Placement of the preparation line and periodontal health--a prospective 2-year clinical study. Surgical crown lengthening: evaluation of the biological width. Clinical and radiographic digital imaging evaluation of a bioresorbable membrane in the treatment of periodontal bone defects. Treatment of wide, shallow, and predominantly 1-wall intrabony defects with a bioabsorbable membrane: a randomized controlled clinical trial. GTR with bioresorbable membranes in the treatment of intrabony defects: a clinical and histologic study. Implants in regenerated bone in patients treated for generalized aggressive periodontitis: a prospective longitudinal study. Culture of human gingival fibroblasts on a biodegradable scaffold and evaluation of its effect on attached gingiva: a randomized, controlled pilot study. Immediate placement and restoration of implants in the aesthetic zone with a trimodal approach: soft tissue alterations and its relation to gingival biotype. Clinical and radiographical evaluation of mineral trioxide aggregate, biodentine and propolis as pulpotomy medicaments in primary teeth Improved periodontal conditions following therapy. Guided tissue regeneration in the treatment of human infrabony defects. Clinical, radiographical and microbiological results: a pilot study. Biodentine versus Mineral Trioxide Aggregate versus Intermediate Restorative Material for Retrograde Root End Filling: An Invitro Study Influence of the cavity-size on the survival rate of proximal ART restorations in primary molars. Clinical, histologic and histomorphometric evaluation of socket preservation using a synthetic nanocrystalline hydroxyapatite in comparison with a bovine xenograft: a randomized clinical trial. Evaluation of four modalities of periodontal therapy. Mean probing depth, probing attachment level and recession changes. Factors influencing the outcome of regenerative therapy in mandibular Class II furcations: Part I. Facial alveolar bone wall width - a cone-beam computed tomography study in Asians.
The aim of this prospect i ve clinical 2-year study was to determine whether the placement of the proximal margins of crowns within the zone of the biologic width results in periodontal alterations . In 41 patients , 116 prepared teeth as well as 82 unrestored , healthy contralateral teeth were examined . The following indices were determined before as well as 3 , 6 , 12 , and 24 months after preparation :  hygiene index , papillary bleeding index ( PBI ) , and probing depth .  After preparation , the distance between the restoration margins and the alveolar crest was measured with a modified periodontal probe on both proximal aspects of each tooth . These values were classified into 3 groups : I = < or = 1 mm between crown margin and alveolar crest , II = 1 to 2 mm , and III = > 2 mm . In addition , radiographs were taken directly after cementation of each restoration and after 12 and 24 months . The hygiene index did not significantly vary during the investigation , but PBI increased in all groups . The highest PBI increase was found in group I ; in this group , the most significant increase was found between 3 and 6 months after preparation . The mean probing depth only increased in group I during the first 3 months after preparation on the mesial aspects . Only minor changes were found on the distal aspects of the teeth in group I and on all aspects in groups II and III . No alterations of the bone levels were diagnosed on the radiographs . These results indicate that the location of the restoration margins within the zone of the biologic width may impair the periodontal health of restored teeth BACKGROUND Previous surgical crown lengthening studies have investigated positional changes of the free gingival margin but not the biological width . Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biological width . However , very little work has been done in humans . Therefore , the purpose of this study was to evaluate the positional changes of the periodontal tissues , particularly the biological width , following surgical crown lengthening in human subjects . METHODS Twenty-three ( 23 ) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and /or to access caries , tooth fracture , or previous prosthetic margins entered the study . The following parameters were obtained from line angles of treated teeth ( teeth requiring surgical crown lengthening ) and adjacent teeth with adjacent and non-adjacent sites : plaque and gingival indexes , free gingival margin , probing depth , attachment level , bone level , direct bone level , and biological width . During surgery , the bone level was reduced based on the future prosthetic margin and predetermined biological width ; flaps were placed at the bony crest . Patients were examined at baseline and at 3 and 6 months postoperatively . RESULTS Eighteen patients completed the study . Overall , the amount of bone resected was 1 to 5 mm . At 90 % of treated sites , > or = 3 mm of bone was removed . At 3 months , the apical displacement of the free gingival margin at non-adjacent , adjacent , and treated sites was 2.46 + /- 0.25 mm , 2.68 + /- 0.20 mm , and 3.07 + /- 0.16 mm , respectively . There was no significant change in the position of the free gingival margin from 3 to 6 months . The biological width at all sites was smaller at 3 and 6 months compared to baseline ( P<0.05 ) except for the treated sites , which were not significantly different from baseline at 6 months . CONCLUSIONS During surgical crown lengthening , the bone level was lowered for placement of the prosthetic margin and reestablishment of the biological width . The biological width , at treated sites , was reestablished to its original vertical dimension by 6 months . In addition , a consistent 3 mm gain of coronal tooth structure was observed at the 3- and 6-month examinations This study evaluated the use of a bioresorbable membrane ( Guidor USA ) for treatment of periodontal angular bone defects in eight periodontitis patients . Presurgical measurements consisted of probing depth , clinical attachment levels , and digital radiographic imaging evaluation . Full-thickness buccal and lingual flaps were elevated allowing for soft tissue debridement , scaling , and root planing . Bioresorbable membranes were placed in at least one of the periodontal defects , and controls were left without barrier placement . Clinical and radiographic results 6 months after the surgical procedure showed clinical and radiographic improvement for control and test lesions . However , sites treated with bioresorbable membranes presented a significant gain in clinical attachment and bone mass when compared to sites that had received flap surgery alone BACKGROUND The regenerative therapy of non-contained intrabony defects achieves better results when bioabsorbable membranes are combined with a filling material . The purpose of the present study was to analyze clinical and radiographic effectiveness of a space-making bioabsorbable membrane in the treatment of wide and shallow intrabony defects characterized by a relevant 1-wall component . METHODS Eighteen pairs of angular bone defects were selected in 18 healthy , non-smoking patients ( age range 30 to 66 years ) . Prior to the surgical phase , patients were enrolled in a strict periodontal program including oral hygiene instructions and scaling and root planing ( presurgical full-mouth plaque score < 10 % ) . Using a split-mouth design , 18 sites were r and omly assigned to receive guided tissue regeneration ( GTR ) using a bioabsorbable membrane ( test group ) and 18 to receive open flap debridement alone ( control group ) . Clinical treatment outcome was evaluated 12 months postoperatively for changes in probing depth ( PD ) , clinical attachment level ( CAL ) , and position of gingival margin ( REC ) and radiographically for bone changes . RESULTS Open flap debridement and GTR yielded statistically significant ( P<0.0001 ) PD reduction ( 2.39+/- 0.92 mm and 3.44+/- 0.78 mm ) , CAL gain ( 1.50+/- 0.99 mm and 2.89 + /- 0.90 mm ) , increased REC ( -0.89 + /- 0.58 mm and -0.56 + /- 0.92 mm ) and bone fill ( 1.05+/- 0.94 mm and 2.13+/- 1.21 mm ) when 12-month data were compared to baseline . The differences between test and control groups were statistically significant for all parameters ( P<0.007 ) except for REC ( P=0.25 ) . CONCLUSION The use of this bioabsorbable membrane would seem to be effective in the treatment of intrabony defects with unfavorable architecture without the use of filling material The aim of the present study was to evaluate clinical ly and histologically the treatment of intrabony periodontal defects with a bioresorbable membrane barrier .  Fifty-two intrabony periodontal defects were treated according to the principles of guided tissue regeneration ( GTR ) with a bioresorbable membrane . Results were evaluated by assessing probing pocket depth , recession of the gingival margin , and clinical attachment level at baseline and at 1 and 2 years after therapy . Bone level changes were evaluated radiographically . The postoperative phase was uneventful in all cases . There was a mean probing pocket depth reduction from 8.4 to 3.6 mm , a mean increase of gingival margin recession from 1.5 to 3.0 mm , and a mean clinical attachment level change from 9.9 to 6.5 mm . Mean attachment gain was 3.4 mm . Two teeth scheduled for extraction were also treated with the same bioresorbable membrane . The histologic analysis 6 months after treatment revealed the formation of new connective tissue attachment and new alveolar bone in both cases . Based on the histologic findings it can be concluded that the clinical improvements following GTR with this type of bioresorbable membrane may represent , at least in part , true periodontal regeneration The aim of this prospect i ve longitudinal study of patients treated for generalized aggressive periodontitis ( GAP ) was the clinical , microbiologic , and radiologic longitudinal evaluation of implants placed into bone regenerated by the guided bone regeneration ( GBR ) technique . Ten patients with GAP who had lost either one or two maxillary incisors or premolars through periodontal disease and whose alveolar bone was neither high nor wide enough for implant placement were enrolled in the study .  GBR was carried out in a two-stage procedure using titanium-reinforced extended polytetrafluoroethylene membranes and titanium screws . No bone graft or bone substitute material s were used . After 6 to 8 months , the membranes and supporting screws were removed , and a total of 15 implants ( Nobel Biocare ) were placed . The control group comprised 10 periodontally healthy patients who had a total of II implants ( Nobel Biocare ) placed in the maxilla ( incisor and premolar region ) without GBR because of aplasia , trauma , or endodontic lesions . All patients were examined 2 to 4 weeks before extraction of the nonretainable teeth ( baseline ) and again immediately after placement of the superstructure . Further examinations were performed within the framework of a 3-month recall schedule over a 3-year period . At each session , clinical parameters ( probing pocket depths , bleeding on probing , gingival recession , clinical attachment level , Gingival Index , and Plaque Index ) were recorded at teeth and implants , and the composition of the subgingival microflora was determined by dark-field microscopy and DNA probe . Intraoral radiographs were taken for control purpose s at baseline , immediately after insertion of the superstructure , and 1 and 3 years later . The GBR technique yielded a horizontal and vertical bone gain of 4.5 to 7.0 mm in the GAP patients . The clinical , microbiologic , and radiologic findings indicated healthy periodontal and periimplant conditions in both patient groups throughout the study . However , a slightly increased attachment loss ( 0.65 mm ) and bone loss ( 1.78 mm ) were recorded at the implants in the regenerated bone after 3 years of loading . The 3-year implant survival rate was 100 % in both groups . The possibility of continuous attachment loss and bone loss occurring at teeth and implants in regenerated bone can not be ruled out in patients treated for aggressive periodontitis . The prognosis for the retention of the teeth and implants is thus open to question BACKGROUND An adequate width of attached gingiva is necessary to maintain healthy periodontium , especially in orthodontics or restorative treatments in periodontics . The purpose of this study was to evaluate the width of attached gingiva after clinical application of a cultured gingival graft compared to a periosteal fenestration technique . METHODS This study was conducted on nine patients ( 18 sites ) with insufficient attached gingiva adjacent to at least two teeth in contralateral quadrants of the same jaw . A small portion ( approximately 3 x 2 x 1 mm ) of attached gingiva ( epithelial + connective tissue ) was removed with a surgical blade . After culture of gingival fibroblasts , 2 x 10(5 ) cells in 250 microl nutritional medium were added to 250 microl collagen gel . One tooth in each patient was r and omized to receive a periosteal fenestration technique for gingival augmentation ( control ) or a tissue-engineered mucosal graft ( test ) . Clinical parameters measured at baseline and 3 months included width of keratinized tissue , probing depth , and width of attached gingiva . RESULTS An increased amount of keratinized tissue was seen at all treated sites after 3 months . The mean increased amount of attached gingiva was 2.8 mm at test sites and 2 mm at control sites ; this difference was significant ( P < 0.05 ) . CONCLUSION Based on the results of this investigation , the tissue-engineered mucosal graft is safe and capable of generating keratinized tissue PURPOSE The aim of this prospect i ve study was to evaluate the soft tissue changes around  implants  in the aesthetic zone , placed under a trimodal approach ( immediate post- extraction placement , flapless , and immediate provisional restoration ) and its relationship to gingival/periodontal biotype of the patient . MATERIAL S AND METHODS The sample consisted of 14 patients from two private practice s that were in need of a tooth extraction in the anterior maxillary region ( cuspid to cuspid ) and were c and i date s to a replacement with a dental implant .  An initial measurement ( baseline ) of the position or the mesial and distal papillae and gingival zenith was made at this time , with a rigid dental-supported stent and an electronic precision caliper , able to the second tenth of a millimeter ; after careful tooth extraction , the periodontal thickness , at a point 5 mm apical to de gingival buccal margin , with an analogical thickness gauge , able to one tenth of a millimeter . Once the implant was inserted an immediate provisional restoration was delivered . To evaluate the soft tissue changes measurements were repeated at 3 , 6 , and 12 months . A statistical analysis was performed to evaluate the changes in the gingival margin around the implant restorations and to identify a possible correlation to patient 's periodontal thickness . RESULTS All 14 patients received Straumann ( ® ) implants ( 9 Tissue Level [ TL ] Regular Neck [ RN ] , 2 TL Narrow Neck [ NN ] , 2 Bone Level [ BL ] Narrow Crossfit [ NC ] , and 1 BL Regular Crossfit [ RC ] ) . All implants integrated and none had any biological complications . Three provisional restorations presented screw loosening and retightened once and one loss retention and was recemented once . In one patient , with a severe bruxing habit , the final restoration suffered screw loosening and was retightened . Of the final restorations , 12 were screw-retained and 2 cemented on custom-made Zirconia abutments . A mean recession of the buccal margin of 0.45 mm was recorded at 12 months ( ± 0.25 mm ) . An acceptable papilla level was present in all cases at 1 year , with mean changes of 0.38 mm ( ± 0.60 ) for the mesial and 0.80 mm ( ± 0.90 ) of the distal papilla , respectively . No correlation could be established between the soft tissue changes and the periodontal biotype of the patient . CONCLUSIONS Within the limitations of this study , the good aesthetic outcome and minimal complications seem to vali date the trimodal approach protocol as a reliable and simple protocol to place and restore immediate implants in the aesthetic zone . No correlation between the patient 's gingival biotype and the soft tissue alterations could be established . Additional studies are needed to verify long-term aesthetic results with this approach and to better define and quantify biotypes Objectives The purpose of this study was to evaluate the efficacy of mineral trioxide aggregate ( MTA ) , Biodentine and Propolis as pulpotomy medicaments in primary dentition , both clinical ly and radiographically . Material s and Methods A total of 75 healthy 3 to 10 yr old children each having at least one carious primary molar tooth were selected . R and om assignment of the pulpotomy medicaments was done as follows : Group I , MTA ; Group II , Biodentine ; Group III , Propolis . All the pulpotomized teeth were evaluated at 3 , 6 , and 9 mon clinical ly and radiographically , based on the scoring criteria system . Results The clinical success rates were found to be similar among the three groups at 3 and 6 mon where as a significant decrease in success rate was observed in Group III ( 84 % ) compared to both Group I ( 100 % ) and Group II ( 100 % ) at 9 mon . Radiographic success rates over a period of 9 mon in Groups I , II , and III were 92 , 80 , and 72 % , respectively . Conclusions Teeth treated with MTA and Biodentine showed more favorable clinical and radiographic success as compared to Propolis at 9 mon follow-up The aim of the present clinical trial was to evaluate the effect of different modes of periodontal therapy on patients with moderately advanced periodontal disease and to express the findings in terms of probing pocket depth and attachment level alterations at periodontal sites with different initial probing depths . The material consisted of 16 patients , 35 - 65 years of age . Following a Baseline examination including assessment s of oral hygiene status , gingival conditions , probing pocket depths and probing attachment levels , the patients were subjected to periodontal treatment . A " split-mouth " design approach of therapy was used and the jaw quadrants were r and omly selected for the following different treatment procedures : ( 1 ) scaling and root planning , ( 2 ) scaling and root planing in conjunction with a gingivectomy procedure , ( 3 ) scaling and root planing in conjunction with an apically repositioned flap procedure without bone recontouring , ( 4 ) scaling and root planing in conjunction with an apically repositioned flap procedure including bone recontouring , ( 5 ) scaling and root planing in conjunction with a modified Widman flap procedure without bone recontouring and ( 6 ) scaling and root planing in conjunction with a modified Widman flap procedure including bone recontouring . The patients were following active treatment enrolled in a supervised maintenance care program including " professional tooth cleaning " once every 2 weeks during a 6-month period of healing , after which a final examination was performed . The investigation demonstrated that active therapy including meticulous subgingival debridement result ed in a low frequency of gingival sites which bled on probing , a high frequency of sites with shallow pockets ( less than 4 mm ) and the disappearance of pockets with a probing depth of greater than 6 mm . Between the Baseline examination and the 6-month re-examination , the probing attachment level for initially shallow pockets remained basically unaltered , but with a tendency of a minor apical shift . This occurred in all 6 treatment groups . For sites with initial probing depths of 4 - 6 mm and greater than 6 mm , there was in all groups some gain of probing attachment . This gain was most pronounced in the initially deeper ( greater than 6 mm ) pockets . With the use of regression analysis , the " critical probing depth " ( CPD ) value ( i.e. the initial probing depth value below which loss of attachment occurred as a result of treatment and above which gain of probing attachment level result ed ) was calculated for each of the 6 methods of treatment used . A comparison of the CPD-values between the 6 treatment groups did not reveal any major differences The aim of the study was to evaluate the clinical , radiographical and microbiological outcome after using guided tissue regeneration ( GTR ) with a bioabsorbable membrane , Resolut . Subjects with bilateral infrabony defects at single rooted teeth were selected . A total of 22 teeth , 2 in each 1 of 7 patients and 4 in 2 patients , with probing pocket depth > or = 5 mm , 3 months after scaling , participated . At baseline , assessment s of plaque and gingival indices , bleeding on probing , probing pocket depth and probing attachment level were recorded and reproducible radiographs for computer-based bone level measurements were taken . Bacterial sample s were collected to investigate the presence of periodontitis-associated bacteria , e.g. , Porphyromonas/Prevotella- and Fusobactrium-like micro-organisms . One tooth was r and omly treated with GTR and the contralateral with an open debridement procedure as a control . Clinical , radiographical and microbiological examinations were repeated 6 and 12 months postoperatively . Both procedures demonstrated a statistically significant improvement of gingival conditions , reduction of pocket depths and gain of attachment . When evaluating the differences between test and control teeth , none of the clinical parameters yielded statistical difference . Computer-based bone-level measurements showed only small differences in the majority of both test and control sites . The differences were not significant . Periodontitis-associated bacteria were present at baseline , but the appearance was not related to any specific site or patient and did not demonstrate any unwanted change in the 6- and 12-month sample s. The findings suggest that the clinical , radiographical and microbiological improvements were not significantly enhanced with the GTR therapy Objective The aim of this study was to evaluate the marginal adaptation of Biodentine in comparison with Mineral Trioxide Aggregate ( MTA ) and Intermediate Restorative Material ( IRM ) , as a root end filling material , using Scanning Electron Microscopy ( SEM ) . Material s and Methods : Thirty permanent maxillary central incisors were chemo-mechanically prepared and obturated . Three millimetres of the root end were resected and 3 mm retro cavity preparation was done using ultrasonic retrotips . The sample s were r and omly divided into three groups ( n=10 ) and were restored with root end filling material s : Group I – MTA , Group II – Biodentine , Group III – IRM . The root ends were sectioned transversely at 1 mm and 2 mm levels and evaluated for marginal adaptation using SEM . The gap between dentin and retro filling material was measured at four quadrants . The mean gap at 1 mm level and 2 mm level from the resected root tip and combined mean were calculated . The data were statistically analyzed , using one-way ANOVA and Tukey ’s HSD post hoc test for intergroup analysis and paired t-test for intragroup analysis . Results : The overall results showed no statistically significant difference between MTA and IRM but both were superior when compared to Biodentine . At 1 mm level there was no statistically significant difference among any of the tested material s. At 2 mm level MTA was superior to both IRM and Biodentine . Conclusion : In overall comparison , MTA and IRM were significantly superior when compared to Biodentine in terms of marginal adaptation , when used as retro grade filling material AIM To evaluate the influence of the size of proximal cavities on the survival rate of the  atraumatic restorative treatment ( ART ) restorations . DESIGN A total of 804 children , aged 6 - 8 years , from a low socio-economic community , with an ART restorable proximal carious lesion in their primary molars , participated . Over a 3-week period , three ' experienced ' and four ' inexperienced ' operators r and omly paired with four ' experienced ' and four ' inexperienced ' assistants , made the restorations at site using h and instruments . They r and omly used Fuji IX , Ketac Molar Easymix and Ketac Molar Aplicap glass ionomer cements to restore the cavities , under r and omly selected rubber dam and cotton roll isolation methods . The fillings were independently evaluated by nine trained and calibrated evaluators . RESULTS After 1 year , the survival rate of the fillings evaluated in the study was 44.8 % . Irrespective of the other factors involved , restorations with the highest survival rate were of size between 2 and 3 mm ( mesio-distal , bucco-lingual , and depth ) or volumes 10.0 - 19.9 mm(3 ) ( Chi-square , P = 0.002 , KM mean survival of 345 days ) . CONCLUSIONS While the survival rates for class II ART restorations were still low , the choice of medium-sized proximal cavities gave better survival rates for this technique OBJECTIVES The aim of this study was to compare a nanocrystalline hydroxyapatite ( NCHA ) , NanoBone ( ® ) and a deproteinized bovine bone mineral ( DBBM ) , Bio-Oss ( ® ) with a collagen membrane on the horizontal ridge width alterations following tooth extraction , in addition to histologic aspects of the grafted extraction sockets . MATERIAL AND METHODS In this r and omized clinical trial , 28 symmetrical , non-molar , extraction sockets using a split-mouth design in 12 patients ( eight women and four men ; aged 21 - 60 ; mean 44.6 ± 11.4 years ) , were r and omly selected in the first group to be grafted with DBBM granules covered with a collagen membrane and in the other group grafted with NCHA covered with a collagen membrane . Following extraction horizontal ridge width was measured using caliper and was blindly compared to the dimensions measured prior to implant placement , at the 6- to 8-month follow-up . Subsequently , a 2 × 6 mm trephine core was obtained with aid of acrylic stent and routine histologic preparation was performed on the specimens . RESULTS The width of the DBBM group decreased from 7.75 ± 1.55 to 6.68 ± 1.85 mm ( P < 0.05 ) , whereas the width of the NCHA group decreased from 7.36 ± 1.94 to 6.43 ± 2.08 mm ( P < 0.05 ) . The mean between-group difference did not reach statistical significance ( P = 0.62 ) . Furthermore , histologic and histomorphometric analyses revealed 28.63 ± 12.53 % vital bone in NCHA group vs. 27.35 ± 12.39 % in DBBM group , and no statistically significant difference between the groups ( P = 0.68 ) . CONCLUSION Socket preservation using either NCHA or DBBM in combination with collagen membrane , results in similar , limited horizontal ridge width alterations following tooth extraction Eighty-two periodontally involved patients were treated in a split mouth design such that one quadrant received coronal scaling ( CS ) , root planing ( RP ) , modified Widman surgery ( MW ) , and flap with osseous resection surgery ( FO ) . The therapy was performed in three phases : Phase I : the teeth previously design ated to receive RP , MW , and FO were thoroughly root planed and the teeth design ated to receive CS were scaled with no subgingival instrumentation , plaque control was initiated and reinforced for the entire mouth ; Phase II : the design ated teeth received MW or FO surgery ; and Phase III : maintenance therapy every three months . The CS teeth received coronal scaling and polishing during maintenance appointments , while RP , MW , and FO teeth received supragingival instrumentation , subgingival instrumentation and polishing .  Clinical measurements were taken initially , four weeks post-Phase I , 10 weeks post-Phase II , and after each of two years of maintenance care . All therapy modalities result ed in a decrease of mean probing depth with the FO producing the greatest decrease followed by MW , RP , and CS . The deeper the initial probing depth , the greater was the mean reduction of probing depth . FO created a loss of mean probing attachment in the 1 to 4 mm category . RP and MW produced the greatest gain of mean probing attachment in the 5 to 6 mm category . RP , MW , and FO produced similar gains in the greater than or equal to 7 mm category . FO created the most gingival recession followed by MW , RP , and CS BACKGROUND Factors influencing the outcome of regenerative therapy of Class II furcations are incompletely and poorly understood . The purpose of this 24-month prospect i ve study was to examine the relationship of patient- , site- , and treatment-related factors to the clinical closure of r and omly selected m and ibular Class II furcations . Results of therapy were evaluated at 1 and 2 years postoperatively . One-year outcome data are presented in this report . METHODS A total of 43 otherwise healthy individuals with chronic periodontitis ( 26 male , 17 female ) , 36 to 70 years of age , completed the 12-month evaluation of the study . Entry criteria included clinical and radiographic evidence of two or more m and ibular facial Class II furcation defects ( > or = 3 mm horizontal probing depth ) .  Surgical therapy was completed by four periodontists ( two each ) in either a university clinic or private practice . Each patient contributed two furcation defects that were treated by combination therapy using an exp and ed polytetrafluoroethylene ( ePTFE ) membrane and demineralized freeze-dried bone allograft ( DFDBA ) . Clinical measurements included a gingival index , plaque index , mobility , and , referencing an occlusal stent , probing depth ( PD ) , probing attachment level-vertical ( PAL-V ) , and probing attachment level-horizontal ( PAL-H ) . Multiple linear measurements were recorded for each site clinical ly and after surgical debridement to characterize defect morphology , root configuration , and barrier placement . Defect volume was computed mathematically . Postsurgical maintenance care was provided at 1 to 2 , 4 , 6 , and 8 weeks , and then biweekly until 3 months , with subsequent supportive periodontal maintenance visits at 3-month intervals . The clinical status of the furcation ( open or closed ) , measured by a non-treating periodontist at 1 and 2 years , was the primary outcome measure . The association of patient-related factors ( e.g. , smoking ) , site-related factors ( e.g. , root configuration and defect morphology ) , and treatment-related factors ( e.g. , membrane exposure ) to clinical status of furcations was assessed using r and om effects hierarchical logistic regression analysis , controlling for design and demographic variables . Non-parametric analysis was used for specific group comparisons . RESULTS Complete clinical closure was achieved in 74 % of all sites . Of the residual furcation defects , 68 % were reduced to Class I. No defects progressed to Class III . Significant improvements in mean PD and PAL-V were obtained following surgical therapy . Although the proportion of sites demonstrating complete furcation closure was comparable for smokers and non-smokers , the proportion of Class II residual defects was significantly higher among smokers than non-smokers ( 62.5 % versus 14.3 % , respectively ) . Increases in presurgical PAL-H were associated with monotonic decreases in the percentage of sites demonstrating complete clinical closure , with only 53 % of lesions > or = 5 mm responding with complete closure . Similarly , significant reductions in the frequency of clinical closure were associated with increases in the distance between the roof of furcation and crest of bone , roof of furcation and base of defect , depth of horizontal defect , and divergence of roots at the crest of bone . CONCLUSIONS The successful clinical closure of Class II furcations was achievable at 1 year following combination therapy with an ePTFE membrane and DFDBA . The highest frequency of clinical furcation closure was observed in early Class II defects . Furcations with vertical or horizontal bone loss of 5 mm or greater responded with the lowest frequency of complete clinical closure . Nevertheless , complete furcation closure was achievable in 50 % of molars with extensive bone loss . Also , 15 out of 22 ( 68 % ) of all residual defects were reduced to Class I and only seven ( 8 % ) failed to improve , demonstrating that successful clinical resolution of advanced defects remains an attainable goal BACKGROUND The width of the facial alveolar bone wall is crucial for long-term successful esthetic outcomes of implants immediately placed into extraction sockets . A threshold of 2 mm is recommended to minimize buccal vertical bone resorption . AIM To assess the width of the facial alveolar bone wall using cone-beam computed tomography images ( CBCT ) . MATERIAL AND METHODS Retrospective CBCT images were acquired from a representative sample of Asians using the i-CAT classic system with a 0.4-mm voxel size . At r and om , 200 CBCT images were selected according to predefined criteria . The DICOM file was imported into the i-CAT Vision software . In the panoramic screen , the middle of each tooth was selected , and in the sagittal window , the middle cross section was selected for performing the measurements using a computer . The vertical distance from the alveolar crest ( BC ) - cemento-enamel junction ( CEJ ) was measured . The width of the facial alveolar bone wall was measured at three locations : 1 , 3 , and 5 mm apical to BC . Descriptive statistics , frequency analyses , and multi-level comparisons were performed . RESULTS The sample consisted of 74 men and 126 women ( mean age of 37.2 years ; range 17 - 82 years ) . A total of 3618 teeth were assessed . There was no significant difference between the values of right and left sides , or between genders . However , statistically significant differences were observed between age groups at all levels . The distance from CEJ to BC varied from 0.4 to 4 mm , with an overall tendency to increase with age . The mean width of the facial alveolar bone wall at anterior teeth was 0.9 mm and increased toward posterior regions . Rarely , a width of 2 mm was yielded ( 0.6 - 1.8 % for anterior teeth , 0.7 - 30.8 % for posterior teeth ) . At a 5-mm distance from BC , minimal widths of facial alveolar bone were identified for the anterior teeth . The frequency of dehiscence ranged from 9.9 % to 51.6 % for anterior and 3.1 % to 53.6 % for posterior teeth , respectively . CONCLUSION A thin facial alveolar bone wall was usually present in both jaws . Hence , for most patients , adjunctive bone augmentation may be needed when installing implants in areas of esthetic concern
No universal dimension of the biologic width appears to exist .
BACKGROUND Consideration of the biologic width in restorative dentistry seems to be important for maintaining periodontal health .
OBJECTIVE To evaluate the dimensions of the biologic width in humans .