Biomedical subjects

R H Heard

Publications and source records attributed to R H Heard.

2 recordsLinked to original sources

PubMed2000

Clinical evaluation of wound healing following multiple exposures to enamel matrix protein derivative in the treatment of intrabony periodontal defects.

BACKGROUND: Multiple exposures to enamel matrix protein derivative (EMD) during periodontal therapy have been shown to be safe for the patient. The purpose of this study was to clinically determine if an altered course of wound healing would occur after multiple exposures to EMD in the treatment of intrabony defects. A secondary aim was to assess the efficacy of EMD in probing depth reduction and clinical attachment level gain. METHODS: Thirty-two systemically healthy patients (18 females, 14 males, 33 to 69 years old) who were being treated for moderate to advanced periodontal disease were selected for the study. Surgical procedures involving 2 sites were separated by at least 8 weeks, and wound healing comparisons were made between the first and second procedure. Patients were given a diary card the day of surgery, which consisted of questions concerning the presence and severity of headaches, root hypersensitivity, tooth pain, swelling, and itching. Patients were also examined at postoperative visits to clinically assess wound healing and discuss responses to the questionnaire. Soft tissue measurements were taken the day of surgery and 6 months postoperatively to ascertain probing depth reduction (PD) and gains in clinical attachment levels (CAL). RESULTS: The results revealed no clinically detectable reaction that could not be attributed to normal postoperative sequelae. There were no differences in reported symptoms between patient gender, first and second procedures, or intrabony and non-intrabony defects. Smokers were found to have a statistically significantly higher incidence of severe symptoms in root hypersensitivity, tooth pain, and swelling compared to non-smokers (n = 21). The mean probing depth reduction was 3.8 +/- 1.5 mm (2 to 9 mm), while the mean clinical attachment level gain was 2.8 +/- 1.7 mm (0 to 8 mm). CONCLUSIONS: The findings of this study demonstrate that EMD is a clinically safe product to use in the treatment of periodontal defects and that multiple uses do not have a negative impact on periodontal wound healing. In addition, a statistically significant gain in clinical attachment and reduction in probing depth were demonstrated.

Adult↗

PubMed2000

Regenerative materials: an overview.

Periodontal reconstructive therapies have demonstrated the ability to reverse the destruction due to periodontitis provided that they are implemented according to their individual indications. By properly evaluating a site, one can employ an evidence-based approach to effectively and predictably treat intrabony defects and furcation involvements. It also should be emphasized that a thorough evaluation of the therapeutic outcome should be continuously performed on all sites in order to determine treatment success and the possible need for further intervention. This is based on the long-term follow-up of cases treated with regenerative therapies, which have shown maintenance of results if the patient had good oral hygiene and was enrolled in a proper maintenance program. With respect to the preceding discussion: 1. The main periodontal reconstructive therapies employed by periodontists are GTR, bone replacement grafts and biologic mediators. 2. It is possible to achieve regeneration when using barriers, autografts, allografts, bovine-derived xenografts and EMDs. 3. Currently, regenerative techniques can be used for the treatment of intrabony defects and furcation involvements given the proper evaluation of each individual site. 4. Various regenerative materials are capable of achieving similar results in intrabony defects and are very predictable when employing evidence-based treatment. 5. A combination of regenerative materials such as barriers and grafts in intrabony defects has not demonstrated any improvement over their use alone. 6. A combination of regenerative materials such as barriers and grafts in mandibular class II furcations has demonstrated improvement over the use of the graft or barrier alone. 7. A combination of regenerative materials such as barriers and grafts in maxillary class II furcations has some limited evidence to support improvement over the use of the graft or barrier alone, but the predictability should not be considered high. 8. A combination of regenerative materials such as barriers and grafts in class III furcations has very limited evidence to support improvement over the use of the graft or barrier alone and should not be considered predictable. 9. Beyond the initial healing phase postsurgically, maintenance and oral hygiene play the largest role in long-term therapeutic success.

Alveolar Bone Loss↗