RESUMO
This retrospective case series describes a layered regenerative approach for five Class III and one borderline Class IV furcation, involving treatment consisting of root management that included conditioning with tetracycline solution followed by the topical application of recombinant platelet-derived growth factor BB. A composite allograft with mesenchymal stem cells was subsequently placed into the furcation and covered by a barrier derived from human amnion-chorion with flaps advanced to completely cover the site. Three furcations, including the one diagnosed as Class IV, had complete closure, two were converted to Class I, and in one instance, there was no improvement. This regenerative algorithm for mandibular Class III furcations may present the potential to save these teeth by altering the prognosis, which has traditionally been poor to hopeless, resulting in many of these teeth routinely being extracted.
Assuntos
Âmnio/transplante , Córion/transplante , Defeitos da Furca/cirurgia , Transplante de Células-Tronco Mesenquimais , Dente Molar/cirurgia , Adulto , Idoso , Aloenxertos , Becaplermina , Feminino , Defeitos da Furca/classificação , Defeitos da Furca/diagnóstico por imagem , Regeneração Tecidual Guiada Periodontal/métodos , Humanos , Masculino , Mandíbula , Pessoa de Meia-Idade , Dente Molar/diagnóstico por imagem , Proteínas Proto-Oncogênicas c-sis/administração & dosagem , Estudos Retrospectivos , Retalhos Cirúrgicos , Tetraciclina/administração & dosagem , Resultado do TratamentoAssuntos
Educação em Odontologia , Pesquisa em Odontologia/história , Pesquisa em Odontologia/tendências , Educação em Odontologia/história , Educação em Odontologia/tendências , Docentes de Odontologia , História do Século XX , História do Século XXI , Humanos , Cooperação Internacional , Intercâmbio Educacional Internacional/história , Israel , Oriente Médio , Faculdades de Odontologia/história , Faculdades de Odontologia/tendências , Especialidades Odontológicas/educação , Ensino/métodosAssuntos
Atenção à Saúde , Assistência Odontológica , Escolha da Profissão , Odontólogos/provisão & distribuição , Doença , Educação Pré-Odontológica , Acessibilidade aos Serviços de Saúde , Nível de Saúde , Humanos , Relações Interprofissionais , Área Carente de Assistência Médica , Doenças da Boca , Saúde Bucal , Estados UnidosRESUMO
The free gingival graft is one of the most versatile and predictable procedures in current use. A review of the significant contributions leading to this procedure is presented. Reports of the free graft series of King and Pennel, as well as the reaction to its initial presentation by members of the Philadelphia Society of Periodontology, are introduced to the dental literature. The chronology of events leading to the rediscovery of the gingival graft procedure in the early 1960s suggests independent and nearly simultaneous clinical innovation took place in Sweden and the United States. Therefore, though fully acknowledging Hilding Björn's seminal contribution, substantial credit must be given to colleagues King and Pennel for introducing the gingival graft procedure to periodontics.
Assuntos
Gengiva/transplante , Retração Gengival/história , Retração Gengival/cirurgia , História do Século XX , Humanos , Estados UnidosRESUMO
BACKGROUND: The authors describe how oral disease, particularly periodontal disease, may place certain patients at increased risk of developing cardiovascular disease and stroke. RESULTS: Although the precise mechanisms of interaction are not clear, two biological mechanisms that may explain the relationship are presented. In addition, the authors describe the dental management issues that need to be understood in treating patients compromised by cardiovascular disease. CONCLUSIONS AND CLINICAL IMPLICATIONS: The patient with cardiovascular disease may present a challenge to the dental health care provider, depending on the degree of hemodynamic compromise and the stability of his or her condition.