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Reconstructive periodontal therapy with simultaneous ridge augmentation. A clinical and histological case series report

Identifieur interne : 001860 ( Pmc/Curation ); précédent : 001859; suivant : 001861

Reconstructive periodontal therapy with simultaneous ridge augmentation. A clinical and histological case series report

Auteurs : Péter Windisch [Hongrie] ; D Ra Szendr I-Kiss [Hongrie] ; Attila Horváth [Hongrie] ; Zsuzsanna Suba [Hongrie] ; István Gera [Hongrie] ; Anton Sculean [Pays-Bas]

Source :

RBID : PMC:2491434

Abstract

Treatment of intrabony periodontal defects with a combination of a natural bone mineral (NBM) and guided tissue regeneration (GTR) has been shown to promote periodontal regeneration in intrabony defects. In certain clinical situations, the teeth presenting intrabony defects are located at close vicinity of the resorbed alveolar ridge. In these particular cases, it is of clinical interest to simultaneously reconstruct both the intrabony periodontal defect and the resorbed alveolar ridge, thus allowing insertion of endosseous dental implants. The aim of the present study was to present the clinical and histological results obtained with a new surgical technique designed to simultaneously reconstruct the intrabony defect and the adjacently located resorbed alveolar ridge. Eight patients with chronic advanced periodontitis displaying intrabony defects located in the close vicinity of resorbed alveolar ridges were consecutively enrolled in the study. After local anesthesia, mucoperiosteal flaps were raised, the granulation tissue removed, and the roots meticulously scaled and planed. A subepithelial connective tissue graft was harvested from the palate and sutured to the oral flap. The intrabony defect and the adjacent alveolar ridge were filled with a NBM and subsequently covered with a bioresorbable collagen membrane (GTR). At 11–20 months (mean, 13.9 ± 3.9 months) after surgery, implants were placed, core biopsies retrieved, and histologically evaluated. Mean pocket depth reduction measured 3.8 ± 1.7 mm and mean clinical attachment level gain 4.3 ± 2.2 mm, respectively. Reentry revealed in all cases a complete fill of the intrabony component and a mean additional vertical hard tissue gain of 1.8 ± 1.8 mm. The histologic evaluation indicated that most NBM particles were surrounded by bone. Mean new bone and mean graft area measured 17.8 ± 2.8% and 32.1 ± 8.3%, respectively. Within their limits, the present findings indicate that the described surgical approach may be successfully used in certain clinical cases to simultaneously treat intrabony defects and to reconstruct the resorbed alveolar ridge.


Url:
DOI: 10.1007/s00784-008-0194-8
PubMed: 18357474
PubMed Central: 2491434

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<country xml:lang="fr">Pays-Bas</country>
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<p>Treatment of intrabony periodontal defects with a combination of a natural bone mineral (NBM) and guided tissue regeneration (GTR) has been shown to promote periodontal regeneration in intrabony defects. In certain clinical situations, the teeth presenting intrabony defects are located at close vicinity of the resorbed alveolar ridge. In these particular cases, it is of clinical interest to simultaneously reconstruct both the intrabony periodontal defect and the resorbed alveolar ridge, thus allowing insertion of endosseous dental implants. The aim of the present study was to present the clinical and histological results obtained with a new surgical technique designed to simultaneously reconstruct the intrabony defect and the adjacently located resorbed alveolar ridge. Eight patients with chronic advanced periodontitis displaying intrabony defects located in the close vicinity of resorbed alveolar ridges were consecutively enrolled in the study. After local anesthesia, mucoperiosteal flaps were raised, the granulation tissue removed, and the roots meticulously scaled and planed. A subepithelial connective tissue graft was harvested from the palate and sutured to the oral flap. The intrabony defect and the adjacent alveolar ridge were filled with a NBM and subsequently covered with a bioresorbable collagen membrane (GTR). At 11–20 months (mean, 13.9 ± 3.9 months) after surgery, implants were placed, core biopsies retrieved, and histologically evaluated. Mean pocket depth reduction measured 3.8 ± 1.7 mm and mean clinical attachment level gain 4.3 ± 2.2 mm, respectively. Reentry revealed in all cases a complete fill of the intrabony component and a mean additional vertical hard tissue gain of 1.8 ± 1.8 mm. The histologic evaluation indicated that most NBM particles were surrounded by bone. Mean new bone and mean graft area measured 17.8 ± 2.8% and 32.1 ± 8.3%, respectively. Within their limits, the present findings indicate that the described surgical approach may be successfully used in certain clinical cases to simultaneously treat intrabony defects and to reconstruct the resorbed alveolar ridge.</p>
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<journal-id journal-id-type="nlm-ta">Clin Oral Investig</journal-id>
<journal-title>Clinical Oral Investigations</journal-title>
<issn pub-type="ppub">1432-6981</issn>
<issn pub-type="epub">1436-3771</issn>
<publisher>
<publisher-name>Springer-Verlag</publisher-name>
<publisher-loc>Berlin/Heidelberg</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">18357474</article-id>
<article-id pub-id-type="pmc">2491434</article-id>
<article-id pub-id-type="publisher-id">194</article-id>
<article-id pub-id-type="doi">10.1007/s00784-008-0194-8</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Reconstructive periodontal therapy with simultaneous ridge augmentation. A clinical and histological case series report</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name name-style="western">
<surname>Windisch</surname>
<given-names>Péter</given-names>
</name>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western">
<surname>Szendrői-Kiss</surname>
<given-names>Dóra</given-names>
</name>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western">
<surname>Horváth</surname>
<given-names>Attila</given-names>
</name>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western">
<surname>Suba</surname>
<given-names>Zsuzsanna</given-names>
</name>
<xref ref-type="aff" rid="Aff2">2</xref>
</contrib>
<contrib contrib-type="author">
<name name-style="western">
<surname>Gera</surname>
<given-names>István</given-names>
</name>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name name-style="western">
<surname>Sculean</surname>
<given-names>Anton</given-names>
</name>
<address>
<phone>+31-24-3668379</phone>
<fax>+31-24-3614657</fax>
<email>a.sculean@dent.umcn.nl</email>
<email>anton.sculean@gmx.de</email>
</address>
<xref ref-type="aff" rid="Aff3">3</xref>
</contrib>
<aff id="Aff1">
<label>1</label>
Department of Periodontology, Semmelweis University, Budapest, Hungary</aff>
<aff id="Aff2">
<label>2</label>
Oral Pathology Unit, Department of Oral and Maxillofacial Surgery, Semmelweis University, Budapest, Hungary</aff>
<aff id="Aff3">
<label>3</label>
Department of Periodontology, Radboud University Medical Center, P.O. Box 9101, 117, Philips van Leydenlaan 25, 6500 Nijmegen, The Netherlands</aff>
</contrib-group>
<pub-date pub-type="epub">
<day>21</day>
<month>3</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="ppub">
<month>9</month>
<year>2008</year>
</pub-date>
<volume>12</volume>
<issue>3</issue>
<fpage>257</fpage>
<lpage>264</lpage>
<history>
<date date-type="received">
<day>26</day>
<month>11</month>
<year>2007</year>
</date>
<date date-type="accepted">
<day>25</day>
<month>2</month>
<year>2008</year>
</date>
</history>
<permissions>
<copyright-statement>© The Author(s) 2008</copyright-statement>
</permissions>
<abstract>
<p>Treatment of intrabony periodontal defects with a combination of a natural bone mineral (NBM) and guided tissue regeneration (GTR) has been shown to promote periodontal regeneration in intrabony defects. In certain clinical situations, the teeth presenting intrabony defects are located at close vicinity of the resorbed alveolar ridge. In these particular cases, it is of clinical interest to simultaneously reconstruct both the intrabony periodontal defect and the resorbed alveolar ridge, thus allowing insertion of endosseous dental implants. The aim of the present study was to present the clinical and histological results obtained with a new surgical technique designed to simultaneously reconstruct the intrabony defect and the adjacently located resorbed alveolar ridge. Eight patients with chronic advanced periodontitis displaying intrabony defects located in the close vicinity of resorbed alveolar ridges were consecutively enrolled in the study. After local anesthesia, mucoperiosteal flaps were raised, the granulation tissue removed, and the roots meticulously scaled and planed. A subepithelial connective tissue graft was harvested from the palate and sutured to the oral flap. The intrabony defect and the adjacent alveolar ridge were filled with a NBM and subsequently covered with a bioresorbable collagen membrane (GTR). At 11–20 months (mean, 13.9 ± 3.9 months) after surgery, implants were placed, core biopsies retrieved, and histologically evaluated. Mean pocket depth reduction measured 3.8 ± 1.7 mm and mean clinical attachment level gain 4.3 ± 2.2 mm, respectively. Reentry revealed in all cases a complete fill of the intrabony component and a mean additional vertical hard tissue gain of 1.8 ± 1.8 mm. The histologic evaluation indicated that most NBM particles were surrounded by bone. Mean new bone and mean graft area measured 17.8 ± 2.8% and 32.1 ± 8.3%, respectively. Within their limits, the present findings indicate that the described surgical approach may be successfully used in certain clinical cases to simultaneously treat intrabony defects and to reconstruct the resorbed alveolar ridge.</p>
</abstract>
<kwd-group>
<title>Keywords</title>
<kwd>Guided tissue regeneration</kwd>
<kwd>Intrabony defects</kwd>
<kwd>Ridge augmentation</kwd>
<kwd>Connective tissue graft</kwd>
<kwd>Resorbable membrane</kwd>
<kwd>Natural bone mineral</kwd>
<kwd>Histology</kwd>
</kwd-group>
<custom-meta-wrap>
<custom-meta>
<meta-name>issue-copyright-statement</meta-name>
<meta-value>© Springer-Verlag 2008</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
</pmc>
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