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M J Danesh-Meyer

Publications and source records attributed to M J Danesh-Meyer.

17 recordsLinked to original sources
PubMed2001

Gingival recession defects and guided tissue regeneration: a review.

The last decade has seen an increasing number of clinical reports on guided tissue regeneration (GTR) for reconstruction of gingival recession defects. This article reviews the value of GTR in the management of gingival recession defects based on records from such reports. Studies and case-series using nonresorbable and bioresorbable membranes, studies comparing GTR to the subepithelial connective tissue graft (CTG) procedure, and histologic reports of healing following GTR, published in the English language from 1985 to 2000, were identified using a Medline search and were included in the data-base for this review. The Following pre- and post-treatment data were collated and evaluated for each of the reports: gingival recession depth, probing depth, clinical attachment level, and width of the keratinized gingiva. In perspective of the limitations of the studies reviewed, it has been shown that GTR may be used for reconstruction of gingival recession detects. Importantly it has not been shown that GTR provides an added clinical benefit for the patient treatment planned for reconstruction of gingival recession defects. i.e. GTR does not appear to offer a significant advantage over mucogingival procedures such as the connective tissue graft or the advanced flap procedure. It is imperative to recognize inherent technical difficulties associated with GTR including primary would closure and secondary membrane exposure: membrane exposures being negatively correlated to desired clinical outcomes. Also, membrane exposures appear consistently more common in smokers than in non-smokers. It is also imperative to recognize shortcomings and adverse effects including space maintenance and unacceptable foreign body reactions associated with some bioresorbable GTR technologies.

Absorbable Implants↗
PubMed2001

Localized ridge augmentation using GBR and platelet-rich plasma: case reports.

Combining platelet-rich plasma (PRP) with autogenous bone graft materials has recently been advocated as a means of enhancing rate and quality of new bone formation in regenerative procedures. The aim of this case series was to evaluate the potential of PRP in combination with bone allograft to enhance bone regeneration in alveolar ridge defects exhibiting both vertical and horizontal loss prior to the placement of dental implants. Augmentation resulted in clinical and radiographic gains in both vertical and horizontal components of the osseous defects, thereby facilitating subsequent placement of dental implants. Histologic evaluation of the cases revealed the presence of residual allograft particles surrounded by connective tissue as well as newly formed bone within the grafted areas. However, the addition of PRP did not appear to enhance the quality or quantity of new bone formation over that reported in comparable guided bone regeneration (GBR) studies without PRP.

Adult↗
PubMed2001

Histological evaluation of sinus augmentation using platelet rich plasma (PRP): a case series.

The use of Platelet Rich Plasma (PRP) in conjunction with autogenous bone graft materials has recently been advocated for use in sinus augmentation surgery as a means of enhancing both quantity and quality of newly forming bone. The use of PRP is based on the premise that autogenous plasma, rich in platelets, contributes large quantities of mitogenic polypeptides such as Platelet Derived Growth Factor (PDGF), Transforming Growth Factor-b (TGF-b) and Insulin-like Growth Factor-I (IGF-I), thereby enhancing osteogenesis. The aim of this study was to evaluate the potential of PRP to enhance bone formation following sinus augmentation with different bone derivative/substitute materials (DFDBA, FDBA, Xenograft, Bioactive Glass). This study presents histology of trephine-obtained core samples from five clinical cases in which sinus augmentation was performed with PRP combined with bone derivatives/substitutes. Histological evaluation of this case series consistently revealed the presence of residual graft particles surrounded by loose connective tissue, with a limited amount of newly formed bone. The findings suggest that the addition of PRP to bone derivative/substitute materials may not significantly enhance bone formation in the maxillary sinus area.

Adult↗
PubMed2000

Oral lesions in patients with psoriasis: clinical presentation and management.

Psoriasis is a chronic inflammatory skin disease that rarely involves the oral cavity. In this report we describe 2 cases, initially diagnosed with cutaneous psoriasis, that present with oral lesions on the attached gingiva. The clinical appearance and differential diagnosis are presented and discussed. Case 1 describes the non-surgical management of intraoral psoriasiform lesions and the use of a free gingival graft to restore an area of gingival recession resulting from an oral lesion. The second case outlines the use of topical corticosteroid therapy as an adjunct to non-surgical periodontal therapy. Although patients with cutaneous psoriasis rarely present with oral involvement, the clinician should be aware that oral lesions may occur. Accurate diagnosis is dependent on a thorough clinical examination, a biopsy of the oral lesions, and a history of cutaneous psoriasis.

Administration, Topical↗
PubMed2000

Implant site development using orthodontic extrusion: a case report.

One of the most important factors in the successful placement of endosseous implants is the presence of adequate alveolar bone at the recipient site. Alveolar bone loss associated with destructive periodontal disease frequently results in osseous defects that may complicate subsequent implant placement. Typically, such defects are treated prior to or at the time of implant surgery using the principles of guided bone regeneration. Under certain circumstances, however, such defects may be managed non-surgically by orthodontic extrusion. Orthodontic extrusion can be used to increase the vertical bone height and volume and to establish a more favourable soft-tissue profile prior to implant placement. The addition, the increase in the vertical osseous dimension at interproximal sites may assist in the preservation of the interdental papillae and can further enhance gingival aesthetics. This report illustrates the treatment sequence for site development with orthodontic extrusion prior to immediate implant placement.

Adult↗
PubMed2000

Tissue engineering in periodontics using rhBMP-2.

The results of these studies show that rhBMP-2 clearly enhances regeneration in periodontal defects (Figures 2&3). The extent of regeneration appears to be significantly influenced by the nature of the carrier material used to deliver the rhBMP-2 to the periodontal wound. While the positive effects of rhBMP-2 on osteogenesis are well established, less is known about the way in which rhBMP-2 effects cementogenesis, or its role in the formation of a new periodontal ligament. From the studies reviewed, it would appear that rhBMP-2 facilitate in the formation of cellular cementum on previously denuded root surfaces. This newly formed cementum has also been shown to support an organised periodontal ligament attachment. Mechanisms related to the possible role of rhBMP-2 in ankylosis are presently unclear and will require further investigation as such sequelle may complicate the clinical utility of rhBMP-2 in periodontal regeneration. Root resorption has also been reported in the above mentioned studies and appears to be related to the concentration of rhBMP-2. Further research directed at understanding how different carriers influence the way in which the rhBMP-2 is released during wound healing should assist researchers with how to best apply these bioengineered proteins to ultimately achieve a more predictable regeneration of the periodontal attachment apparatus. Moreover, additional research into the differing biologic effects of other members of the BMP family of proteins may also hold further promise in the application of this technology to periodontal regeneration.

Animals↗
PubMed2000

Tissue engineering in periodontics and implantology using rhBMP-2.

Regenerative procedures using barrier membrane technology are presently well established in periodontology and implantology. Guided Tissue Regeneration (GTR) and Guided Bone Regeneration (GBR) are based on the premise that barrier membrane materials will promote selective cell re-population and subsequent reconstitution of the periodontal attachment apparatus as well as bone. However, because the predictability of these techniques can be variable, the application of this technology may frequently be restricted to specific case types. There has been increasing interest in the possibility of pharmacologically enhancing regeneration of periodontal and osseous tissues, thereby ultimately providing a more significant and predictable clinical outcome. Bone Morphogenetic Proteins (BMPs) have been isolated, cloned and evaluated in various pre-clinical and clinical models. The results of recent studies involving regeneration of alveolar bone in conjunction with implant therapy and regeneration of PDL attachment with BMPs have been very encouraging. In particular, rhBMP-2 has been shown to promote a degree of osseous and periodontal repair which is significantly greater than that previously seen with conventional GTR/GBR therapies and/or the use of various osseous grafting materials.

Alveolar Bone Loss↗
PubMed1999

Guided tissue regeneration in the management of severe periodontal-endodontic lesions.

Diagnosis of combined periodontal-endodontic lesions can prove difficult and frustrating. They are often characterised by extensive loss of periodontal attachment and alveolar bone, and their successful management depends on careful clinical evaluation, accurate diagnosis, and a structured approach to treatment planning for both the periodontic and endodontic components. Recent advances in regenerative periodontics have led to improved management of periodontal-endodontic lesions. This paper reviews the management of such lesions in light of these recent advances and illustrates this through reports of two patients who had severe periodontal involvement.

Adult↗
PubMed1997

A comparison of 2 polytetrafluoroethylene membranes in guided tissue regeneration in sheep.

The purpose of this study was to evaluate the sheep as a suitable animal model in which to compare periodontal wound healing after surgically induced Class II furcation defects were treated with different guided tissue regeneration (GTR) membranes. 22 mandibular second premolar sites in 11 sheep were used. The experimental design included untreated control teeth, sites treated by surgery alone, and others where surgery included placement of either Gore-Tex Periodontal Material (GTPM) or Gore-Tex Soft Tissue Patch (GTSTP). Sheep were killed 7 wk after surgery. Mesiodistal sections through decalcified second mandibular premolars were evaluated histologically. Histomorphometric analysis of digitized images allowed both area and linear measurements of newly regenerated furcal tissues. Percentage areas of cementum, bone, epithelium and connective tissue filling the furcation region were calculated. Coronal regeneration of alveolar bone and cementum were expressed as a percentage of the original height of the defect. Mean values for each group were subsequently analysed by 1-way ANOVA. Significantly greater regeneration was achieved with both of the GTR membranes, by comparison with the non-GTR surgical control group, with respect to percentage areas of cementum, bone and connective tissue, and the linear measurement of cementum (p < or = 0.05). This study demonstrates successfully the use of the sheep animal model for GTR research, and shows that few differences exist between GTR healing when either GTPM or GTSTP is used in the treatment of class II furcation defects.

Alveolar Bone Loss↗
PubMed1994

Dental Implants. Part I: Biological basis, implant types, and the peri-implant sulcus.

Dental implantology is a rapidly advancing area of dentistry providing a number of alternative treatment possibilities for patients with partially or fully edentulous mouths. The following article is the first in a series of three dealing with various aspects of dental implantology, with a particular emphasis on those areas related to field of periodontology. In this paper we shall consider the biological basis of dental implants, different implant systems, and the peri-implant sulcus. Forthcoming articles will cover the diagnosis and treatment of peri-implantitis and failing implants, guided bone regeneration around implants, immediate implant placement, the placement of implants in the posterior maxillae, and implant maintenance.

Animals↗
PubMed1993

Familial gingival fibromatosis: a report of two patients.

This report describes two patients with familial gingival fibromatosis. Treatment for both patients involved gingivectomies to provide acceptable gingival function and appearance. The first patient has been monitored for only a short period, the second patient for 11 years. Neither patient has shown any recurrence of the condition.

Child↗