The purpose of the present investigation was to study the distribution of interproximal periodontal intrabony defects as related to age, sex and localization, and to examine the relationship between some possible etiological factors and the occurrence of intrabony defects. A total of 209 adult patients presenting for dental treatment at the Royal Dental College in Arhus participated in this study. The patients were subjected to a questionnaire and were examined clinically and radiographically. All osseous defects in the radiographs were recorded but only those with a depth and width of a least 2 mm were considered periodontal intrabony defects. Only 18% of the participants had one or more periodontal intrabony defects but the prevalence was higher in older than in younger age groups. While periodontal intrabony defects occurred with the same frequency on the various tooth types, more defects were found on distal than on mesial surfaces. The presence of periodontal intrabony defects correlated with loss of attachment, increased tooth mobility, a wide interproximal space and open mesio-distal contact relationships between the teeth.
In the recent past, the latissimus dorsi musculocutaneous flap has added a significant tool to the armamentarium of the reconstructive surgeon. The history of its clinical use is reviewed with emphasis on embryological, anatomical and hemodynamic aspects.
The purpose of this investigation was, to compare the histological features of Kielbone and autogenous jaw bone following transplantation into periodontal interradicular lesions in monkeys. Bifurcation defects were produced on mandibular molars and premolars. Kielbone was transplanted into 40 bifurcations while another 30 bifurcations received fresh autogenous cancellous jaw bone. The animals were sacrificed according to a schedule yielding observation periods up to 16 weeks. Before sacrifice the animals were perfused with a mixture of india ink and serum (3:1) by cannulization of the carotid arteries. The specimens were decalcified in a formic acid/sodium citrate solution. Cleared specimens 100μ of thickness were prepared from one half of each specimen. The other half of the specimen was cut into serial sections 8μ thick and stained with hematoxylin and eosin or Mallory's connective tissue stain. During healing of the treated defects Kielbone grafts and grafts of fresh autogenous bone from the jaws displayed similar histological features. In the bifurcation defects, Kielbone as well as autogenous bone grafts occured as isolated bone particles surrounded by a cementum‐like substance. It is suggested that Kielbone may constitute a suitable substitute for autogenous bone grafts in the treatment of periodontal intrabony defects. However, it should be emphasized that neither autogenous jaw bone nor Kielbone did favour bone regeneration in the bifurcation defects.
The purpose of this investigation was to evaluate, in humans, the use of Kielbone as a substitute for fresh autogenous bone in treating periodontal intrabony defects. A total of 92 intrabony defects were treated with a previously described new attachment procedure utilizing free mucosal grafts to cover the intrabony defects following bone grafting. Kielbone was placed in 46 of these defects, while the remaining 46 defects were treated with autogenous bone grafts. The results were evaluated after 6 months by periodontal probing and assessment of the bone level as seen on periodical, identical radiographs. No differences were observed between the amount of clinical gain of attachment obtained in defects treated with Kielbone and those treated with autogenous jaw bone. This indicates that in surgical procedures attempting to restore lost connective tissue attachment, Kielbone constitutes a suitable replacement for fresh autogenous bone. The results are discussed in th light of recent studies that challenge the beneficial effect of bone grafts in the treatment of intrabony defects.
A review of 65 applications of the latissimus dorsi flap based on the thoraco-dorsal vessels to recipient sites in the head and neck area (10), on the torso (22), in the upper extremity (9) and in the lower extremity (24) in 62 patients with malignancies (28) and congenital deformities (6) is presented. Thirty-five flaps were transplanted with microsurgical vascular technique, while 30 flaps were pedicled. Vascular thrombosis at the anastomotic site was seen in 4/35 free tissue transplants and was successfully managed in 3 cases with an overall survival rate of 97% in this group, while all pedicled flaps survived. Healing complications including haematomas and wound infections were related to the nature of the recipient site and most commonly seen in the lower leg after resection of infected bone. In 3 cases leg amputations were performed within 6 months after the reconstruction, while 6 patients had secondary operations for tibial pseudoarthroses. Donor site morbidity was insignificant, without permanent, functional losses. It is concluded, that the thoracodorsal unit is a versatile and safe flap for reconstructive purposes.
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