Biomedical subjects

M Weinlaender

Publications and source records attributed to M Weinlaender.

13 recordsLinked to original sources

PubMed2001

The effectiveness of enamel matrix proteins used in combination with bovine porous bone mineral in the treatment of intrabony defects in humans.

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of enamel matrix proteins (EMPs) used in combination with bovine porous bone mineral (BPBM), compared to open flap debridement (OFD) in the treatment of intrabony defects in humans. MATERIAL AND METHODS: Using a split-mouth design, 24 paired intrabony defects were surgically treated and re-entered 6 months later. Experimental sites were treated with EMPs and grafted with BPBM. Control sites were treated with an OFD. The primary outcomes evaluated in the study were changes in pocket depth, clinical attachment level and defect bone fill. RESULTS: Preoperative pocket depths, attachment levels and intra-operative bone measurements were similar for control and experimental sites. 6-month post surgical measurements revealed a significantly greater reduction in pocket depth (differences of 2.35+/-0.86 mm on buccal and 2.28+/-0.90 mm on lingual measurements) and more gain in clinical attachment (differences of 2.04+/-0.28 mm on buccal and 1.99+/-0.26 mm on lingual measurements) in the experimental sites. Surgical reentry of the defects revealed a significantly greater amount of defect fill in favor of the experimental sites (differences of 2.85+/-0.28 mm on buccal and 2.67+/-0.33 mm on lingual measurements). CONCLUSIONS: The results of this study suggest that combining EMPs and BPBM as a regenerative technique for intraosseous defects results in statistically and clinically significant more favorable results than OFD. The nature of the attachment between the newly regenerated tissue and the root surfaces needs to be evaluated histologically to confirm the presence of new attachment.

Adult↗

PubMed2001

The use of bovine porous bone mineral in combination with enamel matrix proteins or with an autologous fibrinogen/fibronectin system in the treatment of intrabony periodontal defects in humans.

BACKGROUND: Enamel matrix derivative (EMD) and autologous fibrinogen/fibronectin system (AFFS) are agents that have been shown to be effective in periodontal regeneration. Their use in combination with graft materials, however, has not been extensively examined. The purpose of this study was to compare the clinical effectiveness of bovine porous bone mineral (BPBM) used in combination with an EMD or in combination with AFFS as regenerative treatments for periodontal intrabony defects in humans. METHODS: Twenty-three paired intrabony defects were surgically treated using a split mouth design. Defects were treated with BPBM either combined with EMD (BPBM/EMD) or with AFFS (BPBM/AFFS). The clinical parameters evaluated included changes in attachment level, probing depth, and defect fill as revealed by re-entry surgeries at 6 months. RESULTS: Preoperative probing depths, attachment levels, and transoperative bone measurements were similar for the 2 treatment groups. Postsurgical measurements taken at 6 months revealed that both treatment modalities resulted in clinically and statistically significant improvements in probing depth resolution, clinical attachment gain, and defect fill as compared to baseline. Both therapy modalities improved clinical parameters as compared to baseline, but the differences found between the groups were not statistically significant. CONCLUSIONS: The results of this study indicate that EMD and AFFS used in combination with BPBM have similar effects in promoting probing depth reduction, clinical attachment gain, and defect fill when employed as regenerative therapy for intraosseous lesions in humans. A study involving a larger sample size is necessary to statistically confirm the equivalence between the 2 treatment modalities.

Alveolar Bone Loss↗

PubMed2001

Combination use of bovine porous bone mineral, enamel matrix proteins, and a bioabsorbable membrane in intrabony periodontal defects in humans.

BACKGROUND: The purpose of this study was to evaluate the effectiveness of a combination of enamel matrix proteins (EMP), bovine porous bone mineral (BPBM), and a bioabsorbable membrane for guided tissue regeneration (GTR) as regenerative therapy for intrabony defects in humans and compare it to an open flap debridement (OFD) technique. METHODS: Using a split-mouth design, 18 pairs of intrabony defects were treated and surgically reentered 6 months after the initial surgery. Experimental sites were treated with EMP, grafted with BPBM, and received a collagen/polylactic acid membrane for GTR. Control sites were treated with OFD. The primary outcomes evaluated in the study included probing depth resolution, clinical attachment gain, and bony defect fill. RESULTS: Preoperative probing depths, attachment levels, and intraoperative bone measurements were similar for the experimental and control groups. Postsurgical measurements taken at 6 months revealed a significantly greater reduction in probing depth in the experimental group (4.95+/-1.52 mm on buccal sites and 4.74+/-1.47 mm on lingual sites) when compared to the control group (2.83+/-0.83 mm on buccal sites and 2.90+/-0.91 mm on lingual sites). The experimental sites also presented with significantly more attachment gain (3.89+/-1.16 mm on buccal sites and 3.78+/-1.14 mm on lingual sites) than the control sites (1.52+/-0.83 mm on buccal sites and 1.48+/-0.78 mm on lingual sites). Surgical reentry of the treated defects revealed a significantly greater amount of defect fill in favor of the experimental group (4.76+/-1.36 mm on buccal sites and 4.81+/-1.37 mm on lingual sites) as compared to the control group (1.78+/-0.92 mm on buccal sites and 1.67+/-0.90 mm on lingual sites). CONCLUSIONS: The results of this study indicate that a combination technique including BPBM, EMP, and GTR results in better clinical resolution of intrabony defects than treatment with OFD. Differences observed were both statistically and clinically significant. The exact role of each of the 3 technique components in achieving the clinical improvement observed in this study remains to be determined.

Absorbable Implants↗

PubMed2000

A controlled re-entry study on the effectiveness of bovine porous bone mineral used in combination with a collagen membrane of porcine origin in the treatment of intrabony defects in humans.

AIM: The purpose of this study was to evaluate the clinical effectiveness of a bovine porous bone mineral used in combination with a porcine derived collagen membrane as a barrier in promoting periodontal regeneration in intrabony defects in humans. MATERIAL AND METHODS: The study employed a split-mouth design. 22 paired intrabony defects were treated and surgically re-entered 6 months after treatment. Experimental sites were grafted with bovine porous bone mineral and received a collagen membrane for guided tissue regeneration. Control sites were treated with an open flap debridement. RESULTS: Preoperative pocket depths, attachment levels and trans-operative bone measurements were similar for control and experimental sites. Post surgical measurements revealed a significantly greater reduction in pocket depth (differences of 1.89 +/- 0.31 mm on buccal 0.88 +/- 0.27 mm on lingual measurements) and more gain in clinical attachment (differences of 1.51 +/- 0.33 mm on buccal and 1.50 +/- 0.35 mm on lingual measurements) in experimental sites. Surgical reentry of the treated defects revealed a significantly greater amount of defect fill in favor of experimental sites (differences of 2.67 +/- 0.91 mm on buccal and 2.54 +/- 0.87 mm on lingual measurements). CONCLUSIONS: The results of this study indicate that clinical resolution of intrabony defects can be achieved using a combination of bovine porous bone mineral and an absorbable, porcine derived collagen membrane when employing a technique based on the principles of guided tissue regeneration. The nature of the attachment between the newly regenerated tissue and the root surfaces needs to be evaluated histologically to confirm the presence of new attachment.

Absorbable Implants↗

PubMed2000

Influence of bioactive glass on changes in alveolar process dimensions after exodontia.

BACKGROUND: Preservation of the alveolar process after tooth extraction is desirable because it facilitates placement of endosseous implants and minimizes adverse esthetic results associated with fixed partial dentures. The purpose of this study was to evaluate the clinical effectiveness of bioactive glass used as a graft material combined with calcium sulfate used in the form of a mechanical barrier in preserving alveolar ridges after tooth extraction. METHODS: Sixteen patients who required extraction of 2 anterior teeth or bicuspids participated in the study (split mouth design). After tooth extraction and elevation of a buccal full-thickness flap, experimental sockets were filled with bioactive glass, which in turn was covered with a layer of calcium sulfate. Control sites did not receive any graft or calcium sulfate. Titanium pins served as fixed reference points for measurements. No attempt was made to advance the flap to cover the socket areas on control or experimental sites (open socket approach). Reentry surgeries were performed at 6 months. RESULTS: Reentry surgeries showed that experimental sites presented with (1) significantly more internal socket bone fill (6.43 +/- 2.78 mm vs 4.00 +/- 2.33 mm on control sites), (2) less (although not statistically significantly less) resorption of alveolar bone height (0.38 +/- 3.18 mm vs 1.00 +/- 2. 25 mm on control sites), and (3) similar degree of horizontal resorption of the alveolar bony ridge as compared with controls (3. 48 +/- 2.68 mm vs 3.06 +/- 2.41 mm on control sites). CONCLUSIONS: This study suggests that treatment of extraction sockets with a combination of bioactive glass and calcium sulfate is of some benefit in preserving alveolar ridge dimensions after tooth extraction.

Adult↗

PubMed2000

A comparison between enamel matrix proteins used alone or in combination with bovine porous bone mineral in the treatment of intrabony periodontal defects in humans.

BACKGROUND: It has been shown that clinical improvement of intrabony periodontal defects can be achieved with the use of enamel matrix proteins (EMPs) or by grafting with bovine porous bone mineral (BPBM). There is no report on the potential synergistic effect of EMPs and BPBM in periodontal regenerative therapy. The purpose of this study was to compare the clinical effectiveness of EMPs used alone or in combination with BPBM in the treatment of periodontal intrabony defects in humans. METHODS: Twenty-one paired intrabony defects were surgically treated using a split-mouth design. Intrabony defects were treated either with enamel matrix proteins (EMP group) or with enamel matrix proteins combined with bovine porous bone mineral (EMP/BPBM group). Re-entry surgeries were performed at 6 months. RESULTS: Preoperative probing depths, attachment levels, and transoperative bone measurements were similar for the EMP and EMP/BPBM groups. Postsurgical measurements taken at 6 months revealed a significantly greater reduction in probing depth in the EMP/BPBM group (3.43 +/- 1.32 mm on buccal sites and 3.36 +/- 1.35 mm on lingual sites) when compared to the EMP group (1.91 +/- 1.42 mm on buccal sites and 1.85 +/- 1.38 mm on lingual sites). The EMP/BPBM group also presented with significantly more attachment gain (3.13 +/- 1.41 mm on buccal sites and 3.11 +/- 1.39 mm on lingual sites) than the EMP group (1.72 +/- 1.33 mm on buccal sites and 1.75 +/- 1.37 mm on lingual sites). Surgical re-entry of the treated defects revealed a significantly greater amount of defect fill in favor of the EMP/BPBM group (3.82 +/- 1.43 mm on buccal sites and 3.74 +/- 1.38 mm on lingual sites) as compared to the EMP group (1.33 +/1.17 mm on buccal sites and 1.41 +/- 1.19 mm on lingual sites). CONCLUSIONS: The results of this study indicate that BPBM has the ability to augment the effects of EMPs in reducing probing depth, improving clinical attachment levels, and promoting defect fill when compared to presurgical levels.

Adult↗

PubMed1998

Histologic evaluation of guided tissue regeneration using 4 barrier membranes: a comparative furcation study in dogs.

This study evaluated and compared four different barrier membrane materials used to treat class II mandibular premolar and molar furcations in seven dogs with naturally occurring periodontitis. Five class II furcation defects in each animal were randomly assigned to one of four experimental groups or to a control group. Each defect was treated by surgical debridement, root planing, and barrier membrane coverage with one of the four test materials or no barrier membrane (control). Thus, each animal served as its own control. Following 6 months of healing, block sections were used to histologically measure the amount of regenerated tissue and stereometrically enumerate the inflammatory cell infiltration observed with each of the treatment modalities. The four barrier membrane materials (polycarbonate filter, silicone rubber, expanded polytetrafluoroethylene, and polycaprolactone) all provided a wound healing environment that promoted new cementum formation, with mean values ranging from 1.96 +/- 0.031 mm to 2.18 +/- 0.015 mm, and facilitated alveolar bone regeneration, with mean values ranging from 1.18 +/- 0.019 mm to 1.44 +/- 0.014 mm. Control-treated sites showed mean values of only 0.24 +/- 0.007 mm new cementum formation and 0.32 +/- 0.017 mm bone fill. Polycarbonate filter and polycaprolactone membrane barriers elicited a significantly greater chronic inflammatory cell response of lymphocyte and plasma cell infiltrates as compared to expanded polytetrafluoroethylene and silicone rubber, which were comparable to control-treated sites.

Alveolar Process↗

PubMed1998

Preservation of alveolar bone in extraction sockets using bioabsorbable membranes.

The purpose of this study was to evaluate the clinical effectiveness of a bioabsorbable membrane made of glycolide and lactide polymers in preserving alveolar ridges following tooth extraction using a surgical technique based on the principles of guided bone regeneration. Sixteen patients requiring extractions of 2 anterior teeth or bicuspids participated in the study (split-mouth design). Following elevation of buccal and lingual full-thickness flaps and extraction of teeth, experimental sites were covered with bioabsorbable membranes; control sites did not receive any membrane. Titanium pins served as fixed reference points for measurements. Flaps were advanced in order to achieve primary closure of the surgical wound. No membrane became exposed in the course of healing. Reentry surgeries were performed at 6 months. Results showed that experimental sites presented with significantly less loss of alveolar bone height, more internal socket bone fill, and less horizontal resorption of the alveolar bone ridge. This study suggests that treatment of extraction sockets with membranes made of glycolide and lactide polymers is valuable in preserving alveolar bone in extraction sockets and preventing alveolar ridge defects.

Absorption↗

PubMed1998

Evaluation of periosteal membranes and coronally positioned flaps in the treatment of Class II furcation defects: a comparative clinical study in humans.

The purpose of this study was to compare the clinical effectiveness of connective tissue grafts including periosteum used as a mechanical barrier for guided periodontal tissue regeneration and coronally positioned flaps in the treatment of Class II furcation defects. A total of 28 furcation defects were treated; 14 received a periosteal barrier and 14 received a coronally positioned flap. Reentry surgeries were performed at 6 months. No statistically significant differences were found preoperatively between the two treatment groups with respect to clinical parameters and osseous measurements. Postsurgically, both treatment modalities resulted in a significant decrease in probing depth and a significant gain in clinical attachment, but the differences observed were not statistically significant. The periosteal barrier group presented with a significantly better gain in vertical components of the alveolar bone (1.93 +/- 0.15 mm and 0.20 +/- 0.26 mm for periosteal barrier and coronally positioned flap groups, respectively; P < or = 0.001) and horizontal components of the alveolar bone (1.60 +/- 0.21 mm and 0.13 +/- 0.90 mm for periosteal barrier and coronally positioned flap groups, respectively; P < or = 0.001). The results of this trial indicate that similar clinical resolution of Class II furcation defects can be obtained with periosteal barriers and coronally positioned flaps. Periosteal barriers, however, are a better treatment alternative in achieving bone fill of the furcation area.

Alveolar Process↗

PubMed1997

A bone regenerative approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases.

TEN PATIENTS WHO REQUIRED two or more anterior teeth extractions were utilized in this study. Extraction procedures were carried out with a full thickness surgical flap approach. After flap reflection, teeth were removed with a minimum of trauma to the surrounding bone. Following extraction silicone-based impression techniques were used to produce a model of the alveolar process and small metal pins were placed in the alveolus to be used as fixed points to make measurements of ridge dimensions. One socket was covered with an expanded polytetrafluoroethylene (ePTFE) barrier membrane (experimental site); the other socket was a conventional control. The soft tissue flaps were then mobilized using periosteal releasing incision and the wound closed with ePTFE mattress sutures. Six months following extraction, patients were treated with flap surgery to expose both extractions sites to remove the ePTFE membranes and to measure ridge dimensions using the pins as fixed points. Clinical and model measurements have shown statistically significant better ridge dimensions at experimental sites than at control (P < or = 0.05). Three patients with exposed membranes had similar dimensional changes as controls. Results from this study suggested that this improved technique offers a predictable alveolar ridge maintenance enhancing the bone quality for dental implant procedures and esthetic restorative dentistry.

Alveolar Bone Loss↗

PubMed1992

Histomorphometry of bone apposition around three types of endosseous dental implants.

Three different types of commercially available dental implants (Nobelpharma, IMZ, and Integral) were implanted in the edentulous mandibles of seven adult mongrel dogs. Twenty-one implants were harvested with block sections after 12 weeks and embedded in polymethyl methacrylate resin. Undecalcified sections were prepared with the sectioning-grinding technique. The percentage of bone contacting the implant surface was measured with a self-designed histomorphometry method using a millimeter grid in a stereomicroscope. The results demonstrated a significantly higher percentage of bone along the hydroxyapatite-coated implant than that seen with the titanium-surfaced implant types.

Alveolar Process↗

PubMed1991

Bone growth around dental implants.

For the complete understanding of stimulation of bone growth around dental implants, a thorough knowledge is necessary regarding the reaction of bone to trauma and to a variety of implant materials. The atraumatic preparation of the bony implant bed serves to create the most favorable situation for the formation of bone around any implant material. Some implant materials are more likely to result in soft tissue encapsulation despite the most careful handling of bone; others result in different amounts of implant-bone contact zones. From the character and the amount of bone formation around different implants, it can be concluded whether the used materials are biocompatible. Titanium-surfaced implants may not demonstrate the biocompatibility that is seen with hydroxyapatite-coated implants. However, the results seen with hydroxyapatite-coated implants have to be viewed critically because the biointegrity of these coatings has not been demonstrated until now. On the other hand, titanium-surfaced implants have success rates for as long as 25 years and enable the implantologist to rely on a well-accepted implant material. The use of guided tissue regeneration and the sinus augmentation technique appear to enable the implantologist to stimulate bone formation around dental implants. These techniques may extend the limits for the successful placement of dental implants into bone-deficient sites.

Dental Implantation, Endosseous↗

PubMed1989

Soft-tissue modifications of surgical techniques for placement and uncovering of osseointegrated implants.

The recommended modifications of soft-tissue management for two-stage implant surgeries have resulted in improved access for implant placement, accommodation of surgical stents, less formation of cicatrix in the vestibules, better control of flap extensions resulting in improved esthetics, and improved tissue quality for long-term peri-implant maintenance and success. The implication of periodontal guidelines to the uncovering procedure of dental implants result in decreased thickness of peri-implant tissues and less pocket formation around the transmucosal sleeves. These modifications contribute significantly to the long-term periodontal maintenance of peri-implant tissues.

Dental Implantation, Endosseous↗