International Journal of Periodontics & Restorative Dentistry, 02/1994

This paper demonstrates the successful reconstruction of alveolar bone destroyed by advances periodontitis and endodontic failure. It offers a stage approach that is predictable and is superior to extracting the tooth and simultaneously placing an implant fixture, or to extracting the tooth and not performing a ridge enhancement procedure. Four cases using guided tissue regeneration in combination with bone grafts prior to the placement of endosseous dental implants are discussed.

This paper discusses a technique for root coverage using autogenous free gingival grafts. Twenty-two patients who had gingival recession on facial tooth surfaces were studied. The patients underwent surgical treatment, and pretreatment and posttreatment average probing depths for the distal, facial, and mesial tooth surfaces were compared. There was a general decrease in recession for all surfaces. Recession levels tended to remain stable for the duration of the study. There was a slight increase in recession on midfacial surfaces at 4 years that was not statistically significant.

Gingival recession related to periodontal disease or developmental problems can result in root sensitivity, root caries, and esthetically unacceptable root exposures. Consequently, root restorations are performed that often complicate, rather than resolve, the problems created by exposed roots. This article presents a predictable procedure for root coverage on areas of wide denudation in the maxilla and the mandible.

This paper reports on 5 years' experience using a leucite-reinforced porcelain crown system in a private practice setting. A total of 159 units of the porcelain were placed between November 1987 and November 1992. The porcelain can be employed in equigingival and supragingival cases, thereby reducing iatrogenic periodontal problems. The technique and theory of its use is discussed as well as its failure rate, due to fracture, in the various regions of the mouth. Three cases are presented to demonstrate the use of the porcelain.

This study examined the naturally occurring dimensions of the dentogingival junction in 10 adult human cadaver jaws. The connective tissue attachment, epithelial attachment, loss of attachment, and sulcus depth were measured histomorphometrically for 171 tooth surfaces. Mean measurements were 1.34 ± 0.84 mm for sulcus depth; 1.14 ± 0.49 mm for epithelial attachment; 0.77 ± 0.32 mm for connective tissue attachment; and 2.92 ± 1.69 mm for loss of attachment. These dimensions, as measured in this study, support the concept that the connective tissue attachment is a variable width within a more narrow distribution and range than the epithelial attachment, sulcus depth, or loss of attachment. The level of the loss of attachment was not predictive of the connective tissue attachment length.

This study compared clinical, microbiologic, and morphostructural aspects of the healing process in clinical cases treated with expanded polytetrafluoroethylene membranes placed in fresh extraction sockets, which did or did not show early membrane exposure. The examination was focused particularly on morphology of the microbic population and its ability to penetrate membrane pores. Results of the study suggest that use of the membranes is effective in the treatment of fresh extraction sockets with osseointegrated implants; that the membranes are highly biocompatible with gingival tissues; and that early exposure of the membranes during healing hinders the effectiveness of guided tissue regeneration in periimplant tissues.