Regeneración ósea guiada: nuevos avances en la terapéutica de los defectos óseos / Guided bone regeneration: new advances in the treatment of bone defects

Introducción: el procedimiento de regeneración ósea guiada ha demostrado ser una técnica exitosa para promover el llenado de defectos óseos presentes, así como para aumentar las dimensiones de rebordes alveolares atróficos previo a rehabilitación protésica convencional o implanto soportada. Objetivo: describir la utilización clínica de injerto aloplástico de b-fosfato tricálcico como material de relleno en la regeneración de defectos óseos alveolares. Presentación del caso: se presentó el caso de una paciente femenina de 57 años de edad quien acudió a la consulta odontológica por presencia de supuración en un diente anterosuperior, como consecuencia de un proceso infeccioso apical. Al examen clínico se observó resto radicular de incisivo central superior izquierdo e incisivo lateral superior izquierdo; radiográficamente se observó fractura radicular de incisivo central superior derecho. Posterior a la extracción de los restos radiculares, se empleó la técnica de regeneración ósea guiada, utilizando injerto aloplástico de b-fosfato tricálcico con una membrana de colágeno reabsorbible. Tres meses posteriores al tratamiento, se observó aumento en altura y anchura del reborde alveolar, con lo que se logró la conformidad estética y funcional deseada. Conclusión: el caso presentado revela resultados clínicos satisfactorios gracias a la neoformación de hueso observada y a la planificación adecuada del tratamiento con regeneración ósea guiada, por lo que el uso de injerto óseo, específicamente el injerto aloplástico b-fosfato tricálcico, en combinación con las membranas de barrera, se sugiere para el manejo de los defectos óseos alveolares(AU)

Introduction: the procedure of guided bone regeneration has proven to be a successful technique to promote the filling of bone defects and enlarge the dimensions of atrophic alveolar ridges prior to conventional or implant-supported prosthetic rehabilitation. Objective: describe the clinical use of b-tricalcium phosphate alloplastic graft as a filler material in the regeneration of alveolar bone defects. Case report: a female 57-year-old patient presented at dentistry consultation with exudate from an upper anterior tooth due to apical infection. Clinical examination revealed root rests of the upper left central incisor and upper left lateral incisor. Radiography showed root fracture of the upper right central incisor. Upon extraction of the root rests, guided bone regeneration technique was performed, using b-tricalcium phosphate alloplastic grafting with a resorbable collagen membrane. Three months after treatment, an increase in height and width of the alveolar ridge was observed, achieving the desired aesthetic and functional status. Conclusions: satisfactory clinical results in terms of bone neoformation are due to adequate therapeutic planning and the employment of guided bone regeneration. Use of bone grafting, specifically alloplastic graft of b-tricalcium phosphate in combination with barrier membrane, is thus suggested for the management of alveolar bone defects(AU)

Surgical endodontic management of an invasive cervical resorption class 4 with mineral trioxide aggregate: a 6-year follow-up.

Invasive cervical resorption is a type of external resorption rarely seen as an adverse effect after a guided tissue regeneration procedure for a periodontal condition. This case report summarizes the surgical endodontic management of an invasive cervical resorption class 4 (Heithersay) with mineral trioxide aggregate, in a mandibular incisor of a 67-year-old man. A 6-year clinical follow-up with radiovisiography and cone-beam computerized tomography revealed complete healing. A surgical endodontic management could promote healing and survival of a tooth with advanced root resorption due to a periodontal condition.

Root resorption and ankylosis associated with guided tissue regeneration.

BACKGROUND: Root resorption and ankylosis have been reported rarely as sequelae to guided tissue regeneration (GTR). The authors describe a clinical case of root resorption following GTR that involved the use of a bioabsorbable membrane. CASE DESCRIPTION: Two years after GTR was performed on a Class II furcation defect, the clinical examination revealed root resorption reaching the pulp chamber. The furcation defect was filled with epithelium and connective tissue, which contained inflammatory infiltrate and fragments of the membrane. The authors also observed areas of the tooth that exhibited points of ankylosis and root resorption. CLINICAL IMPLICATIONS: Clinical trials have reported favorable clinical and histologic results with GTR. However, this case report, along with other case reports and studies in animals, suggests a high risk of root resorption and ankylosis after GTR, which could limit the indications for this technique.

Surgical reconstruction of interdental papilla using an interposed subepithelial connective tissue graft: a case report.

The unpredictability of current surgical procedures for papilla reconstruction has been a matter of concern for both periodontists and patients. This case report presents a complete papilla reconstruction in a 20-year-old woman using an interposed subepithelial connective tissue graft. The results show that this technique can be successfully used in treating the loss of papillae and achieving long-term stability. The objective of this report is to describe the surgical technique and comment on the factors that may have influenced the final result.