Biomedical subjects

P Eickholz

Publications and source records attributed to P Eickholz.

At least 19 recordsLinked to original sources

PubMed2006

Periodontal therapy in siblings with Papillon-Lefèvre syndrome and tinea capitis: a report of two cases.

OBJECTIVE: Report of clinical and microbiological periodontal findings before and 6 months after treatment of two siblings with Papillon-Lefèvre syndrome (PLS) and tinea capitis. METHODS: Two brothers, RG 3 years and NG 5 years of age, were referred for treatment due to premature mobility of their deciduous teeth. Probing depths (PPD), attachment levels (PAL-V), and furcation involvements were examined clinically. Panoramic radiographs were taken. Subgingival plaque samples within the deepest pocket of each tooth were taken and analysed by real-time polymerase chain reaction (PCR) for Actinobacillus actinomycetemcomitans (AA), Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Fusobacterium nucleatum, and Prevotella intermedia. One-stage full-mouth scaling and extraction of hopeless teeth were performed under general anaesthesia, followed by systemic amoxicillin and metronidazole for 7 days. Clinical and microbiological analyses were performed 6 months after treatment. RESULTS: Before treatment, both siblings had exhibited PPD of up to 13 mm, Class III furcation defects at four teeth, and marginal suppuration. AA was detected in both patients and at all teeth at levels ranging from 3.0 x 10(2) to 5.1 x 10(6). Both patients exhibited palmar and plantar hyperkeratosis. Seven teeth were extracted from RG, and nine from NG. Six months after treatment, PPD had been reduced to <or=5 mm. AA was not detected in any of the remaining teeth. CONCLUSION: Even periodontally affected deciduous teeth of PLS patients can be treated successfully. Suppression of AA to below detection level seems to be of high significance.

Aggregatibacter actinomycetemcomitans↗

PubMed2006

The infrabony defect and its determinants.

BACKGROUND AND OBJECTIVE: The purpose of this study was to assess the defect width of infrabony defects in a cross-sectional study and to evaluate whether the defect width is a function of defect depth. MATERIAL AND METHODS: Complete sets of intra-oral radiographs of patients with severe periodontitis, which exhibited at least one infrabony defect, were digitised and evaluated. The following parameters were measured: depth and width of the infrabony defect, defect angle, and width of the interdental spaces. RESULTS: Fifty-one patients (26 women), ranging from 21 to 73 yr of age (48.5 +/- 13.4 yr), contributed a total of 1272 teeth with 135 infrabony defects (10.6%). Seventeen infrabony defects were located at sites without a neighboring tooth. Infrabony defects were statistically more prevalent in the mandible (n = 82) than in the maxilla (p = 0.013), and more prevalent at mesial sites (n = 92) than at distal sites (p < 0.001). At infrabony defects, the width of interdental spaces at the most coronal extension of the alveolar crest could be measured only at sites with neigboring teeth 2.67 +/- 0.78 mm (range: 1.19-5.70 mm). Analysis failed to reveal a statistically significant difference between defect width at sites with (2.64 +/- 0.82 mm) and sites without (2.76 +/- 0.70 mm) a neighboring tooth. Multilevel regression analysis revealed narrow defect angles to be related to deep infrabony defects, whereas width of the interdental space and distal location were related to wide defects. CONCLUSION: Defect angle depended on defect depth and defect width was not different at sites with or without a neighboring tooth. Even in severe periodontitis, infrabony defects are found only at a minority of teeth.

Adult↗

PubMed2004

Novel mutations in the cathepsin C gene in patients with pre-pubertal aggressive periodontitis and Papillon-Lefèvre syndrome.

Aggressive periodontitis (AP) in pre-pubertal children is often associated with genetic disorders like Papillon-Lefèvre syndrome (PLS). PLS is caused by mutations in the cathepsin C (CTSC) gene. We report a novel CTSC mutation (c.566-572del) in an otherwise healthy AP child and two novel compound heterozygous mutations (c.947T>G, c.1268G>C) in a PLS patient. We conclude that at least a subset of pre-pubertal AP is due to CTSC mutations and therefore may be an allelic variant of PLS.

Adolescent↗

PubMed2002

Effect of dose reduction in digital dental panoramic radiography on image quality.

OBJECTIVES: To investigate the effect of dose reduction in digital panoramic radiography on subjective image quality and diagnostic performance. METHODS: Two digital panoramic radiographs were obtained with the Orthophos DS(Sirona, Bensheim, Germany) of patients (n=100) receiving dental care. The first image was taken at the standard exposure setting. For the second image the tube current was reduced by between 48 and 53%, 63 and 69%, 75 and 80% and 80 and 81% respectively. Ten observers rated both images for 21 specific anatomical details and 30 pathological findings. RESULTS: All radiographs taken at reduced mA levels had a significantly inferior score (P<0.01) for anatomical details. There was no difference in the scores for pathological findings. CONCLUSION: Radiographs obtained at reduced mA had inferior subjective image quality, but there was no difference in diagnostic performance. Thus, a reduction in tube current of approximately 50% is recommended. In certain circumstances such as follow-up radiographic examinations, a reduction of up to 65% should be considered.

Analysis of Variance↗

PubMed2001

Adverse health effects related to mercury exposure from dental amalgam fillings: toxicological or psychological causes?

BACKGROUND: Possible adverse health effects due to mercury released by amalgam fillings have been discussed in several studies of patients who attribute various symptoms to the effects of amalgam fillings. No systematic relation of specific symptoms to increased mercury levels could be established in any of these studies. Thus, a psychosomatic aetiology of the complaints should be considered and psychological factors contributing to their aetiology should be identified. METHODS: A screening questionnaire was used to identify subjects who were convinced that their health had already been affected seriously by their amalgam fillings (N = 40). These amalgam sensitive subjects were compared to amalgam non-sensitive subjects (N = 43). All participants were subjected to dental, general health, toxicological and psychological examinations. RESULTS: The two groups did not differ with respect to the number of amalgam fillings, amalgam surfaces or mercury levels assessed in blood, urine or saliva. However, amalgam sensitive subjects had significantly higher symptom scores both in a screening instrument for medically unexplained somatic symptoms (SOMS) and in the SCL-90-R Somatization scale. Additionally, more subjects from this group (50% versus 4.7%) had severe somatization syndromes. With respect to psychological risk factors, amalgam sensitive subjects had a self-concept of being weak and unable to tolerate stress, more cognitions of environmental threat, and increased habitual anxiety. These psychological factors were significantly correlated with the number and intensity of the reported somatic symptoms. CONCLUSIONS: While our results do not support an organic explanation of the reported symptoms, they are well in accord with the notion of a psychological aetiology of the reported symptoms and complaints. The findings suggest that self-diagnosed 'amalgam illness' is a label for a general tendency toward somatization.

Adult↗

PubMed2001

Reproducibility of peri-implant probing using a force-controlled probe.

The aim of the present study was to evaluate the reproducibility of probing depth (PD) and vertical attachment level (PAL-V) measurements at endosseous implants. Twenty partially edentulous patients who had received 44 Frialit-2 and 30 Astra implants between 1994 and 1996 were examined. At all teeth and implants, clinical parameters (GI, PlI, PD, PAL-V) were measured at 6 sites using the flexible plastic version of the universal explorer TPS probe. At the implants and at teeth that were in similar locations compared to the implants, PD and PAL-V measurements were repeated. For each of the 20 probes that had been used for clinical examination of the 20 patients, the probing force was assessed using a precision balance. As a measure of intraexaminer reproducibility, the following standard deviations of single PD and PAL-V measurements were calculated: Frialit-2: 0.71/0.74 mm; Astra: 0.72/0.75 mm; tooth: 0.59/0.57 mm (PD/PAL-V). Stepwise multiple regression analysis revealed implant/tooth position and GI to influence PD and PAL-V measurement error (P<0.001). At anterior teeth, a lower variability was observed than at posterior teeth (P<0.001). PD and PAL-V measurement error were higher at implants than at teeth and influenced by patients. The respective models explained 13% and 17% of the variability of the dependent variable (PD/PAL-V), respectively. Intraexaminer variability of PD and PAL-V measurements at implants tended to be higher than at teeth. Multivariate analysis of variance revealed probe and probe holder to statistically significantly (P<0.001) influence probing force. However, the differences in probing force between the various probe heads were very small. They reached a maximum of 0.054 N between probe 3 and 14 and may be looked upon as clinically irrelevant.

Adult↗

PubMed2001

Reliability of assessing interproximal bone loss by digital radiography: intrabony defects.

AIM: The aim of the present study was to assess the reproducibility and validity of linear measurements of interproximal bone loss in intrabony defects on digitized radiographic images after application of different filters and magnifications. METHODS: Immediately before surgery 50 radiographs of 50 periodontally diseased teeth exhibiting interproximal intrabony defects were obtained by a standardized technique in 50 patients. Intrasurgically the distances from the cementoenamel-junction (CEJ) to the alveolar crest (AC) and from the CEJ to the deepest extension of the bony defect (BD) were assessed. All radiographs were digitized by a flatbed scanner (resolution: 600x1200 dpi). Using the FRIACOM-soft ware, the linear distances CEJ to AC and CEJ to BD were measured at 50 intrabony defects on digitized but unchanged radiographic images and also after use of 2 different basic image processing modes (filters: enhancement of grey level differences, spreading of grey values) with 7-fold and 14-fold magnification by 2 different examiners. RESULTS: Repeated measures MANOVA revealed reproducibility of the measurement of the distance CEJ to AC to be significantly influenced by examiner (p=0.027) and filter in combination with the height of 2 wall component of the intrabony defect (p=0.066). For the distance CEJ to BD filters had significant influence on reproducibility in correlation with vertical angulation difference (p=0.001). On the average in this study radiographic measurements tended to overestimate the amount of bone loss as assessed by intrasurgical measurements (CEJ-AC: 0.74-1.91 mm; CEJ-DB: -0.04-0.77 mm). Validity of measurement of the distance CEJ-AC was shown to be significantly influenced by the depth of the intrabony defect (p<0.003). Validity of the distance CEJ-BD was significantly influenced by intrasurgically assessed bone loss (p=0.029), horizontal angulation (p=0.066). Filters influenced the validity only in combination with examiner (p<0.001). CONCLUSIONS: In this study, the chosen digital manipulations (filters: spreading, structure) of radiographic images failed to result in statistically significantly more reproducible or valid measurements of interproximal bone loss within intrabony defects when compared to the digitized but unchanged images. All radiographic assessments on the digitized images except for use of enhancement of grey level differences (structure) came close to the intrasurgical gold standard.

Adult↗

PubMed2001

Long-term results of guided tissue regeneration therapy with non-resorbable and bioabsorbable barriers. I. Class II furcations.

BACKGROUND: The aim of this 5-year follow-up study was to clinically and radiographically evaluate the long-term results after guided tissue regeneration (GTR) therapy of Class II furcation defects using non-resorbable and bioabsorbable barriers. METHODS: Nine pairs of contralateral Class II furcation defects were treated in 9 patients with advanced periodontitis. Within each patient, one defect received a non-resorbable (expanded polytetrafluoroethylene [ePTFE]; control, C) barrier and the other a bioabsorbable (polyglactin 910; test, T) barrier by random assignment. At baseline, 6, and 60 +/- 3 months after surgery, clinical parameters and standardized radiographs were obtained. Gain of bone density within furcation areas was assessed using subtraction radiography. RESULTS: Six and 60 months after GTR therapy, statistically significant (P <0.05) horizontal attachment (CAL-H) gain was observed in both groups (C6: 1.7 +/- 0.8 mm; C60: 1.6 +/- 1.2 mm; T6: 2.0 +/- 0.7 mm; T60: 2.2 +/- 0.9 mm). However, 1 furcation assessed as Class I six months after GTR therapy with a bioabsorbable barrier had progressed to Class III after 5 years, and in another patient, 5 years after placement of an ePTFE barrier, 1 furcation had lost all the CAL-H gain that had been observed at 6 months. Subtraction analysis revealed similar area gain in both groups 6 and 60 months postsurgically (C6: 0.3 +/- 0.5; C60 1.0 +/- 1.7; T6: 0.4 +/- 0.4; T60: 1.1 +/- 1.7). CONCLUSIONS: CAL-H gain achieved after GTR therapy in Class II furcations was stable after 5 years in 16 of 18 defects. The study failed to show a statistically significant difference in stability of CAL-H gain between control and test groups 5 years after GTR therapy.

Absorbable Implants↗

PubMed2001

Radiographic defect depth and width for prognosis and description of periodontal healing of infrabony defects.

BACKGROUND: The aims of the present study were to evaluate 1) defect depth and width as a prognostic factor and 2) change in defect width as a describing parameter of periodontal healing in infrabony defects treated by regenerative therapy after 6 and 24 months. METHODS: In 24 patients with advanced periodontitis, 39 infrabony defects were treated by guided tissue regeneration (GTR) using expanded polytetrafluoroethylene (ePTFE) (n = 7) or bioabsorbable barriers (n = 32). Clinical parameters were assessed and 39 standardized radiographs (in triplicate) were taken before and 6 and 24 months after surgery. Using a computer-assisted analysis, the depth, width, and angle of the bony defects were measured. RESULTS: Statistically significant vertical clinical attachment gains (CAL-V: 3.15 +/- 1.63 mm to 3.31 +/- 1.65 mm; P<0.001) and bony fill (1.30 +/- 2.53 mm; P<0.01 to 1.54 +/- 2.70 mm; P<0.005) were observed 6 and 24 months postsurgically. In a multilevel regression analysis CAL-V gain was predicted by baseline CAL-V (P <0.0001), actual smoking (P <0.05), and age (P <0.1). Bony fill could be predicted by baseline height of the infrabony component (P<0.0001), gingival index at baseline (P<0.05), and actual smoking (P <0.01). In narrow (<26 degrees) and deep (> or = 3 mm) infrabony defects bony fill was more pronounced than in wide and shallow defects (P <0.05). CONCLUSIONS: Improvement achieved by guided tissue regeneration in infrabony defects can be maintained up to 24 months after surgery. Narrow and deep infrabony defects respond radiographically and to some extent clinically more favorably to GTR therapy than wide and shallow defects. However, depth of the infrabony component was a stronger prognostic parameter than defect angle. Actual smoking impairs the results of GTR therapy in infrabony defects.

Adult↗

PubMed2001

Combined mechanical and antibiotic periodontal therapy in a case of Papillon-Lefèvre syndrome.

BACKGROUND: Papillon Lefèvre syndrome (PLS) is a rare entity and, as such, it is almost impossible to evaluate an effective therapy in a randomized controlled study. The amount of success reported after therapy for prepubertal periodontitis (PP) in PLS is highly variable from case to case. The goal of this case report is to evaluate the effects of a combined mechanical and antibiotic periodontal therapy regimen in the management of PLS. METHODS: A male patient was diagnosed as suffering from PP associated with PLS at the age of 7 years. He showed hyperkeratosis of the palms and soles, as well as advanced periodontal disease already affecting permanent teeth with maximal probing depth and vertical attachment loss of 12 mm and 11 mm, respectively. Subgingival debridement was performed with simultaneous administration of oral 250 mg amoxicillin 3 times daily and 250 mg metronidazole twice daily for one week. Clinical parameters were assessed and subgingival plaque was collected from all teeth prior to therapy and 7 and 26 months after treatment. Selective cultures for A. actinomycetemcomitans were incubated for each individual tooth and DNA probe analysis was performed for various periodontal pathogens. RESULTS: Prior to combined mechanical and antibiotic treatment, all teeth but one harbored Actinobacillus actinomycetemcomitans subgingivally. However, at 7 and 26 months after therapy A. actinomycetemcomitans could be detected neither by culture nor by DNA probes. Clinical parameters improved markedly and teeth erupting after therapy did not exhibit attachment loss of more than 1.5 mm during the observation period. CONCLUSIONS: Eradication (suppression beneath detection levels) of A. actinomycetemcomitans seems to play a significant role in the successful treatment of localized prepubertal periodontitis in PLS.

Aggregatibacter actinomycetemcomitans↗

PubMed2000

Regenerative periodontal surgery in interproximal intrabony defects with biodegradable barriers.

AIM: The comparison of the effects of guided-tissue regeneration (GTR) using 2 different biodegradable barriers (polylactide acetyltributyl citrate; polydioxanon) in 3- and 2-wall intrabony defects. METHOD: The polydioxanon barrier is an experimental membrane for GTR therapy that consists of an continuous occlusive barrier that has a layer of slings on the side that is meant to face the mucoperiosteal flap. 15 patients provided 15 pairs of similar contralateral periodontal defects: 12 predominantly 2-wall and 18 predominantly 3-wall intrabony defects. Each defect was randomly assigned to treatment with either polylactide acetyltributyl citrate (control [c]) or polydioxanon (test [t]) devices. At baseline and 6 months after surgery, clinical measurements (P1I, GI, PPD, PAL-V) were performed. RESULTS: Barrier exposure was commonly observed in both groups (control/test): 5/4 after 7 days, 9/11 after 14 days and 11/12 after 28 days postsurgically. 4 weeks after surgery, 77% of all barriers were exposed to some extent. However, both treatments revealed a significant GI reduction (p<0.05), PPD reduction [-4.63+/-1.85 mm (t), -4.17+/-1.89 mm (c); p<0.001] and PAL-V gain [3.97+/-1.17 mm (t), 3.40 mm+/-1.40 (c); p<0.001] 6 months after surgery. Regarding GI and PPD reduction as well as PAL-V gain, there were neither statistically significant nor clinically relevant differences between test and control: similar clinical results were found 6 months after surgical treatment using both biodegradable barriers. CONCLUSIONS: Based on the results of the present study, the use of both biodegradable barriers in GTR therapy may be recommended.

Absorbable Implants↗

PubMed2000

Accuracy of radiographic assessment of interproximal bone loss in intrabony defects using linear measurements.

The aim of the present study was to examine the accuracy of linear measurements on radiographs of interproximal bone loss in intrabony defects utilizing the gold standard of surgical measurements. In 22 patients with untreated advanced periodontal disease, 33 standardized radiographs were taken presurgically. The horizontal and vertical angulation difference of the central beam from the orthoradial projection and radiographic magnification was calculated for each radiograph. At the time of surgery, for 34 interproximal intrabony defects, the distances from the cemento-enamel junction (CEJ) to the bottom of the bony defect (BD) and alveolar crest (AC) to BD, and the height of the one-, two- and three-walled section of the intrabony defects were measured. In all radiographs, the linear distance CEJ to BD was assessed. Radiographic and surgical assessments were compared. A stepwise multiple linear regression analysis was used to evaluate factors (angulation difference, patient, surgical measurements) that influenced the discrepancy between radiographic and surgical measurements. The radiographic assessments underestimated bone loss as compared to surgical measurements (1.41+/-2.58 mm).

Adult↗

PubMed2000

Guided tissue regeneration with bioabsorbable barriers: intrabony defects and class II furcations.

BACKGROUND: The aim of this study was to compare the effects of guided tissue regeneration (GTR) using 2 different bioabsorbable barriers (control: polylactide acetyltributyl citrate; test: polydioxanon). The polydioxanon barrier is an experimental membrane for GTR therapy that consists of a continuous occlusive barrier that has a layer of slings on the side that is meant to face the mucoperiosteal flap. METHODS: In 21 patients with 22 pairs of similar contralateral defects (30 intrabony and 14 Class II furcation lesions), each defect was randomly assigned for treatment with either control (c) or test (t) devices. At baseline and 12 months after surgery, clinical measurements, plaque index (PI) gingival index (GI), probing depth (PD), and vertical and horizontal clinical attachment loss (CAL-V; CAL-H) and standardized radiographs were obtained. RESULTS: Barrier exposure was commonly observed in both groups. Four weeks after surgery 61% of all barriers were exposed to some extent. However, both treatments revealed a significant GI reduction (P <0.005), PD reduction (-3.08 +/- 2.29 mm [t]; -3.52 +/- 2.67 mm [c]; P <0.001) and CAL-V gain (2.44 +/- 2.29 mm [t], 2.80 mm +/- 2.21 [c]; P <0.001) 12 months after surgery in all defects. Within the intrabony defects significant bony fill (2.03 +/- 1.70 mm [t]; 1.91 +/- 1.20 mm [c]; P = 0.001), and within the furcations a significant but small CAL-H gain (0.79 +/- 0.68 mm [t]; 1.13 +/- 1.44 mm [c]; P <0.05), was observed. CONCLUSIONS: Regarding GI and PD reduction as well as CAL-V and CAL-H gain, this study failed to reveal statistically significant or clinically relevant differences between test and control 12 months postsurgically. Thus, the use of both bioabsorbable barriers in GTR therapy may be recommended.

Absorbable Implants↗

PubMed1999

Digital radiography of interproximal bone loss; validity of different filters.

The aim of the present study was to compare linear measurements of interproximal bone loss on digitized radiographic images after application of different filters to the gold standard of intrasurgical measurements. Immediately before surgery, 50 radiographs of 50 periodontally-diseased teeth exhibiting interproximal bone loss, were obtained by a standardized technique in 33 patients. Intrasurgically, the distances from the cementoenamel junction (CEJ) to the alveolar crest (AC) and from the CEJ to the deepest extension of the bony defect (BD) were assessed. All radiographs were digitized with a flatbed scanner (resolution: 600x1200 dpi). Using the FRIACOM-soft-ware, the linear distances CEJ to AC and CEJ to BD were measured at 50 interproximal lesions from the digitized but unchanged radiographic images and also after use of 7 different basic image-processing modes (enhancement of contrast [dynamics], inversion, high-pass, enhancement of gray-level differences, mean value, histogram correction, spreading of grey values) with 11-fold magnification. Neither the measurement of the distance CEJ to AC on the unchanged images nor assessments with any of the filters revealed significant differences from the gold standard. Multivariate analysis of variance showed the respective filter (p=0.009), intrasurgical and radiographic assessments (p<0.0001), to statistically significantly, influence the difference between intrasurgical and radiographic measurements of the distance CEJ to BD. The underestimation of the intra-surgically assessed distance CEJ to BD by radiographic measurements ranged from 0.3+/-2.0 to 0.8+/-1.9 mm. The filter "mean value" underestimated interproximal bone loss statistically significantly more than the digitized but unchanged radiograph (p=0.05). In this study, basic digital manipulations (filters) of radiographic images failed to result in statistically significantly more valid measurements of interproximal bone loss when compared to the unchanged but digitized images. All radiographic assessments on the digitized images except for use of one filter (mean value) came close to the intrasurgical gold standard.

Adult↗

PubMed1999

Interexaminer reliability of the assessment of clinical furcation parameters as related to different probes.

The aim of this study was to investigate the interexaminer reliability of the assessment of clinical furcation diagnosis. Horizontal attachment level (PAL-H) measurements were obtained by 3 examiners in 6 molars in each of 10 patients with advanced periodontitis. In each patient, 3 molars were examined using a 3 mm incrementally marked Nabers probe, and 3 molars were examined using a pressure-calibrated plastic probe (TPS). Assignment of the probe was random, and the schedule of examiners was changed for each patient. Clinical assessments were validated by intrasurgical measurements in 6 patients. Sixty molars with 152 furcations were investigated. Multifactorial analysis of variance revealed that PAL-H measurements were significantly influenced by examiner and furcation location, whereas type of probe and schedule of examination had no influence. The overall intraclass correlation coefficient was r = 0.695. The difference between clinical and intrasurgical PAL-H assessment was influenced by examiner and location but not by type of probe. Approximately 70% of the total variance of PAL-H measurements was due to the variance of true values, whereas 30% of the variance may be explained by interexaminer and intraexaminer variance. The pressure-calibrated TPS probe failed to increase the interexaminer reliability of PAL-H measurements when compared to a Nabers probe.

Adolescent↗

PubMed1999

Evidence for healing of Class II and Class III furcations 24 months after guided tissue regeneration therapy: digital subtraction and clinical measurements.

BACKGROUND: The aim of this study was to compare bone regeneration as assessed by subtraction radiography with clinical attachment measurements 24 months after regenerative surgery. METHODS: In 24 patients with advanced periodontitis, 34 Class II and 10 Class III furcations were treated by guided tissue regeneration using expanded polytetrafluoroethylene (n = 18) or bioabsorbable barriers (n = 26). Clinical parameters were assessed and 40 pairs of standardized radiographs were taken before and 24 months after surgery. Bony gain within furcations was assessed using subtraction analysis. RESULTS: In Class II furcations, statistically significant (P <0.001) vertical (CAL-V: 1.06+/-1.56 mm) and horizontal (CAL-H: 2.05+/-1.24 mm) attachment gain was observed 24 months postsurgically. Within Class III defects CAL-V gain was assessed 1.78+/-1.43 mm (P <0.005). CAL-H gain in buccal and lingual Class II furcations was explained by the relative density gain, baseline CAL-H, gingival index (GI) reduction, and individual patients (P <0.001) whereas, multiple regression analysis failed to show a relation between CAL-H gain and any of the subtraction parameters for interproximal furcations. Vertical attachment gain in interproximal sites was explained by net bony area gain (subtraction), PD and GI reduction, baseline CAL-V, defect type, smoking, and individual patients (P<0.001). CONCLUSIONS: There was a statistically significant correlation between clinical and radiographic improvements within furcation defects. However, this correlation was modulated by other factors such as baseline CAL-V or CAL-H, PD and GI reduction, or smoking. The relative density gain seemed to sufficiently describe bony changes related to clinical changes within buccal and lingual furcations, whereas bone area gain suitably described bony changes in interproximal Class II and III furcations.

Absorbable Implants↗

PubMed1998

Validity of radiographic measurement of interproximal bone loss.

The aim of the present study was to compare radiographic assessment of interproximal bone loss using a loupe with a 0.1 mm calibrated grid and a computer-assisted analysis system (LMSRT). In 35 patients suffering from untreated advanced periodontal disease, 62 standardized radiographs were taken presurgically. The horizontal and vertical angulation difference of the central beam from the orthoradial projection was calculated for each radiograph. At the time of surgery, for 115 interproximal defects, the distances from the cementoenamel junction (CEJ) to alveolar crest (AC), and CEJ to bottom of the bony defect (BD) were measured. In all radiographs, the linear distances CEJ to AC, and CEJ to BD were assessed using a loupe and LMSRT. Comparison between radiographic and intrasurgical assessments was performed using paired t-tests. A stepwise multiple linear regression analysis was used to evaluate factors that influence the discrepancy between radiographic and intrasurgical measurements. Both analyzing techniques underestimated interproximal bone loss as compared with intrasurgical measurements (CEJ-AC: loupe: 0.86 +/- 1.84 mm [p < 0.001]; LMSRT: 0.58 +/- 1.86 mm [p < 0.005]; CEJ-BD: loupe: 1.22 +/- 2.33 mm [p < 0.001]; LMSRT: 0.80 +/- 2.09 mm [p < 0.001]). LMSRT underestimated interproximal bone loss significantly less than the loupe (p < 0.001). The difference between LMSRT and intrasurgical assessments was modulated by the factors of vertical and horizontal angulation difference and defect depth (p < 0.1). Orthoradial projection reduced underestimation of radiographic assessment of bone loss. LMSRT underestimated interproximal bone loss to a lesser extent than conventional evaluation by loupe.

Alveolar Bone Loss↗

PubMed1998

Regenerative periodontal surgery with non-resorbable and biodegradable barriers: results after 24 months.

The aim of the present study was to compare the effects of guided tissue regeneration (GTR) with non-resorbable (ePTFE) and biodegradable barriers (Polyglactin 910). 23 patients provided 29 pairs of similar contralateral periodontal defects (12 pairs of interproximal intrabony lesions, 11 pairs of degree II and 6 pairs of degree III furcation defects). Each defect was randomly assigned to treatment with either non-resorbable (control [c]) or biodegradable (test [t]) devices. At baseline, 6, 12, 18, and 24 months after surgery, clinical measurements (PlI, GI, PPD, PAL-V, PAL-H) were performed. Standardized radiographs were obtained at baseline 12 and 24 months postsurgically. On the radiographs, the linear distances from the cemento-enamel junction (CEJ) to the alveolar crest (AC) and from the CEJ to bottom of the bony defect (BD) were measured using a computer-assisted analysing method (LMSRT). Both treatments revealed a significant (p<0.05) PPD reduction [all defects: -2.97 +/- 1.90 mm (t), -2.21 +/- 1.73 mm (c); intrabony defects: -4.00 +/- 1.96 mm (t), -3.00 +/- 1.87 mm (c); degree II furcations: -2.67 +/- 0.97 mm (t), -2.08 +/- 1.54 mm (c)], PAL-V gain [all defects: 2.02 +/- 1.83 mm (t), 1.18 mm +/- 1.50 (c); intrabony defects: 3.45 +/- 1.48 mm (t), 1.95 +/- 1.64 mm (c); degree II furcations: 1.33 +/- 0.94 mm (t), 0.92 +/- 1.47 mm (c)], PAL-H gain [degree II furcations: 2.22 +/- 0.94 mm (t), 1.86 +/- 0.60 mm (c)], and radiographic changes [CEJ-AC: -0.56 +/- 1.98 mm (t), -0.06 +/- 1.19 mm (c); CEJ-BD: 2.10 +/- 1.92 mm (t), 1.24 +/- 2.04 mm (c)] after 24 months. For degree III furcations, neither statistically significant PPD reduction nor PAL-V gain was observed. Similar clinical and radiographic results were found 12 and 24 months after surgical treatment using either non-resorbable or biodegradable barriers. More favorable results concerning PAL-V gain in interproximal intrabony defects could be observed with biodegradable barriers after 24 months than using nonresorbable membranes. Whereas interproximal intrabony lesions and degree II furcation defects responded favorably to GTR therapy, through-and-through furcations must be looked upon as a contraindication for this regenerative technique. Based on the results of the present study, the use of biodegradable barriers in GTR may be recommended and, thereby, a surgical re-entry to remove nonresorbable barriers can be avoided.

Adult↗