Abstract

[Note: Three parts in one.]

I. Review of the Literature and Description of a Regeneration Surgical Technique

This report provides an abbreviated review of the literature on treatment and prognosis of periodontal furcation lesions. In addition, it describes a surgical technique designed to accomplish bone regeneration in class II furcation defects, together with the rationale for the development of this procedure. Results of treatment of 30 defects with this technique are presented in a subsequent report (Gantes et al. 1987).

II. Bone Regeneration in Mandibular Class II Defects

A total of 30 mandibular, buccal class II furcation defects were treated in 22 subjects using a regenerative surgical therapy that included citric acid root conditioning and coronally positioned flaps secured by crown-attached sutures. In addition, grafts of freeze-dried, decalcified allogenic bone were placed in 16 of the 30 defects. The effect of the therapies was evaluated from a series of soft and hard tissue measurements. These measurements demonstrated notable improvement 12 months following therapy. On the average, 67% of the defect volume became filled with bone. 43% of treated defects were completely closed by bone fill. No difference was observed between defects treated with and without bone grafts.

III. A Comparison between Sites Treated with Coronally Positioned Flaps versus Collagenous (Dura Mater) Membranes

A total of 31 mandibular class II furcation defects (29 buccal, 2 lingual) in 19 subjects were treated using a regenerative surgical therapy that included citric acid root conditioning and placement of freeze dried, decalcified bone allografts. In 16 of the defects the surgical flap was coronally positioned and secured by crown attached sutures. In 15 of the defects collagenous membranes (freeze-dried dura mater) were placed in a manner that the membrane covered 2-3 mm of the alveolar bone and extended 2-3 mm coronal to the furcation fornix on the tooth crown. The surgical flap was sutured at a level approximating the alveolar bone. The effect of the therapies was evaluated from a series of soft and hard tissue measurements. These measurements demonstrated improvement in both groups at 12 months. In the coronally positioned flap group, on the average, 74% of the defect volume became filled with bone. 56% of the treated defects were closed by bone fill. All 16 defects showed some degree of improvement. In the dura mater membrane group 42% of the defect volume was filled with bone. 20% of the treated defects were closed by bone fill. 4 of 15 sites in this group showed deterioration following treatment.

LLU Discipline

Periodontics

Department

Periodontics

School

Graduate School

First Advisor

Rolf Nilveus

Second Advisor

Max Crigger

Third Advisor

Steven Garrett

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

1988

Date (Title Page)

6-1988

Language

English

Library of Congress/MESH Subject Headings

Periodontal Diseases -- therapy; Surgery, Oral -- methods; Bone Regeneration; Surgical Flaps; Dura Mater

Type

Dissertation

Page Count

I; 17. II; 30. III; 37

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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