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Tissue Graft (tissue + graft)

Distribution by Scientific Domains
Medical Sciences85%
Polymers and Materials Science9%

Kinds of Tissue Graft

  • connective tissue graft
    		•

    Selected Abstracts

    Treatment of class III multiple gingival recessions: a randomized-clinical trial

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2010
    Sofia Aroca
    Abstract Background: The aim of this controlled randomized split-mouth study was to evaluate whether a modified tunnel/connective tissue graft (CTG) technique , enamel matrix derivative (EMD) combination will improve the treatment of multiple class III recession when compared with the same technique alone. Materials and Methods: Twenty healthy subjects with a mean age of 31.7 years, were enrolled for the trial in a university periodontal clinic. Patients with at least three adjacent gingival recessions on both sides of the mouth were treated with a modified tunnel/CTG technique. On the test side, an EMD was used in addition. Clinical parameters were measured at baseline, 28 days, 3, 6 and 12 months after the surgery. Results are presented at the subject level. Results: The mean root coverage from baseline to 1 year post-surgery was 82% for the test group and 83% for the control group. Complete root coverage was achieved at 1 year in eight (38%) of the 20 surgeries (experimental and control group). Conclusions: One-year results indicate that the modified tunnel/CTG technique is predictable for the treatment of multiple class III recession-type defects. The addition of EMD does not enhance the mean clinical outcomes. [source]

    Hard tissue alterations after socket preservation with additional buccal overbuilding: a study in the beagle dog

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2009
    Stefan Fickl
    Abstract Objectives: The aim of this study was to histometrically assess alterations of the ridge following socket preservation alone and socket preservation with additional buccal overbuilding. Material and Methods: In five beagle dogs four extraction sites were randomly subjected to one of the following treatments: Tx 1: The socket was filled with BioOss Collagen® and covered with a free gingival graft from the palate. Tx 2: The buccal bone plate was augmented using the GBR-technique, the socket was filled with BioOss Collagen® and covered with a free gingival graft. Tx 3: The buccal bone plate was forced into a buccal direction using a manual bone spreader. The socket was filled with BioOss Collagen® and covered with a free gingival graft from the palate. Tx 4: The socket was filled with BioOss Collagen® and a combined free gingival/connective tissue graft was used to cover the socket and for buccal tissue augmentation. For each experimental site, two histological sections were subjected to histometric analysis and evaluated for (i) vertical bone dimensions and (ii) horizontal bone dimensions. Results: All treatment groups showed horizontal and vertical bone loss. The mean vertical bone loss of the buccal bone plate was significantly lower in Tx 4 than in the other groups, while no statistical significant differences could be detected among the groups in the horizontal dimension. Conclusion: Overbuilding the buccal aspect in combination with socket preservation does not seem to be a suitable technique to compensate for the alterations after tooth extraction. [source]

    Connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesion: a randomized-controlled clinical trial

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2009
    Mauro Pedrine Santamaria
    Abstract Background: The aim of this clinical study was to evaluate the treatment of gingival recession, associated with non-carious cervical lesions by a connective tissue graft (CTG) alone, or in combination with a resin-modified glass ionomer restoration (CTG+R). Materials and Methods: Forty patients presenting Miller Class I buccal gingival recessions, associated with non-carious cervical lesions, were selected. The defects were randomly assigned to receive either CTG or CTG+R. Bleeding on probing (BOP), probing depth (PD), relative gingival recession (RGR), clinical attachment level (CAL) and cervical lesion height (CLH) coverage were measured at baseline and 45 days, and 2, 3 and 6 months after treatment. Results: Both groups showed statistically significant gains in CAL and soft tissue coverage. The differences between groups were not statistically significant in BOP, PD, RGR and CAL, after 6 months. The percentages of CLH covered were 74.88 ± 8.66% for CTG and 70.76 ± 9.81% for CTG+R (p>0.05). The estimated root coverage was 91.91 ± 17.76% for CTG and 88.64 ± 11.9% for CTG+R (p>0.05). Conclusion: Within the limits of the present study, it can be concluded that both procedures provide comparable soft tissue coverage. The presence of the glass ionomer restoration may not prevent the root coverage achieved by CTG. [source]

    Clinical and histological evaluation of an acellular dermal matrix allograft in combination with the coronally advanced flap in the treatment of miller class I recession defects: an experimental study in the mini-pig

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2009
    Javier Núñez
    Abstract Objectives: To study the wound healing of acellular dermal matrix (ADM) allografts when used together with coronally advanced flaps (CAF) in the treatment of localized gingival recessions in the mini-pig experimental model. Material and Methods: Dehiscence defects 4 × 5 mm were surgically created in one buccal root surface in each quadrant of PI, II, or III in three mini-pigs. They were then treated with CAF and the interposition of either a connective tissue graft (CTG) or ADM. As the primary outcome, the histological interface between the ADM and the root surface was studied and was compared with CTG. As secondary outcomes, we assessed the amount and quality of the keratinized tissue and clinical outcomes in terms of root coverage and recession reduction. Results: At 3 months, the CTG group attained a mean 76% root coverage, versus 62% in the ADM group. The histological interface with the root surface was similar in both groups. The apical migration of the epithelium was 1.79±0.46 mm for the CTG and 1.21±0.35 mm for ADM. Newly formed cementum was observed with both treatments. New bone and a newly formed periodontal ligament were shown in five specimens in the ADM group and in three in the CTG group. Conclusion: Both materials showed similar clinical and histological outcomes. [source]

    Bilaminar techniques for the treatment of recession-type defects.

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2003
    A comparative clinical study
    Abstract Objectives: Complete root coverage is the primary objective to be accomplished when treating gingival recessions in patients with aesthetic demands. Furthermore, in order to satisfy patient demands fully, root coverage should be accomplished by soft tissue, the thickness and colour of which should not be distinguishable from those of adjacent soft tissue. The aim of the present split-mouth study was to compare the treatment outcome of two surgical approaches of the bilaminar procedure in terms of (i) root coverage and (ii) aesthetic appearance of the surgically treated sites. Material and Methods: Fifteen young systemically and periodontally healthy subjects with two recession-type defects of similar depth affecting contralateral teeth in the aesthetic zone of the maxilla were enrolled in the study. All recessions fall into Miller class I or II. Randomization for test and control treatment was performed by coin toss immediately prior to surgery. All defects were treated with a bilaminar surgical technique: differences between test and control sites resided in the size, thickness and positioning of the connective tissue graft. The clinical re-evaluation was made 1 year after surgery. Results: The two bilaminar techniques resulted in a high percentage of root coverage (97.3% in the test and 94.7% in the control group) and complete root coverage (gingival margin at the cemento-enamel junction (CEJ)) (86.7% in the test and 80% in the control teeth), with no statistically significant difference between them. Conversely, better aesthetic outcome and post-operative course were indicated by the patients for test compared to control sites. Conclusions: The proposed modification of the bilaminar technique improved the aesthetic outcome. The reduced size and minimal thickness of connective tissue graft, together with its positioning apical to the CEJ, facilitated graft coverage by means of the coronally advanced flap. Zusammenfassung Hintergrund: Die vollständige Deckung der Wurzeloberfläche ist das primäre Ziel, das bei der Therapie von fazialen Rezessionen bei Patienten mit ästhetischen Ansprüchen erreicht werden soll. Weiterhin sollte die Rezessionsdeckung, wenn sie den Ansprüchen des Patienten vollends entsprechen soll, mit einer Dicke und Farbe der Gingiva erreicht werden, die nicht vom benachbarten Gewebe zu unterscheiden sind. Zielsetzung: Vergleich der Therapieergebnisse von 2 chirurgischen Varianten der zweischichtigen Technik im Halbseitenversuch hinsichtlich (1) Rezessionsdeckung und (2) ästhetischer Erscheinung der chirurgisch behandelten Stellen. Material und Methoden: 15 junge und parodontal gesunde Personen mit jeweils 2 Rezessionsdefekten ähnlicher Größe an kontralateralen Zähnen im ästhetischen Bereich des Oberkiefers wurden in die Studie aufgenommen. Alle Rezessionen gehörten in die Miller-Klassen I oder II. Die Randomisierung für die Test- und Kontrollbehandlung erfolgte unmittelbar präoperativ durch Münzwurf. Alle Defekte wurden nach einer zweischichtigen chirurgischen Technik behandelt: Die Unterschiede zwischen Test- und Kontrollstellen bestanden in Größe, Dicke und Positionierung des Bindegewebstransplantates. Die klinische Nachuntersuchung erfolgte 1 Jahr postoperativ. Ergebnisse: Beide zweischichtigen Techniken führten zu einem hohen Prozentsatz von Wurzeldeckung (Test: 97,3%; Kontrolle: 94,7%) und kompletter Wurzeldeckung (Gingivarand an der Schmelz-Zement-Grenze [SZG]) (Test: 86,7%; Kontrolle: 80%) ohne statistisch signifikante Unterschiede zwischen beiden Gruppen. Allerdings wurden mit der Testtherapie bessere ästhetische Ergebnisse erzielt als mit der Kontrollbehandlung. Schlussfolgerung: Die vorgestellte Modifikation der zweischichtigen Technik verbesserte die ästhetischen Ergebnisse. Die reduzierte Größe und minimale Dicke des Bindegewebstransplantates zusammen mit seiner Positionierung apikal der SZG erleichterten eine Deckung mittels eines koronalen Verschiebelappens. Résumé Objectif: Un recouvrement complet de la racine est le premier objectif lorsque l'on traite des récessions gingivales chez les patients ayant une demande esthétique. De plus, afin de satisfaire totalement la demande du patient, cette couverture radiculaire doit aussi être réalisé par des tissus mous de couleur et d'épaisseur qui ne se distinguent pas des tissus mous adjacents. Le but de cette étude en bouche séparée était de comparer le devenir de deux approches chirurgicales de la technique bilaminaire pour (i) le recouvrement de la racine et (ii) l'apparence esthétique des sites traités chirurgicalement. Matériel et Méthodes: 15 sujets jeunes et indemnes de maladie parodontale et systèmique présentant deux récessions de profondeur similaires sur des dents contralatérales dans des zones esthétiques du maxillaire furent enrollés dans cette étude. Toutes les récessions étaient des classes I ou II de Miller. La répartition pour les traitements test ou contrôle fut tirée à pile ou face juste avant la chirurgie. Toutes les lésions furent traitées par la technique bilaminaire, la différence entre les groupes résidant dans la taille, l'épaisseur et le positionnement du greffon de tissus conjonctif. La réévaluation clinique fut faite un an après la chirurgie. Résultats: Les deux techniques bilaminaires ont entrainé un fort pourcentage de recouvrement radiculaire (97.3% pour le groupe test et 94.7% pour le groupe contrôle) et le recouvrement complet (gencive marginale au niveau de la CEJ) (86.7% dans le groupe test et 80% pour le groupe contrôle) sans différence statistiquement significative entre elles. Par contre, un meilleur rendu esthétique et suites post opératoires furent rapportés par les patients pour le traitement test. Conclusions: La modification proposée de cette technique bilaminaire améliore le devenir esthétique. La taille réduite et l'épaisseur minimale greffon conjonctif et son positionnement apical au CEJ, ont facilité le recouvrement du greffon par le lambeau déplacé coronairement. [source]

    Pocket elimination surgery with simultaneous connective tissue graft.

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2001
    A case report with 3-year follow-up
    Abstract Background, aims: The purpose of the present case report was to present 2 ways of treating recession in a periodontal patient combined with regular pocket elimination surgery. The techniques used enabled the operator to reduce the number of surgical sessions and clinically evaluate the 3-year coverage of gingival recessions using a subpedicle connective tissue graft. Methods: Surgery consisted of pocket elimination procedures to treat adult periodontitis as a way to harvest connective tissue to be placed in the areas of recession. The grafted tissue was covered by the primary flap or left uncovered in a pouch, according to 2 different techniques described in the literature. Results: In this case, we observed that, with this approach, we were successful in reducing the number of surgical session as well as achieving objective and subjective goals of therapy in treated areas. Zusammenfassung Mit der Präsentation dieses Fallberichtes sollen 2 Methoden zur Rezessionsdeckung bei Parodontitispatienten in Kombination mit chirurgischer Taschenelimination vorgestellt werden. Die Anwendung dieser Methoden machte es möglich, die Zahl der operativen Eingriffe zu reduzieren. Die klinische Rezessionsdeckung durch subepitheliale Bindegewebstransplantate wurde über 3 jahre nachverfolgt. Die parodontalchirurgische Therapie bestand aus einem Verfahren zur Taschenelimination (distale Keilexzion, apikaler Verschiebelappen bei Mobilisation eines Spaltlappens) bei der Behandlung von Erwachsenenparodontitis. Dabei wurden Bindegewebstransplantate gewonnen, die zur Rezessionsdeckung genutzt werden konnten. Die Transplantate wurden entweder mit einem Lappen gedeckt (nach Harris modifizierte Langer-Technik) oder ungedeckt in einer Tasche ("Envelope"-Technik) belassen. In dem präsentierten Fall konnten die Zahl der operativen Eingriffe gesenkt und dabei objektive und subjektive Therapieziele erreicht werden. Résumé L'intérèt de ce rapport de cas est de présenter 2 façons de traiter des récessions chez un patient atteint de maladie parodontale en association avec une chirurgie normale d'élimination des poches. Les techniques utilisées permettent à l'opérateur de réduire le nombre de temps opératoires et nous évaluons cliniquement le recouvrement sur 3 ans des récessions gingivales en utilisant une greffe de tissus conjonctif sous pédiculée. La chirurgie consiste à utiliser les procédures d'élimination des poches, pour traiter la parodontite de l'adulte, comme moyens de prélever du tissus conjonctif qui sera placé sur les zones de récessions. Le tissus greffé est recouvert par le lambeau primaire ou laisséà découvert dans une enveloppe, selon 2 differentes techniques décrites dans la litterature. Dans ce cas, nous avons observé que, avec cette approche, nous réduisions avec succés le nombre de temps opératoires et que nos objectifs de traitement objectifs et subjectifs étaient atteints dans les zones traitées. [source]

    Use of a combination of flaps to achieve primary closure of defect following excision of keratocystic odontogenic tumour: a technical note

    ORAL SURGERY, Issue 3 2010
    J. Patel
    Abstract Aims:, Description of a case of a combination of flaps to achieve primary closure over large defect following the excision of a keratocystic odontogenic tumour. Materials:, Following the resection of a large keratocystic odontogenic tumour. Methods:, Combination of laterally positioned buccal flap, vascularised palatal connective tissue graft and buccal fat pad. Results:, Closure over the large defect. Conclusions:, Successful post-operative healing over the resected region allowing for future restoration space left in the dentition. [source]

    Soft tissue dehiscence coverage around endosseous implants: a prospective cohort study

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2008
    R. Burkhardt
    Abstract Aim: To evaluate the healing outcome of soft tissue dehiscence coverage at implant sites. Material and methods: Ten patients with one mucosal recession defect at an implant site and a contralateral unrestored clinical crown without recession were recruited. The soft tissue recessions were surgically covered using a coronally advanced flap in combination with a free connective tissue graft. Healing was studied at 1, 3 and 6 months post-operatively. Results: Soft tissue dehiscences were covered with a coronal overcompensation of the flap margin up to 1.2 mm after the procedure. After 1 month, the coverage shrank to a mean of 75%, after 3 months to 70% and after 6 months to 66%. Conclusions: The implant sites revealed a substantial, clinically significant improvement following coronal mucosal displacement in combination with connective tissue grafting, but in none of the sites, a could complete implant soft tissue dehiscence coverage be achieved. [source]

    Single-tooth replacement by immediate implant and connective tissue graft: a 1,9-year clinical evaluation

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2004
    Andrea E. Bianchi
    Abstract Objectives: The aim of the present study was to evaluate the long-lasting efficacy of a combined surgical protocol, using immediate implant and subepithelial connective tissue graft for single-tooth replacement. The advantages of this single-center, longitudinal, randomized, blind examiner research were the following: preservation of both keratinized mucosa amount and bone tissue, optimal peri-implant marginal sealing, satisfactory aesthetic results, reduction in treatment time. Materials and methods: In the time period from 1990 to 1998, 116 patients were consecutively admitted for treatment with a total of 116 solid screw ITI-implants supporting single crowns. Ninety-six patients underwent the proposed combined treatment (test group), while 20 received only single immediate implants (control group). The observation time extended from 1 up to 9 years. Results: The 9-year cumulative survival rate was 100% for both test and control groups. Comparative statistical analysis of soft and hard tissue peri-implant parameters demonstrated better results in the test group than in the control during every single 3-year analysis and especially in the last observation interval. The test group also showed very good results in terms of aesthetic parameters, which estimated the keratinized mucosa width, the alignment of crown emergence profile and the patient's satisfaction. Conclusion: Single-tooth replacement by immediate solid screw ITI implants in association with connective tissue autograft was demonstrated to be a predictable procedure. Moreover, this treatment can be considered as a sure system to reach an excellent functional and harmonious aesthetic restoration. Résumé Le but de l'étude présente a été d'évaluer l'efficacitéà long terme d'un protocole chirurgical combiné utilisant l'implant placé immédiatement et un greffon tissulaire de tissu conjonctif sous-épithélial pour le remplacement d'une dent unique. Les avantages de cette recherche randomisée longitudinale dans un seul centre et en aveugle étaient les suivants : préservation de la quantité de muqueuse kératinisée et du tissu osseux, une fermeture marginale paroïmplantaire optimale, des résultats esthétiques satisfaisants et une réduction du temps de traitement. Durant les années 1990 à 1998, 116 patients ont été admis pour le traitement de 116 implants ITI en vis pleines portant des couronnes uniques. Nonante-six patients ont recu le traitement proposé (groupe test) tandis que 20 autres n'ont reçu que des implants placés immédiatement en une étape (groupe contrôle). Le temps d'observation s'échelonnait de un à neuf ans. Le taux de survie cumulatif à neuf années était de 100% dans les deux groupes. L'analyse statistique comparative des tissus mous et durs paroïmplantaires a constaté des meilleurs résultats dans le groupe test que dans le groupe contrôle durant chaque analyse de trois ans et spécialement dans la dernière période d'observation. Le groupe test montrait également de très bons résultats esthétiques concernant la largeur de la muqueuse kératinisée, l'alignement du profil de l'émergence de la couronne et la satisfaction du patient. Le remplacement de dents uniques par des implants ITI en vis pleines placées immédiatement en association avec une greffe de tissu conjonctif est un processus prévisible. De plus, ce traitement peut être considéré comme un système sûr pouvant apporter une restauration fonctionnelle harmonieuse et esthétique. Zusammenfassung Ziele: Das Ziel dieser Studie war es, den Langzeiterfolg eines chirurgischen Protokolls zu untersuchen, das den Einzelzahnersatz mit einem Sofortimplantat in Kombination mit einem subepithelialen Bindegewebstransplantat vorsah. Die Vorteile dieser an einem Zentrum durchgeführten randomisierten, longitudinalen Blindstudie waren die folgenden: Erhaltung sowohl der gesamten keratinisierten Mukosa wie auch des Knochengewebes, der optimale perimplantäre marginale Abschluss, die befriedigenden ästhetischen Resultate und die Verkürzung der Behandlungszeit. Material und Methoden: In der Zeit von 1990 bis 1998 bekamen in der Folge 116 Patienten insgesamt 116 ITI-Vollschraubenimplantate, die mit Einzelkronen versorgt wurden. 96 Patienten wurden nach der vorgestellten kombinierten Methode behandelt (Testgruppe), währenddem die übrigen 20 Patienten einzig das Sofortimplantat erhielten (Kontrollgruppe). Die Beobachtungszeit reichte von 1 bis zu 9 Jahren. Resultate: Die kumulative Überlebensrate nach 9 Jahren betrug für Test- und Kontrollgruppe 100%. Eine statistische Vergleichsanalyse der Parameter von Weich- und Hartgeweben zeigte während jeder der dreijährigen Beobachtungsphasen (insbesondere in der letzten) in der Testgruppe bessere Resultate als in der Kontrollgruppe. Die Testgruppe zeigte auch bezüglich ästhetischen Parametern (Breite der keratinisierten Gingiva, Lokalisation der Durchtrittsstelle der Krone, Zufriedenheit des Patienten) sehr schöne Resultate. Zusammenfassung: Der Einzelzahnersatz mittels Sofortimplantation einer ITI-Vollschraube in Verbindung mit einem freien Bindegewebetransplantat erwies sich als gut beherrschbare Methode. Man kann diese Behandlung sogar als sicher für den Erhalt einer hervorragenden funktionellen, harmonischen und ästhetischen Rekonstruktion empfehlen. Resumen Objetivos: La intención del presente estudio fue evaluar la eficacia a largo plazo de un protocolo quirúrgico combinado, usando implantes inmediatos e injertos de tejido conectivo subepitelial para reemplazar dientes unitarios. Las ventajas de esta investigación unicentro, longitudinal, aleatoria, examinador ciego fueron las siguientes: preservación de tanto de la cantidad de mucosa queratinizada como del tejido óseo, sellado marginal periimplantario óptimo, resultados estéticos satisfactorios, reducción del tiempo del tratamiento. Material y métodos: En el periodo de tiempo desde 1990 a 1998, se admitieron 116 pacientes consecutivos para tratamiento con un total de 116 implantes macizos roscados ITI soportando coronas unitarias. Noventa y seis pacientes se sometieron al tratamiento propuesto (grupo de prueba), mientras 20 recibieron solo implantes inmediatos unitarios (grupo de control). El tiempo de observación se extendió de 1 9 años. Resultados: El índice acumulado de supervivencia a los 9 años fue del 100% tanto para el grupo de prueba como el de control. El análisis estadístico comparativo de los parámetros de los tejidos blandos y duros periimplantarios demostró mejores resultados en el grupo de prueba que en el de control, durante cada análisis de 3 años y especialmente en el último intervalo de observación. El grupo de prueba también mostró muy buenos resultados en términos de parámetros estéticos, que estimaron la anchura de la mucosa queratinizada, la alineación del perfil de emergencia de la corona y la satisfacción del paciente. Conclusión: La sustitución de un diente unitario por implantes macizos roscados inmediatos ITI en asociación con autoinjertos de tejido conectivo demostró ser un procedimiento predecible. Más aun, este tratamiento puede ser considerado como un sistema seguro para alcanzar una excelente restauración estética funcional y armónica. [source]

    Collagenase-Assisted Fat Dissociation for Autologous Fat Transfer

    DERMATOLOGIC SURGERY, Issue 10 2008
    DAVID K. MOSCATELLO PHD
    BACKGROUND The quality of fat for autologous transfer procedures has been a major focus of research in the past few years. The primary goal of these efforts is to improve the viability and longevity of the graft in human subjects. One possible factor in the permanence of theses transplants is the size of the adipose tissue grafts. OBJECTIVE This study evaluated the effects of collagenase digestion on the viability of human adipose tissue. MATERIALS AND METHODS Samples of fat were obtained from subjects undergoing tumescent liposuction. The tissue was digested in a variety of concentrations of collagenase using optimized methods of processing. The digested fat was also subjected to mock injections through small bore needles. RESULTS Eight subjects completed the study. The viability of the fat using the optimized methods of collagenase digestion was consistently higher than 79%. During the mock injection trials, the viability of fat was improved from approximately 17% to 84% by collagenase digestion. CONCLUSIONS Our results show increased viability of human adipose tissue when digested by collagenase. These techniques can be applied to human autologous lipoaugmentation procedures in an effort to improve longevity of the transplanted tissue. [source]

    Surgical Approaches for Stable Vitiligo

    DERMATOLOGIC SURGERY, Issue 10 2005
    Rafael Falabella MD
    Background. Vitiligo therapy is difficult. Depending on its clinical presentation, unilateral or bilateral vitiligo lesions respond well with different repigmentation rates, according to age, affected anatomic area, extension of lesions, time at onset, timing of depigmentation spread, and other associated factors. When stable and refractory to medical treatment, vitiligo lesions may be treated by implanting pigment cells on depigmented areas. Objective. To describe the main events of depigmentation and the fundamentals of surgical techniques for repigmenting vitiligo by implanting noncultured cellular or tissue grafts, in vitro cultured epidermis-bearing pigment cells, or melanocyte suspensions. Methods. A description of the available techniques for repigmentation of vitiligo is done, emphasizing the most important details of each procedure to obtain the best repigmentation and minimize side effects. Results. With most of these techniques, adequate repigmentation is obtained, although there are limitations when applying some methods to clinical practice. Conclusions. Restoration of pigmentation may be accomplished with all available surgical procedures in most anatomic locations, but they are of little value for acral areas. Unilateral vitiligo responds well in a high proportion of patients, and bilateral disease may also respond when stable. Appropriate patient selection is important to achieve the best results. [source]

    A hVIPR transgene as a novel tool for the analysis of circadian function in the mouse suprachiasmatic nucleus

    EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2003
    V. M. King
    Abstract A mouse bearing a novel transgene encoding the human VPAC2 receptor (hVIPR; Shen et al. (2000) PNAS, 97, 11575,11580) was used to investigate circadian function in the hypothalamic suprachiasmatic nuclei (SCN). Neurons expressing hVPAC2R, detected by a beta-galactosidase (,-GAL) tag, have a distinct distribution within the SCN, closely matching that of neurophysin (NP) neurons and extending into the region of peptide histidine isoleucine (PHI) cells. In common with NP and PHI cells, neurons expressing hVPAC2R are circadian in nature, as revealed by synchronous rhythmic expression of mPERIOD (mPER) proteins. A population of SCN cells not expressing PHI, NP or hVPAC2R exhibited circadian PER expression antiphasic with the rest of the SCN. Nocturnal light exposure induced mPER1 in the ventral SCN and mPER2 widely across the nucleus. Induction of nuclear mPER2 in hVPAC2R cells confirmed their photic responsiveness. Having established their circadian properties, we tested the utility of SCN neurons expressing the hVIPR transgene as functionally and anatomically explicit markers for SCN tissue grafts. Prenatal SCN tissue from hVIPR transgenic pups survived transplantation into adult CD1 mice, and expressed ,-GAL, PER and PHI. Over a series of studies, hVIPR transgenic SCN grafts restored circadian activity rhythms to 17 of 72 arrhythmic SCN lesioned recipients (23.6%). By using heterozygous hVIPR transgenic grafts on a heterozygous Clock mutant background we confirmed that restored activity rhythms were conferred by the donor tissue. We conclude that the hVIPR transgene is a powerful and flexible tool for examination of circadian function in the mouse SCN. [source]

    Potential and Bottlenecks of Bioreactors in 3D Cell Culture and Tissue Manufacturing

    ADVANCED MATERIALS, Issue 32-33 2009
    David Wendt
    Abstract Over the last decade, we have witnessed an increased recognition of the importance of 3D culture models to study various aspects of cell physiology and pathology, as well as to engineer implantable tissues. As compared to well-established 2D cell-culture systems, cell/tissue culture within 3D porous biomaterials has introduced new scientific and technical challenges associated with complex transport phenomena, physical forces, and cell,microenvironment interactions. While bioreactor-based 3D model systems have begun to play a crucial role in addressing fundamental scientific questions, numerous hurdles currently impede the most efficient utilization of these systems. We describe how computational modeling and innovative sensor technologies, in conjunction with well-defined and controlled bioreactor-based 3D culture systems, will be key to gain further insight into cell behavior and the complexity of tissue development. These model systems will lay a solid foundation to further develop, optimize, and effectively streamline the essential bioprocesses to safely and reproducibly produce appropriately scaled tissue grafts for clinical studies. [source]

    Management of inter-dental/inter-implant papilla

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2005
    Laura Zetu
    Abstract Objectives: The aims of this paper are to review and compare existing techniques for creation of interdental/interimplant papillae, to address factors that may influence its appearance and to present an approach that authors developed that could help clinicians to manage and recreate the interproximal papillae. Methods: Papers related to interdental and interimplant papillae published over the last 30 years were selected and analyzed. Results: Thorough treatment planning is essential for maintenance of the height of the interproximal papillae following tooth removal. The key for achieving an esthetically pleasing outcome is the clinicians' ability of properly managing/creating interdental/interimplant papillae. Bone support is the foundation for any soft tissue existence, techniques such as socket augmentation, orthodontic extrusion, guided bone regeneration, onlay graft and distraction osteogenesis are often used for this purpose. Soft tissue grafts as well as esthetic mimic restorations can also be used to enhance the esthetic outcomes. Conclusions: An esthetic triangle is developed to address the foundations that are essential for maintaining/creating papilla. These include adequate bone volume, proper soft tissue thickness as well as esthetic appearing restorations. [source]

    Effect of interleukin-1 gene polymorphism in a periodontally healthy Hispanic population treated with mucogingival surgery

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2002
    Raul G. Caffesse
    Abstract Objectives: A genetic test for susceptibility of periodontal disease has been introduced. A positive test indicates a risk factor for more severe periodontal destruction. The prevalence of genotype positive subjects has been reported around 30%. In a Mexican population, we have found a 26% prevalence of genotype positive individuals. Few studies have reported the response to therapy in these individuals. The purpose of this study was to assess the response to mucogingival surgery in an otherwise periodontally healthy Hispanic population. Materials and methods: 22 subjects (7 male and 15 female) with a mean age of 45 years participated. They were treated 3 years prior for the treatment of Types I and II recession defects using connective tissue grafts. No other active periodontal treatment was required, except for preventive maintenance. A full-mouth clinical evaluation was performed which included assessment of gingival inflammation and measurements of probing pocket depth and clinical attachment levels. Mean values per patient were determined. A finger stick blood sample was collected using specially provided DNA filter paper, let dried, and mailed for processing. Results: Results indicated that 5 out of the 22 subjects were genotype positive. The genotype positive subjects presented the following values: GI 1.13±0.17, PPD 2.48±0.46, and CAL 3.38±0.66. The values for the genotype negative subjects were GI 1.06±0.14, PPD 2.38±0.31 and CAL 3.11±0.53. No statistical significant differences were found when both groups were compared (p>0.05). Furthermore, the treatment of the localized recessions was effective and provided similar amount of coverage in genotype positive and negative subjects. However, more genotype negative subjects showed complete coverage of the recession than genotype positive individuals. Conclusions: Within the limits of this study it is concluded that (1) periodontal health can be maintained with proper preventive maintenance irrespective of the genotype present, (2) the mean response to mucogingival surgery to cover localized gingival recessions is similar irrespective of the IL-1 periodontal genotype, however, full coverage is achieved more frequently in genotype negative subjects. Zusammenfassung Ziele: Es wurde ein Gentest für die Anfälligkeit bezüglich einer Parodontalerkrankung eingeführt. Ein positiver Test ist ein Zeichen für einen Risikofaktor für eine stärkere parodontale Destruktion. Die Prävalenz von genotyp-positiven Personen wurde mit etwa 30% angegeben. In einer mexikanischen Population haben wir eine Prävalenz von 26% von genotyp-positiven Individuen vorgefunden. Nur wenige Studien haben bei diesen Patienten über die Reaktion auf die Therapie berichtet. Der Zweck dieser Studie war es die Heilung nach mukogingivaler Chirurgie in einer im Übrigen parodontal gesunden Population mit spanischen Abstammung. Material und Methode: 22 Patienten (7 Männer und 15 Frauen) mit einem Durchschnittsalter von 45 Jahren nahmen an der Studie teil. Sie wurden vor 3 Jahren zur Deckung einer Rezession von Typ I oder II mit einem Bindegewebetransplantat behandelt. Es war keine weitere parodontale Behandlung außer präventiven Erhaltungstherapie notwendig. Es wurde eine vollständige klinische Untersuchung des Gebisses durchgeführt, die die Bestimmung der gingivalen Etnzündung, sowie die Messung der Sondierungstiefe und des klinischen Attachmentniveaus beinhaltete. Es wurden für jeden Patienten die Mittelwerte bestimmt. Eine Blutprobe von der Fingerbeere wurde entnommen, auf ein specielles DNA-Filterpapier aufgetragen, getrocknet und zur Weiterverarbeitung versendet. Ergebnisse: Die Ergebnisse zeigten, dass 5 von 22 Patienten genotyp-positiven waren. Die genotyp-positiven Patienten wiesen folgende Werte auf: GI 1.13±0.17, PPD 2.48±0.46 und CAL 3.38±0.66. Die Werte für die genotyp-negativen Patienten betrugen: GI 1.06±0.14, PPD 2.38±0.31 und CAL 3.11±0.53. Beim Vergleich beider Gruppen ergaben sich keine statistisch signifikanten Unterschiede (p>0.05). Des weiteren war die Behandlung der lokalisierten Rezession effektiv und lieferte bei genotyp-positiven und genotyp-negativen Patienten einen ähnlichen Anteil an Wurzeldeckung. Jedoch zeigten mehr genotyp-negative Patienten eine vollständige Rezessionsdeckung als genotyp-positive Patienten. Schlussfolgerungen: Mit den Einschränkungen dieser Studie kann die Schlussfolgerung gezogen werden, dass (1) unabhängig vom vorliegenden Genotyp mit geeigneten präventiven Maßnahmen die parodontale Gesundheit erhalten werden kann und (2) dass unabhängig vom IL-1-Genotyp, die durchschnittliche Reaktion auf die mukogingivale Chirurgie zur Deckung von lokalisierten Gingivarezessionen ähnlich ist. Jedoch wird eine vollständige Deckung häufiger bei genotyp-negativen Patienten erreicht. Résumé But: Un test génétique pour la suscpetibilitéà la maladie parodontale est présenté. Un test positif indique un facteur de risque pour une destruction parodontale plus sévère. La fréquence globale de sujets positifs au génotype semblerait être de 30%. Dans une population mexicaine, une fréquence globale de 26% d'individus positifs pour le génotype a été trouvée. Peu d'études ont apporté la réponse au traitement chez ces individus. Le but de cette investigation a été de mesurer la réponse de la chirurgie muco-gingivale dans une population hispanique parodontalement saine. Matériaux et méthodes: 7 hommes et 15 femmes d'un âge moyen de 45 ans y ont participé. Ils avaient été traités 3 ans auparavant pour des lésions de récession de type I et II en utilisant des greffes de tissu conjonctif. Aucun autre traitement parodontal actif n'avait été requis, sauf pour la maintenance. Une évaluation clinique de toute la bouche a été effectuée comprenant l'estimation de l'inflammation gingivale et les measures de la profondeur de poche au sondage et des niveaux d'attache clinique. Les valeurs moyennes par patient ont été déterminées. Un échantillon sanguin par piqûre du doigt a été récolté en utilisant un papier filtre ADN, qui fût séché et envoyé pour analyse. Résultats: Les résultats ont indiqué que 5 des 22 sujets étaient génotype positif. Ces sujets présentaient les valeurs suivantes: GI 1.13±0.17, PPD 2.48±0.46 mm et CAL 3.38±0.66 mm. Les valeurs chez les sujets génotype négatif étaient: GI 1.06±0.14, PPD 2.38±0.31 mm et CAL 3.11±0.53 mm. Aucune différence statistiquement significative n'a été trouvée lorsque les deux groupes ont été comparés. De plus le traitement des récessions locales était effectif et apportait une quantité semblable de recouvrement chez les deux types de sujets. Cependant davantage de sujets génotype négatif bénéficiaient d'un recouvrement complet de la récession. Conclusions: Dans les limites d l'étude présente: (1) la santé parodontale peut être maintenue avec des mesures préventives quelque soit le génotype présent, (2) la réponse moyenne de la chirurgie muco-gingivale pour recouvrir des récessions gingivales locales est semblable quelque soit le génotype parodontal IL-1, bien qu'un recouvrement complet est plus souvent réalisé chez les sujets génotype négatif. [source]

    Acellular dermal allograft for vestibuloplasty,an alternative to autogenous soft tissue grafts in preprosthetic surgical procedures: A clinical report

    JOURNAL OF PROSTHODONTICS, Issue 2 2003
    Monish Bhola DDS
    Various vestibular extension procedures have been described in the literature over the past 6 decades, including the use of free gingival grafts. An acellular dermal allograft has been used as a substitute for autogenous soft tissue grafts in root coverage procedures. This clinical report describes the use of such an allograft as a substitute for palatal donor tissue in the vestibular extension of an edentulous maxillary arch with multiple frenum attachments before fabrication of a complete denture. In this patient, healing was uneventful, and 6-month clinical observations demonstrated an apical positioning of the mucogingival junction with an increase in vestibular depth, and the absence of multiple frenae. The acellular dermal allograft appears to be a useful substitute for autogenous palatal grafts in preprosthetic surgery. This approach has many advantages over the free gingival graft, including no donor site morbidity, unlimited availability, and better color match. [source]

    Biodegradable polymers applied in tissue engineering research: a review

    POLYMER INTERNATIONAL, Issue 2 2007
    Monique Martina
    Abstract Typical applications and research areas of polymeric biomaterials include tissue replacement, tissue augmentation, tissue support, and drug delivery. In many cases the body needs only the temporary presence of a device/biomaterial, in which instance biodegradable and certain partially biodegradable polymeric materials are better alternatives than biostable ones. Recent treatment concepts based on scaffold-based tissue engineering principles differ from standard tissue replacement and drug therapies as the engineered tissue aims not only to repair but also regenerate the target tissue. Cells have been cultured outside the body for many years; however, it has only recently become possible for scientists and engineers to grow complex three-dimensional tissue grafts to meet clinical needs. New generations of scaffolds based on synthetic and natural polymers are being developed and evaluated at a rapid pace, aimed at mimicking the structural characteristics of natural extracellular matrix. This review focuses on scaffolds made of more recently developed synthetic polymers for tissue engineering applications. Currently, the design and fabrication of biodegradable synthetic scaffolds is driven by four material categories: (i) common clinically established polymers, including polyglycolide, polylactides, polycaprolactone; (ii) novel di- and tri-block polymers; (iii) newly synthesized or studied polymeric biomaterials, such as polyorthoester, polyanhydrides, polyhydroxyalkanoate, polypyrroles, poly(ether ester amide)s, elastic shape-memory polymers; and (iv) biomimetic materials, supramolecular polymers formed by self-assembly, and matrices presenting distinctive or a variety of biochemical cues. This paper aims to review the latest developments from a scaffold material perspective, mainly pertaining to categories (ii) and (iii) listed above. Copyright © 2006 Society of Chemical Industry [source]