A bio-resorbable type I collagen membrane was investigated as a barrier for guided tissue regeneration. Ten human subjects with at least one pair of contralateral periodontal lesions with probing pocket depths of greater than or equal to 5 mm and radiographic evidence of greater than or equal to 40% bone loss were included. Each patient underwent contralateral surgical flap procedures. A collagen barrier was adapted to the tooth in the experimental defect and the flap replaced and sutured. The controls consisted of the same procedure without the placement of the barrier. Standardized measurements of change in probing attachment levels and fill of intrabony defects were obtained at the time of surgery and 1 year later at the time of surgical re-entry. The differences in change of probing attachment levels and amount of bone fill between individual test and control sites were compared utilizing the student's t-test for paired samples. The mean probing attachment gain in the test sites was 0.56 +/- 0.57 mm, and there was a mean probing attachment loss of 0.71 +/- 0.91 mm in the control sites (P less than 0.01). The gain of bone in test lesions was 1.16 +/- 0.95 mm, while no gain was observed in the control lesions (P less than 0.01). The results of this study demonstrated that sites treated with a collagen barrier comprised of cross-linked bovine Type I collagen exhibited significantly better healing as compared to control sites over the 1-year period of the study.
A comparative study which evaluated two treatment modalities for regeneration of interproximal periodontal lesions was conducted. Eleven pairs of advanced periodontal lesions in 11 human subjects (6 male and 5 female) were treated in a split mouth design with expanded polytetrafluoroethylene (ePTFE) interproximal membranes alone (control) in one lesion and ePTFE interproximal membranes in combination with decalcified freeze-dried bone (test) in the other lesion. At 1 year post-treatment, both treatment modalities revealed a significant increase in clinical attachment levels from baseline (2.0 +/- 1.37 mm test, 2.0 +/- 0.88 mm control) with no significant differences between the two modalities. When the amount of new bone formed in these lesions was assessed using re-entry procedures, a significant difference in new bone formation from baseline was found only for lesions treated with ePTFE alone (0.4 +/- 0.78 mm test, 1.3 +/- 0.96 mm control). It was concluded that at 1 year post-treatment, significant clinical attachment gains could be obtained by the use of ePTFE barriers with or without DFDBA. Statistically significant results in bone fill were only found when ePTFE barriers were used alone.
A study was conducted to observe the changes in areas with untreated mucogingival defects over a 10-year period. The results in this group after 4 years were previously published. Upon entering dental school, a group of 39 freshman dental students were assessed for plaque index, gingival index, probing depth, and width of keratinized gingiva in 112 sites of inadequate keratinized gingiva. Eighteen of the original 39 participants were reassessed for the same parameters in 64 sites after 10 years. The results revealed that 22 sites showed a slight increase in keratinized gingiva, 32 were unchanged, and 10 sites showed a slight decrease in keratinized gingiva. The mean width of keratinized gingiva at the beginning of the study was 1.73 +/- 0.542 mm and was 2.01 +/- 0.864 mm after 10 years. This represented a small, but statistically insignificant, increase in the width of keratinized gingiva. The Plaque Index and Gingival Index of this group at baseline and at 10 years indicated a high level of oral hygiene and gingival health. It was concluded that in the absence of gingival inflammation, areas with small amounts of keratinized gingiva may remain stable over long periods of time.
It was concluded that in the absence of gingival inflammation, areas with small amounts of keratinized tissue may remain stable over long periods of time.
Hemorrhage from palatal donor sites during periodontal mucogingival surgery was controlled by application of Collastat absorbable hemostatic sponges. The use of collagen sponges was evaluated in 20 free-graft cases. In contrast to microfibrillar collagen, which is normally delivered as clumps of material, a Collastat sponge was applied as a single piece that maintained structural integrity even when wet and was easy to maneuver into place. The highly porous sponges conformed to the wound, absorbed fluid and produced consistently reliable hemostasis with no secondary bleeding. By stemming the seepage of blood into the throat, patient safety and comfort were improved. The sponges were left on the wounds and removed at the 1-week postoperative visit, revealing well-formed granulation tissue. Healing proceeded normally with no evidence of infection, tissue reaction, or other adverse effects.
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