Biomedical subjects

U Bragger

Publications and source records attributed to U Bragger.

6 recordsLinked to original sources

PubMed2002

Image processing for enhanced observer agreement in the evaluation of periapical bone changes.

AIM: The aim of the present study was to evaluate the effect of root canal treatment on periapical lesions by conventional and subtracted digital radiographic images of clinical cases. METHODOLOGY: Eleven patients who exhibited clinical or radiological signs of periapical pathology received root canal treatment. Periapical radiographs were obtained immediately postoperatively and recall radiographs at intervals of 3, 6, 9 and 12 months postoperatively were obtained. Identical exposure geometry was maintained. From the standardized radiographs digitized images were produced. Four experienced practitioners interpreted the radiographs and the digitized images. They assessed 59 pairs of images projected at random using a slide projector. On the left side, there was a reference image with no lesion, and on the right an image either with or without a lesion. Each reader was asked to rate each pair of images on a three-point scale: yes, absolutely sure that gain or loss was present; uncertain, if there was gain or loss; no, absolutely sure that no gain or loss was present. There was no time limit for each decision. Inter- and intra-examiner agreement was analyzed using the kappa-statistic for the diagnosis of periapical bone density changes in the periapical region at the different time points either in conventional pairs of radiographs or using digital subtraction images. RESULTS: The inter-examiner agreement (P < 0.001) and the intra-examiner agreement (P = 0.02) when digital pictures where evaluated were significantly higher than with conventional radiographs. CONCLUSIONS: A highly significantly better observer agreement was achieved by digital subtraction radiography during the evaluation of the outcome of root canal treatment on periapical lesions.

Adult↗

PubMed1997

Patterns of periodontal destruction associated with incomplete root fractures.

OBJECTIVES: To clarify the differential radiographic diagnostics of teeth with incomplete root fracture. METHODS: Information on 88 teeth with either a vertical root fracture without displacement of the fractured fragments (n = 22), a vertical periodontal defect (n = 22), a periodontal-endodontic lesion (n = 22) or an endodontic-periapical lesion (n = 22) was collected retrospectively from the patients' records. RESULTS: Significant differences in the mean probing pocket depths were found between each of the four groups of lesions. Teeth with root fractures demonstrated smaller mean probing pocket depths than those with either periodontal or periodontal-endodontic lesions. Radiographic bone loss was significantly greater in teeth with periodontal and periodontal-endodontic lesions when compared with those with fractures. In teeth with vertical root fractures, there was no correlation between the probing depth and the radiographic bone loss (r = 0.01). The correlation coefficient between the greatest probing depth and alveolar bone loss was r = -0.16 in the fractured teeth, with higher values for the other three groups of lesions. 86.4% of the teeth with fractures had a complete root canal filling. Posts were present in 22.7% of the fractured teeth and in 13% of those with an endodontic periapical lesion. 91% of the teeth with vertical fractures were crowned or fixed-bridge abutments. Only 5% of the fractured teeth had no evidence of periapical bone changes. CONCLUSIONS: Incomplete root fractures mainly involve teeth which have undergone successful endodontic treatment. An isolated pocket on one aspect of a suspected tooth is reliably diagnostic for a root fracture.

Alveolar Bone Loss↗

PubMed1995

Guided bone regeneration around an immediate transmucosal implant for single tooth replacement: a case report.

This case report describes the procedure of guided bone regeneration around an endosseous dental implant, placed into an extraction alveolus in the absence of total soft tissue coverage, ie, in a transmucosal condition. The technique presented permits an immediate placement of the implant after the extraction of the maxillary right lateral incisor. A nonresorbable barrier membrane was used, and strict chemical plaque control was maintained during osseointegration. After an uneventful healing period of 6 months, the membrane was removed in a second-stage surgery. Two months later, the fixed single tooth prosthesis was placed. The learning objective of this article is to explain the immediate transmucosal implant surgery technique, using a case report to illustrate the procedure.

Adult↗

PubMed1992

Treatment of an early implant failure according to the principles of guided tissue regeneration (GTR).

The present case report demonstrates the application of guided tissue regeneration (GTR) in combination with antimicrobial therapy for the treatment of an early implant failure. This treatment approach both prevented further loss of bone as well as led to the regeneration of lost bone. By means of color-converted digital subtraction images, remodelling of the tissues adjacent to the defect was documented as early as one month postsurgically. The images demonstrated "bone-fill" in the apical portion of the defect and resorptive changes at the bone crest. This case report demonstrates that combined regenerative and antimicrobial therapy may be a successful treatment approach restoring osseointegration of dental implants following loss of bone due to infection. Continuously increasing bone-fill inside the defect was documented when comparing the radiograph obtained immediately before the GTR procedure and at months 1, 2, 4, 5 and 6 of the healing period, respectively. Clinical measurement obtained at the time of the surgery and at the time of the membrane removal confirmed the radiographic evidence of bone-fill by demonstrating new tissue resistant to probing in close contact to the implant surface at the site of the previous defect. Antimicrobial therapy included an antibiotic regimen during the 1st month of healing as well as topical rinses with an antiseptic (chlorhexidine) over the entire healing period of 6 months. As a result of this treatment approach, the implant was saved and could be used as an abutment for a bridge reconstruction.

Alveolar Bone Loss↗

PubMed1991

Tissue integration of one-stage ITI implants: 3-year results of a longitudinal study with Hollow-Cylinder and Hollow-Screw implants.

This study examined the tissue integration of one-stage, nonsubmerged ITI implants over a period of 3 years. Fifty-four implants were placed in 38 partially edentulous patients. Following healing (at least 3 months), all 54 implants were free of peri-implant infections and revealed no detectable mobility. Radiographs showed no signs of peri-implant radiolucencies, and the implants were in favorable positions for prosthetic restoration. Following incorporation of fixed partial dentures, patients were enrolled in a hygiene recall program with 3-month intervals and were examined once a year. Based on predefined criteria, each implant was classified as successful or failing. After the 3-year observation period, 51 of 53 implants (96.2%) were considered successfully integrated. (One patient with one implant dropped out of the study.) Two implants exhibited recurrent peri-implant infections and were classified as late failures. These results indicate that one-stage ITI implants can achieve successful tissue integration on a predictable basis and that it can be maintained over a period of at least 3 years.

Dental Implants↗

PubMed1990

Bone regeneration adjacent to titanium dental implants using guided tissue regeneration: a report of two cases.

The biologic principle of guided tissue regeneration was applied to regenerate alveolar bone in conjunction with the placement of titanium dental implants. In one case, complete osseointegration of an implant was achieved by the placement of a Teflon membrane over an implant that had been inserted into an alveolus immediately following tooth extraction. In a second case, the same biologic principle was used to increase the volume (height and width) of a resorbed, edentulous alveolar ridge to provide adequate bone dimensions for implant installation. In both cases, the membranes appear to have prevented the repopulation of the wound area by cells other than those derived from surrounding bone tissue. These two different applications of the principle of guided tissue regeneration open new avenues for reconstructive osseous surgery.

Adult↗