Faculty Bibliography

OBJECTIVE: The purpose of this investigation was to compare by scanning electron microscopy (SEM) the surfaces of roots treated with a dentin conditioning agent and other materials that have been used routinely in periodontal therapy for root surface demineralization, namely, citric acid and tetracycline hydrochloride. MATERIALS AND METHODS: Sixteen freshly extracted human teeth were randomly divided into four equal groups; each tooth was hand scaled and planed prior to root surface conditioning with citric acid, tetracycline hydrochloride, and a dentin bonding conditioner; Tenure Dentin Conditioner (DenMat Corporation, Santa Maria, CA). The last has been used previously in conjunction with a resin-ionomer barrier in cases involving guided tissue regeneration. Root specimens were prepared for scanning electron microscopy and representative micrographs were taken at 1000x and 2000x. RESULTS: The results of this study indicate that there are morphological similarities between surfaces obtained with the dentin conditioning agent and the other acidic materials that are used routinely in periodontal regenerative therapy. CONCLUSIONS: Root surface demineralization has been shown to remove the smear layer, and provides a surface which is conductive to mechanical adhesion and cellular mechanisms for growth and attachment.

The cases presented in this report illustrate: (1) the potential for a fluoride-releasing resin-ionomer (Geristore) to be used as a sealant between an e-PTFE membrane (Gore-Tex) and tooth structure during a guided tissue regeneration, and (2) the potential for a resin-ionomer to function as a barrier in guided tissue regeneration. In the first case, the e-PTFE membrane was trimmed to only cover the area to be treated prior to its placement over the lesion. The resin-ionomer was mixed following manufacturers specifications, placed on four corners of the pre-trimmed membrane and luted into place. In the second case, the resin-ionomer alone was placed over the lesion, teased off the lesion with a curette while in a semi-set state, and luted into place with freshly mixed material after it set completely. These cases provide preliminary clinical evidence that a resin-ionomer may be used subgingivally for guided tissue regeneration.

Although cleft lip and palate patients are usually treated by a multidisciplinary team involving physicians and dentists, their periodontal condition may be over-looked. Crowded or malpositioned teeth, hypertrophic gingiva, orthodontic appliances, and prosthetic replacements can impede proper plaque removal and thus perpetuate periodontal disease. It is important to incorporate periodontal treatment into the comprehensive treatment as early as possible. This case report discusses the periodontal surgical procedures involved in eliminating a residual ridge defect and the fitting of the final prosthetic reconstruction. Also, the importance of the identification and management of periodontal conditions characteristic of cleft lip and palate patients before and after surgical, orthodontic, and prosthetic rehabilitation will be emphasized

Pemphigus is an autoimmune disease in which intraepithelial vesicles and bullae of the skin and oral mucosa are produced by the action of autoantibodies against specific desmosomal proteins of squamous epithelium. Usually, oral lesions will appear before skin lesions, and in a majority of the cases only oral lesions are present. The dentist may then be the first to make and early diagnosis. The importance of this case report is to alert the dentist that subtle gingival lesions can be recognized and treated early in such a life-threatening disease. Diagnosis is based on the clinical presentation and confirmed by histologic study and direct immunofluorescence. This case describes the clinical signs, symptoms, histology, and immunofluorescence of pemphigus vulgaris of the gingiva

The purpose of this article is to reexamine the indications of surgical techniques and materials used in the regenerative treatment of periodontal disease. Two cases are presented to illustrate the potential for regenerative therapy in instances where limited success might have been anticipated.

A modified technique aimed at the conservation of maxillary anterior esthetics is proposed for the surgical treatment of periodontal disease when surgery is indicated in addition to nonsurgical debridement. This technique allows access to periodontally diseased root surfaces and suggests a flap design and a method for suturing which minimize postsurgical soft tissue recessions.