Rehabilitation using single stage implants

Implant related prosthesis has become an integral part of rehabilitation of edentulous areas. Single stage implant placement has become popular because of its ease of use and fairly predictable results. In this paper, we present a series of cases of single stage implants being used to rehabilitate different clinical situations. All the implants placed have been successfully restored and followed up for up to one year

Ribonucleic acid interference induced gene knockdown

Despite major advances in periodontal regeneration over the past three decades, complete regeneration of the lost periodontium on a regular and predictable basis in humans has still remained elusive. The identification of stem cells in the periodontal ligament together with the growing concept of tissue engineering has opened new vistas in periodontal regenerative medicine. In this regard, ribonucleic acid interference (RNAi) opens a new gate way for a novel RNA based approach in periodontal management. This paper aims to summarize the current opinion on the mechanisms underlying RNAi, in vitro and in vivo existing applications in the dental research, which could lead to their future use in periodontal regeneration

Root coverage in class I gingival recession defects, combining rotated papillary pedicle graft and coronally repositioned flap, using a micro surgical approach: A clinical evaluation

<b>Background: </b> The purpose of this case study was to evaluate the success and predictability of a rotated papillary pedicle graft in combination with the coronally advanced flap using surgical loupe (2.5X magnification) for the treatment of Miller&#x2032;s class I gingival recession. <b> Materials and Methods: </b> Fifteen systemically healthy patients with isolated gingival recession underwent the procedure. The probing depth, percentage root coverage, width of the keratinized gingiva and the gain in clinical attachment, papilla width, papilla height, area of the papilla at the donor site, were recorded at baseline, 3 months and 12 months. <b> Results: </b> All parameters except probing pocket depth, significantly improved from baseline to 12 months. The mean recession defect of 2.67 &#x00B1; 0.03 mm present at baseline reduced to 0.13 &#x00B1; 0.35 mm at the end of the 3^rd months and stabilized at 0.27 &#x00B1; 0.59 mm at 12 months. The mean reduction in recession depth was 2.40 &#x00B1; 0.03 mm at the end of the study. Complete recession coverage was obtained in 13 of the 15 (87&#x0025;) of the cases treated with a mean percentage recession coverage at 12 months being 86 &#x00B1; 35.19&#x0025;. The gain in the width of the keratinized gingiva was 1.33 &#x00B1; 0.13 mm at the end of the study. There was no postoperative morbidity from where the graft was harvested at the end of the study period. <b> Conclusion:</b> The use of magnification in mucogingival surgery resulted in achieving a high degree of success and predictability as well as an excellent esthetic outcome

Rehabilitation using single stage implants

Implant related prosthesis has become an integral part of rehabilitation of edentulous areas. Single stage implant placement has become popular because of its ease of use and fairly predictable results. In this paper, we present a series of cases of single stage implants being used to rehabilitate different clinical situations. All the implants placed have been successfully restored and followed up for up to one year

Clinical and histological evaluation of alloderm GBR and BioOss in the treatment of Siebert's class I ridge deficiency

Complete prosthetic rehabilitation using implants require the presence of adequate dimensions of alveolar bone. Ridge augmentation procedures include the use of guided bone regeneration (GBR) procedures where the barrier membrane provides cell occlusion and space for the regenerating tissues. Alloderm GBR has been introduced for the purpose of augmenting bone and has been postulated to have the additionally ability to integrate into soft tissues. Twenty-two patients with Siebert's class I ridge deficiency were treated with BioOss and Alloderm GBR and followed up for a period of nine months. Significant increase in ridge dimensions of both hard and soft tissues were observed at six months period itself, suggesting that it as an effective method of augmenting deficient ridges

Osteoblast response (initial adhesion and alkaline phosphatase activity) following exposure to a barrier membrane/enamel matrix derivative combination

Background and Objective: The enamel matrix derivative (EMD) has been used in combination with barrier membranes to optimize regeneration in vertical osseous defects. However, the osteoblast response when exposed to the EMD/barrier membrane combination has not yet been evaluated. The osteoblast behavior when exposed to a combination of regenerative materials must be evaluated to fully understand their effect on bone regeneration. Therefore, the present study was undertaken to estimate the initial adhesion and alkaline phosphatase (ALP) activity of an osteoblast cell line (SaOS-2) when exposed to four commercially available resorbable membranes and determine if the addition of EMD had any modulatory effect on osteoblast behavior. Materials and Methods: 5 x 104 SaOS-2 cells between passages 7-10 were cultured in two 24-well culture plates. Plate A was used for the adhesion assay and Plate B was used for the ALP assay. A MTT (3-[4, 5-dimethylthiazolyl-2]-2, 5-diphenyltetrazolium bromide) assay was done after 24 hours to determine the adhesion of the osteoblastic cells to four barrier membranes: 1) a non cross-linked porcine Type I and III collagen membrane (BG), 2) a weakly cross-linked Type I collagen membrane (HG), 3) a glutaraldehyde cross-linked bovine Type I collagen (BM), and 4) a resorbable polymer membrane (CP). Osteoblast differentiation was studied using an ALP assay with p-nitro phenyl phosphate as the substrate at 24 hours, 72 hours, and 1 week. A total of 50 &#x00B5;g/ml of EMD dissolved in 10 mM acetic acid was added into each well and the entire experimental protocol outlined above was repeated. Results: The osteoblast adhesion to collagen barriers showed a statistically insignificant reduction following the addition of EMD. Adhesion to the polymer barrier, although significantly lower when compared with collagen barriers, was unaffected by the addition of EMD. ALP activity after 1 week among the various groups was as follows: EMD alone (75.59&#x00B1;2.5)>EMD/BG(64.78&#x00B1;3.04)>EMD/HG(55.40&#x00B1;3.89)&#8776;EMD/BM(54.75&#x00B1;4.17)>BG (51.32&#x00B1;2.76)>HG(49.92&#x00B1;2.4)>BM(48.14&#x00B1;1.4)>Control(46.29&#x00B1;1.39)>EMD/CP (37.46&#x00B1;3.54)>CP(32.12&#x00B1;1.49) Conclusion: There was no additive effect on osteoblast adhesion/ALP activity following exposure to an EMD/polymer combination. EMD/collagen positively influences osteoblast differentiation in a time dependent manner

Osteoblast response to commercially available demineralized bone matrices - An<i> in-vitro</i> study

Objective: Reconstruction of lost attachment apparatus is a major goal of periodontal therapy. Although various osteoinductive bone replacement grafts (BRGs) have been used with apparent clinical success, unequivocal evidence of osteoinductivity may be obtained only through the demonstration of increased osteoblastic/osteoclastic differentiation following exposure to these materials. Materials and Methods: Bone marrow stem cells (BMSCs) obtained from rat femur were cultured in Dulbecco&#x2032;s Modified Eagles Medium (DMEM) and 10&#x0025; fetal bovine serum (FBS). They were then exposed to two demineralized bone matrices (DBM&#x2032;s) - Grafton and Osseograft, and divided into three groups, comprising of a negative control (BMSC &#x002B; DMEM &#x002B; 10&#x0025; FBS), Grafton, Osseograft. An osteogenic medium (OM) (10 hm dexamethasone, 10 hm b-glycerophosphate, and 50 &#956;g/ml ascorbic acid) was added to create three subgroups comprising of a positive control (OM), Grafton with OM, Osseograft with OM. Results: After an initial phase (up to day 5), both Grafton and Osseograft induced an increased proliferative activity in the BMSCs, which reached a plateau after day 10. These grafts also induced increased alkaline phosphatase activity when compared to the control groups and to BMSCs with an OM. Conclusion: Both Osseograft and Grafton are capable of inducing osteoblastic proliferation and differentiation

Retrograde peri-implantitis

Retrograde peri-implantitis constitutes an important cause for implant failure. Retrograde peri-implantitis may sometimes prove difficult to identify and hence institution of early treatment may not be possible. This paper presents a report of four cases of (the implant placed developing to) retrograde peri-implantitis. Three of these implants were successfully restored to their fully functional state while one was lost due to extensive damage. The paper highlights the importance of recognizing the etiopathogenic mechanisms, preoperative assessment, and a strong postoperative maintenance protocol to avoid retrograde peri-implant inflammation