Alveolar Crest Height Research Articles

Analysis of a force system for upper molar distalization using a trans-palatal arch and mini-implant: a finite element analysis study

The purpose of this study was to analyse distal movements of molars in a force system using a trans-palatal arch (TPA), fixed to the maxillary first molar, and mini-implants placed at the palatal midline, considering the diagnostic standard for placement site in association with variation in upper molar locations, using finite element (FE) analysis. Three-dimensional FE models, divided by the differing direction of traction force, mesiodistal locations of the left and right molars, and the lateral location of the mini-implant were constructed. (1) When a traction force was fixed from the height of alveolar crest to the mini-implant placed at the middle of palate, the molars underwent bodily movement. (2) When the location of the mini-implant was moved to the left of the midline, the amount of distal movement of the left molar increased. When the mesiodistal locations of the left and right molars differed, the amount of distal movement of the molar located mesially was larger than that of the contralateral molar, even when the mini-implant was located on the midline.

The measurement of the alveolar bone crest in aggressive periodontitis using Cone Beam Computed Tomography imaging

The normal alveolar bone crest located at a distance of 1 to 2 mm from CEJ towards the apical. If there is a bone loss, the alveolar bone crest located at 2 mm more to the apical from CEJ. The alveolar bone loss is one characteristic of aggressive periodontitis and the onset of the disease at the age of puberty. The purpose of this research was to know and to assess the height of alveolar bone crest using Cone Beam Computed Tomography (CBCT) in patients with aggressive periodontitis. The type of this research was descriptive. A total of 317 sample CBCT imagery from 6 aggressive periodontitis patients. The result of this research showed that average height of alveolar bone crest second premolar distal, the first molar mesial, first molar distal and second molar mesial on the first region were 3 mm, 4.2 mm, 6.1 mm, and 4.8 mm respectively. On the second region were 3.2 mm, 3.6 mm, 3.6 mm, and 3.4 mm respectively, and in the third region were 2.4 mm, 2.8 mm, 2.5 mm dan 1.4 mm consecutively. While in the fourth region were 2.9 mm, 3 mm, 2.8 mm, and 2.3 mm respectively. The average height of alveolar bone crest of aggressive periodontitis was 3.8 mm. Slicing CBCT imagery on coronal view for the anterior region and sagittal view for the posterior region, showed the characteristic of height alveolar bone crest was arch-shaped which showed the different height of alveolar bone crest of the second premolar distal until second molar mesial.

New Bone Formation in Nongrafted Sinus Lifting With Space-Maintaining Management: A Novel Technique Using a Titanium Bone Fixation Device

Sinus lifting without graft materials allows new bone formation in the sinus, but the amount of bone formation varies. This study aimed to investigate whether nongrafted sinus lifting using a titanium bone fixation device can promote bone formation in the sinus. Patients with atrophic posterior maxillae jeopardizing implant stability were included. After nongrafted sinus lifting in combination with implant placement, repositioning of the bone window and additional space-maintaining management were performed by use of the bone fixation device. The primary variables recorded retrospectively included implant survival and preoperative and postoperative alveolar crest height with and without Schneiderian membrane perforation. Independent variables included patient demographics, position and dimension of the implants, complications, and follow-up period. The t test was used for comparing differences in bone levels. The implant survival rate was estimated by uses of Kaplan-Meier statistics. The study included 11 patients (4 men and 7 women) and a total of 21 implants. Radiographically, new bone formation around the implant was generally observed in accordance with the implant apex. Postoperative alveolar crest height (mean, 10.9 ± 2.2 mm) was significantly higher compared with residual alveolar crest height (mean, 4.7 ± 1.4 mm), and no significant difference in bone formation was seen according to membrane perforation. The cumulative survival rate was 95.2%. This nongrafted sinus-lifting procedure using a bone fixation device could attain predictable bone formation. Additional space-maintaining management using a bone fixation device in a nongrafted sinus lift offers a useful technique for promoting bone formation in the sinus.

Digital Radiographic Evaluation of the Level of Alveolar Bone Crest in External Hexagon Implants Submitted to 2 Types of Implant Abutments Under Immediate Loading

The aim of this study was to evaluate by means of digital radiography the behavior of the alveolar bone crest in external hexagon implants following the use of 2 different types of abutments, one for conventional cemented prosthesis and one for modified cemented prosthesis. Ten external hexagon implants (platform 4.1) were placed in 5 patients. Initial instrumentation was carried out to obtain primary stability of the temporary prostheses under immediate loading. Each patient received both abutments for conventional and modified cemented prosthesis. Standardized digital periapical radiographies were performed at times T0 (immediately after implant placement) and T1 (4 months after implant placement). A straight line was initially established from the implant platform to the distal and mesial peri-implantar marginal bone tissue (immediately in contact with the implant) and measured by digital radiography, using Sidexis version 2.3 (Sirona Dental Systems GmbH, Bensheim, Germany) software. The data were submitted to paired-samples t-test analysis. There was no significant difference between the conventional and modified cemented prosthesis. In both cases, t-test results were within the null hypothesis level. The abutment for the modified cemented prosthesis resulted in no significant radiographic difference of alveolar bone crest height, when compared with the conventional cemented prostheses.

Predictive value of ridge dimensions on autologous bone graft resorption in staged maxillary sinus augmentation surgery using Cone‐Beam CT

No studies are available that provide predictive parameters regarding the expected amount of resorption after maxillary sinus augmentation surgery using autologous bone grafts. Therefore, the aim of this study was to determine parameters influencing the outcome of the bone graft resorption process. In 20 patients, three-dimensional analysis of alveolar ridge dimensions and bone graft volume change in the atrophic posterior maxilla was performed by Cone-Beam Computerized Tomography imaging. Ridge dimensions were assessed before maxillary sinus augmentation surgery. Bone graft volumes were compared after maxillary sinus floor augmentation surgery and a graft healing interval of several months. To analyze the relation between bone volume changes with the independent variables, patients' gender, age, alveolar crest height and width, and graft healing time interval, a multi-level extension of linear regression was applied. A residual bone height of 6.0mm (SD=3.6mm) and 6.2mm (SD=3.6mm) was found at the left and right sides, respectively. Moreover, alveolar bone widths of 6.5mm (SD=2.2mm) and 7.0mm (SD=2.3mm) at the premolars, and 8.8mm (SD=2.2mm) and 8.9mm (SD=2.5mm) at the molars regions were found at the left and right site, respectively. Bone graft volume decreased by 25.0% (SD=21.0%) after 4.7months (SD=2.7, median=4.0months) of healing time. The variables "age" (P=0.009) and mean alveolar crest "bone height" (P=0.043), showed a significant influence on bone graft resorption. A decrease of 1.0% (SE=0.3%) of bone graft resorption was found for each year the patient grew older, and an increase in bone graft resorption of 1.8% (SE=0.8%) was found for each mm of original bone height before sinus floor augmentation. Graft resorption occurs when using autologous bone grafts for maxillary sinus augmentation. Alveolar crest bone height and patient age have a significant effect on graft resorption, with increased resorption for higher alveolar crest bone height and decreased resorption for older patients. Consequently, patient characteristics that affect the process of bone graft resorption should be given full consideration, when performing sinus augmentation surgery.

Reimplantation of cultivated human bone cells from the posterior maxilla for sinus floor augmentation. Histological results from a randomized controlled clinical trial

The aim of the present randomized clinical study was to evaluate histologically whether the addition of cultivated, autogenous bone cells to a composite graft of deproteinized bovine bone mineral (DBBM) and autogenous bone (AB) for sinus floor augmentation (SFA) enhance bone formation compared with what achieved after SFA with DBBM + AB alone. Twenty patients with remaining posterior maxillary alveolar crest height of less than 3 mm received SFA after randomization either with an DBBM and AB composite in a 1 : 1 ratio or with DBBM + AB supplemented with autogenous bone cells, which were cultivated from a bone biopsy harvested earlier from the tuberosity area. Four months after SFA, two cylindrical biopsies were taken from the augmented sinuses concomitantly with the implant site preparation by means of a trephine bur. An additional biopsy was taken from the tuberosity area. Bone density at the augmented sinus and the tuberosity area and the height of augmentation were estimated on non-decalcified histological sections prepared from the biopsies. A relative bone density index (RBD) was also calculated by dividing bone density at the augmented sinus with bone density at the tuberosity area. All patients but one could receive two implants after SFA; in one patient, only one implant could be placed. All implants were osseointegrated and could be loaded. Median bone density in the sinus was 30% and 25% in the cell seeded and no-cells added DBBM + AB groups, respectively. Bone augmentation height averaged 6.0 and 5.4 mm and RBD averaged 0.48 and 0.73 in the cell seeded and no-cells added DBBM + AB groups, respectively. None of the differences between groups was statistically significant. Cultivated autogenous bone cell seeded to a DBBM + AB composite did not significantly improve bone formation (density and height) after SFA, compared with what was achieved with DBBM + AB alone. Both approaches resulted into enough bone to support implant placement and osseointegration.

Are Panoramic Radiographs Reliable to Diagnose Mild Alveolar Bone Resorption?

It is extremely important to assess variations between the most used radiographs in dental practice, since minimum distortion on obtained images may change diagnosis, treatment plan, and prognosis for the patient. For this, the distance between the enamel-cementum junction and the alveolar bone crest was measured on conventional and digitized periapical, bitewing, and panoramic radiographs and compared among them. From a total of 1484 records, 39 sets of radiographs that fulfilled the inclusion criteria of the study sample were selected. The measurements were grouped according to the intensity of bone loss. Statistically significant difference was found in the averages of the measurements assessed in radiographs with absence of bone loss between conventional panoramic and periapical radiographs, between digitized panoramic and periapical radiographs and between digitized bitewing and panoramic radiographs. By analyzing the results of this work and considering the research protocol used, one can conclude that small losses in height of alveolar bone crest observed in panoramic radiographs should be cautiously evaluated, as they may be overestimated.

Clinical and community risk models of incident tooth loss in postmenopausal women from the Buffalo Osteo Perio Study.

While risk factors for tooth loss in adults have been identified, limited studies describing factors associated with incident tooth loss in postmenopausal women exist. This study assessed both clinical and non-clinical risk factors for incident tooth loss. Postmenopausal women (N = 1341) were recruited between 1997 and 2000 from 1847 eligible Observational Study participants of the Buffalo, NY center of the Women's Health Initiative who had complete dental examinations to assess alveolar bone height, soft tissue attachment and general oral health, and completed questionnaires concerning demographics, general health, lifestyle and oral health (72.6% participation rate). Five years later (2002-2005), 1021 women (76.1%) repeated these examinations and questionnaires. Incident tooth loss was determined by oral examination. After an average 5.1 years of follow-up (SD, 0.38), a total of 323 teeth were lost in 293 women, resulting in 28.7% of women with incident loss of at least one tooth. In multivariable models, diabetes history, gum disease history, smoking, previous tooth loss, BMI and plaque index, baseline clinical measures including alveolar crestal height (ACH) (OR = 1.22 per mm loss, 95% CI 1.11, 1.35), clinical attachment loss (CAL) (OR = 1.13 per mm loss, 95% CI 1.05, 1.23), and pocket depth (PD) (OR = 1.26 per mm loss, 95% CI 1.13, 1.41) were significant risk factors of incident tooth loss. In a community model that included no clinical measures, diabetes history (OR = 2.45, 95% CI 1.26, 4.77), prior gum disease (OR = 1.97, 95% CI 1.43, 2.70), ever smoking (OR = 1.42, 95% CI 1.06, 1.89), number of teeth lost at baseline (OR = 1.05 per tooth, 95% CI 1.02, 1.08), and BMI (OR = 1.15 per 5 km/m(2) increase, 95% CI 1.01, 1.33) were associated with an increased risk of incident tooth loss. Clinical and questionnaire-based models were found to provide similar risk estimates for incident tooth loss in postmenopausal women. These models identified high-risk postmenopausal women where preventive strategies may be targeted.

Association Between Periodontal Disease and Osteoporosis in Postmenopausal Women in Jordan

Some studies suggest that females with osteoporosis are at an increased risk of periodontal attachment loss and tooth loss; however, results have varied. The aim of this study is to determine the relationship between periodontitis and osteoporosis among postmenopausal Jordanian women. This cross-sectional study includes 400 Jordanian postmenopausal women with a mean age of 62.5 years (SD ± 6.4 years). These subjects were recruited from patients who had received a routine dual-energy x-ray absorptiometry examination in the Radiology Department, King Abdullah Hospital, Jordan University of Science and Technology, between June 2008 and February 2009. The relationship between skeletal bone mineral density (BMD) and radiographic and clinical parameters of periodontal status, including the loss of alveolar crestal height (ACH), clinical attachment level, probing depth, and percentage of sites with bleeding on probing, was evaluated after controlling for known confounders. Bivariate analyses revealed no significant differences in the severity and extent of clinical attachment and ACH loss among women with normal BMD, osteopenia, and osteoporosis. However, in the multivariate analysis, women with osteoporosis were more likely to have severe ACH loss (odds ratio [OR]: 4.20; 95% confidence interval [CI]: 1.57 to 11.22) and periodontitis (OR: 2.45; 95% CI: 1.38 to 4.34). Osteoporosis was significantly associated with severe alveolar crestal bone loss and the prevalence of periodontitis cases in postmenopausal Jordanian women.

Influence of carbon dioxide laser irradiation on the healing process of extraction sockets

Objective. To clarify the healing-promoting effects of carbon dioxide laser irradiation in high and low reactive-level laser therapies (HLLT and LLLT, respectively) on extraction sockets after tooth extraction. Material and methods. Forty-two 5-week-old male Wistar rats were divided into laser irradiation and non-irradiation (control) groups and compared. The laser-irradiation group underwent HLLT immediately after tooth extraction and then LLLT 1 day post-extraction. Tissue was excised 6 h and 3, 7, or 21 days after extraction and histopathologically investigated. The alveolar crest height was measured osteomorphometrically 21 days post-extraction, and granulation tissue in the extraction socket surface layer was immunohistologically investigated using anti-α-smooth muscle actin (anti-α-SMA) antibody 3 and 7 days post-extraction. Results. Many osteoclasts appeared and active bone resorption was noted in the irradiation group 3 days after extraction compared to the controls. On Day 7, new bone formation started around the extraction socket in the control group, but from the superficial to over the middle layer of the socket in the irradiation group. On Day 21, a concavity existed in the alveolar crest region in the controls, whereas this region was flat, with no concavity, in the irradiation group. On osteomorphometry, the alveolar crest height was significantly higher in the irradiation (0.7791 ± 0.0122) than the control (0.6516 ± 0.0181) group (P < 0.05). On immunostaining, many α-SMA-positive cells were noted in the control group, but very few in the irradiation group. Conclusion. Laser-irradiated extraction wound healing showed characteristics different from those of the normal healing process, suggesting a favorable healing-promoting effect.

Some morphological features related to mandibular third molar impaction

Objective: The aim of this study was to evaluate the effect of some morphological features of the mandible and mandibular permanent molars on impaction of mandibular third molars with panoramic measurements in a Turkish patient group. Study design: Standardized panoramic radiography variables compiled from 140 patients retrospectively were evaluated. Predictive variables included mesio-distal crown width and inclination of the mandibular molars, vertical and horizontal surface dimension between distal surface of the lower second molar tooth and anterior surface of its ramus, length and width of the mandible ramus and corpus, angle of the mandible gonion, the number of the lower third molar roots, and angulations of roots of the lower third molars. Results and Conclusions: According to the data obtained in this study, the vertical height of the anterior border of the ramus, length of the posterior basal corpus, mesio-distal diameters of the first, second and the third molars, 1/3 root angle of the third molar, number of third molar roots, inclination of the first molar to increase, vertical height of the posterior border of the ramus, vertical height of alveolar crest, and height and the width of the retro-molar space to decrease are all in direct proportion to the possibility of impaction of the third molar.

Clinical outcomes of sinus floor augmentation for implant placement using autogenous bone or bone substitutes: a systematic review

To date, there are still no clear cut guidelines for the use of autogenous bone or bone substitutes. The aim of the present review was to analyze the current literature in order to determine whether there are advantages of using autogenous bone (AB) over bone substitutes (BS) in sinus floor augmentation. The focused question was: is AB superior to BS for sinus floor augmentation in partially dentate or edentulous patients in terms of implant survival, patient morbidity, sinusitis, graft loss, costs, and risk of disease transmission? The analysis was limited to titanium implants with modified surfaces placed in sites with 6 mm of residual bone height and a lateral wall approach to the sinus. A literature search was performed for human studies focusing on sinus floor augmentation. Twenty-one articles were included in the review. The highest level of evidence consisted of prospective cohort studies. A descriptive analysis of the constructed evidence tables indicated that the type of graft did not seem to be associated with the success of the procedure, its complications, or implant survival. Length of healing period, simultaneous implant placement or a staged approach or the height of the residual alveolar crest, sinusitis or graft loss did not modify the lack of effect of graft material on the outcomes. Three studies documented that there was donor site morbidity present after the harvest of AB. When iliac crest bone was harvested this sometimes required hospitalization and surgery under general anesthesia. Moreover, bone harvest extended the operating time. The assessment of disease transmission by BS was not a topic of any of the included articles. The retrieved evidence provides a low level of support for selection of AB or a bone substitute. Clear reasons could not be identified that should prompt the clinician to prefer AB or BS.

Clinical Effectiveness of Autologous Platelet‐Rich Plasma and Peptide‐Enhanced Bone Graft in the Treatment of Intrabony Defects

The goal of periodontal therapy has always been the regeneration of lost attachment apparatus. The use of platelet-rich plasma (PRP) plus anorganic bovine-derived matrix and peptide 15 (ABM/P-15) for periodontal regenerative therapy offers a potentially useful modality for treating periodontal osseous defects. However, it is unknown whether a combination of these materials enhances the outcome of periodontal regenerative therapy. Therefore, this study was carried out to compare the effectiveness of the two regenerative techniques (autologous PRP plus ABM/P-15 versus autologous PRP) in treating intrabony defects in humans by analyzing the clinical and radiologic parameters. Using a split-mouth design, 28 intrabony defects were treated with autologous PRP (control) or a combination of autologous PRP and ABM/P-15 (test). Clinical parameters such as plaque index, sulcus bleeding index, probing depth, attachment level, and gingival marginal level were recorded at baseline and 9 months postoperatively. Hard tissue measurements such as defect fill, defect resolution, and change in alveolar crest height were also recorded using spiral computed tomography (CT). A statistically significant difference was observed in all clinical parameters in the test group compared to the control group. Furthermore, spiral CT images revealed significantly greater bone fill in the test group. A combination of PRP plus ABM/P-15 was more effective than PRP alone in the treatment of intrabony defects. Further studies using a larger sample size are necessary to confirm the results of the present study.

Osteoporosis and Oral Infection: Independent Risk Factors for Oral Bone Loss

Studies have suggested that oral bone loss is independently influenced by local and systemic factors, including osteoporosis. This cross-sectional study of 1256 post-menopausal women, recruited from the Buffalo center of the Women's Health Initiative Observational Study, evaluated the influence of oral infection and age on the associations between osteoporosis and oral bone loss. Systemic bone density was measured by dual-energy x-ray absorptiometry. Alveolar crestal height was measured from standardized dental radiographs. Oral infection was assessed from subgingival plaque samples. Total forearm density [beta (SE)= -0.931 (0.447), p=0.038] and presence of Tannerella forsythensis [beta (SE)=0.125 (0.051), p=0.015] were independently associated with mean alveolar height among women aged <70 years after confounder adjustment. Women aged 70+ years had worse oral bone loss, in general, but neither bone density nor oral infection was significantly associated with mean alveolar height in this age group. Systemic bone density and oral infection independently influenced oral bone loss in post-menopausal women aged <70 years.

Bacterial Species in Subgingival Plaque and Oral Bone Loss in Postmenopausal Women

Oral bacteria are widely recognized in the etiology of periodontal disease. We investigated the prevalence of subgingival bacterial infection with eight species, tested associations between infection and oral bone loss, and assessed potential confounding factors and effect modifiers of those associations in a large community-based cohort of postmenopausal women. A cross-sectional study of oral health and osteoporosis in 1,256 postmenopausal women recruited from the Buffalo, New York Women's Health Initiative Observational Study was conducted. Standardized dental radiographs were used to measure alveolar crestal height (ACH). Subgingival plaque samples were taken, and the presence of eight bacterial species was assessed by indirect immunofluorescent microscopy in each participant. The most prevalent infection was Streptococcus sanguis (59.5%), followed by Prevotella intermedia (43.4%), Tannerella forsythensis (37.9%), Capnocytophaga sp. (36.9%), Eubacterium saburreum (32.7%), Campylobacter rectus (17.4%), Porphyromonas gingivalis (15.1%), and Fusobacterium nucleatum (14.2%). Infections with P. gingivalis, T. forsythensis, P. intermedia, and C. rectus were associated with an increased likelihood of having oral bone loss as measured by ACH, even after adjustment for age, smoking, and income. The body mass index (BMI) was a modifier of this association. Overweight women with T. forsythensis infection were more likely to have oral bone loss (OR = 3.37; 95% confidence interval [CI]: 2.08 to 5.46) than normal weight (OR = 1.27; 95% CI: 0.82 to 1.98) or obese (OR = 1.26, 95% CI: 0.72 to 2.20) women with T. forsythensis infection. The prevalence of specific bacterial infections was determined for a large group of postmenopausal women. Those with infection were more likely to have oral bone loss. Further studies should investigate potential modifying effects of BMI and/or inflammatory factors.

Comparative study of single and multislice computed tomography for assessment of the mandibular canal

Objective:The purpose of this study was to evaluate the accuracy of relative measurements from the roof of the mandibular canal to the alveolar crest in multislice (multidetector) computed tomography (MDCT) and single-slice computed tomography (SSCT).Material and Methods:The sample consisted of 26 printed CT films (7 SSCT and 19 MDCT) from the files of the LABI-3D (3D Imaging Laboratory) of the School of Dentistry of the University of São Paulo (FOUSP), which had been acquired using different protocols. Two observers analyzed in a randomized and independent order a series of 22 oblique CT reconstructions of each patient. Each observer analyzed the CT scans twice. The length of the mandibular canal and the distance between the mandibular canal roof and the crest of the alveolar ridge were obtained. Dahlberg test was used for statistical analysis.Results:The mean error found for the mandibular canal length measurements obtained from SSCT was 0.53 mm in the interobserver analysis, and 0.38 mm for both observers. On MDCT images, the mean error was 0.0 mm in the interobserver analysis, and 0.0 and 0.23 mm in the intraobserver analysis. Regarding the distance between the mandibular canal roof and the alveolar bone crest, the SSCT images showed a mean error of 1.16 mm in the interobserver analysis and 0.66 and 0.59 mm in the intraobserver analysis. In the MDCT images, the mean error was 0.72 mm in the interobserver analysis and 0.50 and 0.54 mm in the intraobserver analysis.Conclusion:Multislice CT was demonstrated a more accurate method and demonstrated high reproducibility in the analysis of important anatomical landmarks for planning of mandibular dental implants, namely the mandibular canal pathway and alveolar crest height.

Fully vs. partially rough implants in maxillary sinus floor augmentation: a randomized‐controlled clinical trial

To compare implants with a rough surface in their whole length (FR) with implants having a 2 mm coronal machined portion (PR) when used in association with a sinus-lift procedure. Twenty-six patients with 2 mm< or =x< or =9 mm residual alveolar crest were prosthetically restored with implants after a staged sinus-lift procedure using osteotomes. In 13 randomly chosen patients, no more than one FR implant was placed (test group), while the rest were PR implants. The other 13 patients received only PR implants (control group). For comparisons, only one implant from each patient was used, i.e., from the test group only the 13 FR implants were used, while from the control group, one PR implant was randomly chosen. The presence/absence of plaque, BOP, PPD and REC were registered at the day of delivery of the restorations and after 1 year. Residual alveolar crest height and marginal bone levels around the implants were evaluated on standardized periapical radiographs taken at various stages. Four FR and two PR implants were lost, and the cumulative survival rate was 82.9% (six lost out of 35). There were no significant differences between the two groups. Implant type, residual alveolar crest height, time of osseointegration, time of implant loading and smoking did not seem to influence implant survival. FR and PR implants placed in augmented sinuses did not differ in their clinical performance.

Female osteoporosis may be associated with composite endpoint of periodontal disease

Article Title and Bibliographic Information The association between osteoporosis and alveolar crestal height in postmenopausal women. Wactawski-Wende J, Hausmann E, Hovey K, et al. J Periodontol 2005;76:2116-24. Level of Evidence 4 Purpose/Question To investigate the association between osteoporosis and the composite endpoint of alveolar crest height and periodontal tooth loss. Source of Funding Government Type of Study/Design Cross-sectional study

The Use of Different Measurements and Definitions of Periodontal Disease in the Study of the Association Between Periodontal Disease and Risk of Myocardial Infarction

The role of periodontal disease as an independent risk factor for cardiovascular disease (CVD) has been under debate because of the inconsistency of findings across studies. One of the major issues is the method used to assess or define periodontal disease. The present study assesses if the observed association between periodontal disease and incident myocardial infarction (MI) depends on the measurements and/or criteria used to define periodontal disease. A population-based case-control study to evaluate the association between PD and risk of MI was conducted between 1997 and 2001 in Western New York with 537 cases and 800 controls, aged 35 to 69 years. Cases were survivors of incident MI from local hospitals in Erie and Niagara counties. Controls were randomly selected from residents of the same counties. Periodontal disease was assessed using interproximal clinical attachment loss (CAL), probing depth (PD), alveolar crest height (ACH), and number of missing teeth. From these measurements, four different case definitions of periodontal disease were created. Using the continuous forms of periodontal measurements, the odds ratios (ORs) (95% confidence interval) of the association with incident MI were 1.46 (1.26 to 1.69), 2.19 (1.66 to 2.89), 1.30 (1.14 to 1.49), and 1.04 (1.02 to 1.07) for mean CAL, PD, ACH, and number of missing teeth, respectively. Regardless of the case definition of periodontal disease, the estimates of the association with incident MI were statistically significant. The observed association between periodontal disease and incident MI was consistent across different measurements and/or case definitions of periodontal disease used. The magnitude of the association varies depending on the measurements or the criteria used to define periodontal disease.

Clinical case reports of injectable tissue-engineered bone for alveolar augmentation with simultaneous implant placement

This clinical study was undertaken to evaluate the use of tissue-engineered bone, mesenchymal stem cells, platelet-rich plasma, and beta-tricalcium phosphate as grafting materials for maxillary sinus floor augmentation or onlay plasty with simultaneous implant placement in six patients with 3- to 5-mm alveolar crestal bone height. All 20 implants were clinically stable at second-stage surgery and 12 months postloading. A mean increase in mineralized tissue height of 7.3 ± 4.6 mm was evident when comparing the pre- and postsurgical radiographs. Injectable tissue-engineered bone provided stable and predictable results in terms of implant success.— Reprinted with permission of Quintessence Publishing.