Dentistry Commons^™

Frequency And Distribution Of Endodontically Treated Teeth, Hina Ahmed, Durr E. Sadaf, Munawar Rahman

Section of Dental-Oral Maxillofacial Surgery

Objective: To determine the distribution and pattern of carious teeth involvement in permanent teeth requiring endodontic treatment. Study Design: Cross-sectional study. Place and Duration of Study: Dental Section of The Aga Khan University Hospital, Karachi, from September 2004 to March 2005. Methodology: Data was collected from the dental records of patients. Tooth was the unit of evaluation. Variables studied were demographics, tooth type, etiology of endodontic treatment and pattern of caries involvement. Data was analyzed using chi-square test and Fischer’s exact test. Results: The total number of patients was 190; total number of teeth involved were 235. Females had more …

Study On Non-Carious Cervical Lesions, Hina Ahmad, Durr E. Sadaf, Munawar Rahman

Section of Dental-Oral Maxillofacial Surgery

Objective: To determine factors associated with Non-Carious Cervical Lesions (NCCLs) and the teeth most commonly involved in such lesions. Study Design: Cross-sectional study. Place and Duration of Study: Department of Operative Dentistry, Section of Dentistry at Aga Khan University Hospital, Karachi, Pakistan, from December 2005 to January 2006. Methodology: A total number of 95 patients with 671 teeth were evaluated using a pre-coded questionnaire. Subject of evaluation was teeth. Patients with symptomatic or asymptomatic NCCLs and permanent dentition were included. Patients exhibiting active, untreatable periodontal disease, rampant uncontrolled caries, xerostomia, primary dentition, patients undergoing orthodontic treatment or bleaching procedure were …

Immediate Provisionalization Of Single 3.0 Mm Diameter Implant In Maxillary And Mandibular Anterior Region, Kotaro Oyama

Loma Linda University Electronic Theses, Dissertations & Projects

Immediate provisionalization of single implants with standard (3.75 - 4.5 mm) and wide diameter (> 4.5 mm) has been well documented. When the space is limited, small diameter implants (3.0 mm) must be used. Although high success rates have been reported, they were limited to healed site and were placed as staged procedures. The purpose of this prospective study was to evaluate the success rate and peri-implant tissue response of small diameter (3.0 mm) implants undergoing immediate provisionalization in the esthetic area.

Eleven patients who had missing maxillary lateral incisor(s) and/or mandibular incisor(s) participated in this study. Thirteen 3.0 mm …

A Continued Investigation Of Craniofacial Growth In Infant Heart Transplant Recipients Receiving Cyclosporine, Gabriel Enriquez

Loma Linda University Electronic Theses, Dissertations & Projects

Since the mid 1980’s, Cyclosporine has proved to be an effective immunosuppressive drug and now has a widespread application in organ transplantation. Several studies, however, have implicated cyclosporine as adversely affecting craniofacial growth in the pediatric population. ^16,18 The purpose of this follow-up study was to continue to evaluate the possible untoward effects of long-term use of cyclosporine on craniofacial growth in a group of infant heart transplantation recipients by re-evaluating as many subjects as possible from the original study and evaluating new subjects. A pediatric group (N=13) was composed of six Caucasian subjects (4 male and 2 female, ages …

Resorbable Barrier Effect In Sinus Graft Using Anorganic Bone, Kyung-Soo Choi

Loma Linda University Electronic Theses, Dissertations & Projects

The effect of a resorbable membrane on new bone formation in human maxillary sinus augmentation using anorganic bovine material is unclear at the present time. As a pilot study, six patients who required bilateral maxillary sinus augmentations for endoessous dental implant treatment were grafted with anorganic bovine bone material. All six patients had a resorbable collagen membrane placed over the graft material on only one side for the sinus augmentation. At the time of implant placement, a minimum of 8 months following sinus graft healing, a biopsy was made of each side to permit histomorphometric analysis.

Similar amounts of new …

Implant Success In Distracted Bone Versus Autogenous Bone-Grafted Sites, Jeffrey Allan Elo

Loma Linda University Electronic Theses, Dissertations & Projects

Endosseous implants are the treatment of choice for restoring function and reconstructing edentulous areas of the maxilla and mandible. Alveolar defects can be reconstructed by either distraction osteogenesis or autogenous bone grafting. After alveolar reconstruction, endosseous implants are used to support and retain the prosthesis for restoration of form and function. We retrospectively analyzed the success rates of endosseous implant placement in distracted versus autogenous bone graft reconstruction sites in our patient population at Loma Linda University Medical Center, Department of Oral and Maxillofacial Surgery. 82 consecutive patients requiring alveolar augmentation prior to implant placement were evaluated. All patients were …

Bone Morphogenic Protein Induced Repair Of The Premaxillary Cleft, Rick J. Rawson

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study is to evaluate the bony augmentation of premaxillary clefts in humans using recombinant bone morphogenic protein (rhBMP-2) in a collagen sponge carrier. 12 patients with unilateral cleft alveolar ridges were evaluated pre- and 4 months postoperatively. 10 patients were repaired with rhBMP-2 while two others were grafted with anterior iliac crest particulate marrow cancellous bone (PMCB). Computed tomographic studies were used to evaluate preoperative alveolar cleft volumes, postoperative bone bridge volumes, and pre/post operative volume ratios.

A pre/post operative volume ratio for patients repaired with rhBMP-2 ranged from 24.1% to 90.6% with a mean of …

Mineralized Bone Allograft In Maxillary Sinuses Histology And Histomorphometry, Sammy Stefan Noumbissi

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Demineralized freeze-dried bone allografts (DFDBA) and deproteinized bovine bone xenografts (DMBBX) have been used for sinus augmentation for many years with varying results, but very little has been reported on the clinical efficacy or the histological analysis of mineralized solvent dehydrated bone allografts (MSDBA) as sinus graft materials. This study histologically and histomorphometrically evaluated an MSDBA material called PUROS to augment atrophic human maxillary sinuses.

Materials & Methods: Seven partially and completely edentulous patients requiring unilateral (n=4) or bilateral (n=3) sinus grafts prior to implant placement were selected for this study. Test grafts consisted of MSDBA, and control …

Condylar Remodeling After Distraction Osteogenesis And Bilateral Sagittal Split Osteotomy, Robert Barker Hoffman

Loma Linda University Electronic Theses, Dissertations & Projects

The present pilot study is a histological evaluation of mandibular condyles taken from minipigs that underwent either traditional mandibular advancement (bilateral sagittal split osteotomy), or a distraction osteogenesis procedure to advance the mandible. One pig received a bilateral sagittal split osteotomy with an immediate mandibular advancement of 14 mm, while another pig underwent distraction osteogenesis consisting of a gradual advancement of 2 mm per day to advance the mandible the same distance. The control animal received no surgery.

In the present study, the mandibular condyles of the three pigs (2 control, 2 bilateral sagittal split osteotomy, and 2 distraction osteogenesis) …

The Histological Effects Of Mandibular Distraction Osteogenesis On Rabbit Condyles, Eunice Jungmin Hong

Loma Linda University Electronic Theses, Dissertations & Projects

The present study is a histological evaluation of condyles taken from rabbits that underwent either a midline or paramedian distraction osteogenesis procedure on the mandibles. Fifteen rabbits were originally operated on and eight of these fifteen successfully made it through both the distraction osteogenesis procedure and the 1 month holding period that followed. There was one control animal.

In the present study, the condyles from these nine rabbits (1 control, 2 midline distraction osteogenesis, 6 paramedian distraction osteogenesis) were prepared for histological evaluation (18 total). Step serial sections were cut along the coronal plane and the sections from the anterior …

Effects Of Various Hemostatic Agents On Bone, David Daryl Roland

Loma Linda University Electronic Theses, Dissertations & Projects

Previous studies have evaluated the effects of various hemostatic agents on radicular tissues following apical surgery. The purpose of this study was to examine the early osseous responses to seven hemostatic agents under identical conditions in rabbits. Sixteen adult male New Zealand white rabbits were used for this study. Following anesthesia, utilizing a midline submandibular incision, standardized bony defects were prepared on the lateral-superior regions of the mandible. Test materials were placed using standardized volumes and exposure times. Bone wax, Surgicel, Capset, alginate, Cut-Trol, Hemogin-L, and silver nitrate were compared to control sites irrigated with saline. Test materials or controls …

Assessment Of Alveolar Bone Density Using Implant Insertion Resistance Torque, Scott Sangmoo Lee

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Implant stability during healing is a pre-requisite for successful osseointegration. In the case of early or immediate implant loading, it is necessary to achieve high level of stabilization during surgical placement. Fixture stabilization can be measured by resonance frequency analysis or implant insertion resistance torque measurement. The aim of this study is to correlate pre-operative radiographic bone density to implant insertion resistance torque in human cadaver jaw bone.

Materials & Methods: Sixty-four implant osteotomy sites in human cadaver jaw bones were previously examined radiographically using quantitative computed tomography (QCT) and quantitative cone-beam computed tomography (QCBCT). Forty-two implant insertion sites …

Quantification Of Bone Deposition In Onlay Bone Grafting, Gregory Alan Kammeyer

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to quantitatively evaluate; 1) mandibular posterior mono-cortical block onlay bone graft success rates 2) the amount of grafted bone retained after initial resorption in radiographic projections. Seven consecutive patients with 14 mandibular posterior implant sites requiring bone augmentation for implants of a standard 3.8mm x 10mm dimension were sought. Mono-cortical block bone grafts from the ipsilateral ascending ramus were placed then observed with two standardized CT scans, dividing them into two groups: Group A had the first CT at 4 weeks after graft placement and a second taken before Prosthodontic reconstruction, 36.7 weeks later. …

Distraction Osteogenesis In Edentulous Alveolar Bone With Rhbmp-2 Enhancement, Liviu F. Eftimie

Loma Linda University Electronic Theses, Dissertations & Projects

Distraction osteogenesis, a unique system of affecting rapid bone healing in fractures, realigning malformed bones, and lengthening congenitally short and traumatically shortened bones has become an increasingly utilized technique for the maxillofacial region. The use of distraction osteogenesis has been described for increasing the height of edentulous mandibular alveolar ridges while concurrently forming new bone within the ridge to allow for adequate reconstruction. A standard protocol for performing distraction osteogenesis in the maxillofacial region has been well documented in the literature. Standard distraction osteogenesis requires an initial surgery to place the distraction osteogenesis device and mobilize the segment to be …

Case Studies For Dentistry®: Development Of A Tool To Author Interactive, Multimedia, Computer-Based Patient Simulations, Louis M. Abbey, Pamela Arnold, Lucy Halunko, Mary Beth Huneke, Stacie Lee

Oral and Maxillofacial Surgery Publications

Computer-based patient simulations have been used to enhance the dental curriculum since the 1980s. This article describes the development of CASE STUDIES for Dentistry (CSD), a patient case simulation building template, developed at Virginia Commonwealth University, with which authors who have no programming expertise can create realistic, effective, interactive multimedia patient simulations by entering their own information and images into a straightforward, fill in the blanks interface. This program was written with Authorware, by Macromedia Inc. Design considerations included emphasis on information collection and analysis, synthesis of collected information, hypothesis proposal and testing, diagnosis, and treatment planning. The program consists …

The Effect Of Mandibular Distraction Osteogenesis On Condylar Rotation In Rabbits, Shelton Hsu

Loma Linda University Electronic Theses, Dissertations & Projects

Distraction osteogenesis (DO) is the gradual lengthening of a healing bone. This surgical technique can be applied to the jawbone to correct an asymmetry or deficiency of the mandible. DO has been added to the list of treatment options for patients with craniofacial anomalies or excessive dental crowding.

Although mandibular distraction osteogenesis has been successfully performed in many patients, the comprehensive effects on the TMJ are not fully understood. The purpose of this study is to compare the amount of rotational and positional change that occurs at the condyles when the rabbit mandible is widened at the midline and paramedian …

An Evaluation Of Progressively Loaded Root Form Dental Implants Placed Into Extraction Sites, Franco Audia

Loma Linda University Electronic Theses, Dissertations & Projects

The conventional protocol for placement of endosseous root form implants requires up to twelve months of ossification of the extraction socket prior to implant placement. An alternative approach includes the immediate placement of dental implants into a prepared extraction socket following tooth removal. The purpose of this study was to compare conventionally placed non-loaded dental implants with those placed immediately into extraction sockets and progressively loaded in adult patients. A total of twenty implants were placed in eighteen patients and followed for a twelve-month period.

Clinically, no significant differences between conventional and immediately placed dental implants were observed. Radiographically, immediately …

A Continued Investigation Of Craniofacial Growth In Infant Heart Transplant Recipients Receiving Cyclosporine, John Michael Cornali

Loma Linda University Electronic Theses, Dissertations & Projects

Cyclosporine is an effective immunosuppressive drug that has found widespread application in organ transplantation. A couple of studies, however, have implicated cyclosporine as adversely affecting craniofacial growth in the pediatric population. The purpose of this follow-up study was to continue to evaluate the possible untoward effects of long-term use of cyclosporine on craniofacial growth in a group of infant heart transplantation recipients by re-evaluating as many subjects as possible from the original study and evaluating new subjects. A prospective group (N=29) of eighteen Caucasian subjects (7 female and 11 male, ages 6-15 years) and eleven Hispanic subjects (3 female and …

Orthognathic Surgery In The Juvenile Rheumatoid Arthritic Patient, David H. Gilbert

Loma Linda University Electronic Theses, Dissertations & Projects

This thesis attempts to use a retrospective evidenced base review of a series of five patients afflicted with juvenile rheumatoid arthritis and its inherent dento-facial deformity as a basis for establishing a proposal for a surgical protocol.

A review of pertinent and current literature is performed in describing the disease process as it relates to epidemiology, histopathophysiology, immunology, and clinical presentation. General treatment options are reviewed for the acutely and chronically afflicted patients as well as specific approaches to dento-facial reconstruction.

The studies reviews a series of five female patients who were evaluated and treated by the same surgeon at …

Comparison Of Mandibular Surgical Techniques For Accessing Cranial Base Vascular Lesions, Michael A. Devlin

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: Treatment of vascular lesions of the high cervical internal carotid artery (zone III) resulting from penetrating trauma, blunt trauma, aneurysms, and atherosclerosis pose a challenge for vascular surgeons due to bony interference's of the mandibular ramus and mastoid process. Although many techniques have been described, two methods, have been identified as effective and associated with low morbidity. The purpose of this study is to compare these two methods, mandibular distraction and vertical ramus osteotomy, for their effectiveness at increasing access to the cranial base and distal internal carotid artery.

Materials and Methods: Five fresh frozen cadavers were utilized …

The Effect Of Systemic Doxycycline On Alveolar Bone Loss Following Periradicular Surgery, G. Reed Cummings

Loma Linda University Electronic Theses, Dissertations & Projects

Studies have shown an average of 0.5 mm to over 1.0 mm of bone loss following full thickness flap reflection. Recent investigations have revealed that the tetracycline family of antibiotics can prevent bone loss. The purpose of this study was to determine the effect of systemic Doxycycline on crestal alveolar bone loss following periradicular surgery in Beagle dogs.

The experiment was divided into two phases. The first phase served as the control (Non-Doxycycline), the second phase as the experiment (Doxycycline). Full thickness flaps were reflected in the mandibular left or right quadrant (control side) of five Beagle dogs. Using a …

A Study Of Craniofacial Growth In Infant Heart Transplant Recipients Receiving Cyclosporine, David G. Niles

Loma Linda University Electronic Theses, Dissertations & Projects

Cyclosporine is an effective immunosuppressive drug that has found widespread application in organ transplantation. However, a few studies have implicated cyclosporine as adversely affecting craniofacial growth in the pediatric population. The purpose of this study was to evaluate the possible untoward effects of cyclosporine long-term on craniofacial growth in a group of infant heart transplantation recipients. A prospective group (n=28) of eighteen Caucasian children (9 female and 9 male, ages 4-10 years) and ten Hispanic children (3 female and 7 male, ages 4-10 years) were evaluated. None of the subjects had undergone orthodontic therapy. All subjects had heart transplantation before …

Dental Implant Drill Guide System, J. Bruce Bavitz

College of Dentistry: Faculty Publications

A method for imbedding a dental implant includes the initial step of casting a model of the patient's jaw and teeth in the vicinity of the implant site. A pilot hole is drilled in the implant site of the model, correlating to the ideal angle and location of the implant in the patient's jaw. A guide rod is provided for forming a guide hole in a stent, with a generally cylindrical shaft and a screw portion mounted at the lower end of the shaft. The screw portion is threaded into the pilot hole with the upper portion of the guide …

The Effect Of Guidor™ And Hop-1 On Hard Tissue Healing : Following Periradicular Surgery In Cats, Hugh Maguire

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to evaluate the effects of the resorbable membrane Guidor™ and the osteogenic protein hOP-1 on hard tissue healing following periradicular surgery in cats.

Surgical endodontic therapy was performed on the maxillary canine teeth of twelve cats. After orthograde root canal therapy, flap reflection, osteotomy, resection of the root end, root end cavity preparation and the placement of a root end filling, eight of the surgical sites were treated with Guidor™ and eight with hOP-1. The remaining eight sites received no further treatment and served as controls.

The animals were sacrificed at twelve weeks following …

An Immediate Implant Stability And Pull-Out Study Comparing Two Different Surgical Techniques : Conventional Drilling Versus Trabecular Compaction : A Pilot Study, Yong Chang Choi

Loma Linda University Electronic Theses, Dissertations & Projects

Poor bone quality at an implant site and the lack of initial implant immobilization are considered the two main factors for first stage implant failure. Modalities are needed to improve the initial stability of implants in poor bone quality situations. The purpose of this study was to compare the immediate implant stability and the pull-out force of implants placed in fresh frozen human alveolar jaw bones by two different surgical techniques: 1) a conventional drilling technique and 2) a trabecular compaction technique. The initial lateral stability (assessed by Periotest values, PTVs), the uniaxial pull-out force (measured by Instron machine) and …

Periodontal Repair In Dogs : Evaluation Of Rhbmp-2 Carriers, Lauralee Nygaard

Loma Linda University Electronic Theses, Dissertations & Projects

This study evaluated candidate carriers for recombinant human bone morphogenic protein-2 (rhBMP-2) in periodontal reconstructive surgery.

Canine demineralized bone matrix (DBM), bovine inorganic crystallene bone matrix (Bio-Oss), bovine derived microfibrillar collagen matrix (Helistat), poly (D,L-lactide-coglycolide) micropaiticles (PLGA), and polylactic acid granules (Drilac) were used with rhBMP-2 (20 (µg/100 µl implant volume) in routine critical size canine supraalveolar periodontal defects. Contralateral defects in six beagle dogs were randomly assigned to receive: DBM/rhBMP-2, DBM-control, Bio-Oss/rhBMP-2, Helistat/rhBMP-2, PLGA/rhBMP-2, or Drilac/rhBMP-2, all with autologous blood except for Helistat and PLGA. Animals were sacrificed eight weeks post-surgery and block sections of the defects were processed …

Healing Potential Of Osteotomies Of The Nasal Sinus In The Dog, Roderick W. Tataryn

Loma Linda University Electronic Theses, Dissertations & Projects

Maxillary sinus osteotomy is sometimes indicated for transantral surgical approaches to palatal roots of maxillary molars. A search of the literature showed an absence of any report on the healing potential of such defects. The purpose of this study was to determine histologically the reparative process of the nasal sinus of dogs following small and large surgical antral perforations. After anesthetizing six beagle dogs, full thickness periosteal flaps were raised overlying the maxillary buccal cortical plates. A 5x5 mm diameter perforation was created with a trephine bur above the second maxillary premolar on one side of each animal. On the …

Evaluation Of Trismus Associated With Mandibular Fractures As It Relates To The Need For Direct Laryngoscopy And Intubation : A Prospective Study, Stephen T. Goei

Loma Linda University Electronic Theses, Dissertations & Projects

Trismus associated with mandibular fractures is thought to increase the risks of general anesthesia. Nasotracheal intubation is necessary since the dental arches will be occluded at the end of the procedure. To establish an airway, an awake nasal intubation or fiberoptic endoscopy is required if direct laryngoscopy cannot be performed due to trismus. A prospective analysis of fifty-one patients with various types of mandibular fractures indicated that trismus was for the most part due to two factors, pain induced guarding and infection. In this series, direct laryngoscopy was easily performed after induction and paralyzation in cases without infection. Direct laryngoscopy …

The Stability Of Mandibular Bilateral Sagittal Split Osteotomy Advancements Using Rigid Skeletal Fixation, Michael E. Fox

Loma Linda University Electronic Theses, Dissertations & Projects

[Abstract Not Included]

Treatment Of Periodontal Furcation Defects, Michael Martin, Bernard Gantes

Loma Linda University Electronic Theses, Dissertations & Projects

[Note: Three parts in one.]

I. Review of the Literature and Description of a Regeneration Surgical Technique

This report provides an abbreviated review of the literature on treatment and prognosis of periodontal furcation lesions. In addition, it describes a surgical technique designed to accomplish bone regeneration in class II furcation defects, together with the rationale for the development of this procedure. Results of treatment of 30 defects with this technique are presented in a subsequent report (Gantes et al. 1987).

II. Bone Regeneration in Mandibular Class II Defects

A total of 30 mandibular, buccal class II furcation defects were treated …