Home About us Contact
|
Home About us Contact | ||
|
|
||
Mean Clinical Attachment Level (mean + clinical_attachment_level)
Selected AbstractsIncomplete adherence to an adjunctive systemic antibiotic regimen decreases clinical outcomes in generalized aggressive periodontitis patients: a pilot retrospective studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2007Adrian Guerrero Abstract Aim: The objective of this study was to explore the effect of incomplete adherence to the prescribed antibiotic regimen, amoxicillin and metronidazole, in the non-surgical treatment of generalized aggressive periodontitis (GAP). Methods: This retrospective study included 18 GAP subjects who received a conventional course of full-mouth non-surgical periodontal treatment using machine-driven and hand instruments and an adjunctive course of systemic antibiotics (500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days). Clinical parameters were collected at baseline and at 2 months post-treatment. Self-reported adherence to the prescribed medication regimen was recorded at 2 months. Results: All clinical parameters, except for the mean clinical attachment level (CAL) in sites with initial probing pocket depth (PPD) 3 mm, improved at 2 months in all subjects. PPD reduction was 3.7 mm [95% confidence interval (CI) 3.2, 4.3 mm] in deep pockets (7 mm) and 2.2 mm (95% CI 1.9, 2.4 mm) in moderate pockets (4,6 mm), while CAL gain was 2.2 mm (95% CI 1.7, 2.6 mm) and 1.2 mm (95% CI 0.8, 1.5 mm), respectively. However, only 11 subjects (61.1%) reported full adherence to the medication. In deep pockets (7 mm), the difference between an adherent and non-adherent/partially adherent subject was 0.9 mm (95% CI 0.1, 1.7 mm, ancova, p=0.027) in PPD reduction and 0.8 mm (95% CI ,0.2, 1.9, p=0.129) in CAL gain at 2 months. In moderate pockets (4,6 mm) this difference was smaller in magnitude: 0.4 mm (95% CI 0.1, 0.9 mm, p=0.036) in PPD reduction and 0.2 mm (95% CI ,0.3, 0.9 mm, p=0.332) in CAL gain. Conclusions: Within the limits of this design, these data suggest that incomplete adherence to a 7-day adjunctive course of systemic metronidazole and amoxicillin is associated with decreased clinical outcomes in subjects with generalized aggressive periodontitis. [source] Five-year results of a prospective, randomized, controlled study evaluating treatment of intra-bony defects with a natural bone mineral and GTRJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2007Anton Sculean Abstract Background: Treatment with a natural bone mineral (NBM) and a guided tissue regeneration (GTR) has been shown to promote periodontal regeneration. However, until now there are only very limited data on the long-term clinical results following this regenerative technique. Aim: To present the 5-year results of a prospective, randomized, controlled clinical study evaluating the treatment of deep intra-bony defects either with open flap debridement (OFD) and a combination of an NBM and GTR (test) or OFD alone (control). Methods: Nineteen patients diagnosed with advanced chronic periodontitis, and each of whom displayed one intra-bony defect, received randomly the test or the control treatment. Results were evaluated at baseline, at 1 and at 5 years following therapy. Results: No statistically significant differences in any of the investigated parameters were observed at baseline between the two groups. At 1 year after therapy, the test group showed a reduction in mean probing depth (PD) from 9.1±1.1 to 3.7±0.8 mm (p<0.001) and a change in mean clinical attachment level (CAL) from 10.4±1.3 to 6.4±1.2 mm (p<0.001). At 5 years, mean PD and CAL measured 4.3±0.8 and 6.7±1.6 mm, respectively. At 5 years, both PD and CAL were statistically significantly improved compared with baseline (p<0.001) without statistically significant differences between the 1- and 5-year results. In the control group, mean PD was reduced from 8.9±1.3 to 4.9±1.2 mm (p<0.001) and mean CAL changed from 10.6±1.4 to 8.8±1.5 mm (p<0.01). At 5 years, mean PD and CAL measured 5.6±1.1 and 9.1±1.3 mm, respectively, and were still statistically significantly improved compared with baseline (p<0.01). No statistically significant differences were found between the 1- and 5-year results. The test treatment, at both 1 and 5 years, yielded statistically significantly higher CAL gains than the control one (p<0.01). Compared with baseline, at 5 years a CAL gain of 3 mm was found in nine defects (90%) of the test group but in none of the defects treated with OFD alone. Conclusions: It was concluded that (i) treatment of intra-bony defects with OFD+NBM+GTR may result in significantly higher CAL gains than treatment with OFD, and (ii) the clinical results obtained after both treatments can be maintained over a period of 5 years. [source] Is coronally positioned flap procedure adjunct with enamel matrix derivative or root conditioning a relevant predictor for achieving root coverage?JOURNAL OF PERIODONTAL RESEARCH, Issue 5 2007A systemic review Background and Objective:, This study is a systemic review of coronally positioned flap, coronally positioned flap + chemical root surface conditioning, or coronally positioned flap + enamel matrix derivative (EMD) for the treatment of Miller class I and II gingival recession. Material and Methods:, All studies available through the Medline database by the end of October 2005 were used. Each study provided mean clinical attachment level, keratinized tissue, probing pocket depth, gingival recession depth and root coverage percentage before and after treatment with coronally positioned flap alone, coronally positioned flap + chemical root surface conditioning , or coronally positioned flap + EMD. Effectiveness was evaluated by comparing the weighted mean average in gingival recession depth, probing pocket depth, clinical attachment level, keratinized tissue and root coverage percentage achieved with the three treatments. Results:, Seven studies for the coronally positioned flap + EMD group, four studies for the coronally positioned flap + chemical root surface conditioning group, and seven studies for the coronally positioned flap group were retrieved for this weighted mean analysis. The results of clinical attachment level, gingival recession depth, and root coverage percentage in the coronally positioned flap + EMD group were statistically significantly better than the changes in the coronally positioned flap and coronally positioned flap + chemical root surface conditioning group at 6 and 12 mo (p < 0.001). There was no significant difference at the 6-mo comparison among clinical attachment level, keratinized tissue, probing pocket depth, and gingival recession depth, except in the root coverage percentage for coronally positioned flap and coronally positioned flap + chemical root surface conditioning groups. Conclusion:, The results suggest that root coverage by the coronally positioned flap and coronally positioned flap + chemical root surface conditioning procedures were unpredictable but became more predictable when the coronally positioned flap procedure was improved by the modification of adding EMD. [source] Early loading (2 or 6 weeks) of sandblasted and acid-etched (SLA) ITI® implants in the posterior mandibleCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2004A 1-year randomized controlled clinical trial Abstract: The aim of this 1-year prospective controlled clinical trial was to evaluate the effect of early loading of ITI® solid screw titanium implants with a sandblasted and acid-etched (SLA) surface on clinical and radiographic parameters. Material and methods: Twenty-seven consecutively admitted patients presenting bilateral edentulous posterior mandibular areas and in need of prosthetic reconstruction were recruited. Sixty-seven ITI® standard solid screw implants with an SLA surface, a diameter of 4.1 mm and a length of 8, 10 or 12 mm were installed bilaterally in molar and premolar areas according to a one-stage surgical protocol. One week (test) and 5 weeks (control) after implant placement, solid ITI® prosthetic abutments were connected using a torque of 35 N cm. No provisional restoration was fabricated. Two weeks (test) and 6 weeks (control) after implant placement, porcelain-fused-to-metal single-tooth crowns were cemented. Clinical measurements were obtained at day 0 and 2, 6, 12, 24 and 52 weeks thereafter. Periapical radiographs were taken immediately after implant placement, after 6 weeks and at the 1-year examination. Results: After 1 year, implant survival was 100%. Two test and one control implants rotated at the time of abutment connection and were left unloaded for 12 additional weeks. At the 1-year examination, no statistically significant differences were found between the test and control sites with respect to pocket probing depths (2.6 mm±0.5 vs. 2.7 mm±0.5), mean clinical attachment levels (3.1 mm±0.4 vs. 3.2 mm±0.5), mean percentages of sites bleeding on probing (9.7% vs. 8.3%), mean widths of keratinized mucosa (1.8 mm±0.4 vs. 1.9 mm±0.5), mean PerioTest® values (,1.4 PTV±0.9 vs. ,1.6 PTV±0.8) or mean crestal bone loss measurements (0.57 mm±0.49 vs. 0.72 mm±0.50). Conclusion: Based on these results, loading of titanium implants with an SLA surface as early as 2 weeks did not appear to jeopardize the osseointegration healing process in the posterior mandible. Furthermore, implants rotating at 35 N cm, if left unloaded for additional 12 weeks, did not negatively affect clinical and radiographic outcomes. Résumé Le but de cet essai clinique contrôlé prospectif d'une année a été d'évaluer l'effet de la mise en charge précoce d'implants en titane vis solide ITI® avec une surface sablée et mordancée (SLA) sur des paramètres cliniques et radiographiques. Vingt-sept patients présentant des aires bilatérales mandibulaires postérieures édentées et nécessitant donc une reconstruction prothétique ont été recrutés. Soixante-sept implants ITI® d'un diamètre de 4,1 mm et d'une longueur de 8, 10 ou 12 mm ont été placés bilatéralement dans les zones molaires et prémolaires suivant le processus chirurgical en une étape. Une semaine (test) et cinq semaines (contrôle) après leur placement des piliers prothétiques ITI® ont été serrés avec une force de 35 Ncm. Aucune restauration provisoire n'a été fabriquée. Deux semaines (test) et six semaines (contrôle) après le placement des implants des couronnes céramo-métalliques indépendantes ont été cimentées. Des mesures cliniques ont été obtenues aux jours 0 et deux, et aux semaines 6, 12, 24 et 52. Des radiographies périapicales ont été prises immédiatement après le placement des implants, après six semaines et une année. Après une année, le taux de survie implantaire était de 100%. Deux implants tests et un contrôle pivotaient au moment de la connexion du pilier et ont été laissés non-chargés pour 12 semaines supplémentaires. Après une année, aucune différence statistique n'a été trouvée entre les sites tests et contrôles en ce qui concerne les profondeurs de poches au sondage (2,6 ±0,5 mm vs 2,7± 0,5 mm), les niveaux d'attache clinique moyens (3,1±0,4 vs 3,2±0,5 mm,) les pourcentages moyens de sites saignant au sondage (9,7% vs 8,3%), les largeurs moyennes de muqueuse attachée (1,8±0,4 mm vs 1,9±0,5 mm), les valeurs Periotest moyennes (,1,4±0,9 PTV vs ,1,6 ±0,8 PTV) ou les mesures de perte osseuse crestale moyennes (0,57 ± 0,49 mm vs 0,72±0,52 mm). La charge d'implants en titane avec surface SLA aussitôt que deux semaines après leur placement ne semblait pas mettre en danger le processus d'ostéoïntégration dans la partie postérieure de la mandibule. De plus, les implants pivotant à 35 Ncm, si laissés non-chargés pour douze semaines supplémentaires, n'affectaient pas de manière négative les mesures cliniques et radiographiques. Zusammenfassung Material und Methoden: Es wurden siebenundzwanzig Patienten mit beidseits zahnlosem Seitenzahnbereich im Unterkiefer, welche eine prothetische Versorgung benötigten, in die Studie aufgenommen. Es wurden 67 ITI® Standard Vollschraubenimplantate mit einem Durchmesser von 4.1 mm und einer Länge von 8, 10 oder 12 mm beidseits in der Molaren- und Prämolarenregion transmukosal eingesetzt. Eine Woche (Test) und 5 Wochen (Kontrolle) nach Implantation wurden ITI® Massivsekundärteile mit einem Drehmoment von 35 Ncm eingesetzt. Es wurde keine provisorische Versorgung angefertigt. Zwei Wochen (Test) und 6 Wochen (Kontrolle) nach Implantation wurden Gold-Porzellan Einzelkronen einzementiert. Klinische Messungen wurden am Tag 0 und nach 2, 6, 12, 24, und 52 Wochen aufgenommen. Periapikale Röntgenaufnahmen wurden sofort nach der Implantation, nach 6 Wochen und anlässlich der 1 Jahreskontrolle angefertigt. Resultate: Nach einem Jahr betrug die Implanta-tüberlebensrate 100%. Zwei Test- und ein Kontrollimplantat drehten sich beim Einschrauben der Sekundärteile und wurden für zusätzliche 12 Wochen unbelastet belassen. Bei der 1 Jahresuntersuchung konnten zwischen Test- und Kontrolli-mplantaten keine statistisch signifikanten Unterschiede bezüglich Sondierungswerten (2.6mm+/,0.5 gegenüber 2.7mm +/,0.5), mittlerem klinischem Attachmentniveau (3.1mm +/,0.4 gegenüber 3.2mm +/,0.5), mittlerem Prozentanteil beim Bluten auf Sondieren (9.7% gegenüber 8.3%), mittlerer Breite der keratinisierten Mukosa (1.8mm +/,0.4 gegenüber 1.9mm +/,0.5), mittleren Periotest® Werten (,1.4 PTV +/,0.9 gegenüber ,1.6 PTV +/,0.8) oder mittlerem marginalem Knochenverlust (0.57mm +/,0.49 gegenüber 0.72mm +/,0.50) gefunden werden. Schlussfolgerung: Gemäss dieser Resultate schien die Belastung von Titanimplantaten mit SLA Oberfäche bereits nach 2 Wochen den Heilungsprozess der Osseointegration im posterioren Unterkiefer nicht zu beeinträchtigen. Implantate, die bei 35Ncm rotierten und daraufhin für weitere 12 Wochen unbelastet blieben, beeinflussten die klinischen und radiologischen Resultate nicht negativ. Resumen La intención de este ensayo clínico prospectivo controlado fue evaluar el efecto de una carga temprana sobre implantes macizos roscados de titanio con una superficie pulverizada con arena y gravada con ácido (SLA) sobre parámetros clínicos y radiográficos. Material y Métodos: Se reclutaron veintisiete pacientes consecutivamente admitidos que presentaron áreas edéntulas bilaterales en la mandíbula posterior y necesitando reconstrucción protésica. Se instalaron bilateralmente en las áreas molar y premolar sesenta y siete implantes ITI® estándar macizos roscados de titanio con una superficie SLA, un diámetro de 4.1 mm y una longitud de 8, 10 o 12 mm de acuerdo con un protocolo quirúrgico de una sola fase. Una semana (prueba) y 5 semanas (control) tras la colocación del implante, se conectaron pilares prostéticos macizos ITI usando un torque de 35 Ncm. No se fabricaron restauraciones provisionales. Dos semanas (prueba) y 6 semanas (control) tras la colocación de los implantes, se cementaron coronas unitarias metalocerámicas. Se obtuvieron medidas clínicas en el día 0 y tras 2, 6, 12, 24 y 52 semanas. Se tomaron radiografías periapicales inmediatamente tras la colocación del implante, a las 6 semanas y en el examen de 1 año. Resultados: Tras 1 año, la supervivencia de los implantes fue del 100%. Dos implantes de prueba y uno de control rotaron en el momento de la conexión del pilar y se dejaron sin carga durante 12 semanas más. En el examen de 1 año, no se encontraron diferencias significativas entre los lugares de prueba y los de control respecto a las profundidades de sondaje (2.6 mm±0.5 vs. 2.7 mm±0.5), niveles medios de inserción clínica (3.1±mm±0.4 vs. 3.2 mm±0.5), porcentaje medio de lugares con sangrado al sondaje (9.7% vs. 8.3%), anchura media de mucosa queratinizada (1.8 mm±0.4 vs. 1.9 mm±0.5), valores medios de Perio Test® (,1.4 PTV±0.9 vs. ,1.6 PTV±0.8) o a las medidas medias de perdida de hueso crestal (0.57 mm±0.49 vs. 0.72 mm±0.50). Conclusiones: Basándose en estos resultados, la carga de implantes de titanio con superficie SLA tan pronto como a las 2 semanas no pareció comprometer el proceso de cicatrización de la osteointegración en la mandíbula posterior. Mas aun, los implantes que rotaron a 35 Ncm, si se dejan sin carga durante 12 semanas más, no afectaron negativamente los resultados clínicos y radiográficos. [source] | ||||||||||