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Hom-lay Wang - One of the best experts on this subject based on the ideXlab platform.

  • Utilizing collagen membranes for Guided Tissue Regeneration-based root coverage
    Periodontology 2000, 2012
    Co-Authors: Hom-lay Wang, Marmar Modarressi
    Abstract:

    Gingival recession is a common clinical problem that can result in hypersensitivity, pain, root caries and esthetic concerns. Conventional soft Tissue procedures for root coverage require an additional surgical site, thereby causing additional trauma and donor site morbidity. In addition, the grafted Tissues heal by repair, with formation of long junctional epithelium with some connective Tissue attachment. Guided Tissue Regeneration-based root coverage was thus developed in an attempt to overcome these limitations while providing comparable clinical results. This paper addresses the biologic foundation of Guided Tissue Regeneration-based root coverage, and describes the indications and contraindications for this technique, as well as the factors that influence outcomes. The step-by-step clinical techniques utilizing collagen membranes are also described. In comparison with conventional soft Tissue procedures, the benefits of Guided Tissue Regeneration-based root coverage procedures include new attachment formation, elimination of donor site morbidity, less chair-time, and unlimited availability and uniform thickness of the product. Collagen membranes, in particular, benefit from product biocompatibility with the host, while promoting chemotaxis, hemostasis, and exchange of gas and nutrients. Such characteristics lead to better wound healing by promoting primary wound coverage, angiogenesis, space creation and maintenance, and clot stability. In conclusion, collagen membranes are a reliable alternative for use in root coverage procedures.

  • Guided Tissue Regeneration: a decision-making model.
    Journal of the International Academy of Periodontology, 2011
    Co-Authors: Jill D. Bashutski, Hsun Liang Chan, Hom-lay Wang
    Abstract:

    Background Guided Tissue Regeneration (GTR) has the potential to promote periodontal Regeneration, which is one of the goals of periodontal surgery. While many successful reports of periodontal Regeneration using barrier membranes exist in the literature, considerable heterogeneity of GTR outcomes is more typical of current reports. The reasons for this variability are numerous, but could be attributed to differences in surgical skills and case selection. There is a need for a current analysis of the factors affecting success and the formation of evidence-based treatment guidelines for GTR. Methods Available English literature pertaining to Guided Tissue Regeneration was reviewed. Sources included peer-reviewed journal publications, online resources, and textbooks. Specific consideration was made to factors affecting GTR outcomes, especially in the context of systematic reviews and meta-analyses. Results Factors, including patient systemic conditions and compliance, defect features, local factors and surgical techniques and materials, that influence GTR outcomes were analyzed and entered into a decision-making model. Conclusion A decision-making model was formulated based upon current evidence regarding factors that influence Guided Tissue Regeneration outcomes. Meticulous case selection based upon known influential variables may help to minimize inconsistency in GTR outcomes.

  • Guided Tissue Regeneration-based root coverage utilizing collagen membranes: technique and case reports.
    Quintessence international (Berlin Germany : 1985), 2002
    Co-Authors: Hom-lay Wang, Khalaf F. Al-shammari
    Abstract:

    Gingival recession defects have traditionally been treated with various grafting procedures. Recently, Guided Tissue Regeneration with collagen membranes has shown promising results. This article reviews the rationale, indications, contraindications, and clinical methods for the use of bioabsorbable collagen membrane barriers. Several properties make collagen membranes attractive candidates for use as barriers in Guided Tissue Regeneration-based root coverage procedures. These include the inhibition of epithelial migration and promotion of new connective Tissue attachment; the ability to aggregate platelets, thereby facilitating wound stabilization and maturation; the promotion of cellular migration and wound closure; the elimination of the need for reentry surgery; and the ability to augment Tissue thickness. Cases are presented to illustrate the surgical principles and techniques.

  • Guided Tissue Regeneration. Absorbable barriers
    Dental clinics of North America, 1998
    Co-Authors: Hom-lay Wang, R. L. Macneil
    Abstract:

    Over the past 15 years, techniques aimed at Regeneration of lost periodontal Tissue have become widely used and accepted in clinical practice. Among these techniques are those which use the principles of Guided Tissue Regeneration (GTR), wherein barriers (i.e., membranes) are used to control cell and Tissue repopulation of the periodontal wound. A variety of non-absorbable and absorbable barriers have been developed and used for this purpose, with a trend in recent years toward increased use of absorbable GTR materials. This article describes the evolution of absorbable barrier materials and overview materials available for clinical use today. In addition, advantages and disadvantages of these materials are discussed, as well as possible new developments in barrier-based GTR therapy.

Marmar Modarressi - One of the best experts on this subject based on the ideXlab platform.

  • Utilizing collagen membranes for Guided Tissue Regeneration-based root coverage
    Periodontology 2000, 2012
    Co-Authors: Hom-lay Wang, Marmar Modarressi
    Abstract:

    Gingival recession is a common clinical problem that can result in hypersensitivity, pain, root caries and esthetic concerns. Conventional soft Tissue procedures for root coverage require an additional surgical site, thereby causing additional trauma and donor site morbidity. In addition, the grafted Tissues heal by repair, with formation of long junctional epithelium with some connective Tissue attachment. Guided Tissue Regeneration-based root coverage was thus developed in an attempt to overcome these limitations while providing comparable clinical results. This paper addresses the biologic foundation of Guided Tissue Regeneration-based root coverage, and describes the indications and contraindications for this technique, as well as the factors that influence outcomes. The step-by-step clinical techniques utilizing collagen membranes are also described. In comparison with conventional soft Tissue procedures, the benefits of Guided Tissue Regeneration-based root coverage procedures include new attachment formation, elimination of donor site morbidity, less chair-time, and unlimited availability and uniform thickness of the product. Collagen membranes, in particular, benefit from product biocompatibility with the host, while promoting chemotaxis, hemostasis, and exchange of gas and nutrients. Such characteristics lead to better wound healing by promoting primary wound coverage, angiogenesis, space creation and maintenance, and clot stability. In conclusion, collagen membranes are a reliable alternative for use in root coverage procedures.

S Nyman - One of the best experts on this subject based on the ideXlab platform.

  • Isolation of periodontal species after Guided Tissue Regeneration.
    Journal of periodontology, 1993
    Co-Authors: A Mombelli, N P Lang, S Nyman
    Abstract:

    One advanced localized periodontal lesion in each of 10 patients was treated using the Guided Tissue Regeneration procedure. Six weeks after placement of expanded polytetrafluoroethylene (ePTFE) membranes, microbial samples were taken from each treated site and the membranes were removed. Six weeks later the cases were re-evaluated. They had all healed successfully with varying amounts of gain of clinical attachment. Gram-negative, anaerobic rods were found in all samples and made up 31% of all organisms cultivated. In 1 patient, Porphyromonas gingivalis was found in a proportion of 17.5%. Six of the other 9 patients harbored Prevotella intermedia (mean proportion 21.3%) and 6 Prevotella melaninogenica (6.8%). Fusobacterium and Capnocytophaga were also frequently found. The results demonstrate that ePTFE membranes are frequently colonized by periodontal microorganisms. The importance of bacterial colonization on clinical success is presently not known. Further studies are needed to determine the effect of the presence or absence of putative pathogens during Guided Tissue Regeneration.

  • Isolation of Periodontal Species After Guided Tissue Regeneration.
    Journal of periodontology, 1993
    Co-Authors: A Mombelli, N P Lang, S Nyman
    Abstract:

    One advanced localized periodontal lesion in each of 10 patients was treated using the Guided Tissue Regeneration procedure. Six weeks after placement of expanded polytetrafluoroethylene (ePTFE) membranes, microbial samples were taken from each treated site and the membranes were removed. Six weeks later the cases were re-evaluated. They had all healed successfully with varying amounts of gain of clinical attachment. Gram-negative, anaerobic rods were found in all samples and made up 31% of all organisms cultivated. In 1 patient, Porphyromonas gingivalis was found in a proportion of 17.5%. Six of the other 9 patients harbored Prevotella intermedia (mean proportion 21.3%) and 6 Prevotella melaninogenica (6.8%). Fusobacterium and Capnocytophaga were also frequently found. The results demonstrate that ePTFE membranes are frequently colonized by periodontal microorganisms. The importance of bacterial colonization on clinical success is presently not known. Further studies are needed to determine the effect of the presence or absence of putative pathogens during Guided Tissue Regeneration. J Periodontol 1993; 64:1171-1175.

  • bone Regeneration using the principle of Guided Tissue Regeneration
    Journal of Clinical Periodontology, 1991
    Co-Authors: S Nyman
    Abstract:

    Abstract. The biological principle of “Guided Tissue Regeneration” (GTR) was developed for regenerating periodontal Tissues, lost as a result of periodontal disease. This principle was based on the hypothesis that non-desirable types of Tissue cells can be prevented from migrating into a wound by means of a membrane barrier and at the same time giving preference to those particular cells to repopulate the wound, which have the capacity to regenerate the desired type of Tissue. This principle may have its application in many areas of surgery, aimed at Regeneration of lost Tissues. One such area is osseous surgery aimed at bone Regeneration. In the present paper, a series of experiments in laboratory animals using the method of GTR for Regeneration of various types of bone defects are presented as well as examples of application in humans for Regeneration of jaw bone defects in conjunction with the placement of dental implants.

Simone Verardi - One of the best experts on this subject based on the ideXlab platform.

Jürgen Groll - One of the best experts on this subject based on the ideXlab platform.

  • In situ Guided Tissue Regeneration in musculoskeletal
    2012
    Co-Authors: Franz Jakob, Regina Ebert, Maximilian Rudert, Ulrich Nöth, Heike Walles, Denitsa Docheva, Matthias Schieker, Lorenz Meinel, Jürgen Groll
    Abstract:

    In situ Guided Tissue Regeneration, also addressed as in situ Tissue engineering or endogenous Regeneration, has a great potential for population-wide "minimal inva- sive" applications. During the last two decades, Tissue engineering has been developed with remarkable in vitro and preclinical success but still the number of applications in clinical routine is extremely small. Moreover, the vision of population-wide applications of ex vivo Tissue engi- neered constructs based on cells, growth and differentiation factors and scaffolds, must probably be deemed unrealistic for economic and regulation-related issues. Hence, the progress made in this respect will be mostly applicable to

  • In situ Guided Tissue Regeneration in musculoskeletal diseases and aging
    Cell and tissue research, 2011
    Co-Authors: Franz Jakob, Regina Ebert, Maximilian Rudert, Ulrich Nöth, Heike Walles, Denitsa Docheva, Matthias Schieker, Lorenz Meinel, Jürgen Groll
    Abstract:

    In situ Guided Tissue Regeneration, also addressed as in situ Tissue engineering or endogenous Regeneration, has a great potential for population-wide “minimal invasive” applications. During the last two decades, Tissue engineering has been developed with remarkable in vitro and preclinical success but still the number of applications in clinical routine is extremely small. Moreover, the vision of population-wide applications of ex vivo Tissue engineered constructs based on cells, growth and differentiation factors and scaffolds, must probably be deemed unrealistic for economic and regulation-related issues. Hence, the progress made in this respect will be mostly applicable to a fraction of post-traumatic or post-surgery situations such as big Tissue defects due to tumor manifestation. Minimally invasive procedures would probably qualify for a broader application and ideally would only require off the shelf standardized products without cells. Such products should mimic the microenvironment of regenerating Tissues and make use of the endogenous Tissue Regeneration capacities. Functionally, the chemotaxis of regenerative cells, their amplification as a transient amplifying pool and their concerted differentiation and remodeling should be addressed. This is especially important because the main target populations for such applications are the elderly and diseased. The quality of regenerative cells is impaired in such organisms and high levels of inhibitors also interfere with Regeneration and healing. In metabolic bone diseases like osteoporosis, it is already known that antagonists for inhibitors such as activin and sclerostin enhance bone formation. Implementing such strategies into applications for in situ Guided Tissue Regeneration should greatly enhance the efficacy of tailored procedures in the future.