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C Ochsenbein

Publications and source records attributed to C Ochsenbein.

17 recordsLinked to original sources
PubMed2001

A longitudinal study comparing scaling, osseous surgery, and modified Widman procedures: results after 5 years.

BACKGROUND: Scaling and root planing, osseous surgery, and modified Widman procedures are effective methods for treating periodontal diseases. Studies have been carried out to determine if these procedures are more effective than others in reducing clinical probing depths, while maintaining clinical attachment levels. The purpose of this report is to present 5-year results from a longitudinal study comparing scaling and root planing (SRP), osseous surgery (OS), and modified Widman (MW) therapies. The study has been completed for 12 years. METHODS: Sixteen adult patients with moderate to advanced periodontal disease were treated with initial scaling and oral hygiene procedures in a private practice. Posthygiene data were used to compare changes in plaque and gingival indices, probing depth (PD), clinical attachment levels (CAL), and recession. Frequency distributions were used to compare changes at individual sites. The first published report was from baseline to one year. This follow-up report is from baseline through 5 years. RESULTS: At 5 years, there were significant decreases in gingival and plaque scores. For the 3 procedures, there were significant decreases in baseline 4 to 6 mm PD (P<0.0001); however, there were no differences between the methods. Similar findings were noted for PD initially greater than 7 mm. At 5 years, OS had the greatest number of 1 to 3 mm sites (332 sites, 73.2%), while MW had the fewest number of 4 to 6 mm PD (98 sites, 21.8%). SRP had the fewest 7 mm and greater sites (15 sites, 3.4%). At 5 years, CAL loss for 1 to 3 mm PD was statistically significant for the 3 procedures. There were slight gains in CAL for 4 to 6 mm probing depths. These gains were not significant. Similar findings were seen for CAL for probing depths greater than 7 mm. OS had the greatest number of sites losing more than 2 mm of CAL (64 sites), followed by SRP (21 sites) and MW (34 sites), respectively. CONCLUSIONS: This 5-year clinical trial demonstrates that with good patient maintenance excellent clinical results can be achieved with various methods of treatment. Within the limits of this study, SRP, OS, and MW were effective at reducing probing depths with slight changes in clinical attachment levels.

Adult↗
PubMed1998

Crown lengthening: the periodontal-restorative connection.

Crown lengthening procedures are based on biologic principles that can be determinants for successful treatment. These procedures are fixed on an understanding of the biologic width. A few of the indications for crown lengthening are caries beneath the gingival margin, fractured teeth with insufficient clinical crown exposure, and teeth with excessive occlusal or incisal wear. This article describes flap designs, the use of a new bur probe for precise measurement of clinical crown exposure, and suturing methods for flap stabilization. Clinical documentation of patients with various clinical situations requiring crown lengthening is presented.

Crown Lengthening↗
PubMed1997

Alveolar bone anatomic profiles as measured from dry skulls. Clinical ramifications.

The purpose of this study was to evaluate the relationship of alveolar bone morphology to tooth shape and form. 111 dry skulls were evaluated at Baylor College of Dentistry (Dallas, Texas). The skulls were arbitrarily divided into flat, scalloped and pronounced scalloped anatomic profiles according to alveolar bone anatomy. The number of buccal dehiscences and fenestrations was determined for each skull according to their anatomic morphotype. 10 skulls from each group were selected for bone height measurements. The measurements were made with a periodontal probe and ruler from the height of the interproximal bone to the buccal alveolar crest. Kodachrome slides were used to measure mesial-distal tooth width and length from ten skulls from each anatomic category. The average number of fenestrations for each group was 3.5. The mean number of dehiscences for flat and scalloped skulls was 0.5. The average number of dehiscences for pronounced scalloped was 1.2. There were no significant differences when the groups were compared. The mean distance from the height of the interdental bone to the alveolar crest was statistically significant when the groups were compared (flat 2.1 mm, scalloped 2.8 mm, pronounced 4.1 mm) (Tukey, p = 0.05). There were no significant differences when tooth shapes were compared with bone anatomy. Pronounced scalloped anatomic profiles were slightly narrower when compared with the other groups. The observations reported have treatment ramifications when patients with scalloped or pronounced scalloped morphotypes are being considered for dental implant placement.

Adult↗
PubMed1995

Human demineralized freeze-dried bone: inadequate induced bone formation in athymic mice. A preliminary report.

The purpose of this study was to test the osteoinductive properties of demineralized freeze-dried bone (DFDBA) randomly purchased from four commercial bone banks. Twenty-five (25) milligrams of bone from each of the banks was implanted into the hindquarter muscles of athymic mice. Two samples from each of the banks were compared with samples from the other banks. A total of 16 implants were grafted into 8 mice. Two additional mice served as controls. One mouse received an implantation of deactived human cortical bone matrix (DBM) (negative control). The other mouse received an implant of human bone morphogenetic protein/non-collagenous proteins (hBMP/NCP) infused to surface demineralized human cortical bone (positive control). At 21 days the mice were killed, the hindquarters were photographed, and the tissues were prepared for histologic evaluation. Of the 16 commercial DFDBA implants, 12 were available for histologic evaluation. There was no radiographic evidence of bone formation for the DFDBA implanted mice or the DBM implants. Small bone ossicles were scarcely visible in the hindquarters of the mouse which received the hBMP/NCP infused bone. Histomorphometric analysis was used to determine the percentage of new and dead bone. The bone was measured in pixels. The predominant histologic feature of the DFDBA implants was non-vital bone chips with minimal amounts of new bone. The average amount of non-vital bone ranged from 78.4% to 92.5%. There was no evidence of bone formation for the DBM implants. The average amount of bone for the mouse which received hBMP/NCP was 96%. The results of this pilot study indicate that commercially-available DFDBA induced clinically insignificant amounts of bone.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Combined approach to the management of intrabony defects.

Although regenerative and osseous surgical procedures have different objectives, they can often be used in combination to achieve predictable results in certain bony defects. This article describes the anatomy of three-walled bony defects and explains the theory behind the combined regenerative-osseous surgical treatment of such lesions.

Alveolar Bone Loss↗
PubMed1991

Guided tissue regeneration for implants placed into extraction sockets: a study in dogs.

Twelve 10 mm implants were placed into immediate extraction sockets in dogs. Six implants were isolated with PTFE membranes and 6 sites served as controls. Standardized clinical measurements were taken at test and control sites. At 18 weeks the dogs were anesthetized and flaps were laid for the purpose of obtaining clinical measurements. The average gain of bone around augmented implants was 2.6 mm, while control sites had an average bone gain of 1.0 mm. Ridge width adjacent to augmented sites increased by 1.2 mm and control sites had an increased width of 0.6 mm. Histologic evaluation of test and control specimens showed greater bone formation around augmented implants. Implants augmented with PTFE membranes had clinically significant amounts of bone regeneration when compared with controls.

Alveolar Process↗
PubMed1988

A longitudinal study comparing scaling, osseous surgery and modified Widman procedures. Results after one year.

The purpose of this study was to compare, longitudinally, the effectiveness of scaling and root planing, osseous surgery, and the modified Widman procedures. The study was carried out in a private practice setting. Sixteen adult patients with moderate to advanced adult periodontitis were treated with initial scaling and oral hygiene procedures. Posthygiene data were used for comparison of changes in probing depth, clinical attachment levels and gingival recession. The initial examination data were used to compare changes in plaque and gingival indices. Frequency distributions were used to compare changes that occurred at individual sites. At one year, plaque and gingival indices were significantly reduced when compared with the initial examination. At one year, shallow pockets (1-3 mm) were reduced when compared to posthygiene. Four- to six-millimeter pockets were significantly reduced by the three procedures. Osseous surgery and modified Widman had significantly greater pocket reduction when compared with scaling. For pockets greater than 7 mm, osseous surgery and the modified Widman had significantly greater reduction when compared with scaling. For pockets 1-3 mm at one year osseous surgery had significantly greater clinical attachment loss when compared with scaling. For 4-6 mm pockets at one year, the three procedures had slight gains in clinical attachment levels. The results were similar for pockets with greater than 7 mm. Interproximal soft tissue craters were measured for six postoperative weeks. Initially, the modified Widman had a higher percentage of soft tissue craters when compared with osseous surgery. At six weeks, however, there were no significant differences when the surgical procedures were compared. Recession was measured at each examination. Recession for 1-3 mm pockets at one year was greater for osseous surgery when compared with scaling and the modified Widman. Recession for 4-6 mm and greater than 7 pockets was greater for the surgical procedures than scaling. The results from this study indicate that with three-month maintenance recalls, both the modified Widman and osseous surgery are effective for pocket reduction, and each will produce a slight gain of clinical attachment over one year. Scaling was effective at maintaining attachment levels but was not as effective in reducing pocket depth.

Adult↗
PubMed1976

Rationale for the lingual approach to mandibular osseous surgery.

The definitive treatment of periodontitis for pocket elimination and the establishment of periodontal architecture that can be effectively maintained with daily personal oral hygiene techniques is sometimes an elusive goal. Performing osseous reduction, primarily from the lingual aspect of the posterior mandible, definitely helps in accomplishing such a goal. This paper should not be interpreted to mean that osseous correction of bony defects should be approached strictly from the lingual, since almost all cases require some buccal recontouring if a satisfactory soft and hard tissue architectural form is to be achieved. Clinical observation and experience have shown that the anatomical patterns, seen in relation to the mandible, have a powerful effect on normal periodontal architecture as well as the types and locations of bony defects encountered. Tooth to bone relationships deserve attention. The buccal housing of the alveolar bone is frequently thin in the premolar region and occasionally on the first molar, while the external oblique ridge causes thicknened bone over the second molar. The vestibular depth on the buccal of the molars is often quite shallow, meaning that only a very limited amount of osteoplasty-osteoectomy can be performed from the buccal. The lingual housing of the alveolar bone is normally thickened and shelf-like from the distal of the third molars to the mesial aspect of the premolar region. Because the posterior teeth are inclined lingually from the second premolar distally, the buccal marginal bone height is higher occlusally than the lingual bone margins, with the interproximal bone therefore sloping somewhat apically and lingually. Interdental craters are the most common defect seen with the onset of periodontitis. Such defects in the lower arch tend to occur beneath the contact areas of the teeth, which are much further to the lingual than in the maxilla. The highest percentage of interproximal craters are shallow and not amenable to grafting techniques in the hands of most clinicians. These shallow craters are prime candidates for osseous reduction techniques. With the progression of periodontitis, the interproximal defects frequently extend to include infrabony lingual defects. Although obtaining lingual access for osseous reduction techniques is often difficult, osteoectomy-osteoplasty techniques performed primarily from the buccal of the posterior mandible frequently result in compromise of the lingual and over treating the buccal in terms of osteoectomy procedures. The lingual embrasure spaces are usually wider than on the buccal, and with adequate reduction of the mylohyoid ridge, greater access for oral hygiene procedures is provided.

Alveolar Process↗
PubMed1975

Mucogingival problems, prevalence and therapy in children.

The clinical impressions of the authors and a survey of mucogingival problems in children lead to the following conclusions: 1. Mucogingival problems occur in children. 2. The prevalence of such problems is 12 to 19% in sample of 100 patients examined. 3. Insufficient keratinized tissue is developmentally related to: a. eruption pattern of the permanent incisors. b. buccolingual width of the alveolar process. 4. The autogenous free gingival graft is recommended as an acceptable procedure to prevent incipient mucogingival problems from progressing. 5. Where orthodontic therapy is anticipated and coincidentally insufficient keratinized tissue exists, a free gingival graft should be performed prior to tooth movement. 6. Grafts would be recommended in children with 1 mm or less of keratinized tissue. 7. Grafts would not be recommended in children when there is over 2 mm of keratinized tissue. 8. Grafts would not be recommended in children with greater than 1 mm of attached gingiva.

Adolescent↗