Clinical safety of enamel matrix derivative (EMDOGAIN®) in the treatment of periodontal defects

Abstract The aim of the present clinical trial was to test tolerability during 2 treatments with EMDOGAIN® in a large number of patients. An open, controlled study design in 10 Swedish specialist clinics was chosen, with a test group of 107 patients treated with EMDOGAIN® in connection with periodontal surgery at 2 surgical test sites per patient. The procedures were performed 2 to 6 weeks apart on one-rooted teeth with at least 4 mm deep intraosseous lesions. A control group of 33 patients underwent flap surgery without EMDOGAIN® at I comparable site. In total 214 test and 33 control surgeries were performed. Serum samples were obtained from test patients for analysis of total and specific antibody levels. 10 of the patients had samples taken before and after the first surgery. 56 other samples were taken after one treatment with EMDOGAIN®, and 63 after 2 treatments. None of the samples, not even from allergy-prone patients after 2 treatments, indicated deviations from established baseline ranges. This indicates that the immunogenic potential of EMDOGAIN® is extremely low when applied in conjunction with periodontal surgery. Comparison between the test and control groups demonstrated the same type and frequency of post-surgical experiences, i.e., reactions caused by the surgical procedure itself. Clinical probing and radiographic evaluation was performed at baseline and 8 months postsurgery. About half of the patients (44 test and 21 control) were also evaluated after 3 years. There was a significant difference between the test and control results at 8 months post surgery. and this difference had increased further at the 3 year follow-up. The 2.5–3 mm increase in attachment and bone level after treatment with EMDOGAIN® was of the same magnitude as seen in the studies with split-mouth design aiming for lest of effectiveness of EMDOGAIN®.     

Carbohydrate moieties of procine 32 kDa enamelin

The structures of asparagine-linked oligosaccharides of porcine 32 kDa enamelin are reported. The oligosaccharides were released by N-oligosaccharide glycopeptidase digestion, and the reducing ends of the oligosaccharides were derivatized with a fluorescent reagent, 2-aminopyridine. The pyridylamino oligosaccharides were separated into eight kinds of oligosaccharides. The structures of these oligosaccharides were determined by a combination of a sequential exoglycosidase digestion and a two-dimensional suger mapping technique. The oligosaccharides consisted of fucose, galactose, mannose, N-acetylglucosamine, and N-acetylneuraminic acid, and were classified into two groups according to their core-sugar chain structures; one was a biantennary-type and the other was a triantennary-type oligosaccharide. The variation of the oligosaccharides in each of these groups was caused by the differences in the number, the site, and the mode of linkage of N-acetylneuraminic acid to the core-sugar chains.     

髓底穿通修复材料密封性的比较研究

选择３２颗新近拔除的磨牙，３号球钻由冠方进入造成髓底穿孔，分为４个实验组，分别充以氧化锌丁香油糊剂、氢氧化钙糊剂、磷酸锌水门汀及玻璃离子粘固粉，丁氧膏密封牙合面。各牙表面涂指甲油后，浸入１％中性红染液，１０天后取出，测各牙穿孔处染液渗入高度。结果显示：实验组染液渗入高度１组＜２组＜３组＜４组，提示４种材料相比，氧化锌丁香油糊剂用于底穿修复的密封性能最好。     

龈下残根修复前正畸治疗五例

目的　对损坏至龈缘下 1 5～ 3 5mm的前牙牙根在修复前行正畸牵引 ,当损坏平齐龈缘时再桩冠修复的方法进行探讨。方法　 3例外伤、2例根面龋的患者 ,共 6个牙根接受完善根管治疗 ,修复前正畸暴露损坏 ,电刀修整牙龈 ,然后桩冠修复。结果　 5例患者在修复后均取得了较满意的效果。结论　若前牙牙根损坏位于龈下釉牙骨质交界处 ,在修复前进行正畸治疗 ,既可保留残根 ,又可制作出有较好功能和美观效果的修复体     

口腔修复临床电刀龈成形术的效果观察

现察口腔修复临床电刀龈成形术的效果。方法：对81例口腔修复门诊牙体缺损患者用电刀进行牙龈成形术并定期复诊观察。结果：81例术后牙龈全部达到修复要求而立即修复，其中70例术后牙龈稳定，占总数的86．4％。结论：电刀龈成形术是口腔修复临床上一种可行的治疗手段。     

CRITERIA ADOPTED BY DENTISTS TO INDICATE THE EXTRACTION OF PERIODONTALLY INVOLVED TEETH

When dealing with patients with periodontal disease of variable severities, dentists must often choose between treating and restoring the involved tooth or indicating its extraction. Different criteria have been adopted in this decision-making process. The purpose of this study was to evaluate the criteria adopted by dentists to indicate the extraction of teeth with periodontitis. Dentists were interviewed at their private practices in three cities of the state of Rio Grande do Sul, Brazil. The evaluated criteria included severity of attachment loss, tooth mobility, furcation involvement, prosthetic planning, periodontal-endodontic lesion, possible systemic involvement due to the presence of periodontitis, referral to a periodontist for evaluation, radiographic bone loss greater than 50%, presence of extensive caries, socio-economic and cultural status of the patient, among others. The most often adopted criteria to indicate the extraction of periodontally affected teeth were the presence of mobility (37.5%), severity of attachment loss (24.3%) and radiographic bone loss greater than 50% (21.2%). The results of the present study demonstrated the difficulties faced by dentists to indicate the extraction of teeth with severe attachment loss, in addition to the establishment of an adequate prognosis. Aspects associated with the past disease were still the most often reported to indicate the extraction of teeth for periodontal reasons.     

釉质发育不全乳牙的超微形态研究

目的：观察不同类型乳牙釉质发育不全的超微表面形态，分析其在分类、致病机制、龋齿易感性中的意义。方法：将发育不全的乳牙固定脱水，临界点干燥，喷金镀膜，日立S－450扫描电子显微镜观察，加速电压20kV。结果：发育不全釉质中存在不同程度形态缺损，病报部位还存在矿化不良。结论：釉质发育不全不仅有釉质量的减少，而且有质的改变，因而可能提高了发育不全釉质对龋齿的易感性。     

慢性氟中毒对小鼠切牙胚内釉上皮TGF-beta1表达的影响

目的 :观察慢性氟中毒对小鼠切牙胚内釉上皮表达 TGF- beta1的影响 ,探讨TGF- beta1在氟牙症发生机制中的作用。方法 :给小鼠分别喂以含 0、5 0、1 0 0 ppm Na F的饮水 ,6周后免疫组化观察结果。结果 :图像分析显示加氟组 TGF- beta1的表达水平低于空白组。结论 :氟可能通过抑制 TGF- beta1的表达干扰内釉上皮的分化和基质分泌 ,导致氟牙症的发生。     

低强度激光对兔实验性牙齿移动牙槽骨组织中骨钙素水平变化的影响

目的观察低强度激光照射对兔实验性牙齿移动牙槽骨组织中骨钙素水平变化的影响。方法30只雄性大耳白兔,随机分为1、3、5、7、14和21d组,共6组,每组5只。在兔左右上颌第一磨牙与上颌切牙之间放置不锈钢闭合螺旋弹簧,牵引第一、二磨牙向近中移动。右侧为实验侧,以2.5J/cm2的He-Ne激光和514J/cm2的CO2激光同时照射。左侧为对照侧,不照射激光。拔除上颌第一磨牙,分别取其近、远中牙槽骨组织(根上2/3处),以放射免疫法检测牙槽骨组织中的骨钙素含量。结果低强度激光照射侧张力区骨钙素含量在施力1、3、5d组高于对照侧(P<0.05);压力区骨钙素含量以施力7d组最高,3、5d组照射侧骨钙素含量低于对照侧(P<0.05)。结论骨钙素在实验性正畸牙齿移动过程中参与了破骨与成骨活动,低强度激光照射可影响正畸牙周组织中骨钙素水平的变化,对正畸牙周组织的骨改建有促进作用。     

口腔颌面部损伤136例分析

本文对136例口腔颌面部损伤的伤因,颌骨骨折、牙损伤及软组织损伤等情况进行了分析。讨论了口腔颌面外伤的特点、急救处理、及骨折线上牙齿的处理等问题。强调对颌面外伤的处理必须注重整体观念。