1/3. Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue. Part 2: Histological evaluation.BACKGROUND: A number of surgical procedures are effective in covering denuded root surfaces. The first paper in this series evaluated the subepithelial connective tissue graft and the coronally advanced flap with enamel matrix derivative (EMD). That paper revealed no significant difference in the percent of root coverage between the two treatments (P = 0.82). There is limited human histological evidence of the type of attachment achieved with these types of procedures. This paper presents a human case report detailing the histological nature of the attachment of these two treatments to the root surfaces previously exposed by recession. methods: One patient presented with two hopeless teeth that were randomized to receive either a subepithelial connective tissue graft or a coronally advanced flap plus EMD. The surgery was accomplished in accordance to the protocol previously described. The teeth and a small collar of tissue were removed at 6 months and underwent histological analysis. RESULTS: Histological evaluation of the subepithelial connective tissue graft revealed a connective tissue attachment between the tooth and graft, and no histological evidence of cementum, bone, or periodontal ligament (PDL) and, therefore, regeneration. In addition, there appeared to be some resorption of the dentin adjacent to the graft. Histological evaluation of the coronally advanced flap with EMD revealed new cementum, organizing PDL fibers and islands of condensing bone at a constant distance from the root surface. CONCLUSIONS: The subepithelial connective tissue graft in this study was found to have adhered to the root surface primarily by a connective tissue attachment with some evidence of root resorption. The coronally advanced flap with EMD was found histologically to have all the tissues necessary for regeneration: new cementum, organizing PDL fibers, and islands of condensing bone. These histologic sections strongly suggest that enamel matrix derivative works in a biomimetic fashion by mimicking the natural process of tooth development.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/3. oral manifestations of oxalosis secondary to ileojejunal intestinal bypass.Oxalosis is a rare condition that may be either hereditary or acquired. It may be secondary to a number of primary causes, which include renal failure, oxalate poisoning, malabsorption syndromes, and in this case, ileojejunal bypass surgery. Systemic oxalate overload following such bypass surgery results from a defect in the enterohepatic circulation and from the loss of calcium and bile salts in the feces. The oxalate is then absorbed into the circulation, and the supersaturated solution precipitates in the systemic tissues. Reported cases of oral involvement are rare. This article presents a 2 1/2-year follow-up of such a patient and the resultant progressive and unrelenting nature of the disorder. As a result of our experience, we suggest early aggressive oral surgical management of the widespread oral lesions.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/3. Problems of root resorption in relation to orthodontic treatment planning: a report of three cases.Three cases are described illustrating problems of root resorption related to orthodontic treatment. In the first case the short roots of many of the teeth made it inappropriate to carry out orthodontic treatment. In the second case there were no signs of root resorption initially, but, following retraction of maxillary incisors with a removable appliance, root resorption was noted affecting molar and premolar teeth, but not the maxillary incisors. In the third case several teeth had short roots, and further shortening of roots occurred during fixed appliance therapy. These cases illustrate the unpredictable nature of root resorption.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |