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Bone tissue regeneration is a rapidly evolving field aimed at the development of biocompatible materials and devices, such as scaffolds, to treat diseased and damaged osseous tissue. Functional scaffolds maintain structural integrity and provide mechanical support at the defect site during the healing process, while simultaneously enabling or improving regeneration through amplified cellular cues between the scaffold and native tissues. Ample research on functionalization has been conducted to improve scaffold–host tissue interaction, including fabrication techniques, biomaterial selection, scaffold surface modifications, integration of bioactive molecular additives, and post-processing modifications. Each of these methods plays a crucial role in enabling scaffolds to not only support but actively participate in the healing and regeneration process in bone and joint surgery. This review provides a state-of-the-art, comprehensive overview of the functionalization of scaffold-based strategies used in tissue engineering, specifically for bone regeneration. Critical issues and obstacles are highlighted, applications and advances are described, and future directions are identified. [ABSTRACT FROM AUTHOR]

Purpose: Untreated severely damaged molar sockets often complicate implant placement. This study evaluated membrane degradation, soft tissue healing, and alveolar crest dimensional changes after alveolar ridge preservation (ARP) in severely damaged molar sockets using a polylactic acid membrane (PLA) and xenograft without primary wound closure. Materials and Methods: A total of 14 damaged molar sockets in 12 patients were grafted with deproteinized bovine bone mineral, which was covered with a PLA membrane without primary wound closure. Wound healing was evaluated at set times. Three sets of CBCT data taken before surgery, at 1 to 2 weeks, and at 6 to 12 months after surgery were reconstructed and superimposed to analyze dimensional changes of the alveolar crest with volumetric imaging software. Results: Two weeks after ARP, no degradation of PLA membrane was present, and the xenograft had either no exfoliation (7 sites, 50%) or mild exfoliation (6 sites, 42.9%). One to 2 months following ARP, the membrane was partially degraded in 6 sites (42.9%) and completely degraded in 8 sites (57.1%). Nine sites (64.3%) presented with mild graft particle exfoliation, and four sites (28.6%) had granulation tissue covering the bone graft. All sites were fully covered by keratinized mucosa by 6 to 12 months. Compared with baseline measurements, the vertical bone graft height decreased by 2.2 ± 2.2 mm, and central alveolar ridge thickness measured at the level of the virtual implant platform decreased by 5.0 ± 5.1 mm after 6 to 12 months. Conclusion: The exposed PLA membrane maintains some barrier function for at least 3 to 4 weeks after ARP in severely damaged molar extraction sites. This technique allowed for implant placements without additional grafting. Future studies should include histologic assessment of the augmented bone and nongrafted control sockets. [ABSTRACT FROM AUTHOR]

The aim of this systematic review is to compare conventional peri-implant flap surgery and reconstructive surgical techniques regarding evidence of remission from peri-implantitis. Searches were made among randomized controlled trials evaluating clinical aspects and the changes in marginal bone level before and after surgical treatment of peri-implantitis, with and without bone substitute. Nine published articles and 442 patients were eligible for inclusion in the study. Reconstructive techniques exhibited a greater extent of defect fill than conventional surgical techniques alone. No significant differences could be found for clinical measures of peri-implant disease (bleeding on probing and reduction of probing depth) from baseline to the 12-month follow-up. With regards to the clinical measures of disease, our review shows that there are no differences between open flap debridement and regenerative surgery. From an esthetic standpoint, it may however be that regenerative measures may lead to improvement but further publications with this focus will be necessary to verify this. [ABSTRACT FROM AUTHOR]

Background: Patient education and demonstration of osseous defects by teachers and clinicians are difficult even though there are different models made up of metal, plastic, plaster, stone, and acrylic. To overcome such difficulty, 3D printed Vanperio model was printed for multifunctional activity. Aims and Objective: The aim of this article was to provide information on the 3D printed VANPERIO model and its implications in the field of periodontics and general dentistry. Conclusion: Vanperio model proves to be a promising model for teachers, students, and clinicians in the field of periodontics and general dentistry as it helps in patient education, student learning and also for various demonstrations which is not possible to achieve in other available expensive models. [ABSTRACT FROM AUTHOR]

Over the years, the concept of periodontal regeneration evolved, so did the bone grafting materials. Though many bone graft materials are available in the market, autografts still remain the most sought after bone graft for the management of osseous defects. However, the availability of autografts and patient compliance are an important consideration before deciding the treatment plan. In order to overcome this drawback, the concept of using demineralized dentin matrix (DDM) as a bone substitute ascended. In this case report, DDM obtained from the hopeless teeth that were indicated for extraction was used for the periodontal management of infrabony defects. The clinical outcome suggested that DDM can be efficaciously employed to attain bone regeneration. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aimed to evaluate the change of bone height following treatment of human intrabony defects with guided tissue regeneration (GTR) with bone grafting or access flap alone by cone-beam computed tomography (CBCT) scan. Materials and methods: This study was conducted as a retrospective longitudinal study. In this study, a total of 2281 teeth sites were included: the GTR group had 1210 sites, and the Flap group had 1071 sites. In the GTR group, demineralized freeze-dried bone (DFDBA) particles in combination with resorbable collagen membrane were used. No regenerative material was applied to the Flap group. CBCT images were taken twice at baseline and at least 2.5 months postoperatively. Bone heights were measured using software on CBCT images. Results: The bony change between the GTR and Flap groups was significantly different (p = 0.00001). Both males and females in the GTR group had smaller bone loss than in the Flap group. In age groups, significant differences of bony height between the GTR and Flap groups were observed in the subgroups consisting of those 29–45 and 46–53 years old. The non-smoking subjects in the GTR group had higher bone heights than those in the Flap group. In the absence of systemic disease and medicine, bone formation was higher in the GTR group than in the Flap group. In terms of oral position, the #14–17, #34–37, and #44–47 subgroups of the GTR group showed higher levels of bone heights than those of the Flap group. Conclusions. The results of this study indicated that the GTR procedure offers the additional benefit of higher bone heights than the Flap procedure does. [ABSTRACT FROM AUTHOR]

During any dental treatment, various instruments, dental materials, and appliances come in contact with the tissues of the oral cavity. Inappropriate handling of these instruments and materials can cause both hard tissue and soft tissue damage. Periodontal destruction due to iatrogenesis and foreign body impaction is not uncommon. The present case report describes an unusual case of iatrogenic periodontal destruction due to restorative overhang as well as impacted restorative material into the interdental region and its management. [ABSTRACT FROM AUTHOR]

Introduction: Periodontal regeneration of maxillary molar proximal furcation defects are challenging due to limited access. While combination therapy of open flap debridement with barrier membrane, bone graft, and biologics are reported to be more successful than monotherapeutic approaches, combination therapy can be complicated and costly. Case Presentation: A total of four teeth in three patients are presented to demonstrate radiographic bone regeneration of deep Class 2 maxillary molar proximal furcation defects (MMPFD) treated with microscope‐assisted papilla preservation technique (PPT) and demineralized freeze‐dried bone allograft (DFDBA). Conclusion(s): Radiographic bone regeneration of deep Class 2 MMPFD is possible with microscope‐assisted PPT and DFDBA. Furthermore, treatment outcomes appear to be superior to those from previous clinical trials of Class 2 MMPFD treatment. [ABSTRACT FROM AUTHOR]

Purpose: Implant primary stability has long been considered a prerequisite for successful osseointegration. However, achieving stability may be difficult when placing implants in wide postextractive bone defects. The purpose of this study was to conduct a clinical and radiographic investigation of bone modifications at porous-structured implants inserted with or without primary stability. Materials and methods: Fifty porous-structured implants were inserted in the posterior sockets of 50 consecutive patients 2 months after tooth extraction, combined with allogeneic bone and a resorbable membrane. The implants were divided into two groups according to insertion torque: spinner (spinning at 35 Ncm, n = 23) and stable (stable at 35 Ncm, n = 27). Implant stability was assessed by resonance frequency analysis from baseline to 6-month function. Follow-up took place 3 years after implant placement. Results: At baseline, the implant stability quotient was undetectable in the spinner group and averaged 75.07 ± 5.84 in the stable group. At uncovering, the implant stability quotient increased to 71.33 ± 4.42 and 77.97 ± 3.30 in the spinner and stable group, respectively (P < 0.001). After 6 months of loading, no between-group difference in implant stability quotient was found (P = 0.13). Marginal bone level changes were similar between groups at all follow-ups, averaging -0.41 ± 0.77 mm and -0.15 ± 0.53 mm at 36-month follow-up in the spinner and stable group, respectively (P = 0.35). No implant failed throughout the observation period. Neither biological nor mechanical complications occurred. Conclusion: Implants with a moderately rough surface and a porous-structured body may osseointegrate even without primary stability. [ABSTRACT FROM AUTHOR]

One of the leading causes of dental implant loss in the present time is peri-implantitis. Peri-implantitis (PI) is a disease of the tissues surrounding dental implants. This paper describes a clinical case of peri-implantitis treated with laser debridement. The use of diode and Er:YAG lasers allows the removal of inflamed tissue and the bacterial biofilm from the implant surface which results in bone regeneration/reparation in the peri-implant area. In this present study, we have discussed about using lasers to be used in treating peri implantitis. Laser therapy can significantly reduce levels of clinical markers of peri-implant tissue inflammation (such as, bleeding upon probing and clinical attachment loss) without interrupting the integrity of the implant or alveolar bone. From this case series, it is observed that Er,Cr YSGG laser is effective and safe in the therapy of peri-implantitis. [ABSTRACT FROM AUTHOR]

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Purpose: Porous titanium granules (PTG) may have potential as an osteoconductive bone graft substitute to treat peri-implant osseous defects. The aim of this study was to analyze clinical and radiographic outcomes of peri-implant osseous defects after treatment with PTG. Materials and Methods: This prospective, randomized, case-control, clinical 12-month study compared open-flap debridement and surface decontamination with titanium curettes and 24% ethylenediaminetetraacetic acid gel (n = 16) to the same protocol but with the addition of PTG (n = 16). One-, two-, and three-wall infrabony defects were included. Patients were given amoxicillin and metronidazole 3 days before surgery and for 7 days afterwards. Implants were submerged and allowed to heal for 6 months. Probing pocket depths, bleeding on probing, implant stability using resonance frequency analysis, and radiographic evaluation were performed at baseline and at 12 months. The threshold for significance was set at .05. Results: Change in radiographic defect height and percent fill of the peri-implant osseous defect significantly favored patients treated with PTG. Both treatment modalities demonstrated significant improvements in probing pocket depth, but significant differences between groups were not observed. The PTG-treated implants showed an increase in implant stability quotient (ISQ) of 1.6 units, compared with a decrease of 0.7 ISQ for the control group. No adverse effects were associated with PTG treatment. Conclusions: Reconstruction with PTG resulted in significantly better radiographic periimplant defect fill compared with controls; however, the results do not necessarily imply reosseointegration or osseointegration of PTG particles. Improvements in clinical parameters were seen in both groups, but no differences between groups were demonstrated. [ABSTRACT FROM AUTHOR]

Background: Development of autologous and recombinant growth factor/matrix combination products represent a new emerging trend in regenerative therapeutics and have gained increasing attention as a strategy to optimize tissue regeneration. The aim of the present study was to evaluate the levels of platelet derived growth factor-BB (PDGF-BB) in gingival crevicular fluid (GCF) during early healing period after the regenerative treatment of intrabony defects using beta tricalcium phosphate (β-TCP) as a bone regeneration material with either platelet rich fibrin (PRF) membrane or collagen membrane (CM) treated with recombinant human PDGF-BB (rhPDGF-BB).Methods: Twenty patients (13 males and 7 females) with chronic periodontitis participated in this prospective, randomized clinical and biochemical study. Each patient was randomly assigned to PRF membrane (group A) or CM incorporated with rhPDGF-BB (group B). GCF samples were obtained on days 3, 7, 14, and 30 for evaluation of PDGF-BB levels and alkaline phosphatase (ALP) levels.Results: On days 3 and 7 following surgery, mean levels of PDGF-BB at sites treated with PRF membrane or CM incorporated with rhPDGF-BB as a barrier membrane were not significantly different. PDGF-BB levels decreased significantly in samples collected on days 14 and 30 with significant differences between both the groups. ALP levels significantly increased from day 3 to day 30 but there was no difference between two groups.Conclusion: Within the limitations of the study, both PRF membrane and CM incorporated with rhPDGF-BB showed comparable GCF levels of PDGF-BB initially with PRF showing more sustained levels throughout the study period. [ABSTRACT FROM AUTHOR]

Introduction: A cemental tear (CeT) is a special type of surface root fracture that may cause periodontal and even periapical tissue destruction. Unfortunately, there is limited knowledge as to how these rare cases can effectively be treated. The present case is believed to be the first reported in the literature treating a bony defect caused by a cemental tear with hyaluronic acid (HA) and a collagen membrane. The aim of this case report is to present a regenerative surgical approach with clinical and tomographic success and stability at 2‐year follow‐up. Case Presentation: A 61‐year‐old patient presented with spontaneous pain and gingival swelling over his right central maxillary incisor. Radiographically, a radiolucent area was observed in the medial third between both central incisors. The tomographic evaluation showed a buccal bone dehiscence and a bony defect. Once the differential diagnosis with an endodontic‐periodontal lesion and root fracture was performed, CeT was the presumptive diagnosis. During the exploratory flap surgery, a small root fragment (CeT) on the mesial side of the tooth was founded and removed. The bony lesion was treated with hyaluronic acid (HA) and a resorbable collagen membrane. At 2‐year follow‐up clinical, radiographic, and tomographic success was observed. Conclusion: A CeT‐associated bony defect could be successfully treated after removing cemental fragments and performing a regenerative approach using HA and a resorbable collagen membrane. [ABSTRACT FROM AUTHOR]

This study compared the in vivo behavior of two biomaterials, xenograft (Bio-Oss®) and alloplastic tricalcium phosphate (Sil-Oss®), vs a control (no biomaterial) in beagle dogs treated with guided bone regeneration (GBR). Six male adult beagle dogs were included. The third and fourth mandibular premolars and first mandibular molars (3P3, 4P4 and 1M1) on both sides were extracted. After 12 weeks of healing, Straumann implants (3.3 × 8 mm) were placed, performing standardized defects (3.3 × 6 mm) in the vestibular aspect of the alveolar bone. The defects were surgically treated by randomized placement of xenograft (Bio-Oss®), alloplastic tricalcium phosphate (Sil-Oss®) or no biomaterial and covered with a resorbable collagen membrane (BioGide®). After an additional 12-week healing period, the lower jaws were dissected. Total area regenerated in the region of interest, total volume, bone to implant contact in the regenerated area, and volumetric changes were measured through histological, histomorphometrical and microcomputed tomography (microCT) techniques. The negative control group showed bone ingrowth inside the defect, with a partial collapse of the buccal bone. This was not observed in the biomaterial-treated groups. Defects treated with the xenograft showed 51.40% (SD 19.83) newly mineralized tissue, while those treated with alloplastic tricalcium showed 62.54% (SD 11.54) newly mineralized tissue; the control showed 71.52% (SD 6.46). Alloplastic tricalcium phosphate modified with monetite and zinc showed similar features in alveolar regeneration of defects to those treated with the xenograft or conventional GBR, but it showed an ideally higher rate of new mineralized tissue formation and accelerated resorption. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The objective of the present paper was to review factors and conditions that are associated with hard and soft‐tissue deficiencies at implant sites. Importance: Hard‐ and soft‐tissue deficiencies at dental implants are common clinical findings. They can lead to complications and compromise implant survival and, hence, may require therapeutic interventions. It is, therefore, important to understand the etiology of hard and soft‐tissue deficiencies. Based on this understanding, strategies should be developed to correct hard and soft‐tissue deficiencies with the aim of improving clinical outcomes of implant therapy. Findings: A large number of etiological factors have been identified that may lead to hard and soft‐tissue deficiencies. These factors include: 1) systemic diseases and conditions of the patients; 2) systemic medications; 3) processes of tissue healing; 4) tissue turnover and tissue response to clinical interventions; 5) trauma to orofacial structures; 6) local diseases affecting the teeth, the periodontium, the bone and the mucosa; 7) biomechanical factors; 8) tissue morphology and tissue phenotype; and 9) iatrogenic factors. These factors may appear as an isolated cause of hard and soft‐tissue defects or may appear in conjunction with other factors. Conclusions: Hard‐ and soft‐tissue deficiencies at implant sites may result from a multitude of factors. They encompass natural resorption processes following tooth extraction, trauma, infectious diseases such as periodontitis, peri‐implantitis, endodontic infections, growth and development, expansion of the sinus floor, anatomical preconditions, mechanical overload, thin soft tissues, lack of keratinized mucosa, malpositioning of implants, migration of teeth, lifelong growth, and systemic diseases. When more than one factor leading to hard and/or soft‐tissue deficiencies appear together, the severity of the resulting condition may increase. Efforts should be made to better identify the relative importance of these etiological factors, and to develop strategies to counteract their negative effects on our patient's wellbeing. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present paper was to review factors and conditions that are associated with hard and soft‐tissue deficiencies at implant sites. Importance: Hard‐ and soft‐tissue deficiencies at dental implants are common clinical findings. They can lead to complications and compromise implant survival and, hence, may require therapeutic interventions. It is, therefore, important to understand the etiology of hard and soft‐tissue deficiencies. Based on this understanding, strategies should be developed to correct hard and soft‐tissue deficiencies with the aim of improving clinical outcomes of implant therapy. Findings: A large number of etiological factors have been identified that may lead to hard and soft‐tissue deficiencies. These factors include: 1) systemic diseases and conditions of the patients; 2) systemic medications; 3) processes of tissue healing; 4) tissue turnover and tissue response to clinical interventions; 5) trauma to orofacial structures; 6) local diseases affecting the teeth, the periodontium, the bone and the mucosa; 7) biomechanical factors; 8) tissue morphology and tissue phenotype; and 9) iatrogenic factors. These factors may appear as an isolated cause of hard and soft‐tissue defects or may appear in conjunction with other factors. Conclusions: Hard‐ and soft‐tissue deficiencies at implant sites may result from a multitude of factors. They encompass natural resorption processes following tooth extraction, trauma, infectious diseases such as periodontitis, peri‐implantitis, endodontic infections, growth and development, expansion of the sinus floor, anatomical preconditions, mechanical overload, thin soft tissues, lack of keratinized mucosa, malpositioning of implants, migration of teeth, lifelong growth, and systemic diseases. When more than one factor leading to hard and/or soft‐tissue deficiencies appear together, the severity of the resulting condition may increase. Efforts should be made to better identify the relative importance of these etiological factors, and to develop strategies to counteract their negative effects on our patient's wellbeing. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present paper was to review factors and conditions that are associated with hard and soft-tissue deficiencies at implant sites.Importance: Hard- and soft-tissue deficiencies at dental implants are common clinical findings. They can lead to complications and compromise implant survival and, hence, may require therapeutic interventions. It is, therefore, important to understand the etiology of hard and soft-tissue deficiencies. Based on this understanding, strategies should be developed to correct hard and soft-tissue deficiencies with the aim of improving clinical outcomes of implant therapy.Findings: A large number of etiological factors have been identified that may lead to hard and soft-tissue deficiencies. These factors include: 1) systemic diseases and conditions of the patients; 2) systemic medications; 3) processes of tissue healing; 4) tissue turnover and tissue response to clinical interventions; 5) trauma to orofacial structures; 6) local diseases affecting the teeth, the periodontium, the bone and the mucosa; 7) biomechanical factors; 8) tissue morphology and tissue phenotype; and 9) iatrogenic factors. These factors may appear as an isolated cause of hard and soft-tissue defects or may appear in conjunction with other factors.Conclusions: Hard- and soft-tissue deficiencies at implant sites may result from a multitude of factors. They encompass natural resorption processes following tooth extraction, trauma, infectious diseases such as periodontitis, peri-implantitis, endodontic infections, growth and development, expansion of the sinus floor, anatomical preconditions, mechanical overload, thin soft tissues, lack of keratinized mucosa, malpositioning of implants, migration of teeth, lifelong growth, and systemic diseases. When more than one factor leading to hard and/or soft-tissue deficiencies appear together, the severity of the resulting condition may increase. Efforts should be made to better identify the relative importance of these etiological factors, and to develop strategies to counteract their negative effects on our patient's wellbeing. [ABSTRACT FROM AUTHOR]

Additive osseous surgery requires graft material to be placed in osseous defects or for sinus lifting procedure. Placement of graft material in dummy jaw or on cadaver jaw by students/learners for practice is needed before actual placement on patients. There is a need to develop a dummy radio-opaque material for use as a practice material by students or learners in defects of dummy jaw or on cadaver jaw. Materials and Methods Dummy graft material was prepared from discarded eggshells (waste) and was used for sinus lifting in a cadaver goat jaw as taste case. Results A measureable radio-opacity of egg-shell particles was seen below the sinus floor after sinus lifting on a cadaver goat jaw. Summary and Conclusions Radio-opaque egg-shell graft material can be used as dummy graft material for practice as a teaching material. [ABSTRACT FROM AUTHOR]

Numerous animal and human studies have provided evidence supporting the belief that periodontal ligament stem cells (PDLSCs) can be harnessed for regeneration of periodontal tissues. Based on current literature on the use of ex vivo stem culture and associated problems, this case report describes a novel approach of direct application PDLSCs using stem cell assistance in periodontal regeneration technique (SAI-PRT) for the regeneration of intrabony periodontal defects bypassing ex vivo cultures. SAI-PRT has emerged as a constructive avenue in the treatment of periodontal osseous defects. Moreover, the current technique is less technique-sensitive, cost-effective and yields promising results. [ABSTRACT FROM AUTHOR]

Background: Horizontal bone loss is the most common periodontal problem confronting the clinician but has received little attention. Platelet rich fibrin (PRF) is a second generation platelet concentrate. The platelets, leucocytes, growth factors and cytokines contained within PRF make it a healing biomaterial with tremendous potential for bone and soft tissue regeneration. Aim: This interventional clinical trial evaluates the clinical effectiveness of Autologous Platelet Rich Fibrin (PRF) in the management of horizontal bony defects. Settings and Design: Department of Periodontics. Design was Non Randomized Clinical Trial with split mouth design. Materials and Methods: A total of 45 sites with horizontal bone loss in 15 patients were studied, 15 sites were treated with PRF gel (experimental group I) and 15 sites were treated with PRF gel and PRF membrane (experimental group II). Control group (15 sites) were treated with open flap debridement. Statistical Analysis: All the parameters were assessed at baseline and after nine months which included Pocket Depth (PD), Clinical Attachment level (CAL), Gingival Recession (REC) and Relative Crest Height (RCH). The mean changes at baseline and after 9 months within each group were compared using Wilcoxon Signed Ranks Test. The mean changes for each parameter between groups were compared using Kruskal Wallis Test. Results: Re-evaluation at nine months revealed that all groups showed a significant reduction in probing depth (1.1±0.38 mm in control, 1.73±0.53 mm in group I, 1.7±0.45 mm in group II) (p<0.05) and clinical attachment gain (0.86±0.58 mm in control, 1.56±0.62 mm in group I, 1.7±0.52 in group II)(p<0.05) as compared to baseline. Intergroup comparisons of reduction in probing depth and clinical attachment gain showed significant differences in the experimental groups as compared to control (p<0.05), but there was no significant difference between the experimental groups (p>0.05). There was no significant difference in gingival recession and radiographic bone levels at 9 months post surgery (p>0.05) in all the three groups Conclusion: Within the limitations of this study, it can be concluded that, clinically the use of PRF in both gel and membrane form is more effective than open flap debridement alone in the management of horizontal periodontal defects at nine months post surgery. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to systematically evaluate the long-term results of periodontal tissues in regenerated infrabony and furcation defects. Material and methods: A search of the Medline database was performed (1960 to 2012), complimented by an additional hand search. For inclusion in the review, clinical trials had to include the long-term evaluation of infrabony and furcation defects submitted to periodontal regeneration for up to 3 years of follow-up. Changes in clinical attachment level (CAL) from pre-surgery, at the first post-surgical, and final evaluations were used to analyze the effects of regenerative treatments over time. Results: A total of 866 articles were found using the descriptors employed. Of these, 216 papers were selected for abstract reading by two evaluators. One hundred and eighty-nine were excluded for not fulfilling the eligibility criteria. Twenty-seven papers were selected for the analysis of the full texts, and 13 were excluded. Two studies were included after a manual search. Finally, 16 papers were selected for the present review. Conclusions: Regenerative techniques for the treatment of infrabony and furcation defects resulted in improved CAL during long-term follow-up periods, even when attachment losses occurred during this period. This improvement should be carefully evaluated with regard to its clinical relevance for dental longevity. Clinical relevance: The improvement in clinical attachment level achieved by regenerative techniques with biomaterials demonstrated satisfactory results over the long-term. However, regenerative techniques still present different success rates with regard to gain in clinical attachment level. [ABSTRACT FROM AUTHOR]

Introduction. Emdogain® represents an extracellular matrix derivative that controls and promotes periodontal regeneration. Several studies have demonstrated that the treatment of periodontal defects with Emdogain® leads to improvements in clinical parameters. However, long-time clinical trials establishing clinical usefulness of Emdogain® are scarce. Therefore, the present randomized split mouth, controlled study was undertaken to evaluate the effectiveness of Emdogain® as an adjunct to open flap debridement for the treatment of intra-bony defects over a period of 5 years. Materials and methods. The study population consisted of 15 chronic periodontitis patients with bilateral interproximal osseous defects. The test group was treated by open flap debridement with EDTA 24% (PrefGel®) followed by enamel matrix derivative (Emdogain®). The control group was treated by open flap debridement with EDTA 24% (PrefGel®). Results. After 1 and 5 years, both the test and control groups showed significant mean PPD reduction. A greater reduction in mean Probing Pocket Depth (PPD) was observed in the test group (3.84 ± 1.05) as compared to the control group (1.92 ± 0.35). The mean Clinical Attachment Level (CAL) gain of 3.18 ± 0.87 mm was observed in the test group, while the control group displayed mean CAL gain of 1.60 ± 0.54 mm. The observed differences were found to be statistically significant in both the groups ( p < 0.05). Percentage bone fill was significantly increased at 12 months post-surgery in test group (66.66 ± 7.8%) as compared to control group (31.71 ± 4.1%). Conclusion. The treatment with Emdogain resulted in a significantly higher CAL gain and PPD reduction in comparison with OFD and PrefGel®. [ABSTRACT FROM AUTHOR]

Orthodontic- Periodontic interactions are mutually beneficial. This combined approach can greatly enhance periodontal health and dentofacial esthetics in periodontally compromised patients. Now a day there is increased demand of esthetic in adult patients. Adult orthodontics is difficult because these patients with soft and hard tissue defects. This article presents different problems related to periodontally compromised patients. [ABSTRACT FROM AUTHOR]

Background: Autogenous bone graft, although considered as a gold standard, has been relegated to background because of limited quantity and donor site morbidity. Revival of interest in its use has been reflected by its tremendous capacity for regeneration in less than ideal situation. Bone blocks have been used for implant site augmentation, with varied success. Aim: Aim of the study was to evaluate the efficacy of autogenous bone block in the regeneration of bone, for saving teeth with a hopeless prognosis. Settings and Design: A total of six patients and 12 sites with grade II and III mobile teeth were treated with autogenous bone blocks and fiber splinting. Subjects and Methods: Attachment loss, probing depths, and radiographic bone loss were recorded at baseline and at 12 months interval. Statistical Analysis Used: The Student paired t test was used for evaluation of the changes from baseline to 12 months. Results: At 12 months post-operatively, there was a highly significant amount of bone gain as compared to the baseline. The mean amount of bone loss reduced from 9.41 ± 1.16 to 5.41 ± 1.01. The clinical attachment loss reduced from 7.37 ± 1.24 mm to 3.79 ± 0.89 mm and probing depth reduced from 7 ± 1.67 mm to 5.5 ± 0.63 mm. The grafted bone was observed to have been incorporated with the host bone in most of the sites as evidenced by radiographs. Conclusions: For teeth with hopeless prognosis, this method can be considered to be a very viable alternative to extraction and replacement by costly implants. [ABSTRACT FROM AUTHOR]

Various root developmental anomalies like palatoradicular groove (PRG) have been associated with worsening of periodontal condition. The aim of the present case report is to describe the regenerative surgical treatment of periodontal and osseous lesion associated with the subgingival extension of PRG. A 23-year-old female patient reported with pain in upper incisor teeth region. On clinical and radiological examination, a deep endosseous defect was found distal to maxillary right lateral incisor that was etiologically associated with the presence of a PRG. Treatment procedures consisted of: Regenerative periodontal therapy using Guided tissue regeneration (GTR) and hydroxyapatite (HA) bone graft and 2) flattening of the radicular portion of the palatal groove. The clinical examination at 1 year revealed shallow residual probing depth (3 mm) and no increase in gingival recession. The radiographic examination showed reduction in the radiolucency suggesting bone fill. A PRG may serve as a pathway for the development of a periodontal osseous defect. The combination of GTR and HA may be clinically and radiographically efficacious in the treatment of such a defect [ABSTRACT FROM AUTHOR]

Developmental grooves are not rare and often appear on maxillary lateral and central incisors and are an important predisposing factor to localized periodontal disease. Various techniques have been adopted to eliminate the groove and regenerate lost periodontium. This report of two cases describes the technique of using the local drug delivery system with chlorehexidine and the guided tissue regeneration (GTR) to control the disease progression and regeneration. [ABSTRACT FROM AUTHOR]

Objectives: Objective of this study is to evaluate the new bone formation in bony defects following insertion of hydroxyapatite graft and to compare the efficacy and regenerative potential of this bone graft material. Method: The patients having osseous defects after surgery were selected. Preoperatively a brief history, examination, relevant blood investigation and radiographs were taken. Post operative observation period of 6 months was planned. Radiographic and bone scintigraphic (isotope study of bone activity) evaluation of bone specimens was completed in defined time. Results: Radiographic evaluation indicated increased calcification surrounding the material, indicative of acceptance of the graft to the bone. Bone scintigraphic evaluation indicated area of increased bone metabolism and is evidenced as area of increased radiotracer uptake, namely 'hot spots' (active bone formation). Conclusion: It can be concluded that the hydroxyapatite graft met the clinical requirement of a bone substitute material which is biocompatible and non-allergic. The use of this material is advantageous over other bone grafts because of simplicity of application, cost effectiveness and easy availability. Due to its microstructure, complete resorption and neo bone formation took place during the course of this study. [ABSTRACT FROM AUTHOR]

Aims: This three-arm study compared the clinical and radiographic efficacy of the modified minimally invasive surgical technique (M-MIST) alone and combined with enamel matrix derivative (EMD) or EMD plus bone mineral derived xenograph (BMDX), in the treatment of isolated, inter-dental intra-bony defects. Materials and Methods: Forty-five deep isolated intra-bony defects in 45 patients were included, accessed with the M-MIST and randomly assigned to three balanced experimental groups. The M-MIST consisted of a small buccal flap without elevation of the defect-associated papilla. After removal of the granulation tissue by sharp dissection and root instrumentation the regenerative material was applied, when indicated, before obtaining primary closure with a single internal modified mattress suture. Surgery was performed with the aid of an operating microscope and microsurgical instruments. Outcomes were evaluated as pocket depth reduction, attachment level gain, radiographic bone fill and patient-related outcomes. Results: Primary wound closure was maintained in all treated sites with the exception of one M-MIST EMD+BMDX site. No patient reported intra-operative or post-operative pain. Within group differences between baseline and 1 year were statistically significant in the three groups in terms of probing pocket depth reduction, clinical attachment level (CAL) gain and bone fill (p<0.0001). Comparisons among the the groups showed no statistically significant difference in any of the measured clinical outcomes. In particular, CAL gains of 4.1 ± 1.4mm were observed in the M-MIST control group, 4.1 ± 1.2mm in the EMD group and 3.7 ± 1.3mm in the EMD1BMDX one. The percentage radiographic bone fill of the intra-bony component was 77 ± 19% in the M-MIST control group, 71 ± 18% in the EMD group and 78 ± 27% in the EMD1BMDX group. Conclusions: M-MIST with or without regenerative materials resulted in significant clinical and radiographic improvements. While this initial study did not have sufficient power to detect inter-group CAL differences <0.96 mm, the observed outcomes were remarkably similar and warrant further investigations. [ABSTRACT FROM AUTHOR]

The aim of this randomized double-blind, clinical trial was to compare the use of enamel matrix derivative (EMD) and demineralised freeze-dried bone allografts (DFDBA) with DFDBA alone for the treatment of human periodontal intrabony defects at 12 months post-surgery. Fifty-six intrabony osseous defects in 56 periodontis patients were randomly assigned to the test group (DFDBA + EMD) or the control group (DFDBA) for periodontal treatment. Clinical and radiographic measurements were made at the baseline and after 12 months. Compared to baseline, the 12-month results indicated that both treatment modalities resulted in significant changes in all clinical parameters (gingival index, bleeding on probing, probing depth (PD), clinical attachment level (CAL), gingival recession; P < 0.05) and radiographic parameters (hard tissue fill (HTF) and bone depth reduction; P < 0.05). Furthermore, statistically significant differences were found in the test group compared to the control group in PD reduction (5.0 mm vs. 4.0 mm; P < 0.05), CAL gain (4.0 mm vs. 3.25 mm), and HTF (4.0 mm vs. 3.5 mm; P < 0.05). In the test group, 25% of sites gained >4 mm of CAL, while in the control group, 7.1% of sites gained >4 mm of CAL. Both treatments showed a good soft and hard periodontal tissue response. At 12 months post-surgery, the combined use of DFDBA and EMD seemed to produce a statistically significant improvement of PD reduction, CAL gain, and HTF. [ABSTRACT FROM AUTHOR]

Background: Minimally invasive surgery (MIS) is a surgical technique using very small incisions indicated for performing regenerative therapy in periodontal defects. The 1 l-month results from a prospective study of MIS were previously published. This article presents the 6-year results of that prospective study. Methods: Patients from two private periodontal practices with advanced periodontitis who, after nonsurgical therapy, had one or more sites with probing depths ≥6 mm were included in the study. An MIS surgical approach was used for all sites ≥6 mm. After surgical debridement, enamel matrix derivative (EMD) was placed into the bony defect. The surgical sites were reevaluated after ≥6 years. Results: Six-year data were available on 142 sites in 13 patients. No significant differences were noted in the results between the two offices, and the data were combined. Probing depths (mean: 3.18 mm; SD: 0.59 mm) and attachment levels (mean: 3.93 mm; SD: 0.19) at 6 years were unchanged from the 1 l-month measurements. No recession from preoperative levels was noted. All sites continued to be considered clinically successful. Conclusions: The combination of MIS and EMD yielded significant reductions in probing depths and improvements in attachment levels while producing no detectable recession. The 1 l-month results remained stable at 6 years. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the osteoconductive properties and biological performance of porous titanium granules used in osseous defects adjacent to titanium implants. Material and methods: In this animal experimental study, calibrated defects were prepared in the tibias of 24 New Zealand rabbits. The defects were randomized into two tests and one control group. The test defects were grafted with either metallic or oxidized porous titanium granules (PTG or WPTG, respectively), whereas control defects were left empty (sham). The defects were closed with a submerged coin shaped titanium implant. Defects were left for healing for 4 weeks. After healing, the implants were removed and the new bone tissue formed onto the implant surface was analyzed for run × 2, osteocalcin, collagen-I, tartrate-resistant acid phosphatase, H+-ATPase, tumor necrosis factor-α, interleukin (IL)-6 and IL-10 gene expression using reverse transcriptase polymerase chain reactuion. Wound fluid from the healed defects was analyzed for lactate dehydrogenase and alkaline phosphatase activity. Finally osteoconductivity was analyzed by micro-computed tomography and histology. Results: Significantly more new bone formed in PTG and WPTG grafted defects compared with sham. The new bone grew both through the porosities of the granules and onto the implant surfaces. The WPTG group showed significantly less expression of key inflammation markers, but with no significant difference in a marker for necrosis. The WPTG also showed a significant increase in collagen-I mRNA expression compared with PTG. Conclusion: The results suggest that PTG and WPTG are both osteoconductive materials that can be used to promote bone formation in osseous defects adjacent to titanium implants without hampering implant osseointegration. To cite this article: Wohlfahrt JC, Monjo M, Rønold HJ, Aass AM, Ellingsen JE, Lyngstadaas SP. Porous titanium granules promote bone healing and growth in rabbit tibia peri-implant osseous defects. Clin. Oral Impl. Res. 21, 2010; 165–173. doi: 10.1111/j.1600-0501.2009.01813.x [ABSTRACT FROM AUTHOR]

This study assessed the value of three-dimensional CT (3D CT) in the diagnosis of craniosynostosis, and correlated the cranial deformity with the presence of osseous defects in cranial vault's bones. One hundred and two children (55♀ and 47♂) with a clinical suspicion of craniosynostosis, underwent spiral computed tomography with 3D reconstruction using the shaded surface display (SSD) and volume rendering (VR) algorithms. We evaluated the presence of osseous defects in cranial bones in correlation with the type of craniosynostosis and the shape of the cranial vault. 3D CT allowed the evaluation of craniosynostosis in all patients. All patients had combined forms of craniosynostosis. Osseous defects in the bones of cranial vault were found in 56 patients of whom nine had scaphocephaly, eight plagiocephaly and one trigonocephaly. CT of the skull with three-dimensional reconstruction can safely and reliably identify craniosynostoses in children and could be used for the identification of osseous defects in the cranial vault. [ABSTRACT FROM AUTHOR]

Aims: This paper describes a modified surgical approach of the minimally invasive surgical technique (modified minimally invasive surgical technique, M-MIST) and preliminarily evaluates its applicability and clinical performances in the treatment of isolated deep intrabony defects in combination with amelogenins. Material and Methods: Twenty deep isolated intrabony defects in 20 patients were studied. Fifteen were surgically accessed with the M-MIST, while in five sites, which presented a lingual intrabony component, the conventional MIST had to be applied. The M-MIST consisted of a buccal incision of the defect-associated papilla, according to the principles of the papilla preservation techniques. Only a buccal flap was raised while the interdental papilla was left in situ. The granulation tissue filling the defect was dissected and removed, leaving the interdental and palatal tissues untouched. Root instrumentation and application of the regenerative material were performed before suturing. Primary closure of the flaps was attained with a single internal modified mattress suture. Surgery was performed with the aid of an operating microscope and microsurgical instruments. Results: The surgical chair-time of the M-MIST-treated sites ( N=15) was 56±8.64 min. Early wound healing was uneventful: primary wound closure was attained and maintained in all sites. No oedema or haematoma was noted. Patients did not report pain or discomfort. The 1-year clinical attachment level (CAL) gain was 4.5±1.4 mm in defects 6±1.5 mm deep. Residual probing depths (PDs) were 3.1±0.6 mm. A minimal increase of 0.1±0.3 mm in gingival recession between baseline and 1 year was observed. Conclusions: M-MIST was applicable on 15 isolated interproximal defects out of 20 selected ones. It resulted in very limited patient morbidity and excellent clinical improvements. These outcomes should be confirmed in a larger study. [ABSTRACT FROM AUTHOR]

Aims: This case cohort study was designed to evaluate the clinical performance and the intra-operative and post-operative morbidity of the “minimally invasive surgical technique” (MIST) associated with the application of an enamel matrix derivative (EMD) in the treatment of multiple deep intra-bony defects in a single surgical procedure. Material and Methods: Forty-four deep intra-bony defects in 20 patients (⩾2 defects/patient) were surgically accessed with the MIST. This technique was designed to limit the mesio-distal flap extension and the apical flap reflection in order to reduce the surgical trauma and increase flap stability. The incision of the defect-associated papilla was performed according to the principles of the papilla preservation techniques. EMD was applied on the debrided and dried root surfaces. Stable primary closure of the flaps was obtained with modified internal mattress sutures. Surgery was performed with the aid of an operating microscope and microsurgical instruments. Clinical outcomes were collected at baseline and at 1 year. Intra-operative and post-operative morbidity was evaluated with questionnaires. Results: The 1-year clinical attachment level (CAL) gain was 4.4±1.4 mm ( p<0.0001 compared with baseline). Seventy-three per cent of defects showed CAL improvements ⩾4 mm. This corresponded to an 83±20% resolution of the defect (15 defects were completely filled). Residual probing pocket depths (PDs) were 2.5±0.6 mm. A minimal increase of 0.2±0.6 mm in gingival recession between baseline and 1 year was recorded. Twelve patients reported a mild perception of the hardship of the surgical procedure. Primary closure was obtained and maintained in all treated sites over time. Only six subjects reported moderate post-operative pain that lasted for 21±5 h. Conclusions: These data indicate that a MIST in combination with EMD can be applied successfully for the treatment of multiple deep intra-bony defects in the same surgical procedure with excellent clinical outcomes and very limited patient morbidity. [ABSTRACT FROM AUTHOR]

Objective: To study the healing at fluoride-modified implants placed in wide circumferential defects. Material and methods: Six mongrel dogs were used. The mandibular premolars and first molars were extracted. Three months later four implants were placed in one side of the mandible of each dog. The control implants (MicroThread™) had a TiOblast surface, while the test implants (OsseoSpeed™) had a fluoride-modified surface. Two implants of each type were placed. The marginal 50% of the prepared canal was widened using step drills. Following installation a 1 mm wide gap occurred between the implant surface and the bone wall in the defect. All implants were submerged. The installation procedure was repeated in the opposite side of the mandible 4 weeks after the first implant surgery. Two weeks later the animals were euthanized and block biopsies containing the implant and surrounding tissues were prepared for histological analysis. Results: The histological analysis revealed that a significantly larger area of osseointegration was established within the defect at fluoride-modified implants than at implants with a TiOblast surface after 6 weeks of healing. Further, the degree of bone-to-implant contact within the defect area was larger at fluoride-modified implants than at the TiOblast implants. Conclusion: It is suggested that the fluoride-modified implant surface promotes bone formation and osseointegration. [ABSTRACT FROM AUTHOR]

Aims: This case cohort study was designed to evaluate the clinical performance and the intra-operative and post-operative morbidity of the minimally invasive surgical technique (MIST) associated with the application of an enamel matrix derivative (EMD) in the treatment of isolated deep intra-bony defects. Material and Methods: Forty deep isolated intra-bony defects in 40 patients were surgically accessed with the MIST. This technique was designed to limit the mesio-distal flap extension and the corono-apical flap reflection in order to reduce the surgical trauma and increase flap stability. The incision of the defect-associated papilla was performed according to the principles of the papilla preservation techniques. EMD was applied on the debrided and dried root surfaces. Stable primary closure of the flaps was obtained with modified internal mattress sutures. Surgery was performed with the aid of an operating microscope and microsurgical instruments. Clinical outcomes were collected at baseline and at 1 year. Intra-operative and post-operative morbidity was evaluated with questionnaires. Results: The 1-year clinical attachment gain was 4.9±1.7 mm ( p<0.0001 compared with baseline). This corresponded to a 77.6±21.9% resolution of the defect. Residual probing pocket depths were 3±0.6 mm. A minimal increase of 0.4±0.7 mm in gingival recession between baseline and 1 year was recorded. No patients experienced intra-operative pain, while only 14 reported a very moderate perception of the hardship of the surgical procedure [7±12 visual-analogue scale (VAS) units, on average]. Primary closure was obtained in all treated sites. At the 1-week follow-up visit, 38 sites (95%) were still closed. Only 12 subjects reported moderate post-operative pain (VAS 19±10) that lasted for 26±17 h. Conclusions: These data indicate that the minimally invasive surgical technique, in combination with EMD, can be successfully applied in the treatment of isolated deep intra-bony defects, resulting in excellent clinical outcomes with very limited intra- and post-operative morbidity. [ABSTRACT FROM AUTHOR]

Aims: This study was undertaken to describe a new surgical approach (minimally invasive surgical technique, MIST) and to evaluate preliminarily its clinical performance and patient perception associated with the application of enamel matrix derivative (EMD) in the treatment of isolated deep intra-bony defects. Methods: Thirteen deep isolated intra-bony defects in 13 patients were surgically accessed with the MIST. This technique was designed to limit the mesio-distal flap extension and the corono-apical reflection in order to reduce the surgical trauma and increase flap stability. The incision of the defect-associated papilla was performed according to the principles of the papilla preservation techniques. EMD was applied on the debrided root surfaces. Stable primary closure of the flaps was obtained with internal modified mattress sutures. Surgery was performed with the aid of an operating microscope and microsurgical instruments. Clinical outcomes were collected at baseline and at 1 year. Intra-operative and post-operative patient perception was also recorded. Results: Early wound healing was uneventful: primary wound closure was obtained and maintained in all sites with the exception of one site with a small wound dehiscence at week 1. No oedema or haematoma were noted. Patients did not report any pain. Three patients experienced slight discomfort for 2-days post-operatively. The 1-year clinical attachment level (CAL) gain was 4.8±1.9 mm. The 1-year percent resolution of the defect was 88.7±20.7%, and reached 100% of the baseline intra-bony component in seven sites. Residual probing depths (PD) were 2.9±0.8 mm. Differences between baseline and 1-year CAL and PD were both clinically and statistically highly significant ( p<0.0001). A minimal increase of 0.1±0.9 mm in gingival recession between baseline and 1 year was recorded ( p=0.39). Conclusions: This case cohort indicates that MIST associated with EMD resulted in excellent clinical improvements while limiting patient morbidity. These preliminary findings need to be confirmed in a larger study. [ABSTRACT FROM AUTHOR]

The diagnosis and treatment of osseous deficiencies associated with anterior shoulder instability have been a challenge to physicians for centuries. Whereas historical goals centered on the stable reduction and prevention of recurrent dislocation, cur- rent standards of success are predicated on the restoration of motion and strength and the return to functional activities, including competitive athletics. Reestablishment of anterior shoulder stability thus requires the recognition of osseous defects of the humeral head and glenoid, as well as a thorough understanding of the available treatment options in the context of a disciplined treatment algorithm. Although many surgical procedures have been described for the management of osseous deficiencies in association with anterior shoulder instability, in the authors' experience, such procedures are seldom necessary. The purpose of this summary is to review treatment options as well as indications and techniques to address these bony deficiencies. [ABSTRACT FROM AUTHOR]

Presents the research "Bone Grafting Procedures for Osseous Defects Associated With Dental Implants," by Gagik Hakobyan. Use of bone grafting therapy for the treatment of osseous defects before dental implant surgery; Surgical procedure of dental implant and removal of maxillary cyst based on the case of a 45-year old man seeking implant rehabilitation; Effects of peroapical lesions around an implant on the extracted or still-present teeth; Factors that are critical to the success of the bone grafting procedures.

Recent and ongoing research efforts have been made to increase the efficacy of biomaterials as structural fillers during in vivo bony reconstructions. Although the selection of the possible material choices has grown, a biomaterial that can be physically molded to the defect/void space as well as offer biomimetic tissue regeneration has yet to be made available. With the potential success of demineralized freeze-dried bone allografts (DFDBA) combined with tendonous collagen as an effective filling material, further research should help to elucidate its use. The purpose of this study was to evaluate the regenerative healing response of five allograft mixtures via the morphology of filled, periodontal defects. Critical size mandibular and maxillary osseous defects were surgically created in six adult baboons. The filling response of four combinations of DFDBA and tendon collagen was compared with an all-collagen graft after 3 months of implantation. The overall results indicate that all combinations of DFDBA and collagen provided a better fill response than the all-collagen matrix (P < 0. 05). Statistically, however, all of the combinations were similar (P > 0.05) with a 60:40 collagen to DFDBA mass ratio resulting in the largest defect fill response. [ABSTRACT FROM AUTHOR]

The aim of this case series was to present the clinical outcomes of non-contained intrabony periodontal defects (IPDs) treated by means of papillary preservation flaps in association with a slowly resorbable bovine pericardium membrane (BPM) and a low-temperature-treated bovine bone graft (BBG). Eight healthy, non-smoking patients (two males and six females, mean age 48 ± 8 years) with stage 3 periodontitis and at least one site with residual probing depth (PD) ≥ 6 mm associated with a non-contained IPD ≥ 3 mm were treated. Two weeks after surgery, no adverse events were observed, and an early wound healing score (EHS) of 8.1 ± 1.0 was recorded. After 1 year, the mean probing depth (PD) reduction and mean clinical attachment level gain (CAL-gain) accounted for 4.8 ± 0.7 and 3.5 ± 0.7 mm, respectively, whereas the mean gingival recession (REC) was of 1.2 ± 0.3 mm. Radiographic bone fill was observed in all cases. In conclusion, the treatment of non-contained IPDs with a slowly resorbable BPM and a low-temperature-treated BBG could be considered safe and may result in significant clinical improvements 1 year after surgery. [ABSTRACT FROM AUTHOR]

Background: Calcium sulfate belongs to synthetic ceramic group of bone graft substitutes having an osteoconductive property. Calcium sulfate is an easily available, economic bone graft substitute. It is a bio-inert material which over a period of weeks get resorbed and fibrovascular tissue takes its place which eventually allows neovascularisation and bone formation within the area. Use of calcium sulfate as a bone graft substitutes avoids the complications and morbidity associated with autograft like infection, second surgery, and finite amount of graft. Material and Methods: A total of 15 patients with benign bone lesions and chronic osteomyelitis were operated and the osseous defects were filled with calcium sulfate which was comprehensively sterilized .Patients were followed with serial radiographs at six week intervals. Calcium sulfate resorption and new bone formation was studied. Results: Thirteen cases out of 15 showed calcium sulphate resorption and new bone incorporation. Calcaium sulphate resorption occurred at an average of 14.5 weeks (range,13- 18weeks) whereas new bone incorporation occurred at an average of 6months ( range,5-7months). Thirteen patients out of these 15 cases returned to full activities of daily living. One patient had pathological fracture at the osseous defect postoperatively. One patient with GCT of distal end of tibia had recurrence of tumor and had to undergo second surgery. Conclusion: Although autogenous bone graft is the gold standard for bone grafting, it has limitations like finite amount, additional surgery and donor site morbidity. Calcium sulphate is safe, efficient and easily available bone graft substitute in the treatment of osseous defects. Most common complication encountered was aseptic serous discharge. Functional results were favorable in most of the cases. [ABSTRACT FROM AUTHOR]

OBJECTIVES - Objective of this study is to evaluate the new bone formation in bony defects after placement of PRP and its efficacy of regenerative potential. METHOD - Twenty five pediatric patients were selected for the study and PRP was extracted from patients own blood and placed in defect in all patients. Post operative clinical and radiographic observation was done at 1st,4th and 6th month. RESULTS - Faster bone healing in all patients was observed. CONCLUSION - It can be concluded by the study that PRP is a better source of bone induction growth factors and regeneration of bone can be done at faster rate which is a favorable biological response similar to natural healing process. [ABSTRACT FROM AUTHOR]

During our routine postmortem examination, we found a female infant with "True Cyclopia." The two entire eye balls had fused completely to form one midline organ. The infant was a female who weighed 2910 g. The gestation period was 35 weeks. Infant lived for a short period of less than 20 minutes. The birth was a product of a 4th pregnancy. [ABSTRACT FROM AUTHOR]