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75
mucoperiosteal flap was re- administered. The use of ontimi- Clinical case reports
tiected prior to restoration of the crobial mauth rinses was op-
lesion. To control the hemor- tionai otter the first week. Representative case reports
rhage from fhe periadontal liga- Subjects were recolied weekly from the 25 subjects ond 50
ment and alveolar bone, a 30% for the tirst 4 weeks, and then restorations evaluated for this
hydrogen peroxide solution on on a monthly basis for the first study are presented below.
o cotton pellet was applied to postoperative year, and every 3
the surgical site for 5 seconds to months thereafter tor an assess-
achieve hemostasis. An alterna- ment of periodontal condition. External raot rsorption
tive method would have been Prior to performing the
to use the Stabident System restorative procedures, a total Externol resorptive lesions were
(Fairfax Dentai) with a local of nine teeth that had been ciassified by Mesaros and
onesthetic containing a vaso- diagnosed as hopeiess by the Wayman^ according to the fol-
constrictor. This technique was patients' dentists were seiected lowing etioiogy: perlapical
designed to allow local anes- for extraction to undergo histo- inflammation, reimplontatian oi
thetic to be injected directly logie evaluation. AM of the teeth, tumors and oysts, trauma,
into the alveolar process vyith patients selected for the histo- impootion of teeth, and idio-
resuiting vasoconstriction and logie part of fhese studies were pathic conditions. The following
onesthesia. Once the restora- immediate denture patients two cases are descriptive of the
tions were in place, they were who were referred by their gen- physioiogic resorptive process
finished with a fine-grit diamond eral dentists. Ot the nine teeth, that tokes ploce as a result ot
inflammatory rsorption.^ These
only, and no attempt was made three teeth were seieoted for
cases may be charaoterized by
to polish the restored surtaoe. treatment with each product.
intense inflammation with areas
When the subgingival lesion At the end of 3 months, these
of bovyl-shaped rsorption of
had invaded the puip oanal, restored teeth with adjacent
the cementum and dentin.
the pulp was extirpated ond o tissues were removed vyith the
gutta peroha point was placed ridge-preserving technique
into the root canals to maintain previously described to histoio-
the patency of the canal prior gioally evaluate restoration-
to the placement of the re- tooth-tissue interfaces.2 The
storative materiai. The root biopsies were fixed in 7D% alco-
canal fillings were completed hol and embedded in methyi
subsequent to the subgingival methacrylate for microscopio
restoration. examination. Serial sections
The mucoperiosteal flaps were out at 10 to 15 pm, and
were replaced and sutured every tenth section was stained
with a 4-0 silk suture, A perio- with either hematoxyiin and
dontal dressing (Coe-Pack, GC eosin, toludine biue, or mineral-
America) vyas piaced for the ized bone stain (MIBS), All
tirst postoperative week. No stained sections were studied
ontibiotics were prescribed or under the light microscope.
Fig d Clinical phatagraph taken 1.5 years postoperative. Note the lack of gingiv
inflammation adjooent fa the resin-ionomer material and triat the dihicai crown
and roof were restored with the resin-ionamer material oniy. The toath as been i
funcfion wifhout a past-and-care buiid-up and a crown lesforation.
Case 4
fig 6a Clinioal pnofograph of a lafer- Fig Ob Ciinicai phofograph of fig o 3 Fig 6c i\/iicrograph of a tissue biock of
ai incisor ahd first premoior. Nate fhe monfhs posfoperotive depicting soft the the laterai ihcisar in Fig 6a takeh 3
ioblai root surfaces are restated with a tissue coverage aver the resin-ianamer months postoperative. Note baoteriot
resin-ianamer material (arrows). material piaced on the faciai root plaque (F) on fhe resin-ionomer
iesions. Note fhe presehce ofbocfena! resfaration (RI) in the denfin (D) next fo
piaQue hear the matginai gingiva. fhe shallow gingival sulcus (S), and the
relative lock of ihftommotofy ceiis ih the
gingival tissues adjacent ta the plaaue
and sutous. (Original magnificatian x
50)
Conclusians References