Bone replacement grafts are widely used to promote
bone formation and periodontal regeneration.
Xenografts are grafts shared between different species.
Currently, there are two available sources of xenografts
used as bone replacement grafts in periodontics: bovine
bone and natural coral.
Soft tissue considerations for implant placementGanesh Nair
pre and post soft tissue considerations prior and post implant placement including various surgical technique for simple and advanced soft tissue augmentation
Periodontitits is a multifactorial disease which leads to progressive loss of periodontal tissues including the alveolar bone. Since autogenous bone grafting has been considered as the gold standard referring to the lowest incidence of graft rejection, this ppt gives an insight about the autogenous bone grafts that can be used in periodontal defects.
Soft tissue considerations for implant placementGanesh Nair
pre and post soft tissue considerations prior and post implant placement including various surgical technique for simple and advanced soft tissue augmentation
Periodontitits is a multifactorial disease which leads to progressive loss of periodontal tissues including the alveolar bone. Since autogenous bone grafting has been considered as the gold standard referring to the lowest incidence of graft rejection, this ppt gives an insight about the autogenous bone grafts that can be used in periodontal defects.
Leadership on the Line: Staying Alive Through The Dangers of LeadingChris Hengstenberg
Notes taken from the book authored by Ronald Heifetz and Martin Linskey.
Heifetz, R., & Linsky, M. (2002). Leadership on the line: Staying alive through the dangers of leading. Boston, Mass.: Harvard Business School Press.
Thank you to the authors for creating a work so enduring and so enlightening. Even after 12 years, the message in this piece still rings true.
Have you heard the words : "Why would anyone hack me?". Security is a serious problem that is often taken for granted and neglected by the product owners in favour of reliability and availability. In addition there are not many developers that are aware of the threats and the long-term harms that a simple attack could do. This session covers the most common web security threats on Web applications like XSS, XSRF, XSI, tampering, leakage, SQL injection and suggests mitigation solutions and coding guidelines.
Anterior crossbites in primary & mixed dentition Orthodontic courses training...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
How To Design An All-Hands Meeting Your Employees Actually Want to AttendAndrew Fayad
Our team has grown fast, and All-Hands meetings have been a key factor in helping us maintain transparency, build engagement, and keep our company culture strong. We take our own experience, and what we've learned from the largest brands to show you how to design and implement an effective All-Hands Meeting at your company.
Healing of Periapical Bone Lesion After Periradicular Surgery And Graft Place...QUESTJOURNAL
Objectives: 1.To clinically evaluate the healing process following periapical surgery with Chitra granules 2.To radiographically evaluate healing, following periapical surgery with Chitra granules. 3.To compare the bone healing in the study group, clinically and radiographically following the modalities of treatment, with that of the control group (without graft). Materials: 1.Chitra hydroxyapatite granules. 2. Gutta-percha — for root canal obturation by lateral condensation. 3. High Copper amalgam used as retrofilling materials. To evaluate healing after periapical surgery using Chitra granules, 22 patients were selected from out patient section of Department of Conservative Dentistry and Endodontics, Govt. Dental College, Kozhikode,based on clinical and radiographical evaluation. The study group consisted of 13 males and 9 females. All were of the age group 15-35 years. After selection they were randomly divided into two groups A and B. In group A the Chitra granule were placed in the bony defect and in group B the defect were left as such after surgery. Results: Clinical parameters showed better early symptom free condition in group A compared to group B. But data found statistically insignificant (t-7.27,df-1.8, P >0.05). Radiographical evaluation data analysis showed statistically significant difference among group A and group B. Conclusion: Biocompatible Chitra granule not only obliterates the cavity but act as a scaffold for bone growth and prevent scar tissue formation.It is osteoconductive. In comparison to the conventional periapical surgery, the placement of Chitra granules facilitates bone regeneration more easily. The material is found to be very cost effective, easily available, easy to manipulate and involves least complication to both clinicians and patients.
Abstract
Background: We set out to determine the possibility of radiographically evaluating the degree of marginal bone loss in humans after functional loading of implants at sites of guided bone regeneration (GBR) with autogenous tooth-based bone graft (ATBBG) material (AutoBT®, Korea Tooth Bank, Seoul, Korea).
Materials and Methods: Using ATBBG material, GBR procedures were performed on the extraction sockets with bone defects such as buccal dehiscence and 6 months of healing was allowed. Dental implants were installed and prosthetic procedures were done after another 6 months of healing. Marginal bone levels (MBLs) were radiographically measured following functional loading (mean duration, 10 months; range, 4–18 months) in 10 patients among 19 patients initially enrolled in this study (4 men and 6 women; age range, 39–65 years; mean age, 55.4 years) who maintained follow-up visits after entire surgical and prosthetic procedures.
Results: No significant MBL differences were noted immediately after GBR, implant placement and prosthesis delivery (F=0.245, P>0.05). Changes in the MBLs were not affected by gender.
Conclusion: The ATBBG material is viable for GBR and can yield a stable MBL even after functional loading of implants. The degree of marginal bone loss after loading with ATBBG is stable.
Osseo-integrated dental implants have been widely used for the rehabilitation of tooth loss. Although dental implants
are considered an available treatment in the paradigm shift from traditional dental therapies, such as fixed dental bridges and
removable dentures, the fundamental problems must be overcome prior to their clinical use in young patients who are still
undergoing jawbone growth. A bio-engineered functional bio-hybrid implant that is combined with adult-derived periodontal
tissue and attached with bone tissue can act as a substitute for cementum. This bio-hybrid implant was successfully engrafted
and it restored physiological function, including bone remodelling, regeneration and appropriate responsiveness to noxious
stimuli. Thus, this article reviews the functional bio-hybrid implant’s potential for clinical use as a next-generation dental
implant using adult-derived tissues.
“Periodontal Regeneration- New Vistas”- Guest lecture as a part of Dr NTRUHS Zonal CDE programme at SVS Institute of Dental Sciences, Mahabubnagar, India on 12/3/2013 and at Meghna Dental College, Nizamabad, India on 31/7/2013.
Objective: To evaluate the results of the effect of nebivolol on tibial bone defect and graft application in new bone development in the rat.
Study Design: Thirty Wistar albino rats were divided into 3 groups. In the Control group, tibia bone defect was created without any treatment. In the Defect+ Graft group, allograft treatment was performed by forming a 6 mm tibial bone defect. In the Defect+Graft+ Nebivolol group, alloplastic bone graft was placed in the calvarial bone defect and then nebivolol (0.34 mg/mL solution/day) treatment was intraperitoneally applied for 28 days.
Results: Histopathological examination revealed inflammation in the defect area, congestion in the vessels, degeneration in collagen fibers, and an increase in osteoclast cells. There was an increase in inflammation and blood vessel structure in graft application, and osteoblastic activity matrix formation after reorganization nebivolol application in collagen fibers. Osteonectin expression was positive in the collagen fiber and matrix, starting in the Graft group, in osteoblasts, whereas in the Nebivolol group, osteoblasts increased in osteocytes and new bone formation.
Conclusion: Nebivolol is thought to have a positive effect on osteoinductive bone growth factors and contribute to the cell-matrix interaction, in addition to the supporting effect of the graft with its antioxidative effect.
Keywords: allograft; bone; bone regeneration; disease models, animal; nebivolol; orthopedic procedures; osteonectin; rats; tibia; tibial defect
Dentists play an important role in the diagnosis and management of desquamative gingivitis. The importance of being able to recognise and properly diagnose this condition is accentuated by the fact that a serious and life threatening disease may initially manifest as desquamative gingivitis.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
1. XENOGRAFTS
Dr. Dandu Sivasai Prasad Reddy
II yr Post graduate
Department of Periodontics
Mamata Dental College
Dr. Dandu Sivasai Prasad Reddy
II yr Post graduate
Department of Periodontics
Mamata Dental College
7. Historically, bone grafting has consisted of:
A surgical procedure to harvest the patients own bone from a secondary site
Utilization of an organic or artificial material to replace missing bone
Structural scaffolds &
matrices for attachment &
proliferation of anchorage
dependent osteoblasts
11. Provide a biologic stimulus (proteins and growth factors) that
induces the progression of mesenchymal stem cells and other
osteoprogenitor cells toward the osteoblast lineage
Eg: DFDBA
12. Is the process by which the graft material acts as a nonviable
scaffold onto and within which the patients own natural bone
grows
They allow apposition from existing bone, but do not produce
or trigger bone formation.
Eg Alloplastic material
14. Clinical objectives of bone grafting for periodontal regeneration
Probing depth reduction
Clinical attachment gain
Bone fill of the osseous defect and
Regeneration of new bone, cementum and periodontal ligament as
determined by histologic analysis.
In a review of animal histologic studies, Mellonig found that 75% of these
studies indicated favorable regenerative results when periodontal
defects were treated with grafting; none showed that non-graft control
sites were superior to grafted ones.
15. Non-toxic-Non-antigenic with patient acceptance
Resistant to infection
Facilitate vascularization
No root resorption or ankylosis
Strong and resistant
Stimulates osteoinduction- & framework for osteoconduction
Easily adaptable
16. Readily and sufficiently available
Minimal surgical procedure with minimal post-operative
sequelae
Predictability
Completely replaced by host bone of the same quality – quantity
Induce & enhance cementogenesis.
CONTD..,CONTD..,
17. Indications of periodontal bone graft
1.Deep intraosseous defect
2.Tooth retention
3.Support for critical teeth
4.Defects associated with aggressive
periodontitis
5.Esthetics
6.Furcation
18. Classification
Conge et al, 1978
AAP 1986
Carranza FA 1990
Rosenberg& Rose 1998
Nasr et al, 1999
19. Resorption of the graft and replacement by new bone
depends upon
Particle size
Pore size
21. CALF BONE - treated by detergent, sterilized and freeze dried. Used for treatment
of osseous defects.
KIEL BONE - Calf or Ox bone denaturated with 20% H2O2, dried with acetone, and
sterilized with ethylene oxide.
ANORGANIC BONE - Ox bone from which the organic material has been extracted by
ethylene diamine. Then sterilized by autoclaving.
Recently a natural, anorganic, microporous, bovine-derived hydroxyapatite bone
matrix, in combination with a cell-binding polypeptide that is a synthetic clone of 15
amino acid sequence of type I collagen is been used.
22. ANORGANIC BOVINE
BONE(ABB(
New processing and purification methods have been
utilized which make it possible to remove all organic
components from a bovine bone source and leaving
behind a non-organic bone matrix in an unchanged
inorganic form.
Commercially available
Bio – Oss
Bio – Oss Collagen
Pepgen-P15
23. Osteoconductive
Chemical & physical characteristics
similar to human mineral matrix
Porosity similar to human cancellous
bone
Large mesh interconnecting pore
system facilitates angiogenesis and
migration of osteoblasts.
Bio - Oss®
25. USES:
1. Treatment of defect sizes up to 2 alveoli, but can be used for
defect size larger than 2 alveoli.
2. Sinus floor elevations.
3. When combined with autogenous bone, it can be used for large
ridge augmentation.
BIO-OSS CONTD..,
26. Bio – Oss Collagen®
(Osteohealth Co., Shirley, NY)
Bio Oss spongiosa granules + 10% highly purified porcine collagen
Collagen component enables convenient handling to be easily
adapted in the defect but does not function as a barrier
Collagen component is resorbed within 4 – 6 weeks.
27. Studies
Stefano Sartori et al., analyse the amount of Bio-Oss
ossification in a case of maxillary sinus augmentation,
recording and comparing histomorphometric data 8 months, 2
and 10 years after surgery.
Eight months after surgery they observed a mean amount of bone tissue
(including medullar spaces) of 29.8% (and 70.2% of Bio-Oss) . At 2years the
bone tissue increased to 69.7% and 10years after surgery it was 86.7% .
28. Effect of low-level laser therapy irradiation and Bio-Oss graft
material on the osteogenesis process in rabbit calvarium defects:
a double blind experimental study- Alireza Rasouli et al., 2014
The mean amount of new bone was 15.83 and 18.5 % in the controls on the
4th and 8th week; 27.66 and 25.16 % in the laser-irradiated group; 35.0
and 41.83 % in Bio-Oss and 41.83 and 47.0 % in the laser + Bio-Oss
treated specimens with significant statistical differences. Application of
LLLT in combination with Bio-Oss can promote bone healing.
29. ABB plus P-15 cell binding
peptide
(pentadecapeptide)
Mimics the cell binding
domain of type I collagen
PepGen P-15
31. Clinical and radiographic evaluation of human periodontal
osseous defect (mandibular grade II furcation) treated with
PepGen P-15 and a bioresorbable membrane (Atrisorb)- 2012 KL
Vandana et.,al .
It can be concluded from this study that the reduction in furcation
defect using PepGen P-15 alone and a combination of PepGen P-15
and Atrisorb were equivocal. It can be suggested that the combined
use of GTR barrier and bone graft did not prove beneficial for the
clinical outcome of the mandibular grade II furcation defect
treatment. Hence, the cost effective and economical treatment of
choice for grade II furcation defects may be bone graft alone.
32. A Novel Combination Of Platelet Rich Fibrin And Pepgen P-15
Xenograft, In The Treatment Of Intrabony Defects: A Volumetric CT
Scan Analysis. 2013
At 6 and 9 month follow-up examination, it was observed that PD
reduced in range of 3 to 5 mm with 1 to 2 mm coronal shift in PGM and
again in CAL of 2 to 5 mm . A three-dimensional (3D) reconstructed
Dentascanimages acquired at 9 month interval, confirmed positive
changes in the defect morphology, with a linear bone growth of 1.5-
3mm( 33 to 37 %).The volumetric analysis showed a bone fill of 55 to
81% at the defect sites
33. Interdisciplinary Management of an Isolated Intrabony Defect- 2014
A 24 year male patient reported with the complaint of food lodgment and
occasional pain in relation to right lower first molar. Clinical examination
revealed deep periodontal pocket measuring 9mm on distal aspect of 46 and no
mobility
34. Treatment of Intrabony Defects with Anorganic Bone Matrix/P-15
or Guided Tissue Regeneration in Patients with Aggressive
Periodontitis -2013
Treatment of intrabony periodontal defects in patients with G-
AgP with ABM/P-15 and GTR improved significantly the clinical
outcomes. The use of ABM/P-15 promoted a better
radiographic bone fill.
35. Porcine derived bone graft:
Xenografts derived from porcine cortical and cancellous bone
have also been developed to be used as bone substitutes
OsteoBiol® It is a commercially available xenograft of porcine origin.
It is heterologous cortico cancellous collagenated bone mix. It always
be hydrated before use
36. Advantages:
It can act as a carrier for various therapeutic agents.
The collagen present in this bio material facilitates blood clotting
and the subsequent invasion of repairing and regenerative cells thus
favouring bone formation.
It also provides cohesive environment for graft particle.
37. Experimental Model of Bone Response to Collagenized Xenografts
of Porcine Origin (OsteoBiol® mp3): A Radiological and
Histomorphometric Study
After 4 months, radiological images revealed bone defects with
a decrease in graft volume and the complete repair of the
osseous defect.
The biomaterial used proved to be biocompatible,
bioabsorbable, and osteoconductive and as such, a possible
bone substitute that did not interfere with the bone’s normal
38. CORROLLINE CALCIUM CARBONATE
Biocoral is a calcium carbonate
Natural coral,
Primarily of aragonite.
It is biocompatible and resorbable
Porous size of 100-200um
39. Combination procedures
A combination of autogenous bone and bone substitute is widely used in
oral surgery procedures
Systematic review recommended a proportion of 1:2 (Merkx et al. 2003).
Pripatnanont et al. (2009) assessed new bone formation generated using
three different proportions of autogenous bone (AB) and deproteinized
bovine bone (BDX) in cortical skull defects in rabbits.
1:1 1:2 1:4
40. In deep intrabony defects treatment, at 12 months evaluation,
the combined use of autogenous spongiosa with bovine-derived
xenograft led to significantly greater gain of clinical attachment and
hard tissue formation compared to the use of autogenous
spongiosa alone
- (Zafiropoulos et al. 2007)
41. Efficacy of Using PDGF and Xenograft With or Without Collagen
Membrane for Bone Regeneration Around Immediate Implants
With Induced Dehiscence-Type Defects: A Microcomputed
Tomographic Study in Dogs- 2013
GBR around immediate implants with dehiscence defects using PDGF
and xenograft alone resulted in higher BBT, BBV, VBH, and BIC than
when performed in combination with CM.
42. A clinical and radiological evaluation of the relative efficacy of
demineralized freeze-dried bone allograft versus anorganic bovine bone
xenograft in the treatment of human infrabony periodontal defects: A 6
months follow-up study- 2014
The use of anorganic bovine bone mineral matrix combined with TGFβ-1
seemed to be effective in the treatment of intrabony defects. This showed an
improvement in the clinical outcome of periodontal therapy superior to the use
of anorganic bovine bone on its own.
43. Risk of transmission of prion mediated diseases – bovine
spongiform encephalopahty
In humans – Creutzfeldt – Jakob disease
WHO – bone as type IV (no transmission)for prion diseases
Segal and Tofe (1999) conducted an extensive review of current
literature on the status of risk assessment of BSE transmission the
risk of disease (BSE) transmission was negligible
Risk of diseasetransmission
44.
45. CONCLUSION
Although complete periodontal regeneration is unpredictable with any
regenerative therapy currently used, periodontal bone grafts show strong
potential. Requirements for a successful graft includes Patient Selection,
material Selection, Proper Flap Reflection and Wound Stability,
Revascularization, Root Debridement, Postsurgical care .A large body of
clinical evidence clearly indicates that grafts consistently lead to better bone
fill than nongrafted controls. As more is learned about the biologic process of
periodontal regeneration, new graft materials are expected to make the task
of periodontal regeneration even more predictable.
46. REFERENCES
•Nasr HF, Reidy AME, Yukna RA. Bone and bone substitutes. Periodontology
2000, 1999; 19: 74-86.
•Carranza FA, Takei HH, Cochran DL. Chapter-67, Reconstructive Periodontal
Surgery. Carranza's Clinical Periodontology, 10th
edition: 968-969.
•Reynolds MA, Reidy AME, Branch-May GL, Gunsolley JC. The efficacy of bone
replacement grafts in the treatment of periodontal osseous defects. Ann
Periodontol 2003; 8(1): 227-265.
•Dental & Medical Device. Product information on Osteo-Biol ®, 2008.
•Dentsply-Friadent. Product information on PepGen P-15®, 2008.
47. •Rita Singh, Lanka Mahesh. Infections Resulting from Bone Grafting Biomaterials.
International Journal of Oral Implantology and Clinical Research, May-August
2013;4(2):68-71
•A.L. Dumitrescu, Chemicals in Surgical Periodontal Therapy, Bone Grafts and
Bone Graft Substitutes in Periodontal Therapy.
•Emmings et al. Chemically modified osseous material for restoration of bone
defects. J Periodontol 1974; 45:385.
•Boyne et al. Transplantation, implantation and grafts. Dent Clin N Am 1971; 15:
434.
•Krejci et al. Osseous grafting in periodontal therapy. Part I - Osseous graft
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. It is thoroughly mixed with few drops of sterile physiologic solution to activate collagen matrix and to enhance its adhesivity. It can also be mixed with osteoBiol gel or with patients blood.