Search

This work describes the therapeutic protocol of combined orthodontic-periodontal treatment and evaluates the effectiveness of surgical and nonsurgical periodontal therapy in the maintenance of a healthy periodontal status after the orthodontic treatment. Surgical periodontal treatment was performed in 267 patients affected by severe periodontal disease, and 128 patients had nonsurgical treatment. For each patient the mean value of probing depth (mPPD) and the rate of positive bleeding on probing (%BoP) of the teeth involved in the orthodontic movement were registered before the start of the periodontal treatment, at the end of the orthodontic treatment, and 2, 4, 6, 10, and 12 years after the end of the orthodontic treatment. Comparison between pretreatment and posttreatment values and between pretreatment and follow-up values showed a decrease in mPPD and %BoP that was of statistical significance. The difference between posttreatment and follow-up values was not statistically significant. These results suggest that orthodontic treatment is no longer a contraindication in the therapy of severe adult periodontitis. In these cases orthodontics improve the possibilities of saving and restoring a deteriorated dentition.

In the present study, 139 periodontally compromised patients received a complete periodontal treatment; in 104 cases this was followed by orthodontic treatment. At the end of the entire therapy, a total of 150 Maryland restorations (69 resin-bonded fixed partial dentures and 81 resin-bonded splints) was placed and then followed for a period of up to 10 years (mean 6.7 y). Thirteen fixed partial dentures and 16 splints failed during the observation period; the 10-year cumulative survival rate from lifetable analysis was 76.2% (70.6% for fixed partial dentures and 80.7% for splints).

This investigation evaluated the predictability of dental implants subjected to bone regeneration procedures at the time of insertion. Fifty-two test implants were inserted into sites with periimplant bone defects. A calcium carbonate allograft material with or without a fibrin-fibronectin sealing system was used to fill the defects. Sixty control implants were inserted into an adequate volume of nonaugmented bone. Each of the 29 study patients received at least one test implant and one control implant. At the second-stage surgery, fill of the bone defect was assessed as complete or incomplete. The cumulative success rate was 91.7% (mean follow-up 55 mo) for the test implants and 93.2% (mean follow-up 59 mo) for the control implants. Within the test group, implants with complete bone fill achieved 97.6% success versus 59.1% success for implants with incomplete bone fill. These preliminary results suggest that implants placed with simultaneous bone regeneration procedures achieve long-term predictability that is comparable to that of implants placed in an adequate volume of bone, provided that complete bone fill of the periimplant defect is achieved. Long-term studies with other augmentation materials are needed to fully validate these findings.

This study evaluated a new surgical technique for the treatment of an alveolar ridge deficiency in 11 patients. Twenty-two implants were placed, 15 of which presented with a combination of supracrestal and dehiscence kinds of defects, and seven presented only supracrestal bone loss. Surgical procedures were performed utilizing a combination of the resorbable space-making material calcium carbonate stabilized with a fibrin-fibronectin sealing system and the immediate placement of titanium dental implants. After implant placement, the mean height for supracrestal and dehiscence defects measured 2.57 +/- 1.41 mm and 2.47 +/- 1.54 mm, respectively. The defects were filled with calcium carbonate and a fibrin-fibronectin sealing system, and the flaps were sutured, avoiding any compression of the treated area. Healing was uneventful in all instances. At second-stage surgery at 6 months, a hard bone-like tissue was detectable at the defect sites. Histologic examination of four defects confirmed the presence of newly formed bone and revealed residual particles of calcium carbonate. There was a mean gain of 2.05 +/- 1.47 mm in the supracrestal defects and of 2.23 +/- 1.62 mm in the dehiscences. The results indicated that calcium carbonate, combined with a fibrin-fibronectin sealing system, is a viable alternative in the treatment of supracrestal and dehiscence bony defects.