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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of clinical periodontology 25 (1998), S. 0 
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract. This prospective split-mouth study was designed to compare the clinical and radiographic healing results in intrabony periodontal defects 12 months after GTR therapy with 2 different bioresorbable barriers. The study comprised 25 healthy patients with one pair of contralaterally located intrabony defects with a probing pocket depth of ≥6 mm and radiographic evidence of angular bone loss of ≥4 mm. The 2 defects of each patient were randomized for treatment either with polylactic acid (PLA) membranes or with polyglactin-910 (PG-910) membranes. The patients received systemic doxycycline (100 mg/d) for 11 days post-operatively. One blinded examiner recorded the following clinical parameters using a pressure calibrated probe at baseline and after 12 months: papillary bleeding index (PBI), gingival recession (REC), probing pocket depth (PPD), and probing attachment level (PAL). The vertical relative attachment gain (V-rAG) was calculated as a % of the PAL gain related to the maximum possible attachment gain (expressed by the intrraoperatively measured depth of the osseous defect). Geometrically standardized intraoral radiographs were quantitatively evaluated for bone changes (density, area) in the defect region using digital subtraction radiography (DSR). Clinical and radiographic data were statistically analyzed using the Wilcoxon-signed-rank test (α=0.05). Postoperative membrane exposures occurred in 9 PLA and 13 PG-910 treated sites. After 12 months of healing, both barrier types provided significant PPD reductions and PAL gain [median (25/75 percentile)]: ΔPPD (PLA: 3.0 (2.0/4.0) mm: PG-910: 3.0 (2.0/4.5) mm]; ΔPAL [PLA: 3.0 (2.5/4.0) mm: PG-910: 2.0 (1.0/4.0) mm]. V-rAG amounted to 60% in PLA sites and 54% in PG-910 sites. DSR revealed significant bone density gain after 12 months. 58.3% of she initial defect area in PLA sites and 54.0% of the initial defect area in PG-910 sites showed bone density gain. Neither clinical nor radiographic data revealed any significant difference between the 2 barrier types after 12 months. In conclusion, this 12-month study demonstrated that PLA and PG-910 membranes provided similar favorable regeneration results in deep intrabony periodontal defects.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of clinical periodontology 24 (1997), S. 0 
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract The aim of this prospective split-mouth-study was to compare the healing results in intrabony defects 12 and 30 months after placement of resorbable (polyglactin-910) and non-resorbable (e-PTFE) GTR-membranes. 11 healthy patients with 30 defects participated. 10 patients with 10 pairs of contralateral lesions, which were treated with both membrane types, were included in the split-mouth-design. Furthermore, in an additional group-design all 30 (16 polyglactin-910 and 14 e-PTFE) treated sites were evaluated. Clinical examinations (PBI, REC, PPD, PAL) and radiographic examinations were carried out under standardized conditions immediately before as well as 12 and 30 months after surgery. Additionally, for the assessment of the effectiveness of the 2 membranes by comparing the regeneration results of different defects, the vertical relative attachment gain (V-rAG) was calculated as a% of the PAL gain related to the maximum possible attachment gain (expressed by the baseline depth of the osseous defect intraoperatively measured). Digital subtraction radiography (DSR) was carried out for the quantitative assessment of bone density changes due to GTR. In the split-mouth-design, both types of membranes provided significant V-rAGs (median) after 12 months (polyglactin: 81.7%: e-PTFE: 100.0%) and after 30 months (polyglactin: 69.1%: e-PTFE: 83.8%) compared to baseline. In 90.0% of the polyglactin and e-PTFE sites, a probing attachment gain of at least 2 mm was maintained over the 30-month period. However, in 2 polyglactin treated sites, and 5 e-PTFE treated sites, a new attachment loss was found between 12 and 30 months. DSR showed bone density gain 12 and 30 months postsurgically. No statistically significant differences could be observed between the 2 membrane materials with regard to clinical and radiographic findings. This was confirmed when considering the total number of defects (group-design). In conclusion, based on this 30-month-study resorbable polyglactin membranes may be regarded as a useful alternative to the well established e-PTFE membranes for the treatment of intrabony defects.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1600-0765
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this in vitro study was to determine the accuracy of digital subtraction radiography (DSR) to detect small changes in calcium mass in alveolar bone adjacent to tooth roots. In each of 4 dried porcine mandible segments, one interproximal and one buccal “defect” region was defined adjacent to a premolar root. A series of cortical and cancellous bone slices with a 50 μm-stepwise increasing thickness (0-5000 μm) were attached to the mandible segments covering the respective “defect” region. Standardized radiographs were quantitatively assessed for density changes using DSR. After dissolving each bone slice in hydrochloric acid, its calcium concentration was photometrically determined. For each bone slice, the mean calcium mass covering a single pixel of the subtraction image was calculated. The Wilcoxon signed-rank test and the Mann-Whitney U-test were used for statistical analysis (α = 0.05). A strong linear correlation (r2 = 0.86-1.00; p ≤ 0.001) was found between the thickness of the bone slices and their calcium mass. Cortical bone showed a 3.5 times higher mean calcium mass/pixel than cancellous bone. Furthermore, a strong linear correlation (r2 = 0.63-1.00; p ≤ 0.001) was found between the mean calcium mass per image pixel and the radiographic density changes. Neither the bone type nor the “defect” localization had a significant influence on radiographic density changes caused by changes in calcium mass. A change in mean calcium mass per image pixel of 0.1-0.15 mg was necessary to be detected by DSR. In conclusion, this study revealed a high accuracy of DSR to detect small changes in calcium mass in alveolar cortical and cancellous bone.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    Journal of periodontal research 38 (2003), S. 0 
    ISSN: 1600-0765
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this controlled retrospective study was to evaluate the influence of an IL-1 gene polymorphism on the clinical and radiographic healing outcomes of GTR therapy. The study included 47 adult periodontitis patients with 94 deep intrabony defects treated by GTR using different membrane materials. The following clinical parameters were recorded at baseline and 12 months after surgery: papillary bleeding index (PBI), gingival recession (REC), probing pocket depth (PPD), clinical attachment level (CAL), and the vertical relative attachment gain (V-rAG). Bone changes in the defect regions due to GTR therapy were quantitatively evaluated using digital subtraction radiography (DSR). Polymorphisms of the IL-1A gene at position − 889 and of the IL-1B gene at position + 3953 were analyzed by PCR. Statistical analysis was performed using the Mann–Whitney-U and the Wilcoxon-Signed-Rank tests (α = 0.05). The study comprised 19 IL-1 genotype positive (IL-1 +) patients and 28 IL-1 genotype negative (IL-1 –) patients. Twelve months after GTR therapy, both patient groups revealed statistically significant PPD reductions and CAL gain [median (25/75% percentiles)]: ΔPPD [IL-1 + : 4.0 (2.5/5.0) mm; IL-1-: 3.8 (3.0/4.9) mm], ΔCAL [IL-1 + : 3.5 (3.0/4.8) mm; IL-1 –: 3.0 (1, 2/4, 5) mm]. V-rAG amounted to 60.0 (47.7/78.6)% in IL-1 + patients and 53.1 (43.4/81.9)% in IL-1 – patients. Both patient groups showed significant bone density gain in 40% (IL-1 +) and 43.6% (IL-1 –) of the initial defect area due to GTR. Neither the clinical nor the radiographic healing parameters revealed any statistically significant differences in the GTR healing outcome between IL-1 + and IL-1 – patients. In conclusion, these 12-month findings indicate that the IL-1 gene polymorphism has no influence on the clinical and radiographic regeneration results following GTR therapy.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of materials science 5 (1994), S. 43-51 
    ISSN: 1573-4838
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: The objective of this study was (1) to improve the succinate dehydrogenase (SDH) staining procedure of the filter test system, and (2) to study the suitability of hydrolases as markers for cell vitality by means of fluorescein diacetate, instead of SDH. The test materials included zinc phosphate cements, conventional and light-cured glass ionomer cements, a composite resin, and methylmethacrylate monomer. Four series of experiments were performed using L-929 mouse fibroblasts: (1) original method, (2) 24 h incubation time with procedural modifications; (3) use of FDA as marker for cell vitality; and (4) the agar overlay method. The staining intensity of the cells in the first series was insufficient. In the second series filter staining was good and showed distinct zones of damaged cells. In the third series cell staining was very distinct and easier to handle than with SDH. The results obtained in the second, third, and fourth series were in agreement with results from other cell culture tests. To compare results from different series an evaluation system based on the area of damaged cells was introduced. Correlations were high between series 2 and 3 as well as between 3 and 4. Our results indicate that the modifications of the filter test improve the method.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Clinical oral investigations 1 (1997), S. 109-118 
    ISSN: 1436-3771
    Keywords: Key words Guided tissue regeneration ; Periodontal disease/surgery ; Intrabony defects ; Polylactic acid ; Polyglactin 910
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The goal of this investigation was to evaluate the effect of postoperative exposure of two different bioresorbable membranes on the guided tissue regeneration (GTR) healing results compared to nonexposed sites. In each of 25 patients one pair of contralateral intrabony lesions was treated either with polylactic acid (PLA) or polyglactin 910 (PG-910) membranes. Postoperative exposure occurred in 9 PLA and 13 PG-910 sites. Standardized clinical [papillary bleeding index (PBI), gingival recession (REC), probing pocket depth (PPD), probing attachment level (PAL)] and radiographic examinations (digital subtraction radiography) were performed immediately before (baseline) and 6 and 12 months postoperatively (p.o.). Subgingival bacterial samples from surgical sites were evaluated by culture at baseline, 6 weeks, and 6 and 12 months p.o. Six months after surgery the changes (Δ) of REC were significantly (P≤0.05) greater in exposed than in nonexposed sites, independently of the membrane material (median): exposed sites, ΔREC=–1 mm; nonexposed sites, ΔREC=0.0 mm. However, 12 months p.o. no significant differences were found due to a decrease in the initial recessions in exposed sites. Although a higher percentage of exposed than nonexposed sites harbored periodontal pathogens 6 weeks p.o. at the gingiva-faced membrane surface, membrane exposure did not have a significant negative effect on ΔPPD, ΔPAL, or radiographic bone density changes 6 and 12 months p.o. Both membranes showed significant gains in PAL and bone density in both exposed and nonexposed sites. In conclusion, this study demonstrates that with consistent infection control the postoperative exposure of PLA and PG-910 membranes has no significant negative effect on the regeneration outcome, although higher initial gingival recessions must be expected than in the nonexposed sites. However, in exposed sites plaque and infection control were clearly impeded by the rough, exposed membrane surfaces and by the initially negative gingival morphology.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Clinical oral investigations 1 (1998), S. 163-168 
    ISSN: 1436-3771
    Keywords: Key words Ceramics ; Inlays ; Clinical trial ; Quantitative margin analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of this clinical study was to evaluate feldspathic ceramic inlays both by clinical criteria and quantitative margin analysis in continuation of an earlier, identically conducted 2-year study. Fifty feldspathic ceramic inlays were adhesively luted in Class II preparations with all margins located in enamel. The inlays were evaluated clinically according to modified USPHS criteria after 3 and 4 years. Quantitative margin analysis was performed with a scanning electron microscope (SEM). Clinically, the inlays showed no recurrent caries and no changes in colour, but superficial marginal discolouration (6%) was apparent after 4 years. Margins were perceptible clinically in 64% of the cases after 4 years. Quantitative margin analysis showed significantly more marginal gaps at the composite/ceramic interface than at the enamel/composite interface. There was neither a significant decrease in perfect margins nor a significant increase in marginal gaps and marginal imperfections at both interfaces between the third and fourth year. Clinically, the inlays performed very well up to 4 years. Clinical evaluation using an explorer only detected substance loss in the cementation gap. The SEM evaluation showed significantly higher changes in marginal qualities during the first 2-year interval of clinical service compared to the second 2-year interval following an exponential mathematical regularity. Quantitative margin analysis should be included in clinical long-term trials to detect early marginal deficiencies at the luting interfaces.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1436-3771
    Keywords: Key words Polyacid-modified resin ; Class V lesion ; Softstart-polymerization ; Clinical performance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  This study investigated the influence of ”softstart-polymerization” on the clinical performance and marginal integrity of polyacid-modified resin restorations (PMR) in class V cavities. Eighty PMR restorations were placed in 20 patients [40 Dyract (DY); 40 Hytac (HY)] with (n pat =10) and without preparation (n pat =10). Restorations were light cured for 40 s either conventionally (CP) or with a lower light intensity for the first 10 s (SSP). Each patient received four restorations (DY-CP, DY-SSP, HY-CP, HY-SSP), which were examined clinically according to modified USPHS criteria, and by quantitative SEM-analysis after 7 days (baseline), 6 months and 1 year. Statistical analysis was performed using the Mann-Whitney-U test (P≤ 0.05) and error rates method. Clinically, no restoration showed recurrent caries or crevices. After 1 year, margins of 24–47% of the HY- and 36–53% of the DY-restorations were rated ”Bravo”. Marginal discoloration occurred in 20–37% in HY- and in 18–21% in DY-restorations. The error rates method revealed no significant differences between materials or between polymerization modes with and without preparation. Pairwise testing showed that without preparation, the marginal adaptation to dentin was significantly worse compared to enamel for HY with both polymerization modes, for DY with SSP. With preparation, no significant differences were found. Cavity preparation may have an influence on differences in marginal quality between enamel and dentin.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Clinical oral investigations 4 (2000), S. 199-205 
    ISSN: 1436-3771
    Keywords: Keywords Partial ceramic crowns ; Clinical evaluation ; Kaplan-Meier survival analysis ; USPHS criteria ; Longevity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The purpose of the present study was to de-termine retrospectively the clinical performance of 42 all-ceramic partial crowns (PCCs) placed during the past 7 years. All patients (n=25) with partial ceramic crowns (n=49) placed by one experienced dentist between 1992 and 1999 were asked to take part in a clinical study, and 22 patients with 42 restorations agreed to do so. All partial ceramic crowns studied were fabricated using the IPS-Empress I all-ceramic system (Vivadent). The following luting composites were used for placing the restorations: 20 (47.6%) Variolink high viscosity (Vivadent), 3 (7.1%) Variolink ultra (Vivadent), 17 (40.5%) Dual Zement (Vivadent), and 2 (4.8%) Compolute (Espe). The partial ceramic crowns were examined clinically using the modified USPHS criteria. Of the 42 restorations, 40 (95.2%) were still in function without any need of replacement. One restoration (2.4%) had failed before starting the clinical study, and another one (2.4%) fractured during the study. Twenty-eight (66.7%) of the partial ceramic crowns evaluated were rated Alpha with respect to marginal adaptation. Twelve (28.6%) restorations were rated Bravo, no Charlie ratings were found and 2 (4.7%) restorations were rated Delta. The Kaplan-Meier analysis was used to calculate the survival rate. The probability of survival (95% confidence interval) for 7 years was 81% (66–96%). These data indicate that partial ceramic crowns may provide successful esthetic restorations in posterior teeth.
    Type of Medium: Electronic Resource
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