硫酸钙在牙槽骨缺损的应用课件.ppt

True regeneration can only be verified by removing tooth and surrounding bone for histologic evaluation. Can use most apical margin of calculus as a place to notch the root. Any cementum with attached periodontal ligament fibers coronal to this notch is new attachment and if associated with new bone formation, then have most likely periodontal regeneration. Radiographic evidence of bone fill post surgery is not reliable because of variation in angulation of X-ray beam and variations in processing film between preoperative and postoperative radiographs. Following periodontal surgery can have clinically decreased pocket depth, but this may be due to tightly adapted gingiva with a long junctional epithelium. Pocket depth can also be decreased by post surgical gingival recession. Clinically can evaluate Bone Regeneration by re-entry surgery to measure bone fill, but cannot ascertain if new cementum or new periodontal fibers have formed. Autogenous Bone Osseous Coagulum Collected from burring Mainly cortical bone Contamination (water, oil) Combined with osseous surgery Osseous Coagulum - Bone Blend Verses Flap Curettage Osseous Grafts III comparison of osseous coagulum – bone blend implants with open curettage Froum SJ et al J. Periodontol 1976, 47:287 75 sites in 28 male patients 37 sites in 23 patients, bone graft 38 sites in 13 patients, flap curettage Initial therapy Grooved splints to measure bone fill Re-entries at 7 to 25 weeks Hip Marrow Graft Cancellous bone Fresh versus frozen Mainly case reports Morbidity of donor site Autogenous Bone Minimal standardized data Data shows limited clinical results Based on case reports Similar Gold Standard in sinus lift procedures No risk of disease or rejection No additional cost of material No commercial sponsor Decalcified Freeze- Dried Bone (D.F.D.B.) Decalcified Freeze- Dried Bone (D.F.D.B.) DFDBA Particle size = 250 – 710 microns 100% ETOH (reduced lipid content) HCL (Decalcification) Washed buffered to a pH