• Comparison of Enamel Matrix Derivative Alone or in Combination with Bone Replacement Graft Materials in the Treatment of Intrabony Defects: A Systematic Review

      Soleymanzadeh, Ahad; Aichelmann-Reidy, Mary Beth (2015)
      The ultimate goal of any periodontal therapy is to regenerate all lost tissues of the periodontium: bone, cementum and periodontal ligament. The purpose of this systematic review was to compare the outcome when BRG was combined with EMD vs. EMD alone for the treatment of periodontal intrabony defects. A comprehensive literature search through February 11, 2015 was performed using Medline and EMBASE for all literature related to intrabony defects treatment using EMD with and without bone graft. Either EMD or combination of EMD with BG resulted in improved clinical outcomes. In conclusion, most studies report differences for gingival recession with the addition of bone graft but this trend was not statistically significant. Bone fill, as measured at reentry, was the only variable yielding more favorable outcome with the combined approach. Mean defect fill 2.36 ± 3.9 mm and 3.78 ± 0.7mm (p< 0.05) for EMD alone and combination therapy, respectively.
    • The optimal size range of particulate demineralized bone matrix for osteoinduction

      Desverreaux, Robert William; Hiatt, James L., 1934- (1991)
      There have been several investigations to determine the optimal particle size range of demineralized bone matrix (DBM) for osteoinduction. Results from these investigations have not been in agreement. Particulate bone matrix preparations can be combined with biodegradable delivery systems to treat ablative bony wounds. Therefore, an optimization of the particle size range is important. The purpose of this study was to determine the optimal size range of particulate DBM for osteoinduction at both a heterotopic and an orthotopic site. DBM was prepared according to the method of Reddi-Huggins and sieved to 13 different size ranges. In the first phase of the experiment DBM (20 mg) was placed in gelatin capsules, sealed in nylon mesh baskets, and implanted in the pectoralis muscle of 210 Long-Evans male and female rats (27 to 35 days old). In the second phase DBM (20 mg) was implanted in an 8 mm critical sized calvarial defect in an additional 210 Long-Evans male and female rats. There were 15 animals per treatment group in each phase of the study. Specimens were retrieved at 28 days post surgery, and embedded, undecalcified in plastic, sectioned, and stained using von Kossa stain. Bone formation was quantitated by radiomorphometry and histomorphometry using a Quantimet 520 Image Analysis System. Moreover, alkaline phosphatase and calcium were quantitated by atomic absorption spectrophotometry in the heterotopic site. All implants demonstrated a high degree of biocompatibility and no significant inflammatory cell infiltrates were observed in any of the specimens. Results indicate that the 590-710 um range particles produced significantly more new bone than all other size ranges (p {dollar}<{dollar} 0.05). These results further narrow those obtained by Reddi and Huggins, who found the optimum size range for particles to be 420-850 um.
    • Panoramic Bone Density in the Posterior Mandible in Patients with, without, or at risk of developing Medication-Related Osteonecrosis of the Jaw (MRONJ)

      ALFARHAN, ISRA; Meiller, Timothy F. (2017)
      Early radiographic changes of MRONJ could help in identifying patients at increased risk of developing the disease. This study compared and contrasted bone density in the posterior mandible of patients with, without, or at risk of developing MRONJ. This was a retrospective study of 46 patients (18 with MRONJ, 20 at risk but without MRONJ, and 8 controls with no exposure to MRONJ associated drugs). ImageJ software was used for bone density evaluation of the radiographs. Bone density was significantly higher in MRONJ patients when compared to at risk patients and controls. In a sub-cohort of patients with MRONJ where we had pre- and post-MRONJ images, the density was significantly higher in the pre-MRONJ radiographs when compared to after MRONJ radiographs and also higher than the at risk radiographs (p-value = 0.03). ImageJ analysis of the panoramic radiographs was successful in detecting significant differences in bone density in our sample.