Gold Standards in Periodontics: A Review

Author(s):  
Pramod Kumar Koirala ◽  
Shaili Pradhan

The field of dentistry has evolved where people expect the best oral health care from specialists. Periodontics is that specialty of dentistry which deals with prevention, diagnosis, and treatment of diseases of the supporting tissues of the teeth. Almost half of the world's population is suffering from periodontal diseases. Periodontitis is the sixth most common chronic diseases in the world and along with dental caries, the most common cause of tooth loss. Through the effort of various professional organisations and research, various reliable products and treatment modalities have been developed. A gold standard is a benchmark which has been thoroughly tested and has reputation as a reliable modality. Some of established gold standards in periodontics include: periodontal probing, measurement of clinical attachment loss, bone loss, cone beam computed tomography, quantitative polymerase chain reaction tests, biopsies as investigative techniques; periodontal debridement, subepithelial connective tissue graft for recession coverage, lasers, autogenous bone in alveolar ridge augmentation prior to oral implantation, dental implant as reconstruction of missing dentition, and chlorhexidine mouth wash as treatment options. The objective of the review is to provide critical evaluation of the data available from existing studies in Periodontics which can help identify potential research areas to explore.  

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2708
Author(s):  
Alice Boilève ◽  
Marc Hilmi ◽  
Matthieu Delaye ◽  
Annemilaï Tijeras-Raballand ◽  
Cindy Neuzillet

Hepatocellular carcinoma (HCC) and biliary tract cancers (BTC) exhibit a poor prognosis with 5-year overall survival rates around 15%, all stages combined. Most of these primary liver malignancies are metastatic at diagnostic, with only limited therapeutic options, relying mainly on systemic therapies. Treatment modalities are different yet partially overlapping between HCC and BTC. The complex molecular profile of BTC yields to several actionable therapeutic targets, contrary to HCC that remains the field of antiangiogenic drugs in non-molecularly selected patients. Immunotherapy is now validated in the first line in HCC in combination with bevacizumab, while clinical activity of single agent immunotherapy appears limited to a subset of patients in BTC, still poorly characterized, and combinations are currently under investigation. In this review, we provide a critical evaluation and grading of clinical relevance on (i) the main prognostic biomarkers in HCC and BTC, (ii) the main theragnostic biomarkers in both tumors, and lastly (iii) what is recommended in clinical practice.


2014 ◽  
Vol 4 (3) ◽  
pp. 129-138
Author(s):  
Robert Spears ◽  
Ibtisam Al-Hashimi ◽  
Eric S Solomon ◽  
David G Kerns ◽  
William W Hallmon ◽  
...  

ABSTRACT Calcium sulfate is a biologically compatible osteoconductive graft material that binds underlying bone graft and provide space maintenance. The purpose of this study was to evaluate calcium sulfate as a barrier compared to a collagen membrane for augmentation of a standardized surgically created ridge defect. For this purpose, bilateral extraction of mandibular premolars was performed on six foxhounds (Canis familiaris). Eight weeks later, a standardized osseous ridge defects (24 total) were created using a 6 mm trephine. The study was approved by the Institutional Animal Care and Use Committee (IACUC) at Baylor College of Dentistry. The osseous defects were allocated into three groups (8 defects each): group 1 received autogenous bone graft covered with collagen membrane (CM); group 2 received autogenous bone graft covered with calcium sulfate barrier (CS), and group 3 was used as control and did not receive bone augmentation and was used as control. The animals were sacrificed after 12 weeks following bone augmentation and sites were evaluated histologically for total ridge width, percentage of bone gain and cortical bone thickness. Results All sites exhibited bony fill within the defect. Analysis of variance did not reveal statistically significant difference in the mean total bone gain among CM, CS, and control groups (12.2,11.6, and 11.9) mm2, respectively, p = 0.875. Conclusion Calcium sulfate does not appear to improve bone regeneration in an osseous defect. How to cite this article Heaton ML, Kerns DG, Hallmon WW, Kessler HP, Spears R, Solomon ES, Al-Hashimi I. Comparison of Calcium Sulfate and Bovine Collagen Barriers for Alveolar Ridge Augmentation. J Contemp Dent 2014;4(3):129-138.


2015 ◽  
Vol 16 (2) ◽  
pp. 154-162 ◽  
Author(s):  
Danilo Alessio Di Stefano ◽  
Gian Battista Greco ◽  
Lorenzo Cinci ◽  
Laura Pieri

ABSTRACT Aim The present work describes a horizontal ridge augmentation in which a titanium mesh was preshaped by adapting it to a stereolithographic model of the patient's jaw that was fabricated from CT scans. Background Guided bone regeneration (GBR) involves covering the augmentation site with a long-lasting barrier to protect it from the invasion of surrounding soft tissues. Among barriers, titanium meshes may provide a successful outcome, but the intraoperatory time needed to shape them is a disadvantage. Case description The 54-year-old patient, missing the right mandibular second bicuspid, first molar, and second molar, had her atrophic ridge augmented with a 30:70 mixture of autogenous bone and equine, enzyme-deantigenic collagenpreserved bone substitute. Two conical implants were inserted concomitantly in the second bicuspid and first molar positions, and the site was protected with the preshaped mesh. Four months later, the titanium mesh was retrieved, a bone sample was collected, and histological and histomorphometric analyses were performed. Provisional and definitive prostheses were then delivered, and follow-up controls were performed for up to 24 months. Conclusion Preshaping the mesh on a model of the patient's mandible shortened the surgical time and enabled faster mesh placement. Two years after surgery, the implants were perfectly functional, and the bone width was stable over time as shown by radiographic controls. Histological analysis of the bone sample showed the heterologous biomaterial to be biocompatible and undergoing advanced remodeling and replacement with newly formed bone. Clinical significance Preshaping a titanium mesh over a stereolithographic model of the patient's jaw allowed for a significant reduction of the intraoperative time and may be therefore, advisable in routine practice. How to cite this article Di Stefano DA, Greco GB, Cinci L, Pieri L. Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft. J Contemp Dent Pract 2015;16(2):154-162.


Author(s):  
Sergio Charifker Ribeiro Martins

The use of guided bone regeneration (GBR) has been gaining more and more ground in the field of implant dentistry, due to higher confidence in the materials available. As this is a highly versatile technique, the same biological basis-cell exclusion–can be used to treat any type of defect. Vertical augmentation in the alveolar ridge is currently treated by the GBR principle, predictably and with high success rates, using a rigid framework associated with a mix of hydroxyapatite and autogenous bone. Lyophilized bovine bone is the hydroxyapatite of choice for this condition because it allows bone volume to be maintained over a long period of time, due to its slow resorption. Another important char-acteristic found in hydroxyapatite is its porosity since it allows – in addition to graft neo-vascularization–a greater ease of cell adhesion when compared to crystalline materials. Thus, this clinical case presents the use (for the first time in the literature) of a vertical augmentation of an atrophic ridge using Criteria Lumina Bone Porous® as the hydroxy-apatite of choice for association with autogenous bone particles.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Bruno Freitas Mello ◽  
Márcio de Carvalho Formiga ◽  
Luiz Fernando de Souza da Silva ◽  
Gustavo dos Santos Coura ◽  
Jamil Awad Shibli

The guided bone regeneration (GBR) technique has been used to achieve optimal bone volume augmentation and allow dental implant placement in atrophic maxilla and mandible, with predictable results and high survival rates. The use of bone substitutes has reduced the necessity of autogenous bone grafts, reducing the morbidity at the donor areas and thus improving the patients’ satisfaction and comfort. This clinical case report shows a clinical and histological evaluation of the bone tissue behavior, in a case that required the horizontal augmentation of the alveolar ridge, with the use of xenograft biomaterial and further dental implant placement. After six months of healing time, six implants were placed, and a bone biopsy was done. The histological analysis depicted some fragments of the xenograft bone graft, integrated with the new-formed bone tissue.


2019 ◽  
Vol 30 (S19) ◽  
pp. 528-528
Author(s):  
Andreas Papandreou ◽  
Maria Sykara ◽  
Panagiotis Ntovas ◽  
Frank Zastrow

2005 ◽  
Vol 31 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Francesco Carinci ◽  
Antonio Farina ◽  
Umberto Zanetti ◽  
Raffaele Vinci ◽  
Stefano Negrini ◽  
...  

Abstract Insertion of endosseous implants is often difficult because of lack of supporting bone. In the case of severe atrophy of the jaws, a large volume of autogenous bone can be harvested from the iliac crest and calvaria. Both grafts undergo partial resorption with time, but the rate of bone loss has not been fully elucidated. The aim of this study was to evaluate the alveolar bone height gain (ABHG) obtained with iliac crest and calvaria bone grafts. Twenty-five patients had mandibular bone grafts, 32 had maxillary bone grafts, and 11 had both mandibular and maxillary bone grafts. Measures were made on preoperative, postoperative, and follow-up radiographs. A general linear model was used to evaluate the rate of ABHG plotted against months elapsed from the time of the operation to the time of follow-up. General linear model output showed a statistically significant effect for only the type of donor bone graft (P = .004), with a better ABHG for calvaria. The iliac crest bone grafts lost most of the ABHG in the first 6 months, whereas calvaria bone grafts lost ABHG over a greater interval of time. The type of bone graft is the strongest predictor of ABHG, and calvaria bone graft had a higher stability than did iliac bone graft. However, the gap in ABHG between the 2 grafts tended to decrease over time.


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