Does Puros Dermis have comparable results to Alloderm?


Split mouth design with 26 sites treated with Puros Dermis and 26 sites treated with Alloderm. A coronally advanced flap was used.


At 6 months both groups had similar improvements in recession coverage with an average of 2.83 mm for Puros Dermis and 3.13 mm for Alloderm. 81.4% root coverage for Puros and 83.4% for Alloderm. Difference between the two materials was not statistically significant.  


No statistical or clinical difference in root coverage, probing depth or keratinized tissue in coronally advanced flaps using etither of the two acellular dermal matrix materials. Both were successful in achieving root coverage.


for more information please refer to:

A Comparative Study of Root Coverage Using Two Different Acellular Dermal Matrix Products

Thomas S. Barker, Marco A. Cueva, Francisco Rivera-Hidalgo, M. Miles Beach, Jeffrey A. Rossmann, David G. Kerns, T. Bradley Crump and Jay D. Shulman

Journal of Periodontology November 2010, Vol. 81


What is average distance from the crest to the mandibular canal on a CT?


195 CT scans from a private practice were examined.  Measurements were made with computer software (Simplant) at 5mm intervals.  Patients were categorized as to age, sex, and missing posterior teeth.


The following data emerged at the 95% confidence level  (Excerpted from Table 1):

Distance from the crest to the inferior alveolar nerve at the first molar:

In males with no missing teeth : 13.85mm

In females with no missing teeth : 12.50mm

In males with missing posterior teeth: 10.20mm

In females with missing posterior teeth: 8.96mm

Other measured variables were available bone volume from the alveolar nerve to the inferior border of the mandible, the buccal cortex and the lingual cortex. 


A high degree of variability in mandibular bone volume surrounding the inferior alveolar nerve.  Greater risk of injury for females. CT scan should be considered when limited bone above the nerve is observed in conventional radiographs.

Dr GebrAel’s comments: 

A must read (and re-read) article giving helpful average measurements as they relate to implant placement in the posterior mandible.


For more information PLEASE Refer To:

Radiographic Considerations for the Regional Anatomy in the Posterior Mandible

Natasha Yashar, Christopher G. Engeland, Alan L. Rosenfeld, Timothy P. Walsh, Joseph P. Califano

Journal Of Periodontology Jan 2012, Vol. 83, No.1, Pages 36-42


Are Results for Enamel Matrix Derivative (Emdogain) comparable to Connective Tissue Grafting at 10 years?


10 years after the original surgery for gingival recession, 10 of 17 patients were returned for follow-up evaluation. Among the parameters measured at 10 years: Percent root coverage, gingival recession depth, probing depths , width of keratinized tissue and clinical attachment levels.


No difference between Emdogain and Coronally Advanced Flap when compared to Connective Tissue and Coronally Advanced Flap for all measured parameters.  


Both procedures are equally clinically effective and stable at 10 years for the treatment of Miller class I and II recession defects.

Dr. Gabrael’s comments:

Important long term data. Gains in root coverage appear stable at 10 years for both treatment modalities.


for more information refer to:

Evaluation of human recession defects treated with coronally advanced flaps and either enamel matrix derivative or connective tissue: Comparison of clinical parameters at 10 years.

Journal of Periodontology November 2012, Vol.83, No.11, Pages 1353- 1362


Does platform switching allow closer implant placement?


Marginal bone levels and tissue quality was evaluated after 2 months of healing for 72 implant sites in 12 pig mandibles.  The interimplant distance was either 2 mm or 3 mm.


No difference was seen when the interimplant distance was 2 mm or 3 mm in terms of interproximal bone loss.


Platform switched implants have a reduced amount of crestal bone loss.  The horizontal displacement of the implant-abutment junction may allow adjacent platform-switched implants to be placed as close as 2 mm apart without losing the height of intercrestal bone.  This should positively affect the preservation of the interdental papilla.


For more information please refer to:

Effect of Interimplant Distance (2 and 3 mm) on the Height of Interimplant Bone Crest: A Histomorphometric Evaluation             

Nicolas Elian, Mitchell Bloom, Michel Dard, Sang-Choon Cho, Richard D. Trushkowsky and Dennis Tarnow

Journal of Periodontology 2011, Vol.82, No.12