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Some uses of precision attachments in restoring the partially dentate mouth are considered. These devices are indicated where neither the clasp-retained denture nor the fixed bridge is entirely suitable.
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This study evaluated candidate carriers for recombinant human bone morphogenetic protein-2 (rhBMP-2)-driven periodontal regeneration. Previous experiments indicated the ability of rhBMP-2 in a particulate delivery system to result in substantial regeneration of bone and periodontal regeneration. In the present study, canine demineralized bone matrix (DBM), bovine deorganified crystalline bone matrix (Bio-Oss), an absorbable collagen sponge (ACS) of type I bovine collagen, poly(D,L-lactide-co-glycolide) microparticles (PLGA), and polylactic acid granules (Drilac) were tested for their ability to support rhBMP-2 (0.2 mg/mL implant volume)-driven periodontal regeneration. The implants were tested in routine critical size canine supra-alveolar periodontal defects with transgingival tooth positioning. Contralateral defects in six beagle dogs were semirandomly assigned to receive: DBM/rhBMP-2, DBM (no rhBMP-2), Bio-Oss/rhBMP-2, ACS/rhBMP-2, PLGA/rhBMP-2, or Drilac/rhBMP-2. Animals were sacrificed 8 weeks postsurgery, and block sections of the defects were processed for light microscopy. Substantial bone regeneration was observed in all defects implanted with rhBMP-2. Other measures of periodontal healing, including cementum regeneration and presence of ankylosis, were more variable between the implants. DBM and Bio-Oss performed well as carriers for rhBMP-2-driven periodontal regeneration, although other impediments to their clinical use exist. This study indicates that qualities of the carrier system, including its space-maintaining capacity can affect the ability of rhBMP-2 to regenerate both alveolar bone and periodontal attachment.
A case is presented of external cervical resorption detected on routine 6-monthly examination. Following root canal therapy orthodontic extrusion and pericision, the tooth was restored using a radicular retained post and core supporting a porcelain bonded to gold full coverage crown.
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In 35 roots from extracted human teeth the pulp tissue was removed and the specimens autoclaved before being transplanted subcutaneously to rats. The animals were sacrificed 7, 14, 21, 90 and 140 d after transplantation and the skin and subcutaneous tissue containing the transplants were prepared for histologic examination. The human roots were well tolerated by the rats with a fibrillar connective tissue capsule surrounding the specimens. In the 90-d and 14-d groups a few root surfaces exhibited small resorption lacunae. The empty root canals became slowly occupied by a maturing granulation tissue occasionally containing foci of lymphocytes. After 140 d the canal tissue was still highly vascular with multinuclear giant cells occasionally located along the dentin walls but no internal resorption was recorded. It is concluded that this model may be useful for systematic testing of root filling materials concomitant with human studies.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Many teeth with apical involvement show apical external resorption, and become difficult to treat. A patient with a severely damaged, periapically compromised permanent molar was treated successfully with a combination of simple root canal therapy and a conventional amalgam restoration. This method offers an inexpensive and predictable alternative and provides the option for a different restorative approach in the future.
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The aim of the present investigation was to evaluate the regenerative potential of the periodontal tissues following tooth reimplantation using a model which excluded the dentogingival epithelium from the process of healing. Maxillary and mandibular incisors, premolars and molars of 5 monkeys were used. Following root filling of all experimental teeth, the teeth were divided into 3 experimental groups. In 1 group, the teeth were extracted following the elevation of full thickness flaps. The crowns were separated from the roots at the level of the buccal cemento-enamel junction and the roots immediately reimplanted into their sockets. The flaps were replaced and sutured to accomplish complete coverage of the roots. In a 2nd group, the teeth were subjected to the same experimental procedure, but in addition, the buccal alveolar bone was removed to about half its original height prior to root reimplantation. The teeth of the 3rd group were subjected to identical experimental procedures as for group II with the addition that the buccal root surfaces were planed to the level of the surgically created bone crest. The animals were sacrificed after 6 months of healing. The jaws were removed and histological specimens prepared for microscopic examination. The results showed that a complete fibrous re-attachment formed onto roots on which the original periodontal ligament tissue was preserved. This occurred irrespective of whether the roots were reimplanted into sockets with normal (group I) or reduced (group II) bone height. When the original periodontal ligament tissue was removed by root planing before reimplantation (group III), healing resulted in a significant amount of new connective tissue attachment. However, coronal to the newly formed fibrous attachment, the root surface frequently showed signs of resorption and particularly so in those roots which remained covered by the soft tissue during the entire course of healing. In the majority of the roots which perforated the covering soft tissue during the early phase of healing, the dentogingival epithelium had migrated apically into contact with the coronally generated fibrous attachment. In these cases, root resorption was never discernible. New bone formation occurred to a variable extent in the roots of groups II-III. No relationship was found, however, between the amount of connective tissue reattachment or new attachment and newly formed alveolar bone, which in turn indicates that bone tissue regrowth and periodontal ligament regeneration are unrelated phenomena.
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