牙周加速成骨正畸临床应用效果的研究进展

牙周加速成骨正畸(PAOO)是指对牙槽骨进行骨皮质切开,并在切开骨表面进行颗粒骨移植以辅助正畸治疗。骨皮质切开诱导的局部加速现象可诱导破骨活性增加,加速骨代谢,从而有效加速正畸牙移动,缩短疗程,并可以减少牙根吸收等正畸并发症的发生。颗粒骨的植入能扩大正畸牙的移动范围,拓宽正畸治疗的适应证,保证牙周健康,提高治疗稳定性。本文就PAOO对正畸治疗中牙移动速率、骨增量效果以及牙根吸收的临床效果作一综述,以便为该技术的临床应用提供参考。     

辅助正畸扩弓治疗的上颌后牙区牙周软硬组织增量1例

目的 本病例报道1例牙周软硬组织增量在正畸治疗过程中出现骨开裂及根面暴露的临床应用。诊治经过：一位26岁男性患者在正畸扩弓治疗过程中出现右上后牙牙龈退缩,遂停止正畸加力,要求牙周治疗。临床检查显示7-5牙Miller Ⅲ类牙龈退缩,CBCT检查显示$\underline{7-5}\rvert$牙颊侧根中1/3-根颈1/3牙槽骨吸收。一期通过膜龈手术完成根面覆盖及角化龈增量后,二期采用骨皮质切开+骨增量手术治疗$\underline{7-5}\rvert$牙颊侧骨开裂。结果 术后1年随访,正畸治疗顺利结束,$\underline{7-5}\rvert$牙根面覆盖效果稳定,颊侧骨充盈良好。结论 治疗正畸过程中出现骨开裂及根面暴露时,基于上皮下结缔组织移植的根面覆盖术联合骨皮质切开+骨增量技术能够取得满意效果,然而其长期稳定性仍有待进一步探究。     

Wilckodontics--an alternative adult orthodontic treatment method: rational and application

Adult orthodontics poses a challenge for practitioners as it involves unique biomechanical considerations due to biologic age related changes and lack of skeletal growth potential. Dental risks in adult orthodontics include, amongst others, root resorption and periodontal complications. As modern life calls for quick and efficient orthodontic treatments, a novel orthodontic modality was developed utilizing adjunctive periodontal surgery that includes bone corticotomy combined with bone augmentation. This multidisciplinary team approach: Periodontally Accelerated Osteogenic Orthodontics (PAOO) or Wilckodontics seems to be promising not only for reducing orthodontic treatment duration, but also for biological aspects during and after orthodontic treatment. PAOO enhances bone remodeling and augmentation, accelerates tooth movement and significantly reduces the duration of treatment. The presented cases manifest the biologic benefit of profound enlargement in the envelope of motion reducing the need for extraction and eliminating the need for aggressive intervention of surgically-assisted rapid maxillary expansion. PAOO serves as a reasonable and safe option for the growing demand of shortened treatment duration of adult teeth movement in three dimensions. Further research is recommended for an in depth evaluation of the long-term stability claimed to be advantageous in this modality.     

Periodontally accelerated osteogenic orthodontics combined with autogenous bone grafting

This case report documents the first use of particulate autogenous bone graft with the corticotomy-assisted rapid orthodontic procedure known as periodontally accelerated osteogenic orthodontics (PAOO). A 41-year-old man, with class II, division 2 crowded occlusion, was treated with the PAOO procedure. Buccal mucoperiosteal flaps were reflected, and selected vertical and horizontal corticotomy was performed around the roots in both the maxillary and mandibular arches. Particulate bone graft was harvested from the rami and exostosis for alveolar ridge augmentation. Orthodontic movement was initiated immediately after the surgical intervention and adjusted every 2 weeks. Eight months after corticotomy surgery, total active orthodontic treatment was completed. No detrimental periodontal effects or root resorption were observed. The alveolar ridges of both the maxilla and mandible maintained the original thickness and configuration despite facial tipping of the incisors. It was concluded that PAOO is an effective treatment approach in adults to decrease treatment time and reduce the risk of root resorption. Selected corticotomy limited to the buccal and labial aspects also significantly reduces treatment time. More clinical studies with additional patients and long-term follow-up are needed to determine the optimal amount of autogenous bone graft.     

Clinical and patient-reported outcomes of tissue engineering strategies for periodontal and peri-implant reconstruction

Scientific advancements in biomaterials, cellular therapies, and growth factors have brought new therapeutic options for periodontal and peri-implant reconstructive procedures. These tissue engineering strategies involve the enrichment of scaffolds with living cells or signaling molecules and aim at mimicking the cascades of wound healing events and the clinical outcomes of conventional autogenous grafts, without the need for donor tissue. Several tissue engineering strategies have been explored over the years for a variety of clinical scenarios, including periodontal regeneration, treatment of gingival recessions/mucogingival conditions, alveolar ridge preservation, bone augmentation procedures, sinus floor elevation, and peri-implant bone regeneration therapies. The goal of this article was to review the tissue engineering strategies that have been performed for periodontal and peri-implant reconstruction and implant site development, and to evaluate their safety, invasiveness, efficacy, and patient-reported outcomes. A detailed systematic search was conducted to identify eligible randomized controlled trials reporting the outcomes of tissue engineering strategies utilized for the aforementioned indications. A total of 128 trials were ultimately included in this review for a detailed qualitative analysis. Commonly performed tissue engineering strategies involved scaffolds enriched with mesenchymal or somatic cells (cell-based tissue engineering strategies), or more often scaffolds loaded with signaling molecules/growth factors (signaling molecule-based tissue engineering strategies). These approaches were found to be safe when utilized for periodontal and peri-implant reconstruction therapies and implant site development. Tissue engineering strategies demonstrated either similar or superior clinical outcomes than conventional approaches for the treatment of infrabony and furcation defects, alveolar ridge preservation, and sinus floor augmentation. Tissue engineering strategies can promote higher root coverage, keratinized tissue width, and gingival thickness gain than scaffolds alone can, and they can often obtain similar mean root coverage compared with autogenous grafts. There is some evidence suggesting that tissue engineering strategies can have a positive effect on patient morbidity, their preference, esthetics, and quality of life when utilized for the treatment of mucogingival deformities. Similarly, tissue engineering strategies can reduce the invasiveness and complications of autogenous graft-based staged bone augmentation. More studies incorporating patient-reported outcomes are needed to understand the cost-benefits of tissue engineering strategies compared with traditional treatments.     

Mandibular bone harvesting for alveolar reconstruction and implant placement: subjective and objective cross-sectional evaluation of donor and recipient site up to 4 years

Aim: To evaluate the long‐term morbidity of intraoral bone harvesting from two different donor sites (mandibular symphysis or ramus) for bone augmentation procedures before or at the time of implant placement and to evaluate the success and the survival rates of implants placed in sites augmented with mandibular bone. Methods: Seventy‐eight patients who received mandibular bone grafts were recalled after 18–42 months follow‐up (mean 29 months). The group consisted of 36 men and 42 women aged between 18 and 68 years old at the moment of augmentation surgery. Vitality of teeth adjacent to the harvesting sites was investigated. Soft tissue superficial sensory function was assessed by the Pointed‐Blunt Test and the Two‐Point‐Discrimination Test. Implant health status was assessed measuring peri‐implant probing depth and bleeding on probing. Implant survival and success rates were also calculated. In order to evaluate patients' perception of the morbidity of the procedures, the patients were asked to answer several questions by means of visual analogue scales (VAS). Results: Only two teeth (out of 282) in the chin harvesting group needed root canal treatment after surgery. A higher frequency of minor temporary and permanent sensorial disturbances was found in the group of patients who received chin harvesting procedures (2.3% vs. 13%P=0.03), while pain during chewing and bleeding were more frequently recorded after ramus harvesting (9.8% vs. 0%P=0.03). No permanent anesthesia of any region of the skin was reported. Implants' survival and success rate were comparable to implants placed in bone reconstructed with other techniques and were not influenced by the choice of the donor site. Patient's perception regarding the morbidity of the procedures was very low and did not differ between ramus and chin harvesting groups (mean VAS scores <4). Conclusion: The present cross‐sectional retrospective study demonstrated the safety of mandibular grafts that reported excellent results in terms of implant success and survival rates with minor complications regarding the donor site area. When the chin was chosen as donor site, minor sensorial disturbances of mucosa and teeth were recorded. The majority of these disturbances were temporary; only few of them were permanent but still had no impact on patient's life. To cite this article:
Cordaro L, Torsello F, Miuccio MT, Mirisola di Torresanto V, Eliopoulos D. Mandibular bone harvesting for alveolar reconstruction and implant placement: subjective and objective cross‐sectional evaluation of donor and recipient site up to 4 years.
Clin. Oral Impl. Res. 22 , 2011; 1320–1326.
doi: 10.1111/j.1600‐0501.2010.02115.x     

Corticotomy-/osteotomy-assisted tooth movement microCTs differ

Corticotomy-assisted and osteotomy-assisted tooth movement involves surgical incisions through the alveolar bone. To ascertain whether teeth move by distraction osteogenesis or by regional accelerated phenomenon (RAP), we randomly assigned 30 Sprague-Dawley rats to one of 5 experimental groups: corticotomy alone, corticotomy-assisted tooth movement, osteotomy alone, osteotomy-assisted tooth movement, or tooth movement alone. Each animal was imaged by microtomography immediately after surgery, after 21 days, and after 2 months. After 21 days, regional accelerated phenomenon was observed in the alveolar bone of the corticotomy-treated animals and distraction osteogenesis in the osteotomy-assisted tooth movement animals. Pixel count data were analyzed by nested ANOVA for 5 experimental groups, split-mouth controls, 3 levels along the root, and 5 sites per level. The most demineralized sites after 21 days differed for each of the experimental groups. Our study indicates that osteotomies and corticotomies induce different alveolar bone reactions, which can be exploited for tooth movement.     

牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效评价

目的: 定量评价牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效。方法: 从上海交通大学医学院附属第九人民医院口腔颅颌面科2014年1月起就诊的连续病例中,选择下前牙区存在原发性牙槽骨缺损且治疗结束后随访时间> 2 年的成人错畸形患者,将其中接受牙槽骨再生正畸治疗的30例患者作为研究对象。通过锥形束CT（cone-beam CT,CBCT）评价不同观察时间点术区的牙槽骨形态,采用SAS 9.1软件包对数据进行统计学处理。结果: 牙槽骨再生正畸治疗成人错畸形伴原发性牙槽骨缺损后,术区未见牙根吸收。根尖水平骨厚度增量效果最佳且远期疗效最为稳定,根长3/4水平次之,根长1/2水平未见骨厚度增量效果。术区唇舌侧出现少量牙槽骨高度降低。结论: 牙槽骨再生正畸技术是治疗成人错畸形伴原发性牙槽骨缺损的有效方式,但仍存在术区少量牙槽骨垂直丢失等局限。     

Management of incision design in symphysis graft procedures: a review of the literature

Symphysis graft procedures are being performed in clinical practice more frequently than ever before. Convenient surgical access, proximity of donor and recipient sites, low morbidity, availability of larger quantities of bone over other donor sites, minimal resorption, no hospitalization, and minimal discomfort are some advantages of this procedure over other intraoral sites. Three types of horizontal incisions can be performed during this procedure: the sulcular, the marginal, and the alveolar mucosal. Most studies regarding the chin graft technique are more concerned with the bone graft aspect than soft tissue management. Moreover, the criteria for the selected flap design appear to be based primarily on clinical experience or the same surgical approach regardless of interfacing factors. The periodontal status, amount of bone loss, periodontal risk of root fenestration, amount of keratinized gingiva, restorations in the gingival margin, and local musculature are some of the clinical findings that should be assessed to indicate the best incision design. In this review article, the advantages, disadvantages, indications, and contraindications of each incision design will be discussed.     

Orthodontic microsurgery: a new surgically guided technique for dental movement

Eight patients with malocclusions were treated with a new orthodontic-surgical technique that reduces the duration of treatment compared to conventional techniques. The monocortical tooth dislocation and ligament distraction (MTDLD) technique combines two different dental movements that work separately but simultaneously on opposite root surfaces. On the root surface corresponding to the direction of movement, vertical and horizontal microsurgical corticotomies are performed around each tooth root with a piezosurgical microsaw to eliminate cortical bone resistance. The immediate application of strong biomechanical forces produces rapid dislocation of the root and the cortical bone together. On the root surface opposite the direction of movement, the force of dislocation produces rapid distraction of ligament fibers. During the osteogenic process that follows, application of normal orthodontic biomechanics achieves the final tooth movement. All eight patients underwent periodontal and radiologic examinations for more than 1 year after treatment. No periodontal defects were observed in any of the patients, including one with a severe malocclusion and a thin periodontal tissue biotype. Compared to traditional orthodontic therapy, the average treatment time with the MTDLD technique in the mandible and maxilla was reduced by 60% and 70%, respectively.     

Collagen based barrier membranes for periodontal guided bone regeneration applications

Certain cell populations within periodontal tissues possess the ability to induce regeneration, provided they have the opportunity to populate the wound or defect. Guided regeneration techniques have been investigated for regenerating periodontal tissues and such therapies usually utilize barrier membranes. Various natural and synthetic barrier membranes have been fabricated and tested to prevent epithelial and connective tissue cells from invading while allowing periodontal cells to selectively migrate into the defect. This paper focuses on the literature relevant to the use and potential of resorbable collagen membranes in GBR procedures, sites of periodontal and intrabony defects, in cases of socket and alveolar ridge preservation and at implant sites. The results of their use in GBR procedures has shown them to be effective and comparable with non-resorbable membranes with regards to clinical attachment gain, probing depth reduction and defect bone filling. They have also shown to prevent epithelial ingrowth into the defect space during the initial wound healing phase postsurgically. Collagen membranes have also been used for root coverage and GBR procedures and have shown good success rates comparable to subepithelial connective tissue grafts and expanded-polytetrafluoroethylene (e-PTFE) membranes. The future for periodontal tissue engineering is very exciting with the use of barrier membranes expected to continue playing a critical role. However, long-term clinical trials are required to further evaluate and confirm the efficacy of the available collagen barrier membranes for periodontal and bone regeneration use.     

Surgery without papilla incision: tunneling flap procedures in plastic periodontal and implant surgery

Diverse clinical advancements, together with some relevant technical innovations, have led to an increase in popularity of tunneling flap procedures in plastic periodontal and implant surgery in the recent past. This trend is further promoted by the fact that these techniques have lately been introduced to a considerably expanded range of indications. While originally described for the treatment of gingival recession‐type defects, tunneling flap procedures may now be applied successfully in a variety of clinical situations in which augmentation of the soft tissues is indicated in the esthetic zone. Potential clinical scenarios include surgical thickening of thin buccal gingiva or peri‐implant mucosa, alveolar ridge/socket preservation and implant second‐stage surgery, as well as soft‐tissue ridge augmentation or pontic site development. In this way, tunneling flap procedures developed from a technique, originally merely intended for surgical root coverage, into a capacious surgical conception in plastic periodontal and implant surgery. The purpose of this article is to provide a comprehensive overview on tunneling flap procedures, to introduce the successive development of the approach along with underlying ideas on surgical wound healing and to present contemporary clinical scenarios in step‐by‐step photograph‐illustrated sequences, which aim to provide clinicians with guidance to help them integrate tunneling flap procedures into their daily clinical routine.     

Interventions for replacing missing teeth: bone augmentation techniques for dental implant treatment

Background: Dental implants require sufficient bone to be adequately stabilized. For some patients implant treatment would not be an option without bone augmentation. A variety of materials and surgical techniques are available for bone augmentation. Objectives: General objectives: To test the null hypothesis of no difference in the success, function, morbidity and patient satisfaction between different bone augmentation techniques for dental implant treatment. Specific objectives: (A) to test whether and when augmentation procedures are necessary; (B) to test which is the most effective augmentation technique for specific clinical indications. Trials were divided into three broad categories according to different indications for the bone augmentation techniques: (1) major vertical or horizontal bone augmentation or both; (2) implants placed in extraction sockets; (3) fenestrated implants. Search strategy: The Cochrane Oral Health Group’s Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched. Several dental journals were handsearched. The bibliographies of review articles were checked, and personal references were searched. More than 55 implant manufacturing companies were also contacted. Last electronic search was conducted on 9 January 2008. Selection criteria: Randomized controlled trials (RCTs) of different techniques and materials for augmenting bone for implant treatment reporting the outcome of implant therapy at least to abutment connection. Data collection and analysis: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. Authors were contacted for any missing information. Results were expressed as random‐effects models using mean differences for continuous outcomes and odd ratios for dichotomous outcomes with 95% confidence intervals. The statistical unit of the analysis was the patient. Main results: Seventeen RCTs out of 40 potentially eligible trials reporting the outcome of 455 patients were suitable for inclusion. Since different techniques were evaluated in different trials, no meta‐analysis could be performed. Ten trials evaluated different techniques for vertical or horizontal bone augmentation or both. Four trials evaluated different techniques of bone grafting for implants placed in extraction sockets and three trials evaluated different techniques to treat bone dehiscence or fenestrations around implants. Authors’ conclusions: Major bone grafting procedures of resorbed mandibles may not be justified. Bone substitutes (Bio‐Oss or Cerasorb) may replace autogenous bone for sinus lift procedures of atrophic maxillary sinuses. Various techniques can augment bone horizontally and vertically, but it is unclear which is the most efficient. It is unclear whether augmentation procedures at immediate single implants placed in fresh extraction sockets are needed, and which is the most effective augmentation procedure, however, sites treated with barrier plus Bio‐Oss showed a higher position of the gingival margin when compared to sites treated with barriers alone. Non‐resorbable barriers at fenestrated implants regenerated more bone than no barriers, however it remains unclear whether such bone is of benefit to the patient. It is unclear which is the most effective technique for augmenting bone around fenestrated implants. Bone morphogenetic proteins may enhance bone formation around implants grafted with Bio‐Oss. Titanium may be preferable to resorbable screws to fixate onlay bone grafts. The use of particulate autogenous bone from intraoral locations, also taken with dedicated aspirators, might be associated with an increased risk of infective complications. These findings are based on few trials including few patients, sometimes having short follow up, and often being judged to be at high risk of bias.     

Unconventional implant treatment: I. Implant placement in contact with ankylosed root fragments. A series of five case reports

Objective: Implant treatment presumes that implants are placed in bone, without any contact with root. At ankylosed teeth, complete root removal is often invasive; subsequently, the sites require additional augmentation procedures to complete the treatment. The aim of this paper is to report on a series of five cases that have been treated with an approach that avoided extractive invasive surgery and bone damage. Material and methods: The procedure consisted of preparing the osteotomy site by drilling through the root. At the end of the drilling sequence, the root fragments that were not removed were deliberately left at the osteotomy site. Their mobility was checked with a dental pick and when stable an implant was placed in contact with them. The sites were required to be asymptomatic and inflammation free. Ankylosed teeth were replaced with 13–15‐mm‐long Osseotite implants, four in the anterior maxilla and one in the anterior mandible. Results: All implants healed uneventfully; they have been now loaded for a period of 12–42 months. On peri‐apical radiographs, appearance of the bone–implant interface was similar to osseointegrated implants. The remaining root fragments were visible, in contact with the implants; no specific pathological sign could be detected. A limited resorption of dentine was found at one site after 4 years. Conclusion: This series of cases suggests that implants placed in contact with ankylosed root fragments might not interfere with implant integration or harm occlusal function, at least in the mid‐term. More cases are warranted before this procedure might be considered as a reliable clinical option when, at ankylosed teeth, one wishes to avoid an invasive extraction surgery.     

Ridge Preservation After Tooth Extraction With Buccal Bone Plate Deficiency Using Tunnel Structured β‐Tricalcium Phosphate Blocks: A 2‐Month Histologic Pilot Study in Beagle Dogs

Background: Reduction in alveolar ridge volume is a direct consequence of tooth extraction. Tunnel β‐tricalcium phosphate (β‐TCP) blocks were manufactured from randomly organized tunnel‐shaped β‐TCP ceramic. Efficacy of these blocks compared to extraction alone for alveolar ridge preservation after tooth extraction with buccal bone deficiency was evaluated. Methods: Maxillary first premolars of six beagle dogs were extracted after removing the buccal bone, and bone defects of 4 × 4 × 5 mm (mesio‐distal width × bucco‐palatal width × depth) were created. Fresh extraction sockets with buccal bone defects were filled with tunnel β‐TCP blocks at test sites. Two months after the operation, histologic and histometric evaluations were performed. Results: Regarding histologic sections, coronal and middle horizontal widths of the alveolar ridge were significantly greater at test sites (3.2 ± 0.5 and 3.6 ± 0.4 mm, respectively) than at control sites (1.2 ± 0.3 and 2.0 ± 0.6 mm, respectively). The amount of woven bone was significantly greater at test sites (62.4% ± 7.9%) than at control sites (26.8% ± 5.3%), although that of connective tissue and bone marrow was significantly greater at control sites (38.1% ± 6.2% and 16.0% ± 6.9%, respectively) than at test sites (10.7% ± 5.7% and 4.1% ± 2.2%, respectively). Regarding basic multicellular units, no statistically significant difference was found between the test and control sites (0.5% ± 0.1% and 0.6% ± 0.1%, respectively). Conclusion: Tunnel β‐TCP blocks represent an effective bone‐graft material for alveolar ridge preservation in fresh extraction sockets with buccal bone defects.     

骨皮质切开术辅助正畸治疗的临床研究

目的探讨骨皮质切开术辅助正畸治疗的临床应用。方法研究临床接受骨皮质切开术辅助治疗的正畸患者48例,男14例,女34例。骨皮质切开术应用于正畸临床:辅助扩弓,拔牙患者的前牙内收,修复前正畸治疗的磨牙前移、残冠牵引,根骨粘连牙齿的移动等。结果在正畸治疗中,辅助骨皮质切开术可以解除骨皮质阻力,加速正畸牙齿移动,增加牙周支持组织及骨覆盖,减少牙根吸收。结论骨皮质切开术辅助正畸治疗不仅可以加速牙齿移动,而且能够有效解决正畸临床的一些疑难问题。     

Improved periodontal conditions following therapy

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 assessments 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 randomly 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 resulted 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 resulted) 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.     

Deproteinized bovine bone in periodontal and implant surgery

Objectives

To review the histological and clinical outcomes of deproteinized bovine bone in different procedures: periodontal regeneration, socket preservation, peri-implant reconstruction and alveolar bone augmentation.

Methods

Histological animal studies and clinical trials on humans regarding the performances of a bone substitute of natural origin, deproteinized bovine bone, have been evaluated. Different procedures have been examined separately.

Results

Osteoconductive properties of the material are accepted by the majority of authors. In periodontal regeneration deproteinized bovine bone seems to be effective with or without barrier membranes in favorable containing defects, resulting in histological evidence of periodontal regeneration, with a prevalence of bone repair.Although some reports describe a lower reduction in socket height and width with various techniques and the grafting of deproteinized bovine bone, there is no evidence to recommend socket filling or manipulation to preserve its dimensions.Peri-implant reconstruction and alveolar ridge augmentation utilizing deproteinized bovine bone are supported by favorable reports but these procedures are affected by a significant amount of adverse events that may jeopardize the success of the treatment.

Significance

Deproteinized bovine bone possesses osteoconductive properties that may improve bone regeneration of favorable containing periodontal defects. No evidence supports socket filling and peri-implant reconstruction.     

An analysis of 58 traumatically intruded and surgically extruded permanent teeth

Abstract – Fifty‐eight traumatically intruded and mainly surgically extruded permanent teeth were followed up for 3 years and 4 months (mid‐term results: 29 teeth) and 9 months (short‐term results: 29 teeth) on average. Statistically, the mid‐term results showed more cases of severe crown discoloration (54%) than the short‐term results (9%), but no difference in pulpal and periodontal healing. Three teeth (5%) were lost. Factors which positively influenced pulpal healing were shallow intrusion depth, intact crown and immaturity of the root. Factors which positively influenced periodontal healing were shallow intrusion depth and minimal surgical manipulation. Alveolar bone healing was positively influenced only by shallow intrusion depth.