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PubMed1997

HRTEM study of biological crystal growth mechanisms in the vicinity of implanted synthetic hydroxyapatite crystals.

Calcium phosphates are widely used as biomaterials. Ultrastructural assessments are of the utmost importance in our understanding of interfacial phenomena. The aim of this study was to learn more about the newly formed crystal growth mechanisms. The interfaces between implanted synthetic hydroxyapatite crystals (HAS) and newly formed crystallites were thoroughly examined on a molecular level. The bone-grafting material (HAS) was implanted into two adult patients, and small biopsies were recovered 6 months after implantation. The raw biomaterial was analyzed by x-ray diffraction and high-resolution transmission electron microscopy (HRTEM). Six months after their implantation, the HAS aggregates were surrounded by a mineralized bone matrix. Tiny crystallites also filled the spaces between the HAS crystals within the aggregates. These newly formed crystallites growing at the surfaces of the implanted HAS crystals appeared to be apatitic. The crystallographic investigations of the nucleation and growing mechanisms of the newly formed crystallites were performed by HRTEM in association with computer simulation and mathematical processing of digitized images. A relationship was noted between the orientation axes of crystallites growing nearby and the zone axes of the implanted HAS, thus strongly suggesting a guiding or substratum role of the HAS particles.

Adult↗

PubMed1997

Human neutrophil collagenase MMP-8 in peri-implant sulcus fluid and its inhibition by clodronate.

The exact molecular mechanisms of the loosening of a dental implant are not well-known. The characteristics of implant sulci are similar to those of periodontal sulci regarding gingival crevicular fluid (GCF) and peri-implant sulcular fluid (PISF). Proteolytic enzymes, matrix metalloproteinases (MMPs), participate in peri-implant tissue remodeling. Clodronate is a well-tolerated bisphosphonate-group drug currently used in bone-resorption-related diseases in humans. The mechanisms of bisphosphonate action are not clarified. Collagenase activity in diseased PISF was significantly higher than in the clinically healthy group. Immunoblotting disclosed that diseased PISF contained increased immunoreactives MMP-8 compared with the healthy PISF. The residual latent collagenase activity in the diseased PISF was activated by gold thioglucose and inhibited completely by 100 microM of doxycycline closely resembling pure neutrophil collagenase (MMP-8). The presence of MMP-8 in diseased but not in clinically healthy PISF may prove to be a useful biochemical indicator to monitor peri-implant health and disease. Pure human neutrophil collagenase (MMP-8) and the MMP-8 present in PISF and in the GCF of both loosening implants and periodontitis-affected teeth were efficiently inhibited in vitro by clodronate (50% inhibition [IC50] was achieved by 150 microM of clodronate), an osteoactive, antiresorptive bisphosphonate. Furthermore, the new finding suggests an extended and hitherto-undescribed potential for clodronate in preventing the loosening of both implants and teeth, based on a dual beneficial effect: prevention of both bone resorption/osteolysis and of soft tissue/dental ligament destruction. Potential new therapeutic indications based on the collagenase-inhibiting effect of clodronate provide potential new therapeutic indications for a variety of diseased involving connective tissue breakdown, such as periodontal disease, arthritides, and tumor invasion.

Adult↗

PubMed1994

Site-specific expression of mRNAs for osteonectin, osteocalcin, and osteopontin revealed by in situ hybridization in rat periodontal ligament during physiological tooth movement.

We investigated the gene expression for non-collagenous proteins in periodontal ligament (PDL) by in situ hybridization histochemistry with a non-radioisotopic probe with cRNAs for osteocalcin (Osc), osteonectin (Osn), and osteopontin (Opn) in rat maxillary dento-alveolar unit containing molars and intact PDL. A highly intense positive signal for Osn and Osc mRNAs was expressed at all distal surfaces of the interradicular septum of buccal roots of the upper second molar in 7-week-old Sprague-Dawley male rats. Cells showing positive signals for Osn and Osc mRNAs were osteoblasts and osteoprogenitor cells. The distribution of Opn mRNA-positive signal was demonstrable at the mesial surface of the interradicular septum of buccal roots, where physiological bone resorption was specifically restricted during physiological tooth movement. Opn mRNA was expressed in cells on the bone resorption surface, including osteoclasts, and osteocytes. A moderately intense positive signal for Osn mRNA was distributed in fibroblasts throughout the ligament. Odontoblasts and pre-mature odontoblasts exhibited a strong signal for Osn and Osc mRNA. Cementoblasts and cementocytes were positive for Osn, Osc, and Opn mRNAs. These findings suggest physiological roles of Osc, Osn, and Opn in bone remodeling, PDL remodeling, dentinogenesis, and cementogenesis.

Animals↗

PubMed1995

Customized jig for a bonded palatal retainer: a case report.

The construction of a customized jig to assist with the placement of multiple multistranded wire retainers is described and illustrated. Its use in a patient with severe resorption of the roots and surrounding alveolar bone of the upper anterior teeth is reported.

Adult↗

PubMedDate not supplied

Periodontal splinting in general dental practice.

Splinting periodontally involved teeth is a technique that has been in use for centuries. This article gives a brief history and review of the literature concerning periodontal splinting and outlines the rationale and indications for the correct application of periodontal splinting in modern dental practice. The common types of splint and clinical techniques involved are described, addressing some of the clinical problems.

Dental Bonding↗

PubMed2001

Multiple myeloma presenting as a painful mandibular swelling: a case report.

Multiple myeloma is a disease characterized by monoclonal proliferation of plasma cells, the most differentiated stage of B-cells. Primary manifestation of multiple myeloma in the jawbones is rare. In the case reported here, a 29-year-old woman who presented with a right mandibular swelling after extraction of a mobile painful tooth turned out to have multiple myeloma. Current diagnostic criteria and management strategies of the disease are discussed.

Adult↗

PubMed2006

An audit of the quality and content of periodontal referrals and the effect of implementing referral criteria.

AIMS: This audit aimed to assess the effect of implementing referral criteria on the quality and content of referral letters sent by general dental practitioners (GDPs) to the periodontal department of a teaching hospital. METHODS: Retrospective data were collected from a total of 450 referrals made in: (i) 1997, prior to any changes; (ii) 2000/2001, after referral guidelines were implemented; and (iii) 2004/2005, after referral criteria were redefined and circulated via Primary Care Trusts. A standardised data-collection form was used to record the information that was provided in the referral letters. This information was also compared to the findings at initial hospital consultations. RESULTS: There was a small improvement in the administrative details provided in the referral communications in 2000/2001 and 2004/2005. Medical history was often incomplete and was mentioned in 31-34% of referral letters. Use of the Basic Periodontal Examination (BPE) score increased from 17% (1997) to 57% (2004/2005). The information on clinical details otherwise increased in 2000/2001 with a tendency to decrease in 2004/2005. There was little agreement between the clinical details in the referral communications and the findings at consultation in the periodontal department. CONCLUSIONS: Following implementation of referral criteria, there was an increase in the clinical details provided in referral letters. However, the validity of the information provided by the GDPs was often questionable. The number of referrals that provided medical history details remained unchanged. Use of a pro forma was not associated with an improvement in the quality of referrals in this audit.

Communication↗

PubMed1965