Genome-wide association study of normal and atypical progesterone profiles in Holstein-Friesian dairy cows.

Female fertility has a major role in dairy production and affects the profitability of dairy cattle. The genetic progress obtained by traditional selection can be slow because of the low heritability of classical fertility traits. Endocrine fertility traits based on progesterone concentration in milk have higher heritability and more directly reflect the cow's own reproductive physiology. The aim of our study was to identify genomic regions for 7 endocrine fertility traits in dairy cows by performing a genome-wide association study with 54,000 SNP. The next step was to fine-map targeted genomic regions with significant SNP using imputed sequences to identify potential candidate genes associated with the normal and atypical progesterone profiles. The association between a SNP and a phenotype was assessed by a single SNP analysis, using a linear mixed model that included a random polygenic effect. Phenotypes and genotypes were available for 1,126 primiparous and multiparous Holstein-Friesian cows from research herds in Ireland, the Netherlands, Sweden, and the United Kingdom. In total, 44 significant SNP associated with 7 endocrine fertility traits were identified on Bos taurus autosome (BTA) 1-4, 6, 8-9, 11-12, 14-17, 19, 21-24, and 29. Three chromosomes, BTA8, BTA17, and BTA23, were imputed from 54,000 SNP genotypes to the whole-genome sequence level with Beagle version 4.1. The fine-mapping identified several significant associations with delayed cyclicity, cessation of cyclicity, commencement of luteal activity, and inter-ovulatory interval. These associations may contribute to an index of markers for genetic improvement of fertility. Several potential candidate genes reported to affect reproduction were also identified in the targeted genomic regions. However, due to high linkage disequilibrium, it was not possible to identify putative causal genes or polymorphisms for any of the regions.

RESPOND: a patient-centred programme to prevent secondary falls in older people presenting to the emergency department with a fall-protocol for a mixed methods programme evaluation.

BACKGROUND: Programme evaluations conducted alongside randomised controlled trials (RCTs) have potential to enhance understanding of trial outcomes. This paper describes a multi-level programme evaluation to be conducted alongside an RCT of a falls prevention programme (RESPOND). OBJECTIVES: (1) To conduct a process evaluation in order to identify the degree of implementation fidelity and associated barriers and facilitators. (2) To evaluate the primary intended impact of the programme: participation in fall prevention strategies and the factors influencing participation. (3) To identify the factors influencing RESPOND RCT outcomes: falls, fall injuries and emergency department (ED) re-presentations. METHODS/DESIGN: 528 community-dwelling adults aged 60-90 years presenting to two EDs with a fall will be recruited and randomly assigned to the intervention or standard care group. All RESPOND participants and RESPOND clinicians will be included in the evaluation. A mixed methods design will be used and a programme logic model will frame the evaluation. Data will be sourced from interviews, focus groups, questionnaires, clinician case notes, recruitment records, participant-completed calendars, hospital administrative datasets and audio-recordings of intervention contacts. Quantitative data will be analysed via descriptive and inferential statistics and qualitative data will be interpreted using thematic analysis. DISCUSSION: The RESPOND programme evaluation will provide information about contextual and influencing factors related to the RESPOND RCT outcomes. The results will assist researchers, clinicians and policy makers regarding decisions about future falls prevention interventions. Insights gained may be applicable to a range of chronic conditions where similar preventive intervention approaches are indicated. TRIAL REGISTRATION NUMBER: This programme evaluation is linked to the RESPOND RCT which is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684).

RESPOND--A patient-centred programme to prevent secondary falls in older people presenting to the emergency department with a fall: protocol for a multicentre randomised controlled trial.

INTRODUCTION: Participation in falls prevention activities by older people following presentation to the emergency department (ED) with a fall is suboptimal. This randomised controlled trial (RCT) will test the RESPOND programme, an intervention designed to improve older persons' participation in falls prevention activities through delivery of patient-centred education and behaviour change strategies. DESIGN AND SETTING: A RCT at two tertiary referral EDs in Melbourne and Perth, Australia. PARTICIPANTS: 528 community-dwelling people aged 60-90 years presenting to the ED with a fall and discharged home will be recruited. People who require an interpreter or hands-on assistance to walk; live in residential aged care or >50 km from the trial hospital; have terminal illness, cognitive impairment, documented aggressive behaviour or a history of psychosis; are receiving palliative care or are unable to use a telephone will be excluded. METHODS: Participants will be randomly allocated to the RESPOND intervention or standard care control group. RESPOND incorporates (1) a home-based risk factor assessment; (2) education, coaching, goal setting and follow-up telephone support for management of one or more of four risk factors with evidence of effective interventions and (3) healthcare provider communication and community linkage delivered over 6 months. Primary outcomes are falls and fall injuries per person-year. DISCUSSION: RESPOND builds on prior falls prevention learnings and aims to help individuals make guided decisions about how they will manage their falls risk. Patient-centred models have been successfully trialled in chronic and cardiovascular disease; however, evidence to support this approach in falls prevention is limited. TRIAL REGISTRATION NUMBER: The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684).

Genetic analysis of atypical progesterone profiles in Holstein-Friesian cows from experimental research herds.

The objective of this study was to quantify the genetic variation in normal and atypical progesterone profiles and investigate if this information could be useful in an improved genetic evaluation for fertility for dairy cows. The phenotypes derived from normal profiles included cycle length traits, including commencement of luteal activity (C-LA), interluteal interval, luteal phase length. and interovulatory interval. In total, 44,977 progesterone test-day records were available from 1,612 lactations on 1,122 primiparous and multiparous Holstein-Friesian cows from Ireland, the Netherlands, Sweden, and the United Kingdom. The atypical progesterone profiles studied were delayed cyclicity, prolonged luteal phase, and cessation of cyclicity. Variance components for the atypical progesterone profiles were estimated using a sire linear mixed model, whereas an animal linear mixed model was used to estimate variance components for the cycle length traits. Heritability was moderate for delayed cyclicity (0.24 ± 0.05) and C-LA (0.18 ± 0.04) but low for prolonged luteal phase (0.02 ± 0.04), luteal phase length (0.08 ± 0.05), interluteal interval (0.08 ± 0.14), and interovulatory interval (0.03 ± 0.04). No genetic variation was detected for cessation of cyclicity. Commencement of luteal activity, luteal phase length, and interovulatory interval were moderately to strongly genetically correlated with days from calving to first service (0.35 ± 0.12, 0.25 ± 0.14, and 0.76 ± 0.24, respectively). Delayed cyclicity and C-LA are traits that can be important in both genetic evaluations and management of fertility to detect (earlier) cows at risk of compromised fertility. Delayed cyclicity and C-LA were both strongly genetically correlated with milk yield in early lactation (0.57 ± 0.14 and 0.45 ± 0.09, respectively), which may imply deterioration in these traits with selection for greater milk yield without cognizance of other traits.

Association of tumour necrosis factor a, b and c microsatellite polymorphisms with clinical disease activity and induction of remission in early rheumatoid arthritis.

OBJECTIVE: To study the associations of tumor necrosis factor (TNF) a, b and c microsatellite markers with 1) the clinical disease activity and 2) the induction of remissions in patients with early rheumatoid arthritis (RA) treated with two treatment strategies. METHODS: In the FIN-RACo (FINnish Rheumatoid Arthritis Combination therapy) trial of two years, 195 patients with recent-onset RA were randomly assigned to receive either a combination (COMBI) (sulphasalazine, methotrexate, hydroxychloroquine, and prednisolone) or a single (SINGLE) (initially sulphasalazine with or without prednisolone) disease modifying antirheumatic drug (DMARD) therapy. TNF a, b and c microsatellite and HLA-DRB1 typings were carried out in 165 (79 COMBI; 86 SINGLE) study completers. RESULTS: At baseline the 28 joint disease activity scores (DAS28) of the patients positive for TNFa2, a13 or b1 microsatellite markers were significantly higher than in the other patients. In the SINGLE patients the DAS28 improved comparably in patients with (n = 31) or without (n = 53) the TNFb1 marker (NS), while the DAS28 of the TNFb1-positive COMBI patients (n = 22) improved significantly more than that of the TNFb1-negative cases (n = 57) (p = 0.014). Respective 31.8% (7/22) and 28.1% (16/57) of the COMBI patients with or without TNFb1 allele achieved remission at one year. The corresponding figure in SINGLE patients were 0% (0/31) and 20.8% (11/53) (p = 0.006). At two years the remission frequencies in the TNFb1+/TNFb1- patients in the COMBI and SINGLE were 50.0%/38.6% and 9.7%/22.6%, respectively. CONCLUSION: Early TNFb1+ RA patients have more active disease but respond more favourably to COMBI treatment than the patients without this microsatellite allele. The finding may be of clinical relevance for the choice of DMARDs in early RA.

A new metabolite contributing to N-acetyl signal in 1H MRS of the brain in Salla disease.

OBJECTIVE: To determine whether N-acetylaspartate (NAA) is reduced in patients with Salla disease, a neurodegenerative disorder. BACKGROUND: 1H MRS allows the brain metabolism to be studied noninvasively in vivo. N-acetyl (NA) is composed primarily of NAA, which is regarded as a neuronal marker. The NA signal in 1H MRS is reduced in several neurodegenerative disorders. Increased NA signal has thus far only been found in Canavan's disease as a result of NAA accumulation in the brain tissue. In Salla disease, an autosomal recessive free sialic acid storage disorder, N-acetylneuraminic acid (NANA), accumulates in lysosomes of brain tissue. METHODS: The authors studied eight patients with Salla disease (age range, 6 to 44 years) and eight age-matched healthy volunteers using quantitative 1H MRS. The spectra were obtained from two selected 8-cm3 volumes of interest localized in the basal ganglia and in the parietal white matter using conventional 1.5-T MRI equipment. The spectral resonance lines of NA groups, creatine and phosphocreatine (Cr), and choline-containing compounds (Cho) were analyzed quantitatively. All MR images were evaluated to verify the state of myelination. RESULTS: 1H MRS from parietal white matter revealed 34% higher NA and 47% higher Cr concentrations, and a 35% lower Cho concentration in the patients with Salla disease compared with the age-matched control subjects. The patients had a 22% higher water content in their parietal white matter, whereas in the basal ganglia the water concentrations did not differ significantly. In the patients' basal ganglia the Cr concentration was 53% higher. CONCLUSIONS: NAA is considered to be a neuronal marker that, except for Canavan's disease, has been found or assumed to be either stable or reduced. However, in Salla disease the high NA signal may have a contribution from accumulated lysosomal NANA, which offsets the possible loss of NAA. The high Cr is in line with the increased glucose uptake found in our earlier 2-fluoro-2-deoxy-D-glucose-PET study, reflecting increased energy demand. It is worth noting that in a conventional 1H MRS ratio-based analysis these underlying abnormalities would have remained undetected. Our study thus emphasizes the importance of a quantitative assessment of metabolite concentrations in 1H MRS for detecting altered brain metabolism.

Effect of water supply method and flow rate on drinking behavior and fluid balance in horses.

This study investigated three methods of water supply on drinking preference and behavior in six Standardbred geldings (2-9 years, 505+/-9 kg). The water sources were buckets (B), pressure valve (PV), and float valve (FV) bowls. In an initial drinking preference test, PV was tested at three flow rates: 3, 8, and 16 l/min (PV3, PV8, and PV16), and FV at 3 l/min (FV3). Water intake was measured in l and presented as the percentage of the total daily water intake from each of two simultaneously presented alternatives. The intake from PV8 was greater than from both PV3 (72+/-11% vs. 28+/-11%) and PV16 (90+/-4% vs. 10+/-4%). All horses showed a strong preference for B, 98+/-1% of the intake compared to 2+/-1% from PV8. Individual variation in the data gave no significant difference in preference between the two automatic bowls. In the second part of the study, drinking behavior and fluid balance were investigated when the horses drank from FV3, PV8, and B for 7 consecutive days in a changeover design. Despite a tendency for an increase in total daily drinking time from FV3, the daily water intake was significantly lower (43+/-3 ml/kg) than from PV8 (54+/-2 ml/kg) and B (58+/-3 ml/kg). Daily net water gain [intake-(fecal+urinary output)] was only 0.5+/-3 ml/kg with FV3, resulting in a negative fluid balance if insensible losses are included. These results show that the water supply method can affect both drinking behavior and fluid balance in the horse.

Localized ridge augmentation in dogs: a pilot study using membranes and hydroxyapatite.

This study was designed to evaluate the potential to reconstruct localized ridge defects with bone by preventing non-osteogenic extraskelatal connective tissue from participating in the process of healing following experimental ridge augmentation treatment procedures. Following the elevation of buccal muco-periosteal flaps, buccal, interproximal, and interradicular bone was removed to the apical level of the second and third premolar teeth and the teeth were extracted to create bucco-lingual ridge defects that averaged 13 mm x 7 mm x 3.5 mm in each quadrant of two adult beagle dogs. The defects were permitted to heal for 90 days. The defects did not fill in with new bone. Subsequently, buccal muco-periosteal flaps were elevated and a membrane was placed over the defect and positioned so that it rested on bone that was exposed adjacent to the defect. In two quadrants test support materials were used to ensure that a space was maintained between the surface of the defect and the membrane. One quadrant was maintained as a sham-operated control site, three sites received membranes and no supporting implants and two sites received supporting implants and no membranes. The surgical schedule was designed to yield sacrifice times of 8 to 12 weeks. In the three quadrants available for study that were covered with membranes, bone and/or non-mineralized connective tissue was found to fill all of the space that had been provided by the membrane. Histologic examination confirmed that the space was filled with young, actively growing bone by 90 days. No new bone formation (bone fill) was observed in the sham-operated control site.

Histometric evaluation of periodontal surgery. III. The effect of bone resection on the connective tissue attachment level.

The purpose of this study was to evaluate the effect of surgical elimination of the osseous walls of angular bony defects on the connective tissue attachment and alveolar bone levels. Using a Rhesus monkey model, 36 periodontal pockets in four animals were operated on while the contralateral pockets served as unoperated controls. Plaque control was maintained until the animals were killed 1 year after surgery. Following routine processing, the interdental tissues were analyzed histometrically. Comparing measurements of surgically treated and untreated sites, resection of the osseous walls of interdentally located angular bony defects caused not only a reduction in the height of the alveolar bone but also a significant loss of connective tissue attachment. The procedure also resulted in the elimination of angular bony defects, intrabony pockets, and in addition, reduced the height of the interdental soft tissue.

Endodontic complications following periodontal and prosthetic treatment of patients with advanced periodontal disease.

A retrospective analysis was carried out to determine the frequency and onset of endodontic complications occurring in 52 patients treated for advanced periodontal disease. Comparisons were made between teeth which, following periodontal treatment, were used as abutments in fixed prosthetic reconstructions and nonabutment teeth. The study included 672 teeth with initially vital pulps (255 abutment teeth and 417 nonabutment teeth). The observation period varied from 4 to 13 years with a mean of 8.7 years. Pulpal necrosis including periapical lesions developed with a significantly higher frequency in abutment teeth than in nonabutment teeth (15% vs. 3%). The majority of these lesions did not appear until several years following the completion of active treatment. Conceivable reasons for the development of pulpal necrosis in teeth subjected to combined periodontal and prosthetic treatment are discussed.

Guided tissue regeneration following treatment of recession-type defects in the monkey.

Recent studies have demonstrated extensive amounts of new attachment formation following reconstructive surgery based on the biological principle of guided tissue regeneration (GTR). The aim of the present investigation was to evaluate the effect of using a polytetrafluorethylene (PTFE) membrane in GTR-treatment of recession-type defects and to examine the interrelationship between the PTFE membrane and surrounding periodontal tissues. Full-thickness flaps were raised around 24 maxillary premolar and molar teeth in 6 monkeys. The buccal alveolar bone was surgically removed to a level corresponding to the apical third of the roots. The exposed root surfaces were scaled and planed. In 12 teeth, PTFE membranes were adjusted to cover the exposed root surfaces from a level 1 to 2 mm apical to the CEJ, to a level 3 to 4 mm apical to the alveolar crest. The coronal border of the membranes was tightly adapted to the root surfaces by sling sutures. Twelve teeth served as control teeth without placement of membranes. The flaps were placed with the margin coronal to the CEJ and sutured. The animals were sacrificed after 3 months of healing and all experimental teeth were subjected to histological analysis. The membranes were found to be incorporated with the surrounding connective tissue, and the apical extension of the junctional epithelium terminated at the coronal border of the membranes. The amount of new attachment formation was on the average 74.3% of the defect height in the test teeth, which corresponded to 100% of the membrane covered root portion. Newly formed connective tissue attachment in the controls amounted to an average of 36.9% of the defect height.(ABSTRACT TRUNCATED AT 250 WORDS)

Suppression of inflammation and bone resorption by indomethacin during experimental periodontitis in dogs.

1. The placement of cotton floss ligatures in a position apical to the gingival margin of premolars and molars in young dogs induced an acute inflammatory reaction in the periodontal tissues resulting in loss of connective tissue attachment and alveolar bone. 2. Bone resorption could be observed histologically within 7 days, and radiographically within 2 to 3 weeks after ligature placement. 3. Daily administration of indomethacin interfered with the periodontal tissue response to ligature placement. Indomethacin was shown to (i) delay the onset and to suppress the magnitude of the acute inflammatory reaction, and (ii) decrease the degree of alveolar bone resorption.

Isolation of periodontal species after guided tissue regeneration.

One advanced localized periodontal lesion in each of 10 patients was treated using the guided tissue regeneration procedure. Six weeks after placement of expanded polytetrafluoroethylene (ePTFE) membranes, microbial samples were taken from each treated site and the membranes were removed. Six weeks later the cases were re-evaluated. They had all healed successfully with varying amounts of gain of clinical attachment. Gram-negative, anaerobic rods were found in all samples and made up 31% of all organisms cultivated. In 1 patient, Porphyromonas gingivalis was found in a proportion of 17.5%. Six of the other 9 patients harbored Prevotella intermedia (mean proportion 21.3%) and 6 Prevotella melaninogenica (6.8%). Fusobacterium and Capnocytophaga were also frequently found. The results demonstrate that ePTFE membranes are frequently colonized by periodontal microorganisms. The importance of bacterial colonization on clinical success is presently not known. Further studies are needed to determine the effect of the presence or absence of putative pathogens during guided tissue regeneration.

Periodontal regeneration via selective cell repopulation.

The purpose of this investigation was to determine the histogenesis of periodontal regeneration using the principle of selective and guided cell repopulation of the root surface. A fenestration model, developed in the squirrel monkey, made it possible to exclude gingival epithelium and connective tissue and promote cell repopulation of the denuded root surface from the periodontal ligament and alveolar bone. Experimental and sham-operated control sites were compared histometrically after 3, 7, 14 and 35 days of healing. The results indicated that new cementum, bone and periodontal ligament formation occurred by the 14th day and that regeneration of the fenestration wound was almost complete by Day 35. Root resorption and ankylosis were observed in both experimental and sham-operated controls. There was significantly more periodontal regeneration in the experimental sites, which favored cell repopulation of the root surface from the periodontal ligament and alveolar bone.

Periodontal status and bruxism. A comparative study of patients with periodontal disease and occlusal parafunctions.

This study investigated a possible association between bruxism and severity of periodontal disease. Subjects consisted of 51 patients (mean age 47.3 years) referred to the Department of Periodontology for treatment of moderate to severe periodontal disease (Perio-group) and 40 patients (mean age 48.9 years) referred to the Department of Stomatognathic Physiology for treatment of symptoms related to bruxism (Bruxism-group). Examination of the two groups included measurements of the alveolar bone height, probing attachment level, tooth mobility, and attrition of teeth. A questionnaire was also used to gain information on the patient's awareness of bruxism and tooth mobility. Awareness of clenching and/or grinding was reported by 57% of patients in the Bruxism-group and 24% of patients in the Perio-group. The perio-patients reported significantly higher frequency of tooth mobility than did the bruxism-patients. Alveolar bone loss, attachment loss, and tooth mobility were significantly more pronounced in the Perio-group than in the Bruxism-group. The Bruxism-group showed a higher frequency of tooth attrition than the Perio-group. Periodontal disease and bruxism seldom occurred in the same individual, and the results indicate that the two phenomena are in general not closely associated.

The influence of the design of two different bioresorbable barriers on the results of guided tissue regeneration therapy. An intra-individual comparative study in the monkey.

The aim of the present study was to compare two bioresorbable barriers to evaluate whether differences in design influence the result of guided tissue regeneration (GTR) therapy. Twenty-four (24) plaque exposed, recession type defects in 4 monkeys were treated. Contralateral defects were randomized for test or control treatment. During a healing period of 6 weeks, gingival recession resulting in device exposure occurred at 3 test and 10 control sites. One control barrier was exfoliated. Histologically, 9 of the 12 test barriers were completely integrated with the surrounding tissues. At 3 test sites, epithelium had migrated apically outside the barrier to a level not exceeding one-third of the height of the device. Seven of the 11 control barriers were enclosed by dentogingival epithelium. The adjacent connective tissue exhibited local inflammatory cell infiltrates (ICT). At the remaining 4 control sites, the epithelial downgrowth as well as the adjacent ICT areas were limited to the coronal 1/3 of the device. New attachment; i.e., new cementum with inserting collagen fibers, averaged 2.2 mm and 0.8 mm at the test and control sites respectively (P < 0.01). Based on the results of the present study, it was concluded that a bioresorbable GTR device, designed to prevent epithelial downgrowth along the barrier surface, has a higher potential to promote new attachment formation than a device which does not have this property.

Periodontal response after tooth movement into intrabony defects.

The present study was undertaken since conflicting evidence exists regarding the effect of such tooth movement on levels of connective tissue attachment. Localized intrabony pockets were produced around isolated incisors in four rhesus monkeys. The root surfaces were planned to the level of the bone at the base of the angular bony defects. An oral hygiene regime was begun and continued for the remainder of the study. The experimental teeth were moved orthodontically into, and through, the original area of the intrabony defect. Two months after cessation of active tooth movement, block specimens were removed for histologic analysis. Control specimens comprised those teeth with induced periodontal defects, but without tooth movement. In specimens not subjected to tooth movement, angular bony defects were present and epithelium lined the root surface to the apical extent of instrumentation. The alveolar bone adjacent to the orthodontically moved teeth no longer had angular defect morphology. On the pressure side, epithelium lined the root surface, was interposed between root surface and bone and terminated at the apical limit of root instrumentation. On the tension side, the crest of the bone was located apical to the level of root planing, and epithelium lined the instrumented portion of the root surface. It was concluded that orthodontic tooth movement into intrabony periodontal defects was without effect upon the levels of connective tissue attachment.

Influence of surface roughness of barrier walls on guided bone augmentation: experimental study in rabbits.

BACKGROUND: By using the guided tissue regeneration concept it is possible to augment bone, beyond the skeletal envelope, provided certain biologic, surgical, and barrier-related demands are met. Among barrier-related factors of importance are the surface properties. PURPOSE: The aim of this study was to evaluate whether different surface roughness of the barrier wall influences the amount and morphology of augmented bone in a secluded space, using a titanium cylinder as barrier device placed on the rabbit skull. MATERIALS AND METHODS: Cylinders of commercially pure titanium were fabricated by machining, using a turning tool. The inner cylinder wall was either left untreated or grit-blasted with titanium dioxide to increase surface roughness. The topographic profile of the inner surface of two cylinders (1 turned and 1 grit-blasted) was measured in vitro to achieve a numeric characterization of each type of surface topography. Two cylinders, one with grit-blasted and one with turned inner walls, were surgically placed and secured to the skull bone of each of eight rabbits. The plate of the cortical bone, facing the experimental area framed by the cylinder wall was removed, and care was taken to ensure total blood fill of the cylinders. After 3 months, the animals were sacrificed to obtain histology for histomorphometry. RESULTS: The relative volume of augmented tissue in the grit-blasted cylinders (77.9 +/- 10.5%) did not differ significantly from that in the turned cylinders (73.4 +/- 5.5%, p = .118), neither did the volume of mineralized bone (20.1 +/- 8.2% vs. 22.1 +/- 7.2%, p = .064). The trabecular density of the augmented bone was higher close to the walls of both the turned and the grit-blasted cylinders compared to the overall trabecular density within the cylinders, but no significant difference between the two groups. However, the area of mineralized bone in direct contact with the inner surface of the titanium cylinder was significantly larger in the grit-blasted (33.9 +/- 13.3%) compared to the turned cylinders (12.0 +/- 8.5%, p = .01). CONCLUSIONS: The use of titanium barriers with a grit-blasted inner surface compared to barriers with a turned surface resulted in the formation of similar amounts of bone beyond the skeletal envelope of the rabbit skull. However, a larger area of augmented mineralized bone was found in direct contact with the inner surface of the grit-blasted cylinders.

Clinical and microbiologic findings that may contribute to dental implant failure.

Clinical and DNA probe analysis were used to evaluate 36 failing implant sites in 13 patients. Failing implants showed evidence of increased mobility and a high incidence of peri-implant radiolucencies in radiographs. The probing depth was greater than 6 mm in 58% of the sites measured. Moderate levels of Actinobacillus actinomycetemcomitans, Bacteroides intermedius, and Bacteroides gingivalis were detected with DNA probe analysis.

Bone regeneration adjacent to titanium dental implants using guided tissue regeneration: a report of two cases.

The biologic principle of guided tissue regeneration was applied to regenerate alveolar bone in conjunction with the placement of titanium dental implants. In one case, complete osseointegration of an implant was achieved by the placement of a Teflon membrane over an implant that had been inserted into an alveolus immediately following tooth extraction. In a second case, the same biologic principle was used to increase the volume (height and width) of a resorbed, edentulous alveolar ridge to provide adequate bone dimensions for implant installation. In both cases, the membranes appear to have prevented the repopulation of the wound area by cells other than those derived from surrounding bone tissue. These two different applications of the principle of guided tissue regeneration open new avenues for reconstructive osseous surgery.