It is unclear what degree of roughness or smoothness result from use of hand instruments alone in comparison to the use of hand instruments in combination with other aids and how it may effect the grade of cleanliness. The aim of this study was to determine in vivo whether the combination of hand instruments with other aids can increase the effectiveness of root debridement. 11 patients with holpless 4 mandibular incisors were involved in this study. After elevating a lingual and buccal mucoperiosteal flap, the 4 incisors were randomly treated with either: (1) no treatment (control); (2) 5-min scaling (method 1); (3) 4-min scaling and 1 min instrumentation with a perio-diamond bur (15 microm) (method 2); (4) 3-min scaling, 1-min instrumentation with a perio-diamond bur (15 microm) and 1 min with an air abrasive system (method 3). The cleanliness of the surface was determined using the method of Eschler and -Rapley. The degree of roughness (Ra and Rt) were measured with a laser beam (computer supported optical surface sensor system). In addition, an SEM analysis was performed. With regard to the remaining calculus (surface cleanliness), method 3 yielded significantly better results than the other 2 methods. The roughness analyses also exhibited that method 3 is superior to methods 1 and 2. The qualitative results of the SEM investigations demonstrated the most homogeneous and smooth surfaces with method 3. Root debridement in vivo was most significant using a combination of different treatment modalities (i. e., curettes, perio-diamond bur and air abrasive system).
The aim of this investigation was to evaluate clinically and histologically the use of a synthetic bone graft (Ionogran) alone and in combination with guided bone regeneration (GBR) for alveolar ridge augmentation. Five beagle dogs were used in this study. Prior to the augmentation procedure the maxillary and mandibular second, third and fourth premolars were extracted. Three months after the extractions, impressions from the area of the ridges were taken. Particles of Ionogran were then placed under mucoperiosteal flaps in each quadrant. On the experimental sites, an expanded polytetrafluoroethylene barrier was placed between the flap and the particles. Impressions were retaken at 1 and 3 months after surgery. Three months after surgery, the animals were sacrificed and specimens were prepared for histological evaluation. Computer-assisted volumetric analyses from the casts revealed an increase in ridge volume from baseline in both groups at 1 and 3 months. There was no difference in the height of the augmentation between the test and control sites. The histological results of this study indicate that this new synthetic bone graft appears to be a safe biocompatible grafting material. There were no apparent histological differences between the graft alone and graft/GBR sites. In both groups, however, graft particles were surrounded by dense fibrous connective tissue and bone formation was limited to the graft bone interface.
The aim of this study was to evaluate clinically and histologically the use of a synthetic bone graft (Ionogran) alone and in combination with guided bone regeneration (GBR) to facilitate bone regeneration and augmentation around exposed implant threads. Five male Beagle dogs were used in this investigation. Prior to the study all 3rd and 4th premolars were extracted. After 3 months, a flap was elevated and two Brånemark implants were inserted in each quadrant in such a way that two-three threads remained exposed over the alveolar bone. On the control sites the synthetic bone graft was then placed around the exposed threads and the flaps were repositioned and sutured. On the test sites, the same procedure was performed, but an expanded polytetrafluoroethylene barrier was placed to cover the bone graft and implants. Three months after implant placement, the barriers on the test sites were removed, healing abutments were inserted on all implants, and a thrice weekly plaque control regime was initiated. The following clinical parameters were measured at 1, 2, and 3 months: Plaque Index, Gingival Index, Probing Depth and Clinical Attachment Level. Three months after abutment connection the animals were killed and specimens were obtained for histological evaluation. Clinical parameters revealed a significant improvement on the experimental sites compared to control sites during the 3 month loading phase. Histological analyses, however, could not determine a difference in the nature of the implant/tissue interphase between experimental and control sites.
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