Surface etching

Details Surface etching Surface etching

1997-05-12

1999-01-19

Azpuru, Carlos A.

Drug, bio-affecting and body treating compositions

Preparations characterized by special physical form

Implant or insert

523113, 523115, 523116, A61F 202

Patent

active

058611673

DESCRIPTION:

BRIEF SUMMARY
The present invention relates to a method for biological, mineralized surface conditioning, especially tooth root conditioning, by selective removal of parts of an exposed root surface, such conditioning being used as an overture to improve attachment of the tooth in connection with periodontal surgery.
The teeth are attached to the alveolar bone through their roots. A thin layer of mineralized cementum is found along the surface of the roots. The cementum layer anchors collagen fibres which extend to the adjacent alveolar bone. The space, thus created between the root and the bone surfaces, is occupied mainly by collagen fibres and connective tissue cells (fibroblasts). The soft tissue, known as the periodontal membrane or ligament, is a highly specialized connective tissue. It has the capacity to form bone as well as cementum and can, provided the right conditions are given, form a new attachment apparatus in areas of the root where it has been lost to periodontal disease.
Periodontal disease is, second to tooth decay, the most frequent oral disease. It is a progressive disease and affects, in its severe form, approximately 10% of the population in the industrialized countries, leading to partial or complete tooth loss. However, most adults have one or more teeth affected by the disease.
The disease is, in its most common form known as marginal periodontitis. It is caused by accumulation of bacterial deposits on tooth surfaces along the gingival margins. These bacterial deposits originate from the hosts indigenous oral microflora and elicit an inflammatory reaction in the gingiva which results in destruction of tooth-supporting tissues (periodontal membrane and alveolar bone). The destruction of tooth-supporting tissues results in a deepening of the space (periodontal pocket) between the root of the tooth and the gum tissue (gingiva). The disease progresses as bacteria migrate apically into the periodontal pocket, which deepens more and more as a result of the soft tissue inflammation. Unless adequate treatment is instigated, the tooth becomes mobile and will eventually fall out when too much of the tooth-supporting tissues have been destroyed.
The overall aim of conventional treatment of marginal periodontitis is to remove bacterial deposits and dental calculus (mineralized bacterial deposits) from the root surfaces in order to eliminate the cause of gingival inflammation. Conventional treatment can be divided into non-surgical and surgical procedures.
Normally, treatment starts by scraping (scaling and root planing) the tooth surfaces in order to remove both visible bacterial deposits and dental calculus and deposits hidden below the gingival margin. This reduces gingival swelling caused by inflammation and often reduces the depth of the periodontal pockets. However, adequate scaling and root planing performed below the gingival margin is difficult and in deeper periodontal pockets inaccessible infected sites will serve as reservoirs for reinfection. This is often the case for teeth with furcation involvements where the infection has spread to the area inbetween the roots. Consequently, surgical procedures, which will enhance access and visibility, may have to be used to completely eliminate soft and hard bacterial deposits.
During periodontal surgery, the periodontitis-affected roots are exposed by detaching the gingiva from the roots and alveolar bone. The roots are then freed from bacterial deposits and dental calculus by scaling and root planing. This involves also removal of granulation tissue and root cementum contaminated by bacterial toxins. After the area has been cleaned, the gingival flaps are repositioned and sutured. Oral hygiene must be maintained at a high level during the subsequent healing period to avoid recurrent disease.
Such conventional treatment procedures are conservative and will only, at best, preserve the remaining tooth-supporting tissues. Thus, tooth support that has already been lost cannot be recreated by conventional treatment.
Periodontal healing is a primary concern in

REFERENCES:
patent: 4850872 (1989-07-01), Goldman et al.
Cao, Zhizhong, et al. "A Scanning Electron Microscopic Observation of Inner Carious Dentin after Cleansing and of the Dentin-Resin Interface" Dental Research, 1992 23/6, pp. 439-444.
Lasho, David J., et al., "A Scanning Electron Microscope Study of the Effects of Various Agents on Instrumented Periodontally Involved Root Surfaces", J. Periodontology, (1993) 54/4 pp. 210-220.
Meryon, S.D., et al. "Smear Removal Agents: a Quantitative Study in Vivo and in Vitro", The Journal of Prosthetic Dentistry, (1987) 57/2 pp. 174-179.

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