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Tissue Wall (tissue + wall)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Some effects of enamel matrix proteins on wound healing in the dento-gingival region

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2002
Jan L. Wennström
Abstract Objective: The aim of the present study was to evaluate by clinical means the effect of enamel matrix proteins on the healing of a soft tissue wound produced by periodontal pocket instrumentation. Material and methods: The study was performed as an intra-individual, longitudinal trial of 3 weeks duration with a double-masked, split-mouth, placebo-controlled and randomized design. The patient material was comprised of 28 subjects with moderately advanced, chronic periodontitis. Each patient presented with 3 sites in each of 2 jaw quadrants with a probing pocket depth (PPD) of 5 mm and bleeding following pocket probing (BoP). Baseline examination, including assessments of plaque, gingival inflammation, PPD, BoP and root dentin sensitivity, was carried out one week after oral hygiene instruction and careful self-performed plaque control. All experimental sites were scaled and root planed, and the soft tissue wall of the pocket was curetted to remove the pocket epithelium and adjacent granulation tissue. The site was carefully irrigated with saline. When the bleeding from the pocket had ceased, a 24% EDTA gel was applied in the site and retained for 2 min. This was followed by careful irrigation with saline. Left and right jaw quadrants were then randomized to subgingival application of enamel matrix derivative (Emdogain®) or vehicle-control. All sites were re-examined after 1, 2 and 3 weeks. In addition, a visual analogue scale (VAS) was used to score the degree of post-treatment discomfort. The primary endpoints of treatment success were defined as (i) pocket closure (PPD 4 mm), (ii) no bleeding following pocket probing, (iii) no sign of gingival inflammation (GI score =0) and (iv) low degree of post-treatment discomfort (VAS 20). Statistical analyzes of intra-individual differences between the test and control treatments were performed by the use of Wilcoxon signed rank test. For comparison of the proportions of sites reaching the defined endpoints of treatment success, a site-based analysis was performed using 2×2 tables and the Fisher exact test. Results: The endpoint "GI score =0" was reached at 16% of the sites subjected to application of Emdogain® at 1 week and at 2% of the control sites (p=0.001). At 2 weeks, the corresponding figures were 25% versus 12% (p=0.028). Absence of BoP was at 1 week 57% for the Emdogain® treated sites compared to 35% for the control sites (p=0.003). At 2 weeks, this endpoint was reached in 73% and 59% of the test and control sites, respectively (p=0.051). In terms of the endpoint defined for probing pocket depth, PPD 4 mm, no differences between test and control sites were found. At 1 week, the proportion of patients reporting a VAS score 20 was significantly higher for the Emdogain® treated quadrants than for controls (p=0.002). Conclusion: The results indicated that Emdogain® topically applied in instrumented pockets enhance the early healing of periodontal soft tissue wounds. Zusammenfassung Zielsetzung: Klinische Untersuchung der Wirkung von Schmelzmatrixprotein (SMP) auf die Heilung der durch subgingivale Instrumentierung verursachten Wunde. Material und Methoden: Das Studiendesign entsprach einer randomisierten longitudinalen plazebokontrollierten doppelt verblindeten Halbseitenstudie, an der 28 Patienten mit mäßig fortgeschrittener chronischer Parodontitis teilnahmen. Jeder Patient wies an 3 Stellen zweier Quadranten Sondierungstiefen (ST) 5 mm und Bluten auf Sondieren (BOP) auf. Eine Woche nach Durchführung von Mundhygieneinstruktionen und gründlicher individueller Mundhygiene erfolgte die Basisuntersuchung: Plaque, gingivale Entzündung, ST, BOP und Zahnhalsüberempfindlichkeit. Alle Testzähne wurden subgingival instrumentiert (Scaling und Wurzelglättung), es wurde eine Weichgewebskürettage durchgeführt und mit Kochsalzlösung (NaCl) gespült. Nach dem Stillstand der Taschenblutung wurde ein 24%iges EDTA-Gel subgingival appliziert und für 2 min belassen. Nach gründlicher NaCl-Spülung erfolgte eine randomisierte Zuweisung der subgingivalen Instillation von SMP-Gel (Test) oder nur Trägergel (Plazebokontrolle) zum rechten bzw. linken Quadranten. Nachuntersuchungen erfolgten nach 1, 2 und 3 Wochen. Dabei wurden zusätzlich die postoperativen Beschwerden mit einer visuellen Analogskala (VAS) erfasst. Als Hauptzielkriterien des Behandlungserfolges wurden definiert: (1) Verschluß der parodontalen Tasche (ST 4 mm), (2) kein BOP, (3) keine Zeichen gingivaler Entzündung (GI=0) und (4) nur geringgradige postoperative Beschwerden (VAS 20). Der Vergleich zwischen Test und Kontrolle erfolgte mit dem Wilcoxon-Test bzw. mit 4-Felder-Tafeln und dem Fisher-Exakt-Test. Ergebnisse: Das Erfolgskriterium "GI=0" war nach 1 Woche bei 16% der Test- und und bei 2% der Kontrollstellen erfüllt (p=0.001). Nach 2 Wochen lagen die Proportionen für Test und Kontrolle bei 25% bzw. 12% (p=0.028). Kein BOP war nach 1 Woche bei 57% der Test- und bei 35% der Kontrollstellen zu beobachten (p=0.003), nach 2 Wochen lagen die Werte bei 73% bzw. 59% (p=0.051). Hinsichtlich des Kriteriums ST 4 mm konnten keine Unterschiede zwischen Test und Kontrolle gefunden werden. 1 Woche nach Instrumentierung war der Anteil der Patienten in der Testgruppe, die eine VAS 20 angaben, höher als in der Kontrollgruppe (p=0.002). 3 Wochen nach Therapie wiesen beide Gruppen hinsichtlich keines der Erfolgskriterien mehr statistisch signifikante Unterschiede auf. Schlussfolgerungen: Die topische subgingivale Applikation von SMP in instrumentierte parodontale Taschen könnte die frühe Wundheilung des Weichgewebes begünstigen. Résumé But: Le but de l'étude présente a été d'évaluer cliniquement l'effet des protéines de la matrice amélaire (Emdogain®) sur la guérison des tissus mous produits par l'instrumentation de la poche parodontale. Matériaux et méthodes: Cette étude a été effectuée en tant qu'essai longitudinal intra-individuel de 3 semaines avec un modèle en double aveugle, par bouche divisée, au hasard et contrôlé par placebo. 28 sujets avec parodontite chronique modérement avancée ont participéà cette étude. Chaque patient présentait 3 sites dans 2 quadrants avec une profondeur au sondage (PPD) 5 mm et un saignement au sondage (BoP). L'examen initial comprenant la prise des indices de plaque, d'inflammation gingivale, de PPD, de BoP et de la sensibilité dentinaire a été effectué une semaine après l'instruction en hygiène buccale et le contrôle de plaque dentaire réalisé par la personne elle-même. Tous les sites expérimentaux ont été détartrés et surfacés, et la paroi de tissu mou de la poche a été curetée pour enlever l'épithélium de la poche et le tissu de granulation adjacent. Ce site a été irrigué avec du sérum physiologique. Lorsque le saignement de la poche avait cessé, un gel d'EDTA 24% a été appliqué dans le site et est resté in situ pendant 2 min. Ensuite une nouvelle irrigation avec du sérum physiologique a été prodiguée. Les quadrants gauches et droits étaient ensuite distribués au hasard pour l'application sous-gingivale du dérivé de la matrice amélaire (Emdogain®) ou en tant que véhicule contrôle. Tous les sites ont été ré-éxaminés aprés 1, 2 et 3 semaines. De plus une échelle analogue de vision (VAS) a été utilisée pour mesurer le degré d'inconfort post-traitement. Les points principaux du succès du traitement étaient définis comme suit (1) fermeture de la poche (PPD 4 mm), (2) absence de saignement au sondage, (3) aucun signe d'inflammation gingivale (GI=0) et (4) un faible degré d'inconfort post-traitement (VS20). Les analyses statistiques des différences intra-individuelles entre les traitements tests et contrôles ont été effectuées à l'aide du test par Wilcoxon Signed Rank. Pour la comparaison des proportions de sites atteignant le succès souhaité, une analyse basée sur les sites a été effectuée en utilisant des tables 2×2 et le test exact de Fisher. Résultats: Le but GI=0 a été atteint dans 16% des sites avec Emdogain® après 1 semaine seulement et dans 2% des sites contrôles (p=0.001). A 2 semaines, les figures correspondantes étaient 25% versus 12% (p=0.028). L'absence de BoP a 1 semaine atteignait 57% des sites traités par Emdogain® contre 35% pour les contrôles (p=0.003). A 2 semaines, ce but était atteint dans respectivement 73% et 59% des sites tests et contrôles (p=0.051). En terme de PPD4 mm, aucune différence n'a été trouvée entre les sites. A 1 semaine, la proportion de patients qui avaient un VAS 20 était significativement plus importante dans le groupe traité par Emdogain® que chez les contrôle (p=0.002). Conclusions: Les résultats ont indiqué que l'Emdogain® placé localement dans des poches nettoyées peut augmenter la guérison précoce des tissus mous parodontaux. [source]

Immunohistochemical and scanning electron microscopic comparison of the collagen network constructions between pig, goat and chicken livers

ANIMAL SCIENCE JOURNAL, Issue 4 2009
Shotaro NISHIMURA
ABSTRACT The distribution and three-dimensional architecture of collagen fibers were compared between pig, goat and chicken livers. Immunohistochemical staining revealed that collagen type I was identified in the interlobular connective tissue region and intralobular areas in pigs and goats. Type III collagen was also identified in the interlobular connective tissue region and intralobular sinusoidal walls. In the chicken liver, only the circumference region of the vessels was immunostained with collagen type I and III antibodies and the interlobular connective tissue wall could not be distinguished clearly. In the intralobular region, collagen type I antibody immunoreacted around the hepatic cells but collagen type III antibody immunoreacted weakly. In the NaOH macerated specimen, well-developed collagen bundles formed the prominent interlobular walls in pigs. In contrast, the wall in the goat liver comprised a thin layer of the bundles. In the chicken liver, there were no notable collagen septa between lobules. The intralobular collagen construction was quite different between the animals, indicating a fragile collagen fibril networks in pigs, a robust framework in goats and dense fabric-like septa in chickens. These results indicate that the distinct collagen frameworks may contribute to the histological strength of the livers in each of the animal species. [source]

Tissue modeling following implant placement in fresh extraction sockets

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2006
Mauricio G. Araújo
Abstract Objective: To study whether osseointegration once established following implant placement in a fresh extraction socket may be lost as a result of tissue modeling. Material and methods: Seven beagle dogs were used. The third and fourth premolars in both quadrants of the mandible were used as experimental teeth. Buccal and lingual full-thickness flaps were elevated and distal roots were removed. Implants were installed in the fresh extraction socket. Semi-submerged healing of the implant sites was allowed. In five dogs, the experimental procedure was first performed in the right side of the mandible and 2 months later in the left mandible. These five animals were sacrificed 1 month after the final implant installation. In two dogs, the premolar sites on both sides of the mandible were treated in one surgical session and biopsies were obtained immediately after implant placement. All biopsies were processed for ground sectioning and stained. Results: The void that existed between the implant and the socket walls at surgery was filled at 4 weeks with woven bone that made contact with the SLA surface. In this interval, (i) the buccal and lingual bone walls underwent marked surface resorption and (ii) the height of the thin buccal hard tissue wall was reduced. The process of healing continued, and the buccal bone crest shifted further in the apical direction. After 12 weeks, the buccal crest was located>2 mm apical of the marginal border of the SLA surface. Conclusion: The bone-to-implant contact that was established during the early phase of socket healing following implant installation was in part lost when the buccal bone wall underwent continued resorption. [source]

Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installation

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2006
Mauricio G. Araújo
Abstract Objective: To determine whether the reduction of the alveolar ridge that occurs following tooth extraction and implant placement is influenced by the size of the hard tissue walls of the socket. Material and methods: Six beagle dogs were used. The third premolar and first molar in both quadrants of the mandible were used. Mucoperiostal flaps were elevated and the distal roots were removed. Implants were installed in the fresh extraction socket in one side of the mandible. The flaps were replaced to allow a semi-submerged healing. The procedure was repeated in the contra later side of the mandible after 2 months. The animals were sacrificed 1 month after the final implant installation. The mandibles were dissected, and each implant site was removed and processed for ground sectioning. Results: Marked hard tissue alterations occurred during healing following tooth extraction and implant installation in the socket. The marginal gap that was present between the implant and the walls of the socket at implantation disappeared as a result of bone fill and resorption of the bone crest. The modeling in the marginal defect region was accompanied by marked attenuation of the dimensions of both the delicate buccal and the wider lingual bone wall. Bone loss at molar sites was more pronounced than at the premolar locations. Conclusion: Implant placement failed to preserve the hard tissue dimension of the ridge following tooth extraction. The buccal as well as the lingual bone walls were resorbed. At the buccal aspect, this resulted in some marginal loss of osseointegration. [source]