontal and peri-implant infections (i.e., cleaning and detoxification of implant surfaces). Preliminary results from basic studies have pointed to the high potential of the Erbium-doped: Yttrium, Aluminum and Garnet (Er:YAG) laser. Furthermore, preliminary clinical data indicate that treatment with this kind of laser may positively influence peri-implant healing. The aim of this research update is to evaluate, based on the currently available evidence, the use of an Er:YAG laser for the treatment of peri-implant infections and to indicate its potential as a new treatment modality.

Dental Implants↗

PubMed2005

Clinical evaluation of an enamel matrix protein derivative combined with either a natural bone mineral or beta-tricalcium phosphate.

BACKGROUND: The purpose of the present study was to compare the healing of deep intrabony defects following treatment with an enamel matrix protein derivative (EMD) combined with either a natural bone mineral (NBM) or beta-tricalcium phosphate (beta-TCP). METHODS: Twenty-four patients with advanced periodontal disease, each of whom displayed one intrabony defect, were randomly treated with a combination of either EMD + NBM or EMD + beta-TCP. Clinical evaluation was performed at baseline and 1 year following therapy. RESULTS: No differences in any of the investigated parameters were observed at baseline between the two groups. Healing was uneventful in all patients. At 1 year after therapy, the sites treated with EMD + NBM showed a reduction in mean probing depth (PD) from 7.9 +/- 1.0 mm to 3.2 +/- 0.6 mm and a change in mean clinical attachment level (CAL) from 8.8 +/- 1.1 mm to 4.5 +/- 0.6 mm (P < 0.001). In the group treated with EMD + beta-TCP, the mean PD was reduced from 7.8 +/- 1.2 mm to 3.2 +/- 0.9 mm, and the mean CAL changed from 8.8 +/- 1.2 mm to 4.7 +/- 1.2 mm (P < 0.001). In both groups, all sites gained at least 3 mm of CAL. CAL gains of 4 or 5 mm were measured in the majority of the cases (75%), irrespective of treatment modality. No statistically significant differences in terms of PD reductions and CAL gains were observed between the two groups. CONCLUSION: Within the limits of the present study, both therapies resulted in significant PD reductions and CAL gains 1 year after surgery.

Adult↗

PubMed2005

Er:YAG laser in defocused mode for scaling of periodontally involved root surfaces: an in vitro pilot study.

BACKGROUND: The Er:YAG laser may be used on periodontally involved teeth in combination with conventional periodontal therapy in order to improve the efficacy of root instrumentation. The aim of this study was to compare the effect of hand instrumentation on root surfaces of periodontally involved teeth with Er:YAG laser application. METHODS: Thirty freshly extracted, non-carious, single-rooted, periodontally diseased human teeth from adult humans with advanced periodontal disease were used in this study. The teeth were divided into three groups of 10 specimens each. Group A was treated with scaling and root planing (SRP) with curets only (control). In group B, the root surfaces were scaled with curets and then lased with an Er:YAG laser (wavelength 2.94 microm). A handpiece with a water spray was used in non-contact mode (defocused) at a distance of 1 cm from root surface. Laser parameters were set at energy of 100 to 200 mJ/pulse, with 10 Hz of frequency. In group C, the root surfaces were lased only with power settings 250 to 300 mJ/pulse and 10 Hz frequency. An epon-araldite plastic embedding technique was used for light microscopic investigation. RESULTS: Histologic findings showed significant differences between the test and control sites. In control sites, after hand instrumentation, the surface was smooth, without a cementum layer, and the dentin layer presented opened tubules. Defects on the dentin layer were also present along root surfaces. In the test sites (B, C) root surfaces revealed no thermal damage; no cracking or tissue carbonization were observed. The superficial layers of lased surfaces appeared smooth and melted without alterations. CONCLUSION: Based on these findings, it appears that it may be feasible to use the Er:YAG laser for root instrumentation without prior root planing if the proper parameters are followed.

Adult↗

PubMed2005

Clinical and histologic evaluation of an enamel matrix protein derivative combined with a bioactive glass for the treatment of intrabony periodontal defects in humans.

The present study clinically and histologically evaluated healing of human intrabony defects following treatment with a combination of enamel matrix derivative (EMD) and bioactive glass (BG) or BG alone. Six patients displaying either combined one- and two-walled (five patients) or three-walled (one patient) intrabony defects around teeth scheduled for extraction were included. A notch was placed at the most apical extent of the calculus on the root surface to serve as a reference. Six months after surgery, the teeth or roots were extracted, together with some of their surrounding soft and hard tissues, and processed for histologic evaluation; a gain of clinical attachment was found in all cases. Healing in all three defects treated with EMD + BG was mainly characterized by new cementum with inserting collagen fibers and new periodontal ligament; most graft particles were surrounded by bone-like tissue, indicating ongoing mineralization. Treatment with BG resulted in epithelial down-growth and connective tissue encapsulation of the graft material in all three specimens. Reformation of cementum and periodontal ligament was observed in one of the specimens, limited to the most apical part of the defect. Formation of bone-like tissue around the graft particles was observed in only one of the three specimens treated with BG. Direct contact between the BG particles and root surface (cementum or dentin) was not observed in any of the six specimens. BG alone has low potential to facilitate periodontal regeneration. However, EMD + BG resulted in formation of new cementum with an associated periodontal ligament, as well as enhanced mineralization around the BG particles.

Bone Substitutes↗

PubMed2004

GTR treatment of intrabony defects with PLA/PGA copolymer or collagen bioresorbable membranes in combination with deproteinized bovine bone (Bio-Oss).

The objectives of this study were to evaluate the results of guided tissue regeneration (GTR) treatment of intrabony defects with two kinds of bioresorbable membranes, with deproteinized bovine bone (Bio-Oss) used as an adjunct. Twenty-eight patients with at least one intrabony defect with a probing pocket depth (PPD) >/=7 mm and radiographic evidence of an intrabony component (IC) >/=4 mm were randomly treated with either a polylactic/polyglycolic (PLA/PGA) acid copolymer or a collagen bioresorbable membrane combined with Bio-Oss implantation. Immediately prior to surgery (baseline) and after 1 year, the following parameters were recorded: (1) PPD, (2) gingival recession (REC), (3) probing attachment level (PAL), (4) presence/absence of plaque (PI), and (5) presence/absence of bleeding on probing (BOP). Occurrence of membrane exposure during healing and the smoking habits of the patients were also recorded. Statistical analysis was carried out using chi(2) -tests and t-tests. There were no significant differences between the two membrane groups regarding the clinical parameters at baseline. Statistically significant clinical improvements (PAL gains, reduced PPDs) were observed 1 year after treatment in both groups. There were no significant differences, however, between the PLA/PGA and the collagen membrane groups regarding any of the evaluated parameters (mean PAL gain: 2.9 mm vs 3.9 mm; mean residual PPD: 4.8 mm vs 4.1 mm, respectively). The membrane material per se does not seem to be a critical factor for the outcome of GTR treatment of intrabony defects with bioresorbable membranes.

Absorbable Implants↗

PubMed2004

Effect of enamel matrix protein derivative on the attachment, proliferation, and viability of human SaOs(2) osteoblasts on titanium implants.

The purpose of the present study was to investigate the effects of an enamel matrix protein derivative (EMD) on attachment, proliferation, and viability of human SaOs(2) osteoblasts on titanium implants. A total of 220 sand-blasted and acid-etched (SLA) titanium discs were placed into 24-well culture plates. Before cell inoculation, McCoy's 5A medium (MCM) containing EMD at 25 micro g/ml, 50 micro g/ml, 100 micro g/ml, and 200 micro g/ml was added, and the culture plates were incubated for 30 min. As control, MCM alone was used. Human osteoblast-like cells (SaOs(2)) (2 x 10(4) cells, fourth passage) were suspended in MCM containing 1% penicillin/streptomycin and 10% fetal bovine serum and then inoculated into the well chambers. The medium was changed after 3 days without the addition of EMD. At days 1, 3, and 6, DNA content of the cells was assessed using the CyQuant cell proliferation assay kit, and mitochondrial activity of the cells was measured using a CellTiter-Glo luminescent cell viability assay. The presence of EMD on the titanium discs at days 1 and 6 was evaluated using immunofluorescence stain (IFS) by means of polyclonal antibodies against amelogenin. Additionally, cell morphology was investigated using scanning electron microscopy. Enamel matrix derivative at 25 micro g/ml, 50 micro g/ml, 100 micro g/ml, and 200 micro g/ml demonstrated similar increases in cell proliferation as the control medium at days 3 and 6 ( P>0.05 between groups, respectively). Proliferation, however, appeared to be ameliorated with increasing EMD concentrations. At 25 micro g/ml and 50 micro g/ml, EMD also demonstrated an increase in cell viability similar to the control medium at days 3 and 6 ( P>0.05 between groups, respectively), while EMD at 100 micro g/ml and 200 micro g/ml resulted in statistically significant higher increase in cell viability than in the control medium at day 6 ( P<0.001 between groups, respectively). In all test groups, IFS at day 6 was markedly lower than at day 1. Scanning electron microscopy revealed comparable cell morphology in all groups. Within the limits of the present study, it was concluded that EMD enhanced cell proliferation and viability of human SaOs(2) osteoblasts on SLA titanium implants in a concentration-dependent manner.

Animals↗

PubMed2004

Biocompatibility of various collagen membranes in cultures of human PDL fibroblasts and human osteoblast-like cells.

The aim of the present study was to evaluate the biocompatibility of differently cross-linked collagen membranes in cultures of human PDL fibroblasts and human osteoblast-like cells. Four collagen membranes [BioGide (BG), BioMend (BM), Ossix (OS) and TutoDent (TD)] were tested. Cells plated on culture dishes (CD) served as positive controls. Six specimens of each membrane were incubated with (1) human PDL fibroblasts [2 x 10(4) cells] (n=24), and (2) human osteoblast-like cells (SaOs-2) [2 x 10(4) cells] (n=24) under standardized conditions. After 7 days, adherent cells were stained with hematoxylin and counted using a reflected light microscope and the cell density per square millimeter was calculated. Additionally, cell morphology was investigated using scanning electron microscopy (SEM). Cell counts were presented as means and standard deviations (cells/mm(2)) and analyzed for statistical difference using the Wilcoxon test: (1) CD (434+/-76)>BG (64+/-19)=OS (61+/-8)>TD (44+/-4)>BM (12+/-5); (2) CD (453+/-92)>BG (94+/-46)=TD (84+/-49)>OS (41+/-23)>BM (0). SEM examination revealed that PDL fibroblasts adherent on BG, TD and OS appeared spindle-shaped and flat, like cells on CD. SaOs-2 osteoblasts adherent on CD were star shaped and flat, but mostly round in shape on BG, OS and TD. BM appeared to be incompatible with the attachment and proliferation of SaOs-2 cells; however, a few PDL fibroblasts were found in a round shape. Within the limits of the present study, it was concluded that (i) BG, TD and OS promoted, and (ii) BM inhibited the attachment and proliferation of human PDL fibroblasts and human SaOs-2 osteoblasts.

Adult↗

PubMed2004

Non-surgical periodontal treatment with a new ultrasonic device (Vector-ultrasonic system) or hand instruments.

OBJECTIVES: The aim of this prospective, randomized, controlled clinical study was to compare the effectiveness of a newly developed ultrasonic device to that of scaling and root planing for non-surgical periodontal treatment. MATERIAL AND METHODS: Thirty-eight patients with moderate to advanced chronic periodontal disease were treated according to an "one-stage procedure" with either a newly developed ultrasonic device (VUS) (Vector-ultrasonic system) or scaling and root planing (SRP) using hand instruments. Clinical assessments by plaque index (PlI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made prior to and at 6 months after treatment. Differences in clinical parameters were analyzed using the Wilcoxon signed ranks test and Mann and Whitney U-test. RESULTS: No differences in any of the investigated parameters were observed at baseline between the two groups. The mean value of BOP decreased in the VUS group from 32% at baseline to 20% after 6 months (p<0.001) and in the SRP group from 30% at baseline to 18% after 6 months (p<0.001). The results have shown that at moderately deep sites (initial PD 4-5 mm) mean CAL changed in the test group from 4.6+/-1.2 to 4.2+/-1.6 mm (p< 0.001) and in the control group from 4.8+/-1.3 to 4.4+/-1.5 mm (p<0.001). At deep sites (initial PD>6 mm) mean CAL changed in the test group from 8.5+/-1.9 to 7.9+/-2.4 mm (p<0.001) and in the control group from 7.9+/-1.6 to 7.2+/-2.2 mm (p<0.001). No statistically significant differences in any of the investigated parameters were found between the two groups. CONCLUSION: Non-surgical periodontal therapy with the tested ultrasonic device may lead to clinical improvements comparable to those obtained with conventional hand instruments.

Chronic Disease↗

PubMed2004

Five-year results following treatment of intrabony defects with enamel matrix proteins and guided tissue regeneration.

BACKGROUND: Treatment with enamel matrix proteins (EMD) or guided tissue regeneration (GTR) has been shown to enhance periodontal regeneration. However, until now there are limited data on the long-term results following these treatment modalities. AIM: The aim of the present clinical study was to present the 5-year results following treatment of intrabony defects with EMD, GTR, combination of EMD and GTR, and open flap debridement (OFD). MATERIAL AND METHODS: Forty-two patients, each of whom displayed one intrabony defect of a probing depth of at least 6 mm, were randomly treated with one of the four treatment modalities. The following parameters were evaluated prior to surgery, at 1 year and at 5 years after: plaque index, gingival index, bleeding on probing, probing pocket depth (PPD), gingival recession, and clinical attachment level (CAL). No statistically significant differences in any of the parameters were observed at baseline between the four groups. RESULTS: The sites treated with EMD demonstrated a mean CAL gain of 3.4+/-1.1 mm (p<0.001) and of 2.9+/-1.6 mm (p<0.001) at 1 and 5 years, respectively. The sites treated with GTR showed a mean CAL gain of 3.2+/-0.8 (p<0.001) at 1 year and of 2.7+/-0.9 mm (p<0.001) at 5 years. The mean CAL gain at sites treated with EMD+GTR was 3.0+/-1.0 mm (p<0.001) and 2.6+/-0.7 mm (p<0.001) at 1 and 5 years, respectively. The sites treated with OFD demonstrated a mean CAL gain of 1.6+/-1.0 mm (p<0.001) at 1 year and 1.3+/-1.2 mm (p<0.001) at 5 years. At 1 year, the only statistically significant difference between the four different treatments was found in terms of PPD reduction and CAL gain between EMD and OFD (p<0.05). However, at 5 years there were no statistically significant differences in any of the investigated parameters between the four different treatments. CONCLUSION: Within the limits of the present study, it may be concluded that the short-term clinical results following treatment with EMD, GTR, EMD+GTR, and OFD can be maintained over a period of 5 years.

Alveolar Bone Loss↗

PubMed2004

Healing of intrabony defects following surgical treatment with or without an Er:YAG laser.

AIM: The aim of this controlled, parallel design clinical study was to compare the healing of intrabony periodontal defects following treatment with access flap surgery with and without debridement with an Er:YAG laser. METHODS: Twenty-three patients each of whom exhibited one deep intrabony defect were randomly treated with either access flap surgery followed by root surface and defect debridement using an Er:YAG laser (KEY3) (160 mJ, 10 Hz) (test), or with access flap surgery followed by root surface and defect debridement using hand and ultrasonic instruments (control). The following clinical parameters were recorded at baseline and at 6 months: plaque index; gingival index; bleeding on probing; probing depth (PD); gingival recession; and clinical attachment level (CAL). The primary outcome variable was CAL. No statistically significant differences between the groups were found at baseline. RESULTS: No serious adverse events were observed after any of the treatments. The results have shown that in the test group the PD decreased from 7.8+/-1.3 to 4.1+/-1.3 mm (p<0.001) and the CAL changed from 9.8+/-2.9 to 7.2+/-2.5 mm (p<0.001). In the control group the PD decreased from 7.8+/-0.8 to 4.6+/-1.6 mm (p<0.001) and the CAL changed from 9.2+/-1.2 to 7.7+/-1.6 mm (p<0.01). The test group displayed a higher tendency for CAL gain, although this tendency did not prove to be statistically significant. CONCLUSION: Within the limits of the present study, it can be concluded that: (i) at 6 months following treatment both therapies led to significant improvements of the investigated clinical parameters, and (ii) an Er:YAG laser may represent a suitable alternative for defect and root surface debridement in conjunction with periodontal surgery.

Alveolar Bone Loss↗

PubMed2004

Periodontal treatment with an Er:YAG laser compared to ultrasonic instrumentation: a pilot study.

BACKGROUND: The aim of the present study was to compare the effectiveness of an Er:YAG laser to that of ultrasonic scaling for non-surgical periodontal treatment. METHODS: Twenty patients with moderate to advanced periodontal disease were randomly treated in a split-mouth design with a single episode of subgingival debridement using either an Er:YAG laser device (160 mJ/pulse, 10 Hz) combined with a calculus detection system with fluorescence induced by 655 nm InGaAsP diode laser radiation (ERL), or an ultrasonic instrument (UI). Clinical assessments of full-mouth plaque score (FMPS), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL) were made at baseline and at 3 and 6 months following therapy. RESULTS: No differences in any of the investigated parameters were observed at baseline between the two groups. The mean value of BOP decreased in the ERL group from 40% at baseline to 17% after 6 months (P<0.0001) and in the UI group from 46% at baseline to 15% after 6 months (P<0.0001). The sites treated with ERL demonstrated mean CAL gain of 1.48 +/- 0.73 mm (P<0.001) and of 1.11 +/- 0.59 mm (P<0.001) at 3 and 6 months, respectively. The sites treated with UI demonstrated mean CAL gain of 1.53 +/- 0.67 mm (P<0.001) and of 1.11 +/- 0.46 mm (P<0.001) at 3 and 6 months, respectively. No statistically significant differences were observed between the groups (P>0.05). CONCLUSION: Within the limits of the present study, it can be concluded that both therapies led to significant improvements of the investigated clinical parameters.

Adult↗

PubMed2004

A randomized clinical trial comparing enamel matrix derivative and membrane treatment of buccal Class II furcation involvement in mandibular molars. Part I: Study design and results for primary outcomes.

BACKGROUND: The objective of this multicenter, randomized trial was to compare enamel matrix derivative (EMD; test) with barrier membranes (control) for the treatment of mandibular buccal Class II furcation defects. METHODS: Forty-five patients with 90 comparable defects on contralateral molars were included. Defects were randomly assigned to EMD or bioabsorbable barrier membrane; the contralateral defect received the alternative treatment. Assessments at baseline and 8 and 14 months included gingival margin levels, probing depths, bleeding on probing, vertical attachment levels, and vertical bone sounding from a stent at five buccal sites/ tooth. Defect dimensions were recorded at surgery and during reentry at 14 months. Change of open horizontal furcation depth was the primary outcome variable. Adverse reactions and patient perceptions were also noted. RESULTS: Both treatment modalities led to significant clinical improvements. The median reduction of open horizontal furcation depth was 2.8 mm with the corresponding interquartile interval (1.5 mm, 3.5 mm) at test sites compared with 1.8 mm (1.0 mm, 2.8 mm) at control sites. The Hodges-Lehmann estimator of the advantage (reduction test versus control) was 0.75 mm (95% confidence interval [CI]: 0.125 mm, 1.375 mm, P = 0.033, Wilcoxon). The frequency of complete furcation closure was 8/45 (test) and 3/45 (control); partial closure, 27/45 in both groups; no change, 9/45 and 11/45, respectively; and deterioration, 1/45 and 4/45, respectively. The frequency of no pain or no swelling at 1 week post-surgery was 62% and 44%, respectively, at the test sites and 12% and 6% at the control sites. CONCLUSION: There was a significantly greater reduction in horizontal furcation depth and a comparatively lower incidence of postoperative pain/swelling following enamel matrix derivative compared to membrane therapy.

Absorbable Implants↗

PubMed2004

A randomized clinical trial comparing enamel matrix derivative and membrane treatment of buccal class II furcation involvement in mandibular molars. Part II: secondary outcomes.

BACKGROUND: This multicenter, randomized trial compared enamel matrix derivative (EMD) with barrier membranes for the treatment of Class II mandibular furcations with regard to secondary outcomes. The influence of furcation morphology on the effectiveness of either treatment was also evaluated. METHODS: Forty-eight patients (age range 28 to 73 years; 22 females, 26 males) with buccal Class II furcation involvements in both contralateral lower first or second molars were included. After initial periodontal treatment, defects were randomized to either EMD or bioabsorbable guided tissue regeneration (GTR) barrier. Study design and the results for the primary parameter were previously described. Results of the following secondary outcome variables are reported here: changes of the hard tissue boundaries describing the anatomical situation of the furcation defect and changes in the following clinical parameters between baseline and 14 months: plaque, level of gingival margin, probing depth, bleeding on probing, attachment level, and bone sounding at five sites/tooth at the buccal side. Descriptive statistics were applied for changes in clinical parameters and measurements of hard tissue boundaries. The differences observed under treatment with EMD or membrane were analyzed by means of the Wilcoxon two-sample test. The difference between the effect of the EMD and membrane treatment was estimated by means of the Hodges-Lehmann estimator. RESULTS: Overall, similar healing results were observed for both treatments. However, there was slightly more recession in the mid-furcation site following membrane treatment (P = 0.04). Additionally, different treatment effects could be detected for the distances from the stent or cemento-enamel junction (CEJ) to the buccal bone crest, mid-distal root (Pstent = 0.01; PCEJ = 0.07) and for the distance from the stent or CEJ to the buccal bone crest, mid-mesial root (Pstent = 0.01; PCEJ = 0.01). There was no measurable bone resorption in EMD sites, whereas a slight resorption occurred with membrane treatment. Furcation morphology at the time of surgery was not associated with clinical outcome, irrespective of the treatment. CONCLUSION: With regard to secondary outcome parameters, enamel matrix derivative treatment led to a similar regenerative result as the membrane procedure.

Absorbable Implants↗

PubMed2004

Human histologic evaluation of an intrabony defect treated with enamel matrix derivative, xenograft, and GTR.

The purpose of the present case report is to clinically and histologically evaluate the healing of one advanced intrabony defect following treatment with an enamel matrix protein derivative (EMD) combined with a bovine-derived xenograft (BDX) and guided tissue regeneration (GTR). One patient with generalized chronic periodontitis and one advanced intrabony defect was treated with EMD + BDX + GTR. Notches were placed in the root at the level of the calculus and alveolar crest to aid histologic identification of new periodontal tissues. Postoperative healing was uneventful. At the 7-month histologic examination, healing in the intrabony component of the defect was characterized by formation of new connective tissue attachment (new cellular cementum with inserting collagen fibers) and new bone in the intrabony component. The BDX particles were surrounded by bone-like tissue. No direct contact between the graft particles and root surface (cementum or dentin) was observed. Healing in the suprabony defect component occurred through epithelial downgrowth that stopped at the level of the coronal notch. The BDX particles were entirely encapsulated in dense connective tissue, without any signs of bone formation. The present case report shows formation of new attachment apparatus consisting of new bone, cementum, and periodontal ligament in the intrabony component of one human defect treated with EMD + BDX + GTR.

Alveolar Bone Loss↗

PubMed2004

Clinical evaluation of an enamel matrix derivative and a bioresorbable membrane in the treatment of degree III mandibular furcation involvement: a series of nine patients.

The present study evaluated the effect of combining an enamel matrix derivative (EMD) and a bioresorbable membrane (GTR) in the surgical treatment of degree III mandibular furcation involvements. Nine patients with chronic periodontitis, presenting a total of 14 degree III mandibular furcation involvements, were included in the study. Surgical treatment of the defects was randomly assigned: (1) EMD (four defects); (2) GTR (three defects); and (3) EMD and GTR (seven defects). The degree of involvement was assessed prior to surgery and after 6 and 12 months by measuring the probing attachment level in the horizontal and vertical directions at the furcation site. At 6 and 12 months, partial closure of the involvements had occurred in approximately half of the treated furcations, and the vertical probing level consistently improved following all three treatment modalities. The results suggest that all three treatment modalities may improve healing following surgical treatment of degree III mandibular furcation involvements. However, further studies are needed to examine the clinical significance of these results and the histologic characteristics of the healing following application of EMD.

Adult↗

PubMed2004

[Treatment of periimplantitis with laser or ultrasound. A review of the literature].

In addition to conventional treatment modalities (mechanical and chemical), the use of different lasers has been increasingly proposed for the treatment of peri-implantitis. Results from both controlled clinical and basic studies have pointed to the high potential of an Er:YAG-laser. Its excellent ability to effectively ablate dental calculus without producing major thermal side-effects to adjacent tissue has been demonstrated in numerous studies. Recently, a new ultrasonic device has been used for the treatment of periodontal and peri-implantitis infections. Preliminary clinical data indicate that treatment with both treatment procedures may positively influence peri-implant healing. The aim of the present review paper is to evaluate, based on the available evidence, the use of an Er:YAG-laser and a newly introduced ultrasonic device for treatment of peri-implantitis in comparison to a conventional treatment approach.

Biofilms↗

PubMed2003

The effect of postsurgical administration of a selective cyclo-oxygenase-2 inhibitor on the healing of intrabony defects following treatment with enamel matrix proteins.

Regenerative treatment with enamel matrix proteins (EMD) has been shown to promote regeneration in intrabony periodontal defects. However, up to now various postoperative regimens such as the routine administration of nonsteroidal anti-inflammatory drugs (NSAIDs) were often used in combination with enamel matrix proteins. Therefore, it cannot be excluded that the results might have been influenced by the effect of the postoperative medication. The aim of this randomized, controlled, blinded, clinical investigation was to determine the effect of postsurgical administration of a selective cyclo-oxygenase-2 inhibitor on the healing of intrabony periodontal defects following regenerative periodontal surgery with EMD. Twenty two patients, each of whom exhibited one deep intrabony defect, were randomly treated with either EMD plus a selective cyclo-oxygenase-2 (COX-2) inhibitor (test) or with EMD alone (control). The postoperative regimen consisted of oral administration of 12.5 mg rofecoxib twice daily for 14 days. The following parameters were recorded at baseline and at 6 months by the same calibrated and blinded investigator: plaque index (Pl), gingival index (GI), bleeding on probing (BOP), pocket depth (PD), gingival recession (GR), and clinical attachment level (CAL). Power analysis to determine superiority of the anti-inflammatory treatment showed that the available sample size would yield 70% power to detect a 1 mm difference. No statistical significant differences in any of the investigated parameters between the two groups were observed at baseline. The results show that, in the test group, mean PD decreased from 8.7+/-1.4 mm to 4.7+/-2.0 mm (P<0.001) and mean CAL from 9.7+/-2.0 mm to 6.5+/-2.1 mm (P<0.001). In the control group, mean PD decreased from 8.6+/-1.6 mm to 4.7+/-1.8 mm (P<0.001) and mean CAL from 9.5+/-1.6 mm to 6.5+/-2.2 mm (P<0.001). There were no significant differences between the two groups in any of the investigated parameters. Within the limits of the present study, it can be concluded that the systemic administration of a selective COX-2 inhibitor following regenerative periodontal surgery with EMD did not result in additional clinical improvements when compared to treatment with EMD alone.

Alveolar Bone Loss↗

PubMed2003

In vivo and in vitro effects of an Er:YAG laser, a GaAlAs diode laser, and scaling and root planing on periodontally diseased root surfaces: a comparative histologic study.

BACKGROUND AND OBJECTIVES: The aim of the present histologic study was to compare the in vivo and in vitro effects of an erbium: yttrium, aluminum, and garnet (Er:YAG) laser (ERL), combined with a fluorescent calculus detection system, a diode laser (DL) and scaling and root planing (SRP) on periodontally diseased root surfaces. STUDY DESIGN/MATERIALS AND METHODS: Twenty-four single rooted teeth, considered for extraction due to severe periodontal destruction, were included in the study. Prior to extraction all mesial root surfaces were randomly assigned to the following treatment groups: (1) ERL combined with a calculus detection system with fluorescence induced by 655 nm InGaAsP DL radiation (160 mJ/pulse and 10 pulses/second under water irrigation) (ERL), or (2) GaAlAs DL (1.8 W, pulse/pause relation 1:10), or (3) SRP using hand instruments. Immediately after extraction, all distal root surfaces were treated with the same instruments under standardized conditions. For light microscopic investigation, a plastic embedding technique was used to cut the undecalcified roots into 30 microm thick crossections. The following parameters were recorded by on blind examiner: remaining debris, root surface morphology, and thermal side effects. RESULTS: Root surfaces instrumented with both, ERL in vivo and DL in vitro exhibited no detectable surface alterations. In contrast, ERL scaling in vitro and SRP in vivo/in vitro produced superficial microchanges in root cementum. However, irradiation with DL in vivo caused severe damages to the root surface (i.e., crater formation). There were no signs of thermal side effects in all laser treated groups. ERL provided subgingival calculus removal on a level equivalent to that provided by SRP. DL was unsuitable for calculus removal, since macroscopic inspection revealed the presence of large amounts of subgingival calculus. CONCLUSIONS: The present in vivo results showed that (i) ERL, combined with a fluorescent calculus detection system, provided a selective subgingival calculus removal on a level equivalent to that provided by SRP, and (ii) DL, using this power output, was unsuitable for calculus removal and altered the root surface in an undesirable manner.

Dental Calculus↗