ATLAS OF

THIRD EDITION

EDWARD S. COHEN, DMD

Clinical Instructor
Tufts Dental School
Associate Clinical Instructor
Boston University Goldman School
of Graduate Dentistry
Boston, Massachusetts

2007

BC Decker Inc
Hamilton

..
..

 616.31-089
56.6
76

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76
/ . . ; . . . . . . - .:
, 2011. - 512 .: .
ISBN 978-5-98811-198-6

616.31-08
56.6

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.

ISBN 978-5-98811-198-6 (.)

ISBN 1-55009-267-7 (.)

The original English language work has been published by B.C. DECKER, INC
Hamilton, Ontario, Canada, 2007, All rights reserved

, , 2 0 1 1

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1.

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2.

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3.

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4.

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5.

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6.

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7.

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25

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26
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13. ...............................................................................................................
14.

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19. : ........................................................

30

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20. .............................................................................................. 31
21. ............................................................................... 32
22. .................................................................................... 37
23. ...................................................................................................................... 39
24. ................................................................................................ 41
25.

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26.
27.
28.
29.

43
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, ..................... 47
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50'

EDTA
ENAP

AJIK

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Drs. Dennis Shanelec Leonard S. Tibbits
,
, Drs. Arun . Garg
Craig Misch

,
Dr. Eiji Funakoshi

,
, Dr. James
Hanratty ,
,


, Dr. Periklis Proussaefs
Loma Linda.

Drs. Scott Kissel, Roger Wise, Fed

erico Brugnami, Irving Glickman, Ken

neth Kornman George Goumenous 3i
.



.
, ,
,

,

: The Principles of Vi

sual Perception and Their Clinical Application to

Denture Esthetics, Richard E. Lombardi, Es
thetics of Anterior Fixed Prosthodontics, Gerard
J. Chiche and Alain Pinault, Fundamen
tals of Esthetics, Claude R. Rufenacht.
Shanon
OBrien-Cohen, Christine Watson, Ju
dith Cohen Brigette Deveraux

.
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Robert Ullrich,


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Boston, Massachusetts

,
(1988 .) .
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(
):
Burton Becker, Gerald . Bowers,
Daniel Buser, Robert Del Castillo, Stuart
Froum, Bernard Gantes, Gary Golovic,
Jan Gottlow, Claude G. Ibbot, L. Laurell,

James T. Mellovig, Sture Nyman, Knut

Selvig, Richard H. Shanaman, Athenos
Spiros, Sigmond Stahl, Dennis R Tarnow
Theodore West.

W. R. Gore Associates, Flagstaff,
AZ Guidor AB, Gothenburg, Sweden
( 13
) Ethicon Inc., Somerville.
NJ ( 3
)

.

Bob Ullrich (
) Harry Maskell (),


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Boston, Massachusetts

10

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Glickmans Clinical Periodontology,

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Lindhes: Clinical Periodon
tology,

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Edward Allen, Raul Caffesse, Jose
Carvalho, Giovanni Castellucci, David
Garber, Barry Jaye Edwin Rosenberg

; Mark Hirsh, Mayer Liebman
Peter Ferrigno
Jeanne McCormack.
Rebecca Mugherini, Christine Roberts
Judith Cohen .

Harry W. Maskell,
, Robert
. Ullrich, Jr.





.
.
Boston, Massachusetts

14

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. 1.1.

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1.
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2. ,

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(. 1.1) (Newman Kornman,
1994).
3.
,

(. 1.2)
(McGuire Nunn, 1996).

1.1.

Newman Kornman (1994).

Newman . (1994)
,
,

( )
(
). Kornman .
(2000) ,
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:
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(. 1.2).

Page

Schroeder (1976).
,

(Page Kornman, 1997). ,

( ),
,

(
) (Haffajee et al., 1983; Haffajee, Socransky, 1996).


,

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(. 1.3) (McGuire, 2000).

(. . 1.2).

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(Tjan, 1986):
1. Ante: (Ante,

1926).

-1

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+ .
++ , ,
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1.2.
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: 0,1, 2, 3

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( / )
(, , ):
//
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McGuire Newman (1996).

. 1-3.

15

16

(Smith, 1961).
3.
(Reynolds, 1968).

1.3.

2.

( ):
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( ): 25%

. , / I .

( ): 50%- ,

(5-14 ) McGuire (1991) Mc
Guire Nunn (1996, 1996b, 1999)

(. 1.3)

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1.

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2.

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5096
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Ghiai Bissada (1994).
5.

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McGuire Nunn (1996)
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( ): 50% ,
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II ,
III ; 2+ ;

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McGuire Nunn (1996).

1.4.

1 - 2
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2


1 - 2

(

) 12
1
2

Ghiai Bissada (1994)

Nieri . (2002)

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(Brown Loe, 1993). ,
(
)
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(Newman
et al., 1994).
Loe . (1986),
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-1
Kornman . (1997)
,

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(,
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(. 1.4).
Kornman . (1997)

-1 (-1)

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-1,
,


2

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,
78% (

17

, 1.4.
. Dr. . Kornman.
( Munksgaard,
Copenhagen, Denmark)

> 30%

= 36

= 63

-1-
(-1 2 + -1 + 3953 2)
. 1.5.
. (
Dr. . Kornman et al., J Clinical Periodontology, 1997)

40-60 ),

, 18,9,

-1
86% 1
(. 1.5 1.6).

Packhill . (2000),
,

4,9

,

.
Kornman .
:
,

. 1.6.
(> 30 %) . (
Dr. . Kornman et al., J Clinical Periodontology, 1997)

-1,


(. 1.7).

, -1


(Masada et al., 1990; Stashenko
et al., 1991; Wilton et al., 1992; Feldner
et al., 1994). Cavanaugh
. (1998)

.
Lang . (2000)
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-1

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-1.
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18

: Fc-V
RII,
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lgG2

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-1

( Dr. . Kornman, editor.

Periodontology 2000
Munksgarrd, Copenhagen,
Denmark)

1999 . McGuire Nunn
42 ,
14 ,
-1.
,
-1

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4.5% (47 1044 ),
27 (57,5%)

-1, 38%
.
McGuire Nunn
. 1.5.
DeSanctis Zuchelli (1999)


-1. ,

-1
4 ,
-1
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Axelson (2002)
10-
283

-1
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1.5.
1

(-1)

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7,7

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8,8

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6,2

3,6

3,2

,
, -1- ,
.

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PST (Genetic Test for Susceptibility to
Periodontal Disease, Kimball Genetics,
Denver, Colorado)
-1.
,
. 1.6,
(. 1.8 1.9).

1.6.
-1

PST-

0,16

0.26

PST+

0,30

0,33

PST-

0,43

0.55

PST+

0,95

1,20

0,40

,
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Kornman (1997, 2002), Hart Kornman
(1997), McGuire Nunn (1999), Meisel
. (2004),

Nieri . (2002).
Nieri . (2002) 10-

60 (
40-58 )
(23 , 38,3%)
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(1566 ), :
1.

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= 22

>

CD

PST + ( )
PST - ( )
. 1.8. 10
(PST+) (PST-)
. ( Ayelson et al. Diagnosis and Risk Prediction of Periodontal Disease, 2002.
Quintessence, Illinois)

19

Kimball Genetics
PST
(Genetic Test for Susceptibility to
Periodontal Disease)
-1.
:
1.
,
:
;
.
2.
,
.
3.
.
4.
.
5.
.
. ,
Greenstein Hart (2002)

, (the American Academy of Periodontology Research, Science and Therapy Committee, 2005),



-1,
,
,
,
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,
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SMO - PST - (
, )
SMO + PST - (
, )
SMO - PST + (
, )
SMO + PST + (
, )
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(SMO-PST+), , (SMO+PST-), ,
(SMO+PST+) -1. (
Ayelson et al. Diagnosis and Risk Prediction of Periodontal Disease, 2002. Quintessence,
Illinois)

3,3% (52 1566).
2.

.
3.



:
;

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Nieri . (2002)
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(. 1.10)


(Stillman, 1917; Box, 1935).


(Loe et al., 1965), Glickman
Smulow (1962, 1965, 1967)

,

.
,

(
) (. 1.11).

20

. 1.11.
Glickman. ()
,
. ()
,
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. (D)
. (
Dr. Irving Glickman)

. 1.10.
. ()
,
. ()


. (
Dr. Irving Glickman)

,
(Svanberg, 1974; Linane
Ericsson, 1976; Lindhe Svanberg, 1976)
(Poison, 1974; Kantor et al.,
1976; Poison et al., 1976),

(1989)
,

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1992 . Burgett .
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Harrel Nunn, J Perio 2001)

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Harrel (2003) ,

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24

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(ENAP) :
ENAP
3. Wid
man.



1862-1884
S.Robicsek

Cizezinky
1914
Bentler 1916

Norberg1926

Kirkland 1931

( )
Kronfeid1935

27

Neuman 1912
Widman 1916

Zemsky 1926

Kirkland 1936

Ingle 1952

Goldman 1953
Friedman 1957

Goldman 1950

Nabers 1957

Pushback1953
Pouch 1953
Kazanjian
1936

i

Grupe 1956 j

1954

1961,1962

1963

_____ 1962______

Grupe 1966

1964

1967

1965

1967

1968

1963,1964,1966

1968

1968

1969

1963

1963

i
j
S.V.E.
1976

1985

1991

1968,1985

1983

1976,1986

1979

1982,1985

1979,1983

1985,1986

1979,1982

1985

1980,1981

1986

1985

G-TAM
1991,1992

1989

? 1983

G-TAM1988

1996

- .......
1996

1996

1958

1957

.
1964

Obwegeser
1956

Elden-Mejchar
1963

1957

1964

1960

Stewart
1954

Goldman 1949

Schluger1949

1963,1964

()
___ 1965,1968

-

1958,1965

1969

1971

1972

ENAP
1976

ENAP
1977

1990

1988

1969

1970

Widman 1974

1976

1965

1968

1972

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1985,1988,1991

1990

. 2.1.

. -

28

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( , - (). ( )
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( ) -

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29

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3.

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2.
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: Kinoshita S, Wen RC. Color atlas of periodontics. St. Louis: Mosby-Year Book; 1985.

( ):

1. .
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Postlethwait (1971), Varma
. (1974) Ethicon (1985),

:
1. (
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3. .
4. .
5. .
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(Ethicon, Somerville, New Jer
sey),
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Eiliicon.

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34


.
(10-14 ).
5. Gore- (Flag
staff, Arizona) Vicryl

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1. :

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-3.

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.

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3.
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(Postlethwait, 1968;
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(Hermann, 1971).

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(Hermann, 1971).

(. 34) (Thacker
et al, 1975):
1.
(. 34,4).
2.
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35

.
3.
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. Thacker
(1975) ,


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Ethicon (1985)

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37

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.
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38

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,
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Ethicon (1985)

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1.
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39

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- 3/8 1/2.

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40

Ethicon (1985)

:
1.
.
2.

.
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41

42

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43

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44

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45

46

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Laurell (
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47

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49

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50

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51

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chanan Robertson (1987) ,

3




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(1989)
:

52

! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....

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1977 . Fredi Rosenfeld
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Widman
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Widman, 1974 .
Ramfjord Nissle.

Ramfjord,

Widman (
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55

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57

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58

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59

60

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64

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68

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69

70

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71

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(Friedman, 1962).



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1 (Lange, Loe, 1972; Miyasato et al 1977; Hangorsky, Bissada,
1980; de Trey, Bernimoulin, 1980; Dorfman et al., 1980, 1982). Kirch
. (1986), Wennstrom (1987)
Salkin . (1987) ,



.

(Maynard, Wilson, 1979; Ericsson, Lindhe, 1984),
(Maynard, Ochsenbein, 1975;
Coatoam et al., 1981)
(Gottsegen, 1954; Corn, 1964;
Gorman, 1967),

(Baker, Seymour, 1976; de , Berni
moulin, 1980).

Goldman Cohen (1979)

-
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Kennedy . (1985)

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Lindhe
. (1973), Baker Seymour (1976).
Rubin (1979) Lindhe Nyman (1980).
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72

Wennstrom (1985)
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1964).
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76

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(Ariaudo, Tyrell, I960; Hileman, I960).

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79

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81

82

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83

84

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1960- (Bjorn, 1963;
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.
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-. pyp*i

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. :

i
15 .

, ,
.

(Sullivan, Atkins, 1968).

,

, . . j
.
, , <
, ;

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.

88

. 6.15.
. ( ) :

. ( )

. ( C , D )

.
, -
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-
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. () ,
,
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( )

. ( L ) ,

(. 6.15, ) .

, . .


(. 6.15, 0).

.


,
(. 6.15, R ) . ,

,
-.

:
(Avitene, . R. Bard Inc., Murray
Hill, New Jersey)
() (Colastat, Kendal Co.,
Boston, Massachusetts).
,
.

(Saroff et al., 1980; Stein et al.,

1985).
.



(. 6.15, S ).

.
,
,
,

15 (. 6.15, ).

,
.

;

,
.

,
Corn:
(. 6.15, U , 7);
,
.

,
.
Castroviejo .

,


.

,

.

(Sullivan,
Atkins, 1968).


,
.

-
(. 6.15, W ) ,
,

(. 6.15, "),
(
Carvalho et al., 1982; Holbrook
Ochsenbein, 1983).

. 6.17-6.21.

1.


.

2.

3.

4.

5.

87

,
,

(. 6.22,4).

,

.


.

5 ,

,

.


(. 6 . 2 2 , ) .

/
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88

. 6.1S.
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-
() ,
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. ( ) ,
,
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.
( )

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89

. 6.15. (). () , . (N)

, . ( )
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. (. R ) , . (5)
. ( )
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. ,
. ( X )

go

<0,5

3,5-0,75

( )

0,75-1,25

> 1,25

( )

. 6.16. .

. 6.17,
. ( ) :
. ( )

. ( )
. ( D ) . ( )
.
( F ) . ( G ) .
() 6 .

91

. 6.18. . (/I) . ( )
. ( ) -
. , . ( D )
. ( ) . ( F ) 4 . William Irving, Needham,

. 6.19. . ( ) . ( ) .
. ( D ) . ( ) . ( F ) 2 .

( )

92

. 6.21. ,
. ( ) . .
( ) , . ()
(
Irving Lickman). (D)
5-0. ( ) . { F ) 1

. 6.20. .
. ( )
. ( ) . ( )
.
(D)
6 . . .
(E)
: . ( F ) 12 :

93

()
()

()

. 6.22. . ()
, , ,

(). ,

(). ( ) ()
()
. ( )
. ( D ) -

.

,

.

,

(Dordick
et al, 1976).
,

,
,
,

. Seibert (1980)


,

.
,

,

.
,
-
.
.
15
-
(. 6.23, ) .


, , ,
(. 6.23, , D ).

(. . ,

).
.
.
,
.

,


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.
.

(Robin
son, 1961; Corn, 1962)

(. 6.24, ) .

15
.

, 1-2 .

.

,

;
-

. , Morman .
(1979) , , . .

,
-,

.

(
)
(
)

94

. 6.23.

. { , )
, ,
- 1 . ( C , D )

- 6.24. -

. ( )



. ( )

,

95

Corn, , 1964

Dhalberg, , 1969
Goldman,
, 1982

. 6.25.
.
( ) Grupe. ( )

. ( ) ,
,
. ( D )
,
. ( )
,


( )

(
,
,
).


.

1956 . Grupe Warren

,

,

(. 6.25, 4).

- ,


.

Grupe (1966)

(. 6.25, ) .
Staffileno (1964)

,
.
Corn (194)
,

,
(. 6.25, - >


. Dahlberg
(1969)

,
(. 6.25, D ).
Goldman Smukler (1978) 1983 .

,
,

,

,

(. 6.25, ) .

1. .
2.
.
3.
.

1.

.
2.
.
3.
.
4.
.

1.

.
2. .
3. .

96
4.

,
.

-.
. .26,
,
-
,
.
(,
. )
(d, , f)
. 6.26, .



,

.
(pH 1,0),

(EDTA) (pH 7,0)

3-5 ,
.

,


.


(Stahl, Tarnow, 1985).
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15
( . 6.26, ) .

,
V-

(. 6.26, , D ) . ,
V-

,
, ,

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,
.

. . 6.26,
(d, , f),

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2
-,
, 3-4 .

15. V ,
(. 6.26, ) .

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;
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V- .

. 6.27-6.30.

1. . 6.31,4


.


.
2. . 6 . 3 1 ,

.
,
.
,

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. ( ) . ( ) V- . (D) V-
. , ()
. ( ) . ( F ) - .
(G)
(). () ,
() . (/) . (J)
(-F). () , . (I)
. - -

97

98

. 6.27. . ( ) .
. ( ) : V- , .
- , -' ^' (. . 6.5). ( ) V- , V- .
, . ( D ) .
-. ( ) . . ( F ) 2 .
. William Irving, Needham,

. 6.28. . ( , ) ,
. ( , ) , ( ) ( ) , . ( , )

99

. 6.29.
. ( ) .

. ( ) -
. ( )
. ( D ) 3 . .
( ) 2 . .

. 6.30. . [ )
31 41.
32 42. ( ) .
. ( ) . ( D )
,

2 .
3. . 6 3 1 ,
:


.
, / .
. 6.31,0

.


.
4. . 6.31,

.

,
,

100

. 6.31.
. ( )

- . ( )
.
( ) (),

.
CD)
- .
- ; -
-

,
,

. ,

.
. 6.32,

,
.
. 6.32,
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.

.
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15
V-
.

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,

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()


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(. 6.32, ).
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,
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.
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,

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. 6.33-6.35.

. 6.32. , . ( ) . ( ) : - V- ; d-e -
, . . () V- .
CD) V- . ( E , F )
( ) ( F ) . ( G )
- . () . ( I )
V- , . { ] ) . ( K , L )
. - ; - ; - -

101

102

. 6.33.
,
.
(A) .
.
(B)
V- . ( )
,
. ()) 8 . .

. ( )

. .
Edward
S. Cohen, DMD, Glickman's Clinical Periodon
tology
W.B. Saunders

, 6.34. ,

. (/1) ,


. ( )
. ( )
, .
V-
-.
(D)

. ( ) 3 .

.
McDonald, Foxboro,

103

. 6.35.
. ( ) .
. ( )
: V-
, . ( ) V- ,
.

. ( D ) ,
. ( ) 3
,

Dahlberg (1969)
,

,

. . 6.36,
.
,
V .

. 6.36. . : [ ) V- . ( )
, V- . . ( )
. : ( 1 ) , . -
(). ( 2 ) . (3) . .
( 4 ) 7 . . . -

104

.

,
V-

-,

.
V-

15, ,
(. 6.36, ) .

(. 6.36, ) .

, Goldman
Smukler (1978)
.
. 6.37, ,
25

,
.

17-21 ,

.
,

.
. 6.37,

17-21 .
-
(. 6.37, ) .

Goldman . (1982)
,
,




.
. 6.38, ,
V-

15.

.

-
(. 6.38, ) .

.
.

15

.


(. 6.38, D ) .
. 6.38,
,

.

V- .
. 6.38, F
,
.

. 6.39.

. 6,37. . : () () 17-21
. ( ) , () . ( )
-. : ( 1) , 21 . (2) , V-
. (3) -. ( 4 ) 6 . ,
. - -

105

. 6,38. . () . ( ) V- . () V-
() , . (D)
. ( ) . ( F )
. ; ; -

. 6.39. , . () . ()
. () V- -. (D) . ()
-. ( F ) 7 . . . -

106

(25 )
.

,

, , ,

,
. . 6.40,
. . 6.40,
(
),
V- .

-
(. 640, ).

. 6.416.42.

Wainberg
(Goldman
et al., 1964),
Cohen Ross (1968)
.

/


.

1. ,

, .
2.

.
3.
.

. 6.40.
. ( , )
. ( , )
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. ( , )
, .


. CD) .
; ;

1.
,

, .
2.

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,
.
3.

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1.

:
,
.

. 6.41. . ( ) . ( ) : '; '. .

, . ( ) V-
. ( D ) . ( ) ( ,
) ( , ) . (F) 4 :
,

. () 14. ( ) . ( )
V- -. ( D ) . ( )
. . ( ) .

. 6.42.

107

108

-
,

(. 6.43, ) . , ,
1
-
(. 6.43, ); 1

.

. 6.43, .




,
,
. V-

.


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.


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,

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(,
- ) (. 6.43,6).

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,
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,
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,
.

Corn,

(. 6.45,1)
(. 6.43,./).



4-0, 5-0 6-0 -3.

,
.

,


.


(. 6.43, ).

(. 6.43, ), -

,
.

5 ,



.

. 6.44.

,

- .


.
,
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(1)
(2)
.



(. 6.45,4,4).
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(,
V-)
,
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,

,
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). ,

1 .
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, .

. 6.46.

1.

,

.

. 6.43. . () . () ; -
. () V- . (D) V- . () ()
. ( F ) - . (G)
, . () () . ( ! )
Corn. { ] ) . () . (L)
. ; ; ; ; -

109

110

. 6.44. . ( ) . . ()
. () V- . ( D ) ,
. () . ( F ) 6 .

. 6.45. . (, ) ; . (, )
, V- .
. - ; -

(, )

2.

3.

4.

5.

6.

. 6.46.
. () .
04) . ()
. () . ()
- . ( )
- . (D)
. ( D ' ) 6 100%-

111

.

(. 6.47, ).

(
)

,



.


(. 6.47, ).

,



.


,

(. 6.47, ).


,
. ,


,
. ,

(. 6.47, D).


,

.

,
,
. 6.47, .

. 6.47, ,


,
.

Hattier (1967)
-

112

. 6.47. : . ( ) . ()
() () . () . (D)
. ( E , F ) - . ;

. 6.48. Hattler. ( ) .
24 25. ( ) . () . ( D )
. ( ) 2 . . ( F ) 6 . .
- .

113

,

, .




. ,

.




.

. 6.50

. 6.49. Hattler
. ( ) . () . ()
. ( D ) .
.

,

.


.

,
,
.

(.
21
).
,
,
.

. 6.48
6.49.

()

()

,


.


,
.
,
(Corn, 1964):
1. .
2. .
3.
.

,
, -

.
,

, .
.


.
,

15.

,
.
.

,
.

.


.



,
.

.

. 6.50-6.54.

114

, 6.50. (). () . () . ,
. () . .
. ( ) -. ( F ) 6 . ,

(D)

. 6.51. (). () . () . ()
. . (D) -
, . ( ) . ( F ) 5 . .

. 6.52. (). () . () 4-0. () .

6-0. ( F )

(D)

()

. 6.53. () . ( , ) { )
G4). ( , ) - . ( , )

115

1 1 6

. 6.54. () . (,) , .

(. ) .

(, )

, ,

117

,
,
.

,

. ,

,

.

(-)

.
, Ochsenbein
Bohannan (1963,1964)

.
. 7.1
:

(-)
(. 7.1, ),

(. 7.1, )
(. 7.1, ).

: ,
,

(. 7.1, D).
Ochsenbein Bohannan,

,
,

.

1. .
2.
.
3.
.
4.
.
5.
-
.

1. .
2. .
3.
.
4. ,

,
.

1. ,
.
2.
.
3.
.

, . .

.

(Easley, 1967).

,


.

(. 7.2).

118

. 7.2. .

. 7.1.
. ( )
(-)

. ( )
.
(C)

.
(D) ,

(. 7.3). , -




.


: ,
.

,


.

. 7.4


.
,



.

Staffileno (1969)
,
,
j
,


.

1.

.
2. .
3.
.
4. ]
.

119

. 7.3. . ( )
,
. () . () . (D)

. 7.4. /. , , , . .
, . ( ) . ()
. () . (D) . () ,

120
,




,

.

. ,
. .
.
,
,
,
.
,

.



.


(. 7.5, ).

,

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, .

15 () 12 (
).

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.
,


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, .
,

,


.

.



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.



.

,
,
.


, 15 12
(. 7.5, D, >).

,
.

Ochsenbein 1 2

,

(. 7.5, , ). 1

- ,


. 2

,
,
.
,


.


Friedman.

,
,

.


, ,
,
(. 7.5, , F).
.
,

,
2,

(Edel, 1974)

(Langer, Calagna, 1980; Langer, Langer,

1985).

. 7.6 7.7.

121

<

, 7.5. . () . [ ' )
. ( ) . ( ) ,
. ( , )
V , . . ,

122

S.
( ). {D)

,

: , ) Ochsenbein
,
(). (F, F)

. 7.6.
. () ,
,

. () () .
() (2) . (D)
.
( ) .
() . (G)
. () 7 . .


.

123

124

. 7.7. . () . .

() (2). () .
. (.D) . () . ( F) 8 . ;

Ochsenbein 1958 ., Och
senbein Bohannan 1963 .
, 1965 .,
Prichard,
.
-
(ledge-and-wedge).

.
,


.

,
Widman, ENAP,
,
,
.


.

,
.
,
,

I. .

,
(. 7.8, , ).

(. 7.8, , ).

(. 7.8, , ).

,
, .

,
.


.



.
, . .

.
II. .

.


(. 7.8, D, D).
,
.

125

. 7.8. -.

[)

. () .
. (, )
. ( , )
. ,

.


(. 7.8, D, D). Ochsenbein 1 2
Friedman

(. 7.8, ,
) .
,

,


(. 7.8, '').

. 7.9 7.10.

126

. 7.8. (). D , D )
. , ,
.
- ,
. (,) Ochsenbein
(). (F, F)
;

127

. 7.9. ( -). ()
. ( ) . () .
CD) . () (2) .
. (G)

(F)

. 7.10.
. () .
( )
. ()
. CD)
. ( )
. ( F ) 5 .

128

1. .

,

(. 7.11, ).

.
2.
, -
.

(. 7.11, ).



.


.
3.

(. 7.11, ).


.
4.



(. 7.11,11).
5.


.



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.
,
.

. 7,11.
.
() . ( )

. ()
,

.

,

. ( D)

. ( )

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().


,

,
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,



.
Robinson 1963 .,
Kramer Schwartz (194),
Rob
inson
(1966)
,
.


,

1.

.
2.

.
3.
, .
4.

.


(,
).

129

1. .
2. ,
-.
3. .
, ,

.

.

.

, 12 15
(. 7.12, ). ,

. 7.12. . () .
(, ), . () ,
. () . (D) . ( , )

130

(. 7.12, ).

,

. . 7.12, ,
D ,

.

.



(. 7.12, ).
,
,

(. 7.12, E,F).
,
,

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.

.

15 ;

]
.


(. 7.13, , )

,
,

(. . 7.13, ).


.

()
.
kocti
Kirkland Or
ban (. 7.13, , D).
,
, i

(. 7.13, )
(. 7.13,--

. 7.13. - , - . () . ,
(, ). ( )
. ( C , D ) ,
. ( ) . ( )

131

. 7.14. . () . () : 1 -
; 2 ; 3 - .

() .

(D)

()

(F)

, 3 .

.

. 7.14-7.16.

. 7.15. . () . () :
1 ; 2 - ; 3 -
. () . (D) , .

()

(F)

132

. 7.16.
. (4)
. ( )
12 . () ,
.
(D) . ( )
(2). () 2
. ( G ) . ( )
, 3 .

,

,
, Langer Langer (1990)
.

1.

.
2.

1.

5-6
,
15 (. 7.17, ).
2.
,
15
.
(. 7.17, ).
.

.

3.

.
4.

.

.
5.
Oschenbein

(. 7.17, ).
6.

()
(. 7.17, D).
7. (. 7.17, ).
8.

/
.

(. 7.17, F).

. 7.18.

. 7.17. . () .

() (. . 7.5 ). () ,
. (D) . () . [F)
. ,

134

. 7.18. . ( ) . ( )
; . () . (D) ;
. (. ) .

()

3 .

135

,
.



(),

.
1967 . Frisch .
,


.
,
,
Kirkland (
, 1931, 1936),

,

.



,

.
,


. Lie (1992)

,

.

1. .
2.
.
3.
.
4.
.

1.
.
2.


.

Frisch .
,
.

(,
, );

4 ,

.




.

.

,

.

1. . 8.1,

.

.

. 8.1. . ( , ) . ( C,D) , , .

( E , F ) , . . . 8.2

2. . 8.1,
.



.

,
.
3.
11 15.

(. 8.1, ).

,
.

.
4.


(. 8.1, D).

,

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.
5. . 8.1, E,F

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.




.
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8.4)
,

.

,

.

. 8.2. . [)
, . () (. . 6 - ).
()
. . . (D)
. () ,
( ). (F)

138

. 8.3. . (, ) ; . ( )
. ( D , E ) . ( F )
. ( G ) . () . (/,/)
, . (. K , L ) 4 . .

13S

. 8.4. . ( , )
; . ()
.
( D ) . ( E , F )
. ( G , H )
; 5 .

Takei . (1985, 1988, 1991)

. ,
,
Genon Bender (1984),



.

1.

1.

.
2.
.
3.

1. .
2. .

1. .

1. ,
/ -

,
.
2.
/
,
.
,
,
3
5
(. 8.5, ).
3.
,

Kirkland
(. 8.5, ) .
4.



.
II.
(. 8.5, ).

140

5.

.

.

(. 8.5, D).
6.

(. 8.5, ).
7. ,
,



(. 8.5, F).

. 8.6, 8.7.

. 8.5. . ( ) . ( ) . ( ) . ( D )
, . ( ) ,
. ( F ) .

. 8.6. . ( , ) ,
. ( ) .
, .
( D ) . ( ) - ,
. ( F ) . ( G , H )
. . . A . ( I J ) 8 .; .
, .

. .7. . ( , ) ; . (C , D ) ,
. . ( ) .
( F ) . ( G , H ) , . (/) 2 .; .
. ( J ) . ( ) 3 .; . ( L ) 1 .

 :; 8^^^1^1|^^^^58^5&'-'-- - - i

.
,
1935 . Kronfeld

.


,

:
1. Goldman (1950) The Development
of Physiologic Gingival Contours by
Gingivoplasty /
.
2. Schluger (1949) Osseous Resec
tion A Basic Principle in Periodon
tal Surgery /
.
3. Friedman (1955) Periodontal Osse
ous Surgery: Osteoplasty and Osteot
omy /
:
.
4. Prichard (1957) The Infrabony Tech
nique as a Predictable Procedure /


.

5. Goldman and Cohen (1958) The In

frabony Pocket: Classification and

Treatment /
: .
6. Ochsenbein (1958) Osseous Resec
tion in Periodontal Surgery /
.
7. Ochsenbein (1986) Primer for Os
seous Surgery /
.

,

, ,
.

,

,
,
.

. ,
,
,
, ,

.

,
.

.



() ,
,

(. 9-1).

,


(. 9-2).

,
.
, ,
Ochsenbein (1977),

.

. 9.1. . (, )

. (] )
, . .

Ochsenbein ,

.

:
1. :
(. . 10
. 11

),
2. :
:
:


;
* :

,


.

()
.
1. , :

,

.
2. :
.
3. , :
.
.

.

. 9.2.
.
,
, -

, ,


(Mombellil
et al., 1995; Rawlinson et al., 1995; Levy
et al., 1999, 2004a, 2004b; Tuan et al.,

146

2000). Chevy . (2002)

,
,
,

...

...
.

(1996)


:
1. :
;
;

.
2. .
3. .
4. .
5.

,
; .


:
1)

(Townsend-Olsen 1985; Saxen et al.,
1990);
2)
(1dahl et al., 1996, 1996b);
3)

(Gunsolley et al., 1994; Mobelli et al.,
1995).

(Ea
sley, 1967; Mealey et al., 1997).

:
1) ;

2) (,
);
3)
( I, II, III);
4) .

,
,
(
,

),


(


).

,

.



.

.
.

,


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(. . 6
- ).

-

,
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.



.
,

.

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,
.

(Friedman, 1955), ,

.

,



,
(. 9-3):
1.
.
2. .
3.
,
.
4.

.
5. ,
/
.
6.
.
7.
.
8.

.
9.
.

,
(Ochsenbein, 1958), (
) (Carranza, 1984).
,
,

.

,



.

.


.

.



,

147

. 9.3. . ( ) . () . ()
. (D)
. ()

.

,
.

, (
) .





.

. 9-4,

.

,

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.

.
,

6, 8 10

(. 94, ).

.
,
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4-5 .

148
, . .


.
,

(. . 9.2)

. ,

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.
. 9-4, D 2 4

(. . ) .

.

( Ochsenbein
1 2) (. 94, ).

,

(. 9-4, F).
. 95-9.7

. 9.4. , . ()
. () . ()
. (D) . ()
. ( F ) .

. 9.5, ,
. ( ) ;
. ( )
.
(
. (D)
. ()
.
( F) . (G)
. ( )
.

149

. 9,6. . ( , ,
) ,
. .

( C . D ) .
.

.
-
. ( , ' )

.
. ( F ,
G )
{ F )
( G ) . ( I ) ( ' ) . (/ )
.
( )

 151

. 9.7. , . (. -D) .

(A-D')

152

1.

.
2.
.
3. .
4.
.
5.
.

6.

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7. .

1.
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2.
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3.

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3.
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1.

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2. (

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3.
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4. .

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Ochsenbein. . (. )
. ( F ) ;



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.


.
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(2, 4 6)

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153

,



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. 9.8,
,

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2, 4
. ,

.



(. 9.8, D).

,

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,
(Schluger, 1949) (. 9.8, ).

.

.

( Ochsenbein)
.

. 9-8, F.

,

.

. 9-9 9-.

154

. 9.9.
(
)

. 1.
( )


. ( )
.




. ( C , D )


;
,


-
,
-


( ).
( )
( )
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.



. { G )

; .
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;


. 9.10.
(
)
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,
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-
.
() ()

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( )

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.

155

(. 9.11, ), . .

/
.

, ,


(. 9.11, ).




(. 9.11, , ).

:
1. .
2.
.
3.

.
4. .
5. .
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,


.

. 9.11. . (,) .
(,) . (, ) ,

157

.



.
(. . 8


),

,
,
,
.

.

,

.

Tibbetts . (1976),
Ochsenbein (1986)


.
,

. Ochsenbein ,


...
,
. Tibbetts
., Ochsenbein



.

,

,
,

.

. 9-12-9-14.

. 9.12. . 1. ( )
. ( )
. . ( ) .
. ( D ) (
) , . ( )
; ()
. ( F )
. ( G ) . . ()
. ,
- .
- ; - ; . .

158

. 9.12. (). (J) . .

- . () . (L) (
). () , (). (N)
.

. 9.13. . 2. ()
. ( ) , . ()
. (D) . ( ) .
. ( F ) . . - ; . - .

159

. 9.13. (). ( G)

. ()
,
. (/)

,
. (J) ,
. ()

, .
F. - ; . -

. 9.14. . ( ) .
. ( ) - ; . ()
, . (D) .
() , , . OF) 6 . . Edward D. Cohen, DMD Glickmans Clinical
Periodontology W. . Saunders

160

(. 9-15).


(. . 9-15).

.
, . 11.13,
,

.

(),
,

(),
,
,
,
.



.

(
) (. 9.16). Gargulio .
(1961) ,
2,04 (
0,97 ,
1,07 ),
0,69 .
(

II, . 2

.)

.
:

. 9.15.
.
04) ,

.
,



. ( )

1: - 2:

- .
2: - ,
, 2:
.




.
3:

.
0,69
4:

,
0,97

2,04
.

5:

1,07





.
6:



,
. 9.16. .


.

161

,

.

,
,
() .

Goldman (1949, 1958)

(. 10.1),

(Ellegaard, Loe, 1971).

,


.
,

.
Reynolds . (2003),


, 1966
2002 .,

(), (2005)
,
:
1.
.
2.
.
3.
.
4.

.
5.

()


,

.
6.
:

;

. 10.1.
.

162

();
(Bio-Oss,
Osteohealth,
Uniondale,
New
York);

(Emdogain Straumann, Basel,
Switzerland).
:

,
<-

(1989)
(2001).

,

,

.


,

!'
,

.

,
.

,
.



,
(
)

.


.

. 10.2
,
(Ratcliff, 1966; Glickman, 1972; Wirthlin, 1981):
1. (. 10.2, Al).
2.
(. 10.2, 2)
,
(. 10.2, 2).
3. (. 10.2, ).

:
1. ,
,

(. 10.2,5).
2.

(. 10.2, ).
3.
,
(. 10.2, , ).
4.

(. 10.2, D).

. . 10.4


.

,

.

( , ,
EDTA)

.
Takei . (1985)
,


,

(. . 8

,
. 8.5-S.7). Cortellini
1995 .,
, 2001 .
,
.
4.


2-3
(. 10.3, 5.

.

:
,
.

1.

1.

.
2.

(. 10.3, ).
3.
-

(. 10.3, -).

,

(. 10.2, 10.3, G).
,

,
,

.


.

,

163

. 10.2.
: ( ) 1 - ; 2 - ; 2 -
, ;
3 . () ,
(1) .
(C)
(2)
(2).
(D)

(Stahl, 1977) (Aleo et al, 1975).

,

(Pritchard, 1983) ,

.

2.

,
(. 10.2,
[2, ] 10.3, /).
,
.



.



(. 10.3,/).

3.



.

,

,
.
.

( 2)

,

,

(. . 10.2, D).
. -

(. 10.3,1).
6.
(,
, , )

,
( ) (

) (. 10.3, ).
7.

,
,
(. 10.3, N, 0).
8.

,
(. 10.5).

,
.

164
9.

,

.
100%,
/
15
(. 10.6).

,
.

,
Gore- (Vicryl)
(. 10.3, ).

,


14 .

,

.
11.

(100 2
) (250
3 ) 10-14.
7 .
14 .

3 .

.
,

, . 10.3.
,

,
. 10.7.
10.

:
1.
.
2. (,
Osteohealth, NY; Emdogain Bio-Oss).
3.
.
4. (
).
. 10.1

. 10.3.
. () , 7 . (-D)

. () , .
(F)
. (G ) ,
. ()

.
Bowers . (1982)

,

? .&? ^

165

. 103. ( ). ( I) . (/)
. ,
, . ()
. (. L )
. ()
. ( N)
. () . ( )
100%- . () 1 .
. (R)
. James Mellonig, San Antonio, TX

10.1.
,
, ,
, .
,
,
,
.
, Bio-Oss, Endogain,

.

,
SD

,
95%

,-

1172

1,8 1,4

1 6 1,9

407

2,8 1,6

921

480

3,5 1,6

3 2 3,7

1283

3,8 1,7

3,7-4,0

1^-5 ; ;

,-

Tonetti Cortellini (2001) Tonetti (2004).

95% 95%- : ;
; - .
2001 .

166

. 10.4. . ( )
. . ( )

. 10.5. .
,

(A-)

. 10.6.
. {,')
.


.
(, )
,
100 %

167

. 10.7. , . (A-)
. (-)
.

Mellonig (1992),


:
1. .
2.
(, ).
3.
.
4.
.
5.

.
6. ,
.
7.
.
8. .
9.
.
10.

.

,
(Ramfjord,
1971).
,

,
,

.

.
Pritchard (1983),

,
,

.
,

.
:

.
,



.

Becker . (1986).
Ellegaard . (1974),
Karring Ellegaard (1976),


,

,
(. . 11
).
,



.

,
.

168

,
,

.

(Goldman, Cohen, 1979):
1. (Urist, McLean,
1952)
:
;
;
.
2. (Urist et al., 1958).

,
, ,
.
3. (Ellegaard
et al., 1976) ,


.

Mellonig (1992)
:
1. .
2.
.
3.

.
4.
.
5.
.

6.

.
7. .
8.
.

,
.

,
(Bell, 1964; Schallhorn, 1976):
1. .
2. .
3.
.
4. .
5. :
;

;

- .
6. .

.

.

.

1.
:
;
.
2. :
;
;
;
;

.

1. .
2.

(AJIK) /
.
3. .
,
/

,
(Bowers
et al., 1985).

,

.

1. .
2. .

1. .

. Froum . (1982)

,

.

1. /3-.
2.

, (
[HTR]).

,

,
(. . 11
).

Schallhorn (1967, 1968)


,


.

Turkell
,
(Min
imum Essential Media)
.

.

,
.
(
)

.



(. 10.8).

-

(Dragoo, 1973; Hiatt, Schallhorn, 1973),

,
,

(El
legaard et al., 1976).

3 3,5 ,

(Nabors, OLeary, 1965;

Hiatt, Schallhorn, 1973; Froum, 1976)

. 10.8.
. () .
() -
. () ,
. (D)

. () 7 . .
(.F )
. (G) 7 .
,
, .
Edward S. Cohen, DMD
Glickman's Periodontology
W. . Saunders .

169

170

-, - ( )
. ,

(Ross, Cohen, 1968; Naber, 1972),
(Listgarten, Rosenbert, 1979).
.
:
1. (Salvin Dental, North Carolina)
(. 10.9).
2. Maxillon (Maxillon Co., Hollis,
N'H) (. 10.10).
. Robinson (1969)


,

,
.


. ,
,
Nabers OLeary (1965).

.

,

(. 10.11).

, ,
,
.

. 10.9. (Salvin Dental,

North Carolina) .
() . {)
. ()
. (D)
. () .
,

, Robinson ,

-

,
-
.
Freeman (1973)

. 10.10.
Maxillon (Maxillon Co., NH). G4)
. () Maxillon
. () .
. (D)
. ()
. ,
,

.
.
Diem . (1972)

Robinson
,

.
,
,
, ,
. ( ),
,
60
,

. Froum
. (1975, , 1976) ,


,
,

.
,

,
.
. Hiatt Schallhorn
(1973)

.
, ,

.


(. 10.12).
166

,
(. 10.13)
,

,
.

:

. 10.11.
:


. ()
. () 23, 5
6 . { ) 24,
7 . ( D ) -

. ()
. (. F )
,

,
,

.

. Haliiday (1969)

172

. 10.12. . () . () . () - . (D) . () .
(F) . (G) . ()
. ( I ) . (/) ,
. ( ) , . (I) ,

. 10.13.

. () ,
. ()
. ( ) .
CD)
. ( )

.
6-7 .
,

.



.

,

6-8 . (. 10.14).

.
Ewen
(1965)

,


.

,


(Nabers, OLeary, 1967).

,

.


,
.

. ,
,
,

.
,
(
) (Louise, 1992).

()
(. 10.15).

,
(Interpore) (Oreamuno et
al., 1980; Kennedy et al, 1985, 1988; Bar
nett et al., 1989; Bowen et al, 1989)


. Egelbert (1992),
,
,
2 ,
3 .

173

Kennedy . (1988),
(In
terpore 200)
II
,

( 1,82 ;
< 0,0001)
. Corsair (1990)
51%

(OsteoGen Impladent Ltd. Holliswood, New York)

. 5-

(Periograf) Yukna (1980) ,

86%
62 %
38%
, ,

. Yukna (1990).

(HTR), , 71%

( 50%
),
,
, 24%. Shahmiri
(1992) -

174

. 10.14.
. ()
- . ()
. ()
. (D)

8-10 . . ()

. (F ) ()
.

(). (G,H)
,
. .
Edward S. Cohen, DMD Glickman's
Periodontology,
W. . Saunders .

175

. 10.15.
. 04) , 10-
. ( ) , 13 . ()

. (D)

. () 3 . :
3 . ( F ) 10 .
,

(
HTR).
Saffar . (1990)

, ,
.
,
(. . 10.15). Pepelassi
. (1991)
,
,
50%
II

,

.

III

.

,



,
, HTR-,
,

.

(). Urist (1965, 1.968,
1971, 1980)
.

,
- .


(
),
.

250 500 .
:
1) ;
2) ;

3)

-.
250
,
.


(. 10.2):
1. .
2. .
3. .
4. .
5. .
6. .
7. .
Mellonig (1984)

.
64,7 %
37,8% ( < 0,01).
,
,
78%, 90%. Bowers .
(1985) ,

176

10.2.

Bio-Ossa

+++

++

+++

++

++

++

+++

++

+++

++

++

+++

+++

+++

+++

+++

++

+++

++

+++

+++

++

+++

++

+++

++++

+++

Bio-Oss
b . . 10.3.

,

, . Bowers
. (1989, )


32 25

(. 10.16).

( < 0,005),
( < 0,005),
( < 0,05)
( < 0,001)

, ,
.



.
Laurell . (1998) 21
(512 )
:
1.

(2,2 1,1 ).
2.
1,2
2,3


,
.
3.


2 ,
:

, %
00 +
+

49
66

, %
38,7
61,2

4.
4 5

,
(> 6 ),

.
. Schwartz . (1996), Becker (1995)
Garraway . (1998) ,

, ,

. .

. 10.17-10.22.

50% 39
50% 1 .

,
.
Yukna Vastardis (2005)
in vitro
( ),

, .
,

,

, .
Plattelli Scarano (1996)
Paul . (2001),

. Rummeltart (1989)
,

.
. ,

.

,


,

(. 10.23).

().

,

.
.


(Saun
ders et al., 1983). Sepe . (1978)
Mellonig (1980, 1981) ,
60% 50%

. Saun
ders . (1983) ,

80%
50%

.
Yukna Sepe (1982)

4:1 62

22 ,

(
,
1996). Gross (1997)

,
:
1. .
2. ()
.
3.

.
4.
, ,
.
5. .
6. .
7.
.

17

8.

(

).
9.
.
10.
(

;
).
. .
12.
.
13.

.
14.

(,
,
).
15.

.
16.

.

. 10.16. () , ,
()
(). .
()
( -, 4). ( ) () .
. ,
() () (). , (
-, 40). () , ,
(). , ()
().
() ( -, 40).
Gerald . Bowers, Baltimore, MD. -

- .
,
,
,


.
,
( )
( Louise, 1992).



(. . 10.15).

(1996),
(2003)

.
,
(
).
Reynolds . (2003)
,

,
-

178

. 10.17. . () :
. ( ) . ( ) . ( D )
. . ( ) . ( F )

. 10.18.
. ( , ' ) . ( , ' ) .
. ( , " ) .

179

()
. ,
. () .
(D) . ( )

. 10.19. . () .

II
III . Martin . (1988),
Gantes . (1988, 1991),
Garrett . (1990)

.

(2003)

(2009)
.
.



. Stahl

Froum (1991)





.

II .
(Martin et al., 1988; Garrett et
al., 1990) ,

,
.

6770% , 100%
43 56% .

(
).
III
15 % .
,


. Egelberg (1992)



(Renvert et al., 1981, 1985, 1985;
Chamberlin, 1985),

-

180

. 10.20. . (, )
. (C , D )

II . ( E , F )
. ( G , H )
, . ( I J ) (
), . . ( )
( ), . c D \ a E

6} {&

. 10.21, .
G4) . ( ) -,
. ( )

. (D) .
,

. ( ) 4
. { F )

11 21. 11 21
. ( G ) 9,5 .
. ()
: , 5
.

(Renvert et al., 1985b)

(1,1-2,0 )
(0,61,3 ).

1. II III
.
2.
II
.

1. .
2. .
3. .

18

1.

,
(. 10.24, ).
2.

,
.
15 .
,
(. 10.24, ).
3.

(. 10.24, ).
4.
- .



.
-

182

. 10.22. . (,
) , . () -
. (D) . (E,F) .

. (G ) 10 . .
. () :

. 10,23.
. ( )
. ( )
.
. ( )
.

. ( D )

; .
()


. ( F )
;
(G )
.

18!

184

(. 10.24, ) .
5.
.
6. -

(. 10.24, D ) .
".

(pH 1,0)
,
3 ,

(. 10.24, ) .
8.


.
9.

. 4-0

;


;

,
,

,


;
,

(. 10.24, F ) .
10.
(3% ).
.
. 250
2 .
,

, .
2 .

. 10.25.

(1996)
,
,

. 10.24. . () ,
. ( ) . ()
. ( D )
.() (pH 1,0 3 ).
( F )

. ,
(Murphy, Gunsolly, 2003; Reynolds et al..
2003;
, 2005) , ,

,
.

(Bio-Oss)
(
) ,
(, 2001).
Bio-Oss
.
-

185

Massachusetts),
Bio-Oss
,

.

1.
2.
3.
4.
5.

.
.
.
.

.
6.
.
7. ,
:

. 10.25. . () . ( )

II . ( ) . (D)
. (D) .
. Bernard Gantes

300 .

,
,
.
, OsteoGraft

(1100 );

(Gross, 1997). Bio-Oss
Bio-Oss,
10% .
Nu-Oss ( Surgical Supply, Brockton,

;

;

.




(Co
hen et al., 1990; Brion, 1991; Clergeau et al., 1996). Richardson .
(1999)
, ,

,

. Schwartz . (1998)
,

, ,
.
,
,





[
/?] -2. Benke
. (2001)


,
/3.
,
Wenz . (2001)
, -

186

4-
Bio-Oss
. ,



( , ,
).

. Mellonig (2000), Camelo . (1998)

(Bio-Gide, Osteohealth)

.
Nevins . (2003)

Bio-Oss
(Osteohealth) (Bio-Guide, Os
teohealth, Uniondale, New York)


.

.



1996 .
3,0; 1,9; 3 1,7
.
,
(. 10.26-10.29).

Reynolds
. (2003) ,

,

, .

(2005),
,


,

, (
)

. 10.26. -

. 10.28.

().
Bio-Oss,
,
() (
, )

. 10.29.

( )
.
Bio-Oss (
) (
, )

. 10.27.

: Bio-Oss .

.

; - .
() 3d () (
, 10,5)

. . 10.30-10.34

. . 10.3

.
,

,
, Bio-Oss BioOss ,

( ,

).
,
,
Bio-Oss. Bio-Oss

,

(
)
(Gross,
1977).

Bio-Oss
. 10.30-10.34.

() . () . ()BioOss . (D) BioGuide . () . (F) .

. 10.30. , Bio-Oss/BioGuide.

186

188

. 10.31.

, Bio-Oss /BioGuide.
( ) . ( ) .
( ) Bio-Oss . ( D ) BioGuide
. ( )
Gore-Tex. (F )
11 .
. ( G , H ) -

,

. 10.32.

. ( )
;
II . ( , )
(-5). ( )
(RCM6[Ace Surgical Supply,
Brockton, Massachusetts]) .
( ) (Resolute,
Adapt, WL Gore Inc, Flaggstaff, Arizona)
. ( D , D )

189

190

. 10.33.

II

. 04) .
( ) II
. ( ) (Bio-Oss). (D) (Bio-Mend,
Zimmer Dental, Carlsbad, California)
. ( )
. ( F )
100%-

191

. 10.34.
,
. (,)
, ,

. ()

. (D.E)

. (F) Bio-Oss .
(G,H) Resolute Adapt,
. (IJ) 2 .

192

(). ( , ) ; .
(. L,L) 2 . ; . ,) 3 . ;
. ( N , N ) 4-5 . .
, . ,

. 10.34.

192

194

(,
).

(Stahl, 1977, 1986).
,


,

(Melcher, 1976; Aukhil et al.,
1988).



,

(McHugh, 1988).

.

,

. Caton (1980)

:

;
Widman

,

.
.

,

(Bowers et al, 1982, 1985, 1989b).
Ellegaard . (1974)
,

,

.


. (Ellegaard,
1983) ,

10-12 ,


.
Melcher (1976) ,



: 1
lamina propria
; 2 ;
3 ; 4 .
,

,

(. 11.1).



. Melcher (1962, 1976)
Aukhil . (1988) ,

:
,
(),

;
(,
) (. . 11.1).
Aukhil . (1988) ,

,
,

.

,
,


. Karring . (1980)
, ,
, . Nyman

195

. 11.1. . ( ) ,
. ( ) . ( ) . (D )
(). ( )

. (1980)

.
,
,
.

. Nyman .
(1982)
,
,

,
,

. Gottlow . (1984)
, Gore (W.L. Gore, Inc. Flagstaff, )

,
( )

. Karring .
(1986)


,




. ,
,


.

196

. Nyman . (1982)

,
(. 11.2).

5
3 .
. Gottlow . (1986)
12 (5
) 10 ,

-

.
,

,
,

,
()


, ,

, ,
,
. Caffesse . (1991)

,
,

, ,

().
(Boyle et al.,
1983; Gottlow et al., 1984; Lindhe et al.,
1984; Houston et al.. 1985)
,

.
,

19 1 . (Dines, Cohen; . 11.3).

,
-

. 11.2.
. ( )
:
,
, ,
. ()
. ()

. (D)
,




. ()
. ( F)

,
(Boyle et al,
1983; Gottlow et al., 1984; Lindhe et al.,

. 11.3.

(Millipore
Co., New Bedford, Massachusetts) (1971).
[ ) . ( )
.
.

1984; Houston et al., 1985).

,


. Gottlow . (1986)
,

(
)
-

:
,

,
,

.

Becker
. (1988) Handelsman .
(1991), ,


. Cortellini . (1993,
1993b) Tonetti . (1993)
,
4,3 2,5
40
.
100/6-
32,5% ,
50% 57,5 %
, 50% 10%
. ,




.
Lindle . (2003) Laurell
. (1998)
(78 ; 1795 )
,

:
1.

.
2.

, .
3. (,
)
.
4. (
< 27)

197

,
* 37).
5.
> 4 .
6.

.
7.
.
8.
4
5 .
9. ,
,
.
10.

2,3-3,5
.
11.

,
.
Cortellini Tonetti (2005)

,
.

, , ,

,



(. 11.4),



1 92,7 12%.

Becker . (1988)
II III
27

2,3 1,5
II III
,
3,7 (< 0,01). ,


, ,
, ,

.
.

198

I.

> 2

< 2

> 4 MMd

> 37

3-

< 4

II.

< 4 _

__>4

> 4

< 37

: , .
(Cortellini et al., 1995).
(Cortellini et al., 1999).
d .
.
, Bio-Oss, Emdogain.

. 11.4.

Pontoriero
(1987, 1988, 1989, 1992)
II III ,
(

Gore-Tex).

,
90% II 25-35%
III ,
,
20%
II 0% III
.
III
50-60%
. ,

,
III 3

.
,
3 .
Metzer . (1991)
,



II
.
Lekovic . (1989)


,

4,09 .
Selvig (1990) ,


,

,

.
Gottlow Karring (1992)

,
.
,
, -

,
.
Lindhe (2003) 21
(423
II )
:
1.
.
2.

: 2,5 1,3 .
3. 0
67%.
4.


.
5.

1,6 ,

.
6.

.
Bowers . (2003)

II
84
68 % ,
II I .

(,
, )
,
. Schallhorn McClaine (1988)

(
Gore-)

. , ,

, 72%
(33 46)
,

,

31 %
(5 16),
.

5,3 4,5

,


4,2 ( )
3,1 ( ). ,


.
Kerstein . (1992)
,

(1996, 2003) (2005)
, ,

,

,
.
McClaine Shallhorn (1993)
,

53-70 . ,



(J) = 0,005)

( = 0,003).
II ,

,
(40 %)

.

. ,
31 %
,
.
Gotlow
Karring (1992),

4-5 .

Anderegg . (1991)
(
Gore-)
.

199

( = 0,05)
,
,

.
,

. Lekovic (1990)

, ,

,

.
Stahl Froum (1991)

,

. Camelo . (2000)
89%

-.


(Garrett, 1996; Murphy, Gun-solly, 2003;
Reynolds et al., 2003) (Wang.
2005)


:
1.

,


.
2.


.
3.


.
4.

200

.

5. -

6.

.
7.

.
8.


:
;
;
(Bio-Oss);
;
:
;

:
;
;

(

);


.
9.

-
II .
10.


(III )

I
III .
. , Cortellini
. (1994)
,
50 ,
168 22
.
, (
)
.

(1989) ,

.
(1996)
,

II
,

,
,



,

,


, ,

.

Gore-Tex Barrier.
Gore-Tex
(Murphy, Gunsolly, 2003),
.
,

.

, ,


.

,

,

,
.
(. 11.5).
.

(, ,
,
,

. 11.S.
(Gore-Tex)

,
)

,
Gore-Tex,
.

1.
.
2. ;
.
.


.

1. II

,

, ,
,
,

.
,
-
,
.


2.

> 4-5 .

1.

II .
2. .

1. III

, ,

, ,

.
2. .

3.
,
.
4. :
;
.
5. (Lu, 2002;
Villaco et al., 2004)


.

1. ,
.
2.

.
3. .
4. .

1. III
.
2. .
Bowers . (2003)
,

II ,

:
1.

:
9 4 % ,


;

70% ,


.
2.
:

:
>5 , 53%;
<4 , 84%;
:
> 4 , 61 ";
< 3 , 93 %;

;

;
:
<4 , 71 %;
5 6 , 100%;

1.
.
2.

.
3. .
4. .
5. (
):
:
, , Bio-Oss;
: , ;

.
:
,
, EDTA;

;
(
).

,
,
,

.

()
.

1.

201

-
.



(. 11.6,4).
2.

.

(. 11.6,5).
3.
- /
,
,
.

. Cortellini(2005)
,
.

4.

,
.

1. .



.
2.

(. 11.6, ,).
3.

/ .
4.

EDTA.
,
,
.
5.

.
6.
: , ,
Bio-Oss, Emdogain,
.

202
.
,
.

1.

1.
.
2. ,

(. 11,6,E,F).
3.
.
.
4.
,

,

3

(. 116,E,F).
5.


.
.
6.
, , ,
,

.
7.

.
.

,

,
.

1. Gore-Tex (
)



(. 11.6, G,H).
2.

, .
3.

.

2.

3.

4.

5.

6.

,
(),
, (Reso
lute Adapt [W. L. Gore Inc, Flagstaff,
Arizona], RCM6 [Ace Surgical Supply,
Brockton, Massachusetts],

Gore-Tex,

(. 11.6, G).


,


.

2-3
.

,

.



.
,
.
,

, .

Gore-Tex

2 . (. 11.6, ).

()
1.
4-8 .

.
2. ,

.

(. 11.6,/).
3.

,

.
,
(. 11.6,/).

4.

(. 11.6, iv).
5.


.
6.
.
7.
Go
re-
(. 11.6,1).

1.
10 .


Peridex.
2. 7-10
250
100 .
.

3.
.
4.
6 .
5.

,
.
6.
2 .,
,
, .
7. ,
.
8.

.
9.

6-9 .

. 11.7-11.9;
,
,
. 11.10-11.12.

. 11.6. . G4) .

203

( )
. ( , D ) , ,
. ( ) . OF) U-
. ( G ) Gore-Tex: . () .
(.I,J) . - . () .
( L )

204

. 11.7.

. () .
12- . ()

: 1) ; 2)
; 3)
; 4)
. ( ) ,

. ( D )

. ( ) ( Gore-Tex)
. ( F )
.
( G ) Gore-Tex 10 .

. ()
12 . (/) .
5- . { ] )
( )

. 11.8. . ( )
. () . ()
. (D ) . ( )
. (F ) .

206

. 11.9.

.
( , )

14. ( , )

( , )
Gore-Tex .
( D , D )
,

207

. 11.10. I!

. (,') II . ( )
. ( ) (Gore-Tex). ( ' ) . ( D')
.

208

. 11.11.
( III ). ()
. ( ) III
. ( )

. ( D )

. ( )
U-
. ( F )
Gore-Tex. (61
. ()
.

. (/)
. (/) ,

.

209

. 11.12. . ( ) ,
. ( ) , . ( )
, III . ( D )
, III . ( ) Colatape. ( F )
. (G ) Gore-Tex.
() 4 . . ( 1 , ] , ) , . (L )

210

,


:
1. .
2.
(
).
3. .
4.
.
5.

.
6.
(
).
7.
100%.

(Bunyaratavaj, Wang, 2001),
(Murphy, Gunsolley, 2003)

(2005)
,

. ,


, ,

;

) (. 11.16)

, (Javanovic, 2004).
(

)
.
.
. 11.1 .
, .
.

. 11.1311.15. . . 9 Gore-Tex

.

(Nevins,
. Mellonig, 1992; Javanovic, Buser, 1994;
- Buser et al., 1990)
(Simion et al,
2001). ,
,
,

, ,
(G-TAM, [W.L. Gore Inc, Flagstaff,
,
Arizona]) (Fiorellini, Nevins, 2003).
.
, . Gore-Tex
:
.
1)

(
),
,
. ; 2) ,

, ,
(

),

( (. . 11.5).

11.1.

BioGide

RCM6

I III

24 .

100%- I

26-38 .

BioMend
Bio-Mend-Extend
OSSIX
Periogen

6-8 .
18 .
6 .
4-8 .

Paroguide

DPPA

100%- I
100%- I
100%- I
I III
96%- I 4%-

Osteohealth, Shirley, NY
Surgical Supply,
Brockton, MA
Sulzer Calcitek, Carlsbad, CA
Sulzer Calcitek, Carlsbad, CA
31, West Palm Beach, FI.
Collagen Inc., Palo Alto, CA

4-8 .

Coletica, Lyon, France

Resolute Adapt X
Resolute Adapt LT
Guidor
Cytoplast (Vicryl Mesh)
Epi-guide
Resolute Adapt

PGA/TMC
PGA/TMC
PLA
Polyglactin 9
PLA
PLA/PGA/TMC

Bunyaratavej Wang (2001).

DPPA - ; PGA
.

, .
16-24
16-24
10-12
3-6
10-12
8-10

- ; PLA - ; - .

W.L. Gore 8c Associates

W.L. Gore & Associates
John 0 Butler
Ace Surgical Supply
THM Biomedical
W.L. Gore & Associates

. 11.13. Bio-Oss, . ( ) . ( ) ; -
. ( ) Bio-Oss . ( D ) . ( )
. ( F ) Gore-Tex. ( G ) . ()

211

212

. 11.14.

. () . ( )
; -
. ()

. ( D)
. ( ) .
( F) 11 . .
( G,H ) ,
,

. 11.15. . ( ) .

13 , . ( ) , 13 . (C , D ) ,
. . (E,F)
, . (G,H) . (I)
. (/) 10 . . (K,L) , ,

214

,
(. . 11.18, 11.19). Buse
(1991, 1993) Javanovic (2004)



(. . 11.23).
1. :

:
;
;
;

.
2. :

.
3. :
.
.


.

.

. 11.16. . (,)
. (,) .
(, ) ,

.

.

1. .
2. .

1. .

2. .
3. .
4.
.
5. .
.

.



(. 11.17).
1.
- !

.
. ,
,
(Schenk et al.
1994).
2.
,

(. 11.17, , ).
3. (
)
i
.

,


Gore-Tex (. 11.17, ).
4. , ,

, .


5. (Shallhorn, McClaine, 1988,
1993)
(Nevins et al., 2003)

(. 11.17 )).
6.
,
.

3 .

(. 11.17,,).
7.

,

.

2 (. 11.17, ).

8. Gore-Tex


.
,
.
9.

, ,

(Beck
er, Becker, 1990) -
(Buser et al., 1990,1993).
10.
-

215

Gore-Tex
(. 11.17,/',/").
11.
,
1-9 .
.
12.



-
.


.

. 11.18-11.25.

. 11.17.
(
). (,*)
. ( , ' ) /
. ( , ) .
.
(. D , D ) ,

,
. ( , )
Gore-Tex
.
,
. (F,F)
.

216

11.17.

. 11.18.

. ()
.
. ( )

,
. ()
.
. ( D )
. ( )
Gore-Tex 5. ( F )
Gore-Tex.


. ( G )
. ( )
. Richard Shanamen,
Reading,

217

218

. 11.20.

. ( )
,
. ( )
. ( )
1-3 .
( D )
. ( )
Gore-Tex .
( F ) 6 .,
. ( G )
,
. ()

219

. 11.21. , . () . ( ) .

( ) , . ( D )
. () . ( F ) ;

220

. 11.22. ,
. ( ) . ( ) . () .
( D ) . ( ) .
. ( F ) . ( G ) Gore-Tex

221

. 11.22. (). {)

. ( )
. (/)
6 .
. ( )
,

. (I)

. ( )

. ( N )
, .
( 0 , )
.
.
Dr. Edward
Cohen, Sharon, MA

222

. 11.23.
Gore-Tex (ITI). 04)
. ( , )
. ( , ) . ( D , D )

. 11.23. (). (., ) . (F,F)

. (G) 6 ., .
() , . (/) .
(/) . Daniel Buser, Bern, Switzerland

223

224

225

. 11.24. () . ( )
2 .
. ( N )
.

. ()

. ( )
6 . . ( Q )
3 .
. ( R ) .
(5)
. Scott
Kessel Practical
Periodontics and Aesthetic Dentistry 2005

226
3. ,
,

,
, , ,

.
4. ,
.
5.
2 .
6.

250
10-14 .

,
.

10 2001

7451$

( , ' )
Memfix (Straumann, USA). ( B , B ! )
Bove.
Straumann, USA. ( )
Bio-Tac (Implant Innovations,
Florida)
. 11.25.

Gore-Tex
,

,

1.
.
2. ,
, 2 .

GTAM
1.
,

.

.
2. Gore-Tex
,

,
1
9 .
3. .
,
,

,


, :
,


, .

,
,

,
.



.

227

.

:
1.
.
2.
.
3.
.
4. ,
. .
.
5. ,
.
6.
.
.

, 2 .

.

,

.
1. .
2. .
3. .
4. .
5. .
6. .
7. .
8. .
9. .

1. 6-12 .
.
2.
(
)
.

,
,

Hertwig,

,
.

.
(90%)
.

()

(Emdogain, Strauman).
, ,


(FDA)

: , (Hammarstrom,
1997, 1997b).
,
Sculean . (2002) ,
2 .,
4 .

(Heden, 1999, 2000; Tonetti et al., 2002).
Pontoriero . (1999) Silverstri
. (2000)

. Heidi Gestrelius (2001)
FDA 1998 2001 .
,

,
.

(,
) Heijl (1997)
Hukna Mellonig (2000).

II Jepsen
. (2003) ,



. Francetti
. (2005) ,

12 .,
6 .
Rasperini . (2005)

7 .
Giannobile . (2003)


(2005) ,

.

,
,
,

.
Heden Wennstrom (2006)
(5 )



,

(5,4 , < 0,001)
(5,2 .
< 0,001) .
. (, Bio-Oss),
.

1.

-
(. 11.26, ):

(. 11.26, );

.
2.
(. 11.26, ).
3.

(. 11.26, ).
4.

24% EDTA
(Biora), pH
2 (. 11.26, ).
,

EDTA

5.

,
(. 11.26, F).
6. :


.

:
;


.
,
.

228

.
7. (. 11.26, G,
).

,
.

.
,


, ,
.


.
. ,
. ,
,
.

8. ,
,
.
.
/ ,
.
(. 11.26, IJ).

9.

, .

,

(. 11.26, " I).
.
.

10.


.
11.

:

( 0, 12%);

* 100
10-21 (Mellonig, 1999).

. 11.27-11.30.

11.4.

< 2

' 1

> 2

> 37

< 27

< 4

> 4

4
> 4

< 4 1

Cortellini Tonetti (2005) Cortellini Bowers (1995).

MMCC - (Cortellini et al., 1995);
; YCCJI - , (Cortellini et al., 1999).
, .
.
' : , Bio-Oss, Emdogain.


. 11.26. Emdogain

229

. ()
. ()
. () -
,
. ( D )
. ( )
EDTA (24%). (. F )
.
(G) . ()

. (/)
,

. (J)
,
. () . (L)
. (
Strauman, USA)

230

. 11.27. Emdogain . ( ) .

( ) - . ( ) ,
. ( D ) Emdogain EDTA. ( ) . ( F ) .
Struman, USA

*!

. 11.28. (. !> ( )
- , i,
'-. ( 1
0 | , > oiroxoi
( 1 ) ) ->
-, ,
0 1 < . (- ) Peno?m,w: -a v
Emdogain.
(F) 10 . .

. ( G ) ,
. () 26 . ,

231

232

() .
() ,

. 11.29.

EDTA. ()
Emdogain

Emdogain. (D)
. ()
. (F )
. ,

. 11.30.
. {, ) 12 . (
David . Yu, San Antonia,
). ( , ) 36 .
( Gunner Henden,
rlstadt, Sweden). {, )
5 (
Gunnar Henden, Karlstadt,
Sweden).
Straumm, USA

233

234

.
() -
,

, -

,
- ,
.

:

(. 12.2, ).
.

(. 12.2, D )
.

Carnevale . (2003)

.

,
- ,
:
(. 12.3).

-
.
,
.

.

(. 12.3,5).


(. 12.3,5).

(. 12.3, ).

24

,


.

23
Nabers 1 2. (. 12.1).


.

,
,
, (. 12.2, , ).

. 12 .1 . ,
.
() N 2 23. () Nabers
12

(. 12.3, ).

235

Newell (1981, 1984)

,

Glickman
(1958), . (1975) Lindhe
(1983).

. Newell
Tarnow
Fletcher (1984), ,

.

Glickman (1958):

I:


(. 12.4).
II:

(. 12.4, ).
III:
(. 12.4, ).
IV:


(. 12.4, ).

Lindhe(7983):

. 12.2. . (, )
, , .
(C,D ) , . ,
,

(. 12.3, D ).


:

1.
2.
3.
4.

.
.
.

/.
5.
.

I:

(. 12.5,4) ().
II:

(. 12.5,5) ().
III:
(. 12.5, ) ().

Tarnow Fletcher
(1984):

:
1-3 .
:
4-6 .

236

KOPHfli

. 12.3. . () . () . ()
. (D) . () .
.
, . - ; -
; - ; - ; - ; -

:
7 .

,
,
Lindhe (I, II, III).

. ,
,

. 12.1.
,

:
1. ,
.

237

IV cm

. 12.4.
Glickman. ( ) I II .
. ( ) IV

()

III

,
,

(
)

,

( I, Glickman)
. ,

,
(Goldman.
1958), .

. 12.5.
Lindhe. () I .
() III

()

II .

2. .
3. (
-
).
4. /.
5.
.

. (1975)

-




, ;

238

.


.
I II
(. 12.6, 12.7).

,


.



.

. ,

,

, .


(Sepe et al., 1978; Saunders et al., 1983).


(I II )
, ,
,

12.1.

,
-

Glickman (1958)
Lindhe (1983)
Tarnow (1984)

(Bowers et al., 2003).

. . 11
.

,
II III ,

(. 12.8).

,

I
I
.

2

II
II
,

III IV
III
,

"

, .
.
1 .
2 .

. 12.6,
I (Lindhe). () . ()
. ()
.

. 12.7. II (Lindhe). () . ()
. ()
. (D)


.


(Lindhe, 1983).
Hellden . (1989)

149
10 107 . (
37,5 .).
, 75 %
, 6,7% (10 ) ,
4% (7 )
15,4% (23 )

. ,

,
(. . 12.4,
12.5).

.

.


,
,
.
,


/ (. 12.9).

,
96,7%
(701 ),
(97%; 1472 ) (Fugazzatto, 2001), , ,

(65-74%) (Engquist et al.;
1991; Jaffin, Berman, 1991). Oarnivale
(1990) 3,6%
(19 488 )
5 , Ricchetti
(2004),

9,6% 11,5 (19

169 ). Langer (1981)
38% (38 100
).

(.
).

,



, ,
.

(
,
,
),

. 12.8. . [)
III . ()
. ( ) ,
,

239

.

(Haskill, Stanley,
1982),
.

. 12.9. -
. (, )

,
/

,
.



()


,

.

240

( et al., 1975, 1992; Langer et
al., 1981; Carnevale et al., 1991; Suardstrfom, 2001)
(5- )
. ,


85-100% .
.

, III IV
.

14.
(.
).

, ,
.

,
(Bassada,
1969; Langer et al., 1981).
,

(. 12.11).

, ,
, .

, ,
,

(. 12.10):
1.
/
.
2.

.
. -
3. -
-
.
- .
4. .
5. .
6.
.
, ,
7. .
,
8. ,
. - ,

.

9.
.
.
10.


,
.

11.

.
,
12.
.
.
13.

.
,
14.
-
.

(> 30%).

15.
, (. 12.12).
.
. Gher Dunlap (1980). Herman
16.
.
. (1983) ,
17.
.
.
18.
:
;

.
, ,
.
1. III .
2.
II

.
3.
.
4. .
5.
.
6.

(

),

,
.
7.
(< 3 );
.

8.


.
.
9. .
10.
.

11.
.
,
12.
.
13.
,

. -
.

(Corranza ., 2002)

1. .
2.
.
3.
.

241

. 12.1, . ( ) /.
. ( ) . ( ) /.
. ( D ) . ( ) . { F )

4.

. 12.11.
.
,
,
. ; - ; -

. 12.12.
.
,
. -
; -

.
5.
:
;
;
;

.
6.

.

242

:





.
-
- .


,
.
,
.
,
.
701L
700,
.
,
,
.
.

.
.



.

4
.

.

.



.

.
-

.

,

.
.


.
. 12.13-12.15.




(. 12.16).

.


.
Majzoub (1992) ,


86%

(< 2,04 ).
. 12.17, ,

,
.

-
.

4 6
,
.


,

(. 12.17, , ).
. 12.17, ,
7016

,
()
.
,

.

,
.

-

(. 12.17, D, D).


.


(. 12.17, , F).
,




(. 12.17, F, F).

.
Rosenberg (1988)

:
1.
,


(. 12.17, F).
2.


(. 12.17, F,F).
3.


.
4.

.
5.

(. 12.17 ).
6.

,
.

. 12.13.
. (,)
. () .
(D,E)
II .
(. F ) ,
. (G)
.

, . ( ) , ,
,

. (/) . (/) 5 ;
. (
5

243

244

. 12.14.

. (. )

. ( ) .
( D) 6 ,

. Dr. William
Irving, Needham, MA

. 12.15,
. () ,
. ()
. ()
,
.

. (D)
. () ,
;
. (F)
. {(])
. ()
5

245

. 12.16. . () . () . ()
. ( D ) . ( )
. (F ) .
Cary Golavic, Portsmouth, NH

,


(. 12.17, , ).

. 12.18-12.22.

246

. 12.17.

-
. (,') ,
.

. (, )

701L. (, )

.
(D,D)

>

247

, 12.17. (). (,')

. ( F)
,

6 . (G, G')

, . (,)
.

248

. 12.18. ( , ) , - . ( )
. ( D ) (6) . ( ) N 2 7011_
. ( F ) - ( 2) . ( G) . ()
( 3). (/) ; . (/) (4). ( , . (L)

. 12.19. - - . ( , ) ,
. () II . ( D ) , - , . ( )
. ( F ) - ;
. ( G ) , ,
. () . (I)
. (/) . () . (Z) , .
, . John
Dolbec, Easton,

249

250

. 12.21. -

. ()
. 12.20. . ( ) . ( ) -
; .

() - . . ( ) 5
, . ( D ) . .
(E,F ) , . ,
. [ C , D )
. ( G ) , ,
. () .
5 .
Dr. Bernard Croll, New York, NY
.
Dr. William Irving, Needham, MA

251

. 12.22. - . () . () 701L. ()
.

(D) . () . . (F ) 4 .

1. :

;

;


.
2. .
3. .
4.
.
5.
,
.
6.
.
7.

.

,
.

;


.


,

.

, 76%

),



.


(. 12.23).

,


,

.
,

.

,

.
.

.

252

. 12.23. - . (,') ,
. (,) .
(, ) 1 ; . Dr. Barry Jaye, Brockton, MA




. 12.2.

253

12.2.

()

()

..

:



(Tseng et al.,
1996; Brugnami, Mellonig, 1999). Doutthitt . (2001)

. Brit
ain . (2005)
in vitro ,
(BioGide [Osteo-health, Shirley, NY])

(Bio-Oss [Osteohealth, Shirley, NY])

.

,

(. 12.24, 12.25).

254

, 12.24.

. () 1 1 .
( B )
.
(C)


. ( D )
. ( )
.
(F ) ,
. ( G ) 1 .
()
.
.
Federico Brignami, Rome, Italy

255

. 12.25.
. 04) ,
N9 21. ()
.
(C) .
(D)
.
(E )
. ( F ) 1
,
. (G )
. ()
12 .

260

,

(, ,
, ).

,

.


.

aesthesis,
.


.


(Rufenacht, 1990).

,

, (. 13.1).

.

.
,
-
(Lombard, 1973).

(Lombard, 1973).


,
. ,
,
,



(. 13-2).

( Rufenacht,
1990).
(. 13-3):
1. .
2. .
3. ( ).
4. .
5. : , ,
.

(. 13.4):
1. .
2. .

. 13.1.

. 13.2.

. 13.3. - ,

261

. 13.4. ,

3. .
4. .
5. : , .

,

,


(Graves,
1951) (. 13.5, 13.6).

, ,

.
(
) (
).


,
,
. -

,


(. 13.7).

,
,
.

,


(. 13.8).

. 13.5. ,
,

. 13.6.
,

,

. 13.7.

:



.

(Gulamerian, 1963; Lombard,
1973) (. 13.9):

262

. 13.8.
:

1) ,
;
2) ;
3)
;
4) .


(. 13.10):
1) ;
2)
.
-

(Rufenacht, 1990)
(. 13.11).

. 13.9. , ,

.
,

,
(. 13.12):
1. .
2. .
3. .
4.
.
, ,
(. 13.13):
1. .
2. /
.
3.
.

,
.

. 13.10. ()
.
(, ) .
,

,


,

- .

. 13.11. ,

-
,

.


.
, /

.

263

. 13.12.

. 13.13. ,

,

,
.

(. 13-14).
,



.

(Lombard, 1973) ,

, ,

(. 13.15).

. 13.14. . () .
( ). (, )

. 13.16. .

,
(. 13-16).
-

. 13.15. {)
. ()
. ()

264


-
(. 13-17).

(. 13.18):
1. .
2. .
3. .
. 13.17. ,
4. .

5. .

,
(. 13.19):
1. .
2. .
3. .
4. .
5. .
,

( )
.
,
, ,
,
.

, -


,
.
. 14
,

(. 13.20).


,

.

.

,
,

,
(. 13.21).

. 13.19.

() ()
,

=+

. 13.18. .

. 13.20.

. ( )
. ()

.
, -
,
, .
.

()

,
1,618 1,

.





.
-,

,
. 13.21.
,

, .

,

. ,

265

,


,
.

266

,
. ,
- ,
,
.

-
,

. ,


, ,

. ,


,
,

(Rifkin, 2000).


,
. - ,
,
,
, . .

,
,

,
5
,


(Goldstein, 1998).

.
,

( )
-
;
,
,
.

. , '',
,

.


(Lumbard, 1973). ,
,

,
.

I. .
II. -.
III. -.
IV. .

I.

. (. 14.1)
1. (Annette, Berg
man, 1992, 1992b; Chiche, Pinault,
1994; Moskowitz, Nayar, 1995; Rifkin,
2000 ).

:
();
();
();
().

(. 14.2, , ):
:
;
: ;
: .

(Rifkin, 2000):

267

. 14.1. .


.

.
,

, 18-20 ;

,
36-40 .

(Arnett, Bergman, 1993) (. 14.3):

:

;
III .

:

;

.
2. (. 14.4).

:
();
(
);
().


(Ahmad,
1998).
:

;
;
.
,
,
.


, ,
.

. 14.2. .
,

( ) ( )

. 14.3.
.

. 14.4.
. -

268

,
, .

Kokish (1999)
,
,
3 ,
.
,

(. 14.5).

. . .
(Rifkin, 2000).
,
.
,
,
( ).
(
).


(Golub, 1988) (. 14.6). ,
, :
;
.

(Rufenacht, 1990).
, -
,
(. 14.7, 14.8).



.
() .
-
(. 14.9).

(Arnett, Bergman,
1993, 1993b; Rifkin, 2000; Spear, 1991; Strub,Turp, 2001; Subtelny, 1959).

:
.
: , , , .
.
.
:
.
.
, (. 14.10):
(. 14.10, ).
(. 14.10,5).
Ricketts (. 14.10, ).
(. 14.10, ):
// (G-S-P);
// (N-S-P);
/ / (
) (Subtelny, 1959).

. 14.5. .

,
. (
,
)

. 14.6. .

. 14.7. .

,
-

G-S-P

(
) (. 14.10, ).
,
(

269

. 14.8. .
, -
,

. 14.10.
. ( ) . ()
. ()
Ricketts. (D)
. () Simon
. 14.9. .

,

).

(. 14.10, ).
,


.
( )
(

).
1. (. 14.11).


:

.

.
: , ,
.
:
3 .
.
: ->,
.

- :
:
(Maritato, Douglas, 194);

:
III, II, II;
: II, I,
(Pound, 1962).

:

, ;

;

;
.
2. (. 14.12).

. -

270

,
.
85-105 (85
95 ; 95-105
).
,



.

85-105
(Arnett, Bergham, 1993).
3. Ricketts,
(. 14.13).
,

().
4 2
.
;

;

;
.
4.
(. 14.14).
:

G-S-P (//
) 165
175 (Arnette, Bergham,
1993b);
N-S-P (// ) 11
165 (Subtelny, 1959).

:
(
> 175 G-S-P):

();

().
*

( < 15 G-S-P):

();

(
);

().
5. Simon (Hughes, 1951)
(. 14.15).

() ( ), (S) (G)

. 14.11. . {,)
. ,
. (, )
. (, ) .
, .
, , ,
. (D,D)
[] [] . ,
[]
[]

. 14.12. .

. 14.13. - Ricketts

. 14.14. . () . ()
(). ()

271

Ricketts
,
.

- (1999)
.
:
1.
:
.
2. :
;
.
3.
: ,
.
4. :
;
.
5. , : ,
;
.
6. :
.
:
1.
: ; III .
2. :
.
3.
Andy Gump (
):
; II .
4. :
.
5. : ,
;
.
:
1. : :

II. -
,
- .
, , .

. 14.15. Simon.

. (. 14.16).

.
. /

C-S-G.

(G-S-P), Simon, -

:
1. .
2. .
3. .
,
:
1. .
2. .

272

. 14.16. -

. 14.17.

3.
.
4. .
5.
,

.
6. .


,
, .

.
(. . 14.16).
1.

. 14.18.

;
;
;
,
;
;
.
2. ,
,

,

(Golub, 1988).

,

(Golub, 1988; Rufenacht, 1990; Chiche, Pinault, 1994).

71% ,

(71,3%), (68,8%)
(. 14.1 . 14.17).

27,8% ,

(26,9%)
(28,3%) (. 14.2 . 14.18).
,

14.1. ,

500

352 (70,4%)

148 (29,6%)

Miller et al. (1979).

95/6 66,4-74,4%.

14.2. ,

500

352 (70,4%)

148 (29,6%)

Miller et al. (1979).

95% 23,9-31,7%.

(Golub, 1988),



.
. .
.
,
.

,

. ,

(Lombard, 1973).
Lombard (1973) ,
, ,

, ,
,
,

.
,
()

.

( -

273

);

.


,
, .
,

(. 14.19).
,
-.

.
1. ()
(. 14.20).
,
, ,
.
2. (
) (. 14.21).
(. 14.22)
,
.

:
, ;
;

;
;
,
.

(. 14.23):
1. , .
2. .
3. .


,

(Rufenacht, 1990).
/

, (Pound,
1962) (. 14.24).
Lieb . (1967)


.


.


(. 14.25).

. 14.19.
.

. 14.20.

. 14.21.

. 14.22. ,
. ()
{Orbicularis oris). ()
(Levator labiisuperioris). ()
{Zygomaticus minor). (D)
(Zygomaticus major). ()
(Buccinator). (F)
(Masseter). ( G)
(Platysma). () (Depressor
angulioris). (D (De
pressor labii inferioris). (J)
(Mentalis). (Modiolus)

. 14.23.

. 14.24. . ()
. ()
,

274

14.3.

. 14.25.
. ,
.

(Moskowitz,
Nayyar, 1995):
1. :
().
2.
:

.
3. :
().
4. .
LARS.
:
1. (Lip morphology).
2. (Age).
3. (Race).
4. (Sex).

LARS. (Vig Bruno, 1972).
1. .
,
.
16 24 .
(< 15 )

,
(> 24 )
(. 14.3).
2. .

(. 14.4).

,


.

,

(Ahmed, 1998).



(Lieber et al., 1967).

,


,

10-15
16-20

21-25
26-30
31-35

0,77

3,92
3,44
2,18

0,68

0,93
0,25

1,95
2,25

0,98

Vig Bruno (1978)

14.4.

14.5.

(
)

Vig Bruno (1978).

Vig Bruno (1978).

. ,

,

( ),
. ,
,
.
,

.
5. .

,


(. 14.5).
4 .

(. 14.6).

III.


,

14.6.

(
)
,

Vig Bruno (1978).

(Ahmad,
1998). Studer . (1996) Gold
stein (2002)




(. 14.26):
1. .
2. .
3. .
4. .
5. .
6. .

275

7. .
8. .
9. .
10.

.
11.
.
12.
.
11

: . ,

(. 14.27).

1.
,

, ,
.
, ,

(Ahmad, 1998),
,

.
(
),
,
.

, ,

(Chiche, Pinault, 1994); ,

(. 14.28,
14.29).




(Moskowitz, Nayyar, 1995; Cranham, 1999; Spear, 1999),
.

:
1. ,
,

(Spear, 1999).
2.

(Kokish, 1999)3. ,

(Ortman Tsao,
1979; Shiftman, 1984).
4. ,
,

. 14.27. -

(,)
. 1.
. 2. . 3.
. 4. . 5. .
6. . 7. .
8. . 9.
. 10.

. 14.26.

(Spear,
1999) (. 14.30).


(Shiftman, 1984).
Miller
. (1979), ,
,
,
,
,



.

,
(Spear, 1999).
,

,


(. 14-31).
Kokich (1999)

. 14.28.

. 14.29.
.

-
,


4 ,
.


2 .
,

276

. 14.30.

() , ( ) -
()

. 14.33.

. 14.32.
. 14.31.
.

30 %

,
,
,

(. 14.32).
2. ,

;


.

,

1 .


(Frush, Fisher, 1958)
(. 14.33).
Ahmad (1998)
.


,

> 45, < 90.
Struder . (1996)
-

. () . ( )
. ()
. ,

,

(. 14.34):
.

.
.
.
.
( ).
.
.

.
3. .

,
.

.



(. 14.35).
4. .

. -

,
,

.

,
(. 14.36).


(Chiche, Pinault, 1994).


:

,
(. . 14.30):
;

;
(
).
,
:
( )
( )

;
[] [];
;

.
5. .





(. 14.37).
6. .


.

277

. 14.34.

. - ,
. () . ()
. () . (D) . () . ()
. (G) . ()
. (!)

. 14.35.

. 14.36.

. 14.37.

278

,
,

(. 14.38).


( 2x2 )
.


,

(Morely, Eubank,
2000) (. 14.39).

. 14.38.

. 14.39.

. 14.40. ,

. 14.41.
,

7. ,
.


(. 14.40):
:
.
:
.
: .
: .
.
,
(. 14.41).

8.
.

. ,


,

(. . 18
),

,


(. 14.42).



(Weisgolci, 1977) (. 14.43).
* .

. 17,

9.
.

. 14.42.
.
( )
( )

-

.


(Moskowitz, Nayyar, 1995; Morely,
Eubank, 2001) (. 14.44, 14.45).
10. .
,
.

, .


,

. 14.43. . ()
. ()

(. 14.46,
14.47).
11. ().
-

279

. 14.44.

. 14.46.

. 14.45.
,
.
(. )

. ( )

. ( )

.

,

,
(Frush, Fisher, 1958).
,

, -- (. 14.48).

IV.
. .
1.

.

,

.

,
(Frush, Fisher, 1958; Lombard, 1973).
0,20,4 (. 14.49).
:
;

( [] []);
;

. 14.47.

. ,

. 14.48.

280

. 14.51.

. 14.49.

. 14.50.

(
);
:
:
;
: .


(Lumbard,
1973).
:

(37 %, . . 0,2 ).

:
;
;
* ;
.
:

( );
(
).
2. .
,

.

,
( )
(Frush, Fisher,
1958).


(3,98 ) .

, ,
, ,
. ,
,

(Chiche, Pinault, 1994)
(. 14.50).

:

.

.
.
:

;
.
3. . ,


.



(. 14.51).
.

. 14.52-14.54

.

:
.
.

.

.

. 14.52.

. 14.53.

. 14.54.

.
. .


(. 14.55),

. , . . -


,

,

, ,
(Lombard,
1973) (. 14.56).


.
,
,
, (Frush
Fisher, 1958).
,

.
Chiche Pinault (1994)

:
.

.
.
1. .
,
/,

. ,
0,75-0,80 .

(> 0,8 )
,
(< 0,65 )

(Lombard, 1973) (. 14.57).

:

. 14.55. .
.
,

, ,
.

,
,
(phi) (Phillips, 1999).
,
(
, ),
( ,
), (
(Fi
bonacci)), (
) (. 14.58).

1:1,6
:
S/L = L/(S + L) - 2/(1 + V5) = 0,618

/ =
= 0,75-0,80.
Chiche Pinault (1994) ,

8,37 9,3 ,
10,4 11,2 . ,

/
0,74 0,89 ,

Wheeler 8,0
(8,5/10,5 ) Woelfel 0,76 (8,6/11,2 ), Bjorndal
. 0,8 (9,0/11,2 ) Shellingburg 0,8 (8,5/10,4 ) (Wheel
er, 1966; Bjornaul, 1974; Wuelfel, 1990).
2. .

.

281

,

,
,

. 14.56. .
, ()
,
()

()

.
,
.
Levin (1978)

,

. 14.57.

282

. 14.58. . ( ) .
()
. ()
. (D )
. ()

.
,

.
, Levin

,

.
II . <
,
(Javaheri Shahnavoz, 2002):
;
;
;
.

.
:
= 1,68.
= 1.
= 0,68.


.
.
,
(Javaheri, Shahnavoz, 2002).

3. . ,

,
.

(Lumbard, 1973).
, Chiche Pinault (1994)
,

:

(Berry, 1905):

.

(House et al., 1929):
*/16
.

(Wil
liams, 1914):
.
(Frush,
Fisher, 1973):
,
SAP.

,


0,75-0,80
,

,

,
-
.

:
1.
-
:
;
;
;
.
2.
.
3.
.
4.
.
5. 2-4
.
6.
1-3 .
7.
.
8.
.
9. .

284

,


(. 15.1).

,

,

.
,
,

, ,
. ,
,
,
; ,

. Spear . (2006)
,




. ,
, ,
,


.

:
,
,

*
.

*

( II).

. 15.1.
. -, , .
.

,
, . .

(Cliche, Pinault,
1994; Morley, Eubank, 2001; Spear co., 2006).
,


(0,70-0,80)


,
,

(Ahmad,
1998; Cranham, 1999) (. 15.2).

285

15.1. ()
-

1,91 3,40

3,65 0,59

3,37 1,26

Vig Bruno (1978), Cliche Pinault (1994).

.


,
(. 15.1).

,

, ,
, ,
.

,
,

(Ahmad, 1998) (. 15.3).

-
, ,


,

-, /

.
,
,

.
- (Moskow- ,
itz, Nayyor, 1995; Morely, Eubank, 2001),
.
. . [] ,
(. 15.4).


, Morely Eubank
(2001)
(.),
-.

,
,
, .

. ,
,
. 15.2.
.

(-D) , -,

, ,
.
,

:
1. :

:


1-3
(Kokich, 1999);

:

,
,
,
.

(. 15.5).
2. /
:

:

;
( )

(
) (. 15.6).
3. :

,

:
F:

;
V:

;
S: Pound (1977)


.

>1,5
.
.

( > 2,5 ),
(Cliche, Pinault.
1994). F
V (. 15.7).

286

. 15.4.

. () ,
.
. () .

. 15.3. , . {,')
. (,) . (, )

4. Spear . (2006)


:
;
;
.

:
1. 8,3-9,3 .
2. 10,4-11,2 .
3.
0,75-8,0.

( -
)
. ,
-
,

/

.

-


,

(Kois, 1996).

,

.
Robins (1999) ,

,
, ,
(. 15.8).

,



.


(Spear, 1999).

288

,

, -
,
/
,
.
:
1.
.
2.
( )
(
- ).
3. .
4. .
5. .
,

,
:
1) ;
2) ;
3) (. 15.9).

:

1. :
.
2. :
(),
() /
.
3. :
.
4. .
II , , ,

,

,
(360) (Levine, McGuire, 1997).
,


(Keough, 2003).

. 1S.9.

.


,

,

. 15.8.

: (
) . (, 1 )
:
,
, -
. (, 1 )
:
, -
. (, )
.
; -
.
, . .
(Spear, 1999)

(2-4 ),
,

(10,4-11,2 ),
-

,
-

289

. 15.10. .
() . () /. ()
. (D)

(. 15.10).
:
1.
.
2.
.

3. .
,

, .
. / (. 15.11).

15.2.

-
()

- - ; - - .
;|
.

. 1S.11. . (, ')
: ()
, ,
. (,)
: ,
, .
(, ) .
, ,

290

(
),
,
( ),


,
,


.

,


, ,
,


(. 16.1).

,
(

).
Sicher 1959 . Gargiulo
. (1961)


2,04 (
0,97 ,
1,07 ) 0,69
(. 16.1). ,


(IIV)
(. 16.2).

( ) 1,80
(III I 1,77 (IV),
2,04 .

Nevins Skurow (1984)

,

.
3 ,
.
Vacek . (1994)

(,
, )
-

16.1.

III
( )
IV
( )

0,97

1,07

2,04

0,69

2,73

0,74

1,06

1,80

0.61

2,41

0,71

1,06

1,77

1,77

3.54

- .

16.2.
() ,

291

. 16.1.

. ,

( 1,75 2,08 )
15% ,
,
2,04 .

,
.


,
(,
, ).

(Gargiulo et al., 1961; Vacek et al 1994),

. Kois (1994)
Spear (1999) ,

3,0 4,55,5 . ,


.
Becker . (1997)
(
, )

(2,1, 2,8
4 ).
3,0 3,5 (Wheeler,
1961).
Spear ,
1,5-2,5


.

,
3,0

,
.

16.3-

Tarnow . (1992),
, ,

,

55,5 .


(. 16.3, . 16.2).
Cho
. (2006),
,

,
.
Van der Velon (1982),
, ,

4,33 3 .
Nyman (1977) Rusling
(1976) , 2
3,5 5,1
.

6 . (Maynard Daniel.
1977; Rosenberg et al., 1999; banning et
al., 2003; Deas et al., 2004) 3 (Kois.
1994),
.


, ,
,
.
,

,
(N)
34
5
67
8
9 10
(2) (11)
(73)
(112) (63)
(21)
(4) (2)

II , -

,

| ||\ . 1! 1 )

2 (100) 11 (100)

0 (0) 0 (0)

(%)

72 (98)

63 (56) 17 (27)

2(10)

1(2)

49 (44) 46 (73)

19 (90)

1 (25) 0 (0)
3 (75) 2 (100)

Tarnow et al. (1992).

. 16.2. . ()
. ( ) ,
I . ( ) ,
2 . - ; ; - -

292

:

(Oschenbein, Ross, 1973; Weisgold,
1977; Jensen, Weisgold, 1995). Olsson
Lindhe (1991)
.
Oschenbein Ross (1969, 1973)

. Olsson Lind
he (1991) ,

,
(85 15 %).

(Oschen
bein, Ross, 1969; Jensen, Weisgold, 1995;
Seadoun, Le Gall, 1998).

(. 17.1,4):
1. .
2.
.

3.

,
.
4.
.
5. /
.
6. .
7.
.
8. .
9. .
10.


.

, ,
,
5
, ,

(Tarnow et
al., 1992).



.

()

(. 17.1, By.
1.
.
2. .
3. , ,
- .
4. , .

5.
6.
7.
8.

9.

.

.
.


.


.

. 17.1. :
. (4)
. ()

.
Maynard Wilson (1979),

5 (3 ),
Stetler Bissada (1987),
,

,
.

293

Kois (2004) -

, , (. 17.1).

17.1.

()

()

()

- .

294

D.W. Cohen (1962)


,
/
. ,

( 4 ),


,

, ,



(Ingber et al., 1977; Rosenberg et al.,
1980; Saadoun et al., 1983; Allen, 1993;
Miller, Allan, 1996; Kois, 1994, 1996,
2004; Rosenberg et al., 1999; Spear, 1999;
Becker et al., 1998; banning et al., 2003).
,

:
, (Kois, 1994).
( )
, ,
.

3.
.
4. .
5.
.
6. .

1.
2.
3.
4.
5.

1. .
2.
.
3. .
4. .
5. .
6. .
7. / (

).
8. .
.
,
(Allen, 1993).
, ,
(
).

1.
2.
3.
4.
5.
6.
7.
8.

1, .
2. .

.
.
.
.
.

9.

.
.
.
.

.
.
.
,

.

.

1.
2.
3.
4.
5.
6.

/.

.
.

.
.

.


295

7. .
8.
.
9. .
,

295

18.1.

DGC, DGC,

>3

> 3-4,5

3-4,5

<3

<3-4,5

DGC .

(Alien, 1993)
1.
.
2. .
3.
.
4.
:
;

;

, ;

.
5. :
;
,
4 6 .
.
6. :
;


.
7. :

;
.
8.
.
.

Rosenberg . (1999)
:


3 . .

Kois (1994) ,

3 (2,04
, 1

). ,
,




(. 18.1).
Bragger . (1992) ,

3



6 .
Ingber . (1977) ,


...
,
. ,
3
,


(. Vacek et al., 1994). Herrero . (1995)
,
,
3 ,
, ,
3 . Rosenberg
. (1980 1999) Weinberg Eskow
(2000)
3,5 4 , Wagenberg
. (1989)
5-5,25 .
Pontoriero Carnevale (2001)

84
30
12 . .
,
3,7 0,8
0,5 0,6
3,2 0,8 .


(

). ,

:
1)

;
2)


.

, ban
ning . (2003), ,
> 3
,
,

3- .

Smukler Chaibi (1997)

:
1.
.
2. ,

.
3.

:
;
.
4.

.
5.


,
.
6. ,

:

296

;
.

. Dibart . (2003) ,

4 ,

.

1.

.
2. -
,
.
3.

,

.
4.

(4-5 ),

.
5. :

,

.
6. :

(Oschen
bein, Ross, 1969, 1973).

7.

, :

;


.
8.
-
, , (Becker et al., 1998;
Rosenberg et al., 1999):




;

.
9. :

;

;

.
10. : ,

.
.
,
4
.
.

,
Brassier (958; 957).

12.

,


.
13.


:

;

.

,
;

:

.
14.
:

:
(> 4-5 ):
1 ;
(3 ):
;
(< 3 ):

(
), ,

.
.

,
(6 .) (Deas et al., 2004).

. 18.1-18.7.

. 18.1. . ( ) . ( )
. ( - . ( D ) . ( ) . (. F )
. ( G )
. () ( Dr. Michael Katz, Westport,
MA)

297

298

. 18.2.
. () , . () .
. () 3 .
(D) 3 . ()
. ( F) 8 . ,

. 18.3. : . (,)
. (C,D )
. (E,F) ,
. (G,H) 3 . . (/,/) 12- 22- 32-
42-. . ( ) . ( L )
. . ( Dr. David Edwards, West
Bridgewater, MA)

299

300

. 18.4. . (4) .

. ( ) .
. () .
. (D) . . ()
. ( F. , G) . ()
. .
13- 1 1 -

. 18.5. . () .

. () . ( .
,
. (D) . () . ( F)
4 . . (G, ) ,
( Dr. Joe Nash, Brockton, MA)

301

302

() .
11 - 21- . () . () . (D)
. () 11 . .
. (F) 2

. 18.6. : .

. 18.7. . (,)
, ,
11 - 21 - . () . (D)
. ) . (F) . (G,H)
. (
Dr. Michael Katz, Westport, MA)

303

304

:
(Weinberg, Eskow,
2000).

,
, ,


(Mox-Salentign, Klyvert, 1990).



(Gottlieb, Orban, 1933).

,
,

(Gottlieb, Orban, 1922;
Manson, 1963). Gargiulo .
(1961)

:
1:

.
II:
.
,
.

III:

- ,

.
IV:

- .
II , I II
,
(. 19.1).

Goldman Cohen (1968)

. Volcansky
Cleaton-Jones (1974)


. Volcansky
Cleaton-Jones (1976)
, 12,1 % 1025
,
24,2 6,2 ,

.
1979 . Volcansky Cleaton-Jones
Black (1902),
Gottlieb Orban (1933) Manson
(1963),
.
Tjan . (1984)
7 % 14 % .

,
,

Coslet . (1977)
,



(. 19-2).

. 19.1. .
(/) .
( I I )
. ( I I I )
- .
( I V )
-

305

1.
- ,
-

.
,
Bowers (1963)
Loe, Aniamo (1966).
. .

-
, -

- .

() I,
. () I, . () II, A. (D) II, . -
- ; -

. 19.2. .

.
1,5
2 -
.
.
-
.

:
1.
.
2. -
.
3.

. 19-1

. 19.3.

. 19.3. .

I, . - I, II,

306

| I TI 1
19.1.

I-A

I-B

,
- ,
()

(
)

. 19.4.
- ( I, ). (, )
, .
() . D ) ,
-
( I, ). ()
. (F)
. ( G )
(6 . ). ( )
. .

( )

:
1. .
2. .
3.
.
4.
,

;

.
5. ,
.
6. .
, , ,
.

Davis (1999) ,


,
(
)
(
).

I- II-A
. 19.4-19.10.

 ! ; ;

307

. 19.5. - . () . () ,
. () . (D) . (E,F)
.

. 19.6.

( I-). (,) ,
.
()
. (D)
.
- . ()

. . (F )
. (GM) (8 .
). , G.H. -
.

308

. 19,7. ( I-). (,) ,

. 13-23. () -
(D) . (E,F) - - . (G,H) -
- . ,
, . (/) .
. (/) 7 . .
. (K,L ) - . . ( William
Irving, Needham, )

309

. 19.8. -
. () .

,
11 21. ()

. (D)
. ,
. (E.F)
. (G, ) -
.
,

14, 18 24

. 19.9. . I,

, -
. ( )
. ()
. (D)
. () .

310

C&P1Y
Trjbyte

Triad
VLC Provisional Material

. 19.10. Triad
. (,
) ,
,
. ()
Triad. (D)
. () .
(.F) ,
. (G)

. ()
. (/)
. (],)
.
( ). (L) .
. , . . (
Dickerman, Sharon, ; Michael Katz, Westport, )

,



.



,
3-5 (Allen, 1988).
1. ,
,

-
, .
2.




- .
3. (
)


:
:
:

-
;
. :
;

-
;

;

,

.
4.

,

(Robbins, 1999).
5.

.
6.

:
3
(. 18 ' );

:
1-2
-

:


;

1-2

;
:

;

;
> .
7. (
) ( I)
- () (
II) -
.
8.
,
.


:
* ;

;
*
.

I-A (Allen, 1988;
Kois, 1994) . 19.7.

5-
2 :
1.
-


.
2.
.
3.
.
4.

15,

.
5. -

311

,
.
. , .

, ,

,
,



(Johnson, Sievers, 1985),
, ,

(Levine, 1997).
Heithersay (1973)


. Imber (1975, 1976.
1077, 1989) ,
.
Imber (1989)

,


,

.
,
,
,

.
3-4

.

20-30

(
),
(Johnson, Sievens, 1986:
Wang, Wang, 1992).

2 . (Ingber, 1976).

, (Nemcovsky et al 2001).

312

1.
.
2.
.
3.
.
4.
:
,
;

;
;
.
5.
.

1. ,
.
2. .
3. .
4. .

1. .
2. .

3.
.
4.
.
5.
.
6. ,

.

1.
2.
3.
4.

.
.
.
.

1.
.

,
.

.
Pontoriero . (1987) zlowsky . (1988)

.

,


.
,
15


, .
,
,

. glungh . (1991) ,


-

( . 19-1119.14).

. 19.11.
. (,)

. ()
,
.
CD) . (,
F)
,

. (G)
.
. ()

.
.

. {JK)

314

. 19.12. . (, ) . () .
18. (D )
.
. . (E,F, G)
. . (
Arnold Rosen, Boston, )

. 19.13. . ( , )
. ( ) , 21, . ( D ) 21. ( ) . ( David
Edward, Bridgewater, )

315

316

. 19.14.
. (,
) . . () 4 .
. . ( D ) 1 . .
( E , F ) 3 . .
, . ((7,)
.

319

(Loe et
al., 1965; Theilade et al., 1966).

,
(genhausen et al., 1966; Simon et al., 1970,
1971; Synderman, 1972).

(
)




(Aleo et al., 1974).
,
,
in vitro (Aleo et al., 1975;
Fine et al., 1980) (Hatfield, Bauhammers, 1971); in vitro
,

(Aleo et
al., 1975; Cogen et al., 1983, 1984),
, in vivo

(OLeary, Kafrany, 1983; Borghetti et al., 1987)
(Jones, OLeary, 1978).

,


,

,

, (Wirthlin, 1981)

(Karring et al.,
1980; Lopez et al., 1980).





(Miller, 1985b)
(Yukna,
1980, 1990).


,



(. 20.1).

New York Dental Re
cord 1846 ., Younger (1893,
1897) Stewart (1899).

,

.




(Register, 1973).

Register (1973, 1975, 1976),
,


(Bang et al., 1967; Dubuc, 1967;
Ueo-mans, Urist, 1967; Urist, 1971),

. Register Burdick
(1975) ,



(pH 1,0)

2-3 . Sterratt
. (1991) ,
pH
1,42,

.

320

()

,
,

Garrett (1978),

, ,

,
3-5

.
,

.
Poison . (1984),

, ,

. 20.1 -
. ( )
.

;
. ()
/
. ()
-
. (D)

.
( )

,
,


(pH 1,0; 2-3 )
, -

321

(. 20.2).


in vitro ,



(Boyko et al.,
1980). ,
- ,

(Leighton 1982; Pol-son, Prove, 1982;
Steinberg, 1987).
-1. .'/

-a

- *. . Mg*

.

(Crigger
et al., 1978; Craig et al., 1980; Nilveus et
al., 1980; Nilveus, Egelberg, 1980; Ririe et
al., 1980; Selvig et al., 1981, 1990),




.
,


.

(Poison, Caton, 1982; Poi
son, Prove, 1982, 1983; Prove, Poison,
1982). ,


,

,

(Poison,
Caton 1982). Poison Prague (1982)
,

,
... .

, 20,2, . ()
(1 500). ()

(pH 1,0 3 ). ,
(1500). Knut A. Selvig, Bergen, Norway

(Steinberg, 1987).

(Poison,
Prove,
1982) (. 20.3),

(Steinberg, 1987).



,

,
,
(Poison, , 1983;
Wikesjo et al., 1991).
,



(,

Widman,

, )

(Cole, 1980; Shiloah, 1980; Bogle et al..

1981; Common, McFall, 1983; Frank.
1983; Stahl, 1985; Gantes et al., 1988a.
1988b; Schallhorn, McClain, 1988;
Hanes, Poison, 1989; Stahl, Froum, 1991;
McClain, Schallhorn, 1993),
(Stahl, Froum.
1977; Ibbott et al., 1985; Gottlow et al..
1986; Marks, Mehta, 1986; Handelsman, 1991; Lamell et al., 1998).

.

(Gantes et al., 1988,1991)
,

322

pH 1,0


,

XIII

. 20.3. .
,

II (
/ ;
)



(66-70%
; 44-67%
100% ).
Stahl Froum (1991) (. 20.4),
Cole
(1980),

4,5

( 1,7

.
,
,

:
1. (Daly,
1982).

2. (Aleo et al.,
1975).
3.
(Poi
son et al., 1984).
4. (Poison
et al., 1984).
5.
(Wikesjo, 1991).
6. (Register, 1975, 1976).
7.
(Boyko et al., 1980).
8.
(Stahl, Tarnow,
1985; Stahl, 1986)

(Levine, Stahl,
1972; Masileti, 1975).
9.
(Hagner, Poison, 1986) (Poison, Haynes, 1986).
.
EDTA Blonlol (1996, 1995,
1995b, 2000)

, EDTA ( EDTA).

,
,
:
1. (Bak
er et al., 1983).
2.
,
(Wikesjo et
al, 1986).
3. (Bjorvatn, 1983).
4.

(Terranova et al., 1986).

5.

(Alger et al.,
1990).

:
1.

(Golub et al., 1984).

2.

(Al-Ali et al., 1989; Papelarsi et al.,
1991).
3.
2 14
(Baker, 1983b).
4.
(Hars,
Massler, 1972).
5.

(Terranova, 1986).
,
(> 100 )
(Somerman et al., 1988),
.



(Haynes et
al., 1991). ,


(> 0,5%) /
(> 5 ).
,


,


.

323

. 20,4.
. ( )
. ( )
,
(pH 1,0). ( )
. ( D )

. ,
.

. (Alger et al.,
1990; Machtei et al., 1993; Parashis et al., 1993; Darhous et al,
1995)
.

24% EDTA
pH (7,0),



pH
(1,0) :

1.
(Blomlof et al.,
1997).
2.
(Blomlof et al.,
1996).
3.
(Blomlof, Lindskog,
1995).
4.
(Blomlof et al.,
2000 ).
5.

(Blomlof et al., 1996).

, EDTA

(Posthethwane et al, 1978;

Fernyhaugh, Page, 1983)

.
,

,
EDTA .

324

(
= 440 ),

,

(Seelich, Redl, 1979;

Baum, Wright, 1980).
(Kleinman et
al., 1976; Boyko et al., 1980)
(Ruoslahti et al., 1980)
(Terranova, Lundquist, 1981)

(Kleinman
et al., 1981; Mensing et al., 1983).

(1)

(Caffesse et al., 1978b) (2)

(Caffesse et al
1987b).

0,38/
(Smith et al., 1987).
,
(Prato et
al., 1987), Tissucol, Cortelliln . (1991)

1.

.
2.

.
.

.

3. EDTA

2 .
2-5 .
4.

1-2 .
5.

, ,
,

(
,
) (Miller, 1983, 1985; Allen,
Miller, 1989)

(
),
,
(
) (Schallhorn, McClain, 1988;
McClain, Schallhorn, 1993)

II (
)
.

, Annals ]
Periodontology (Garrett, 1996; Mariotti, 2003; , 2005)
,
,

EDTA

,
,

.

,
(Reynolds et
al., 2003).
.
EDTA
(pH 7,0).

}) .
,
/
,
.

.
.

325

,

.

:
1.
.
2. .
3. 1
.
4. .
5. .
6. .
7.
.
II . Pagliaro . (2004) Clauser
. (2004) (1970-2000)
,

. , :
1, (
,
,
) .
2,
.
3- 1-2
.
4 -

2 .
Hwang Wnag (2006) Boldi . ,
,
. Pini-Prato . ,

- .

. Sullivan Atkins (198, 198)
Hall (1984)

.
, ,

,
20%
(Mlinek, 1973).

,

, ,

.
1972 1982 .

(Hawley, Staffilino, 1970; Ward, 1974; Livingston, 1975),

Miller (1982, 1985b)

,
,
, ,
II (
).

( Holbrook, Ochsenbein,
1983; Ibbott et al., 1985; Bertrand, Dun
lap, 1988; Borghetti, Gardella, 1990; Tolmie, 1991),

,
.

Baker
Seymour (1976),

.

(. 21.1):
1.

.
2.
.
3.
,
.
4. ,
.

Sullivan Atkins (1968)
:
, ,
, .
, ,


. Miller (1985b)
,


.

-)

II

ill

III

. 21.1. . (,') . ( ') . (, )

, , . (D,D")

, 21.2 . {,) I . ( ") II . (, ) III . ( D") IV .

-

I .
(
).

/
. :
. : . :
100% (. 212,).
II . .
/
. :
. : .
: 100%
(. 21.2,5).

III . II
. :
.
:
. :
100% (. 21.2, ).
IV .

. :
. :

. :
(. 21.2,0).

. 21.3.

(. 21.3,%):
1.


, ,

2.

3.

4.

5.
6.

7.

8.

,
.

.
(pH 10)


3-5 (Miller, 1982).

,


.

,

,
,

(. . 20
),

. ,

,

(. 21.3,5).


,

4-6

(. 21.3, ).

.

1,5-2 (Miller, 1982)
(. 21.3, D').



(. 21.4, 5).


.

(Hol-brook,
Ochsenbein, 1983).

(3-4 )
,

(. 21.3, D,D).
9.

,

(. 21.3, ).
10.

(. 21.3,5,/:).
11.
( 21.3,5).

. 21.4-21.6.

Carvalho (1972) Holbrook Och
senbein (1983)
,


.
,

. , ,
,
- .


,

(. 21.7),

1.

,

, , Sul
livan Atkins (1968),


(. 21.8, ).
2-3 .

2.

,
(. 21.8,5).
3.


(. 21.8, ).
4. . 21.8, D

,

. . 21.8, 5

. 21.3, 21.6 21.9.

Goldman . (194) Matter

(1976, 1980)

.

.
,
,
(. . 21.9).

.
1965 . Harvey
,

,

.
. Bernimoulin (1975)

,
.

.

. 21.3. . { , ' ) :
. ( ) . ( ' ) . ( D ' )
. ( , ' ) . ( ) 8 .
. - ; - ; - -

. 21.4.
. ()
. . ()
. II .
( ) ,
. (D,E)

. (F) .
( G )
. () 2 .
.

, 21.5. . (/) . ( , ' )

, . ( , ) II , . (
D ' ) .

. 21,6. . (, ') .
. ( , ' ) , , . { , ) . ( D . D ' ) 7 . .

. 21.7,



.
.

. 21.8.
( Holrook Ochsenbein). G4)

(). ( )
(). ( ) ,

(). ( D ) /

. ( )

. - ; ; - ; -
;

. 21.9.

32 31 . ()
. () ,
. ()

. ( D)
6 . . ( ) 6
.

Allen Miller (1989)

8 (97,8%)
.


.

1.
.
2.
.

(> ).

1.
.
2.
.
3. .
4.

.
---sgsgsssss " - - ' , t

. 21.10, ,


.

,
, ,
,
.


,
,

.
(pH 1,0)

3-5 .

-
(. 21.10, , ),

.
,
. 15


.

,
.
.
(. 21.10, ,
) 1 -
.

,
,
.

.
,
.

. . 21.10, D
(.
. 21.11).
. 21.12-21.14.

, 21.10. , . { ) .
, (). ( ) -
, ().
(). ( ) , . . (/)
. ( ' ) - . ( )
, , . ( 1 ) 2
. . - -

. 21.11. . (,) . , ,
, .
. () . (] ) - . { . - -

. 21.12. . . () . () . ,
() ('). () . ( D ) .
( ) . ( F ) .

. 21.13. . (,') . (,) -

. ( ) (, ) ( ) .
(D,D) . -

. 21.14. . {,) .
. (,) , . {, )
. (D,D) . ,

,


(Karring et al.,
1971),
, (Edel, 1974; Becker
Becker, 1986).
Langer Langer (1985)
,
,


. Nelson (1987)


90%.

(Nelson
1987; Harris, 1992),

.
,

.
Jahnke . (1993),

,
( < 0,03)
.

.
2. .

,
,

.
1.
5-6

15.
.

(. 21.16,4,4).

1.

1. ,

.
2. ,
.

1.

2.

3.

4.

1.
2.
3.
4.

.
.
.
.
5.
.
6.
.

5.

,
,
, ,
.

.


(pH 1,0
3-5 ), ( 3-5
) EDTA (pH 7,0).
15
,
(
).


-


(. 21.15, , ).



.
(. 21.15, ).

,

(. 21.15,0).

II .
,
.

,

,

.
2.

3
15.

.


(. 21.16, , ).
.
2-3
1,5-2 .

3.


.
,
.

(. 21.16, , ).
.

,
(
),
-
.


; ,


.

.. 21.15.
:
. () . ()
. ()
. (D)
(),
. ()
()
,
. ( F )
. - ; -

4.

(. 21.16, D,D).
5.

,

(. 21,16, ,').

6.

(. 21.16, ').
Monnet-Corti . (2006)
,

,
, 100%

5 93%
8 .

, 21.17.

3
. 21.16,
:
( ). (
') ,
5-7 ,
. (,' )
,
2-3 .
,
()
1,5-2 ,
. (, ')

1. 15

.

.
2.
,

.


(. . 21.15, ).
3.
,

,
.
,
,
(.
. 21.15, ).

3
. 21.16.
:
( ). (,
) ,
5-7 ,
. ( , ' )
,
2-3 .
,
()
1,5-2 ,
. ( ')

1. 15

.

.
2.
.

.


(. . 21.15, ).
3.
,

,
.
,
,
(.
. 21.15, ).

. 21.16. (). ( D)
.


. [,)
, .
(F,F) ,

, .
,

.
,

.

4.

,
,

(-3).
,
(.
. 21.15, F).
,
610 .

Langer Langer (1992),

:
1.

.
2. .
3. .

4.

.
5.

.
6.
.
7.
.

. 21.18-21.32.

. 21.26-21.28.

. 21.29-21.31.

. 21.17. I. . (,)
.
.
.
(,)
.

. {, )
1. (D,D)
2.
()
.

. 21.17. I (). (F,F )

. (G, (?)
() .
(. )
, .
(D
. (/) . (
Dr. Roger
Wise, Swampscott, MA
Quintessence Publishing )

. 21.17. II. ( ) .
. () . ()
. ,
. () . (D)

. 21.18. . ( ) . . ( ) . ( ) - . ( D )

, . ( )
, . ( F ) . ( G )

. 21.18. { ). () , . (/) .
(/) ; - , . ()
. (L)
. () ( ). (N)
. (0) . ,
. ( )
(: 1 , 4 ; : 2 - , 3
). (Q) . ( R) 6 .
. ( S) . . -

. 21.19.
. (,) . (, )
. . (, ) . (D, D)
.

. 21.20. 04) 23- 24- . ( )

. ( ) . (D) , . ,
2 . ( ) .
( F ) 6 .

. 21.21.
. (1,1, C1,D1,E1) , , :
. [2,2, C2,D2,E2) . , . (,, C3,D3,E3)
. (. 4,4, C4,D4,E4) .
(45,-65, C5,D5,E5) 6 ., 5 , 2 , 12 10 .

, 21.22,


. ( ) :
. ()
. ( )

. ( D )
. ( ) 4 .:

. 21.23
. () : . ( )
. ( )
. ( D ) 4 . ( ) 5 :

 . 21.24. . ( ) . . ( )
; . ( ) . CD)
. ( ) . (F )
.

. 21.25.

. ( )
:

. ( ) ;
. ( )
. ( D ) . ( )

. ( F )
1 2 , 1 1 21 . ( G )
. ( ) 3 .
.
George Goumenos,
,

. 21.26. . ( ) . ( )
; . () . ()) ( )
. ( F ) 10 . 100%-

. 21.27. . ( ) .
. ( ) , . ( )
. ( D ) . (. E , F )
( - Michael Katz, Westport, )

. 21.28.


. [) .
(B)
.
(C)
, . (D)
. ()
. ( F )
. ( G )
8 . () 5

. 21.29. . () :
. () . () . CD)
-. () . ( F ) . ( Dr. Scott
Kissel, New York, NY James Hanratty, Swampscott, MA)

. 21.30.


. ()
: 23. ()
; . ()
.
(D)
.
(E) . ( F )

. (G) . D.
()

Nelson
(1987)

Langer
Langer (1985).

.

.

( 7 10 ) 88%
. Harris (1992)
97,4%
,

.


,
.

1. .
2.
.

,
.

. 21.33 (
) 21.34 (
) .
1.

.


.

2. 15

(. 21.33,
21.34, ).
-
.
3. (. 21.33,
21.34, ),


(. 21.33,5 21.34, ).
4.
,
(. 21.34, ), .
4-0
5-0, -3 (. 21.33,-F 21.34, )

. 21.37-21.39,
. 21.40 21.41.

. 21.31.
. () :
,
() . ()
.
(D)
;
.
(E)
.
(F )
.
(G)
. () :

() :
10 . () . ()
. (D) . (,) 4 . 1
. 21.32. .

. 21.33. : . () : . ()
, . . ()
. (D) . ()
. (F) . ; - -

. 21.34. (): . ()

. () . () . (D)
. () . (F) .
. - ; -

. 21.35. .
. {) : . ( ) . ()
. (D) . ( ) . (F) 8 .: 100%-
. . - -

. 21.36, .
() . ( ) . ( ) . ( D )
5-0. ( ) . ( F ) 7 . .
- -

. 21.37. () . () . () . . (D)
. ( ) 4-0. (F ) 12 .;
100%- . SCTG -

. 21.38.

. () ;

. ( )
. ()

-
5-0. ( D ) ^
.
( ) . *

. 21.39.
. () :
. () ,
() . ()
. ( ) . ()
. ( D,D) 8 .: 100%-
. - -

. 21.40.
. . ( ) : . () : - ; , . ()
. (D) . ()
. (F) 8 .: 100%-
.

. 21.41.

. (1,2,,
4)
:
.
(1,2,,4)

. (Cl, 2, ,
4)

4-0 6-0. (D1,
D2, D4)
. (1,
2,,4) 8-12 .

.

. -


,
,
Tarnow (1986).


2-3 .

2.

1. .

.

2.

2-3 .

1.
,

.
2.
.
3.
.

1.
2-3 .

1.

( ).
2.
. 21.42, , .

.
3. 15
,
(. 21.42, ) .
.
4.
,

(.
. 21.41, ) .
.

(. 21.42, ).

5.
,

2

(. 21.42,0).
6. ,


(. 21.42, ) .
7.
-
, 5
.

,
(
)
(. 21.42, ).

. 21.43 21.44.

. 21.42. . ( ) . . ( ) ,
. ( ) , . ( D )
. ( ) . ( F ) . -

. 21.43. . 04)
. ()
. ()
. ( D )

. () 3 .

. 21.44. : . ( ) . () ;
. (C,D) 1 . (E,F) 1 . .
- Dennis Tarnow, New York, NY


1.
.
2.
.

15

(
, , ,

).

( )

-

(. 21.45, , ).


,
.

(1,5-2 )

(. 21.45,5).

, -

15
(. 21.45, ).
4.
-
-

,
(. 21.45, ).
5.
,
(. 21.45 ,D).
6.

2
.

(. 2145, ).
7. ,

(. 21.45, F).
8. 10

.

. 21.46.

() :
. () ; . (D) .
() - . ( F )
,

. 21.45. (). ( ) : .

. 21.46. . () . ( )
. () . ( D ) . ()
. ( F ) 5 .

Carvalho . (1982)

.


,

.

,
(. 21.47,).

(. 21.47, ).

,
.

)
,
, 5-0
(. 21.47, ).
21.47, D,

. . 21.47, F
.

(. 21.48).

Cortellilni . (1991), Tinti
. (1992), McGuire (1992) Pra
to . (1992)

(AlloDerm[LifeCell Inc. Palo Alto,
California])

Miller (1985),

.
Langer Langer (1982)

.
,
,

.

,
.
.
:
1.
.
2. :
;
;
.

. 21.47,, ( Carvalho). () ()
. () . ()
(); . (D) . () ,
. (F)

. 21.48. ( ). ()
. . () .
() . (D) . () . (F) 1 .
(: JC Carvalho, FE Putiglioni, and S Kon. Combination of a connective tissue pedicle flap with a
free gingival graft to cover localized gingival recession. Int J Periodont Rest Dent 1982;4:27)

 :
1.
.
2.
.
3. .
4. .
5.
.
6. .
7.
.

:
1. (Callan, 1990).
2. (Yukna
et al 1977).
3. :
* Guidor (Guidor AB, Huddinge,
Sweden) (Harris, 1998);
Gore-Tex (Pini Prato et al., 1993;
Jensen et al., 1998);
Biomend ( Wang et al., 1999);
Bioguide (Burns et al., 2000);
Epiguide;
> Emdogain;
Vicryl (DeSanctis and Zucchelli,
1996).

,
:
1.
.
2. .
3. .
4. .
5.
(Gore-).
6.
(Guidor).



.
(AichelmanReidy et al., 1999, 2001: Harris, 1999
2000, 2001, 2002; Henderson et al., 2001;
Mahn, 2001; Novaes et al., 2001; Tal et al.,
2002)
(87-96%)
,

.
Cores . (2004) Woodyard
. (2004) ,

.

(Cummings et al., 2005)

.
Mi' U (Harris, 2004) -

, 5 ,
.

1. .
2.
.
3.

.
4. .
5. .
6.
:
: ;
;
:
;

;
.


:
1. .
2.

.
3. .

1. .
2. .
3. .
4.
.

.
,
,
,
.

,
,

,

(7 ) (James, Klein, 19 7 4).

,


(
)

-,

(Livesey et al., 1994; Wainwright et al..

1994).

(14-21 ),
(4-5 .) (Wainwright et al., 1996).
,
.

, ,
,

.


, . .
.
1
II ,
,

,
,

(. 21.49).
(2003)
(2005),

 . 2 1 . 4 9 . . ()
. ( ) . ()
. ( D ) .
( ) . ( F )

. (G) . ( )
1 .
.
Biohorizons

. 21.50. . () . ( )
. () . ( D )
. Biohorizons

 .
,




.

10 , 4 .

40 .

,
,

(. 21.50).
II {1 >1 .
37 .

1. .
(
, );
:
100

.

,
.
2,
.

,
,
, .
(

.)
,

, .

50
.


5 .

.
, ,

. 21.51. .

, . (
Biohorizons)

.


50

.

5 .

40 .

,
,

.

.

,


.
,

10 .

1.
,

,
,
.
,

.


(. 21.51):

:
.
:

.


.
:

, ,
.

,
,
.

i I . , .
(
), .

.

1.

'
.
2.

-
3-5 ,

.

.
.

:
1. .
2. .

5.

. ,

.

1.

.
2.
(,

).
3.
:
(pH 1,0);
EDTA (pH 7,0)


;
(100-125 ).
4. / :
-
(X);
X
;
(
)
X.

. 21.52.
. ()
. () .
. ()

. (D) 5-0. ()
1

()
.

.

(Allen, 1994, 1994b; Harris, 2001;
Novaes, 2001).
, .. ,
.
1.

.
2.

.
3.
.
4.
(
),
1-2
,

.

. . (2004) , ,

,
.

5.

.
6.
;


-
.
7. ,

.
8. ,
,

4-0, 5-0

6-0.

.
3-4 -
.
, .

, , . Dodge '.
(1998) ,

,


(. ).

9.

4-0 5-0, 5-0
5-0.

10.

-
(ISO-Dent,
Ellman International);
, Harris (2002).
11.
(. 21.52,
21.53).

-
.

.
1.

.
2.

.
3.

.
4.
, 3-4
.
5.

.
.

,
.

6.

;
.
,

- .
7. ,

( 3-4
).
8.
(Dodge et
al., 1998; Henderson et al., 2001):

- ;

(

);

.


.


;

. 21.S3.

. (,) :
N? 13-24. {,) ( ) .
(, ) () ( ). (D,D)
5-0. (, ) 10 .



-
;

5-0

5-0

-
.
9.

5-0,
5-0,
5-0 Gore- 5-0.
.

/
,
.

10.

0,12%
.
. . 21.54-21.56.

1. 0,12 %.
2. :
50 1
14 ;
50 3
10 .
3. ( ).
4. 1 18 (

):
1-3- : 3 ;
4-5- : 2 ;
7-9- : 1 .
5.
(
2 ).

.

, , .

.


.

. 21.54. . () . ()
. . () .
Dodge. (D)
( Dodge). () .
( F ) . . 100%-

(. 21.56-21.59).

(Mahn,
1999).
:
1. .
2.
.
3.
.

1.

.
2.

.
3.

Orban
(

)
(
).
4.

5-0.
5.

4-0 5-0,

(. 21.60).
. / ,

.

. 21.55.

. (,) .
()
; Dodge.
(, ) 5-0. (.D,D)

[,) :
. () . (D) Dodge. () .
(. F) 10 .: 100%-

. 21.56. .

. 21.57. . ( ) . . ()

12-22. () . CD) .
() . (F) . (G) 4 .
. ( ) . (I) . (/)
. () . (L) . . (
- Richard Rossman, Randolph, )

. 21.58. . ()
. 22. ()
. 23 24 . () . (D)
. ( ) 20() 7(B) 6().
. (F)
. (G) . ()
. ( 8 . .
. . (J) (2- ). ()
. . ( L )

. 21.59.
. ()
:
. () .
(C)
.
(D)

377

.
,


.

Seibert (1983)

:
I.
-

-

(. 22.1).
II.
-

-
(. 22.2).
III. -
-
,

(. 22.3).

Meltzer (1979)




. Seibert (1983, 1983b)
,

. . 22.4
22.5

.
,

(. 22.5, G).

.


.

,
.

. 22.1, I

. 22.2, I

Garber Rosenberg (1981)


.
-

. 22.3. III



,

,
.

Langer (1980) Abrams (1980).
. 22.6,


,
.
15
,

(. 22.6, ).

.

4-0 5-0.

(. 22.6, ).


. . 22.6, D


. . 22.6,


,
.
. 22.6, F

,
.

. 22.7-22.9.

1985 . Allen .

,
Kaldahl . (1982),
,

.

. 22.4.
III. ( ) III.
. ()
. . () 2 .
.
.
- . (D)
- . () 2 .
. , , 10.4,
(F) . Dr. Jay Seibert, Philadelphia, PA

. 22.10, , .

6-12

.

.


(. 22.10, ).

(. 22.10, , D).


,
. 22.10, , F.

379

. 22.5. 2- III . {)
. III . () .

. () . (D) . ( E,F ) 2 . .
.
. (G) 2 . ,
. ( ) . ()
. (/) 14 .
( 2 .
. (I) (1 ). Dr. Jay Seibert, Philadelphia,
PA

. 22.6. . () - .

. () . ()
. (D) . () ; .
( F) :

. 22.7. . () . .

( ) . () . CD)
. ( F ) 3 . . Garber D, Rosenberg .
. Compend Contin Educ Gen Dent 1981 ;2:212

. 22.8. . ( A) ; I . ( ) . ()
. ()) . () 2 .
. . ( F)

. 22.9. . (, )
; . ( )

. (D) ,
; . () .
. ( F)

,
.

, ,

(. 22.10, F).

. 22.11.
.
,
.

1.
.
2.
-

.

1.
.

1. .
2.
.
3. .
4.

.
5. .

1.
15

(

) (. 22.12, ).
2.
'

(. 22.12, ).
3.

.

-

.

,

(. 22.12, ).
4.
,
,

.
5.
(. . 21
)


.


(. 22.12, ).
6.


.

(. 22.12, ).
. 22.13-22.20.

. 22.10. : . 04) ; .

()
. ( ) ; . ( D )
. ( ) . ( F )
. ( G )

. 22.11. : . () ;

. () . () . ,
10-15 . (D)
. () - . ( F)
. (G,H) : . ,

. 22.12. . {) . ()

. () . (D)
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. -

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:
(). {, )
:
III . ( )

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. (,
)

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. -

, 22,13. (). (G, G') .

() , . ( )
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. ( L , ) :
. - -

, 22.14. I . () :
I . () . ()
5-0. (D)
. () .
. ( F)
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, 22.15. II . (,) : .
() II , 1 3 x 5 . (D) . , , ,
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. 22.16.
II .
() .
. () -
. ()


. (D)


. ()
.
(F) . (G)

. . ()

. 22.17. II . () .
( 22). (C,D)
III . () : . (F, G) . ()
. ()
. (/) ; . () 3 . .
. (L)
. ()
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. 22.18.

(
). ( ) .
111 22 II 23.
II .
()
. (D)
.
(E)

.
( F ) . ( G)
6 .

. 22.19.

( ).
() . ( )

1 0 x 5 . ( )
. ( D )

. ( )

. (F )

. (G )

. ()
.

394

. 22.20.
. () . 11 21
. ( ) , ,
. ( )
. ( D ) 3 .
()
. . (F )
. (G ) (
). () . Dr.
Scott Kissel, New York, NY

Siebert Louis (1995, 1996)

III .

.
1.

.
2.
.
3. .
4.

:

-
;
- .
5.

.

3.

1.
15

1.
(.

),
15.
2.
2.



Siebert Louis (1995, 1996)


.

.
.
, .

.
.

3.

1.

.

.
.
. ,
, .
2.
4-0.

. 22.21 22.22.

(Siebert, 1992)
,
, ,
-


.

I .

,

,
.

1.

(4-0 5-0) -3.

2.

.
3.
.
4.


.
.

. 22.21. . ( )

, .
. ( )
.
. ( )
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. { ) .
(F)
- ,
. ( G , H )

, .
.
. 22.5.

(, )
, . . ()
. (D)
. ( ) .
. (F ) . (G) . ( )
. (/, /) . .

. 22.22. .

Greenstein (1985) Ashman, Bruins
(1985).
Cohen (1988)
,
,

.



.



, .

,

, ,

(Amler et al., I960; Atwood,

1963; Carlson et al., 1967a, 1967b; John
son, 1969; Pietrokows, 1969; Abrams
1987; Lekovic et al., 1997; Lekovic et al.,
1998; Isel-la et al, 2003; Schropp et al.,
2003).


(1,5-2 )
40-50% 6-12 .
,

3 .
(Schropp et al., 2003). ,
,
,

,
,
(Lekoic et
al, 1997,1998; Isella et al, 2003).

,
.

1. .
2. .
3.
.
4. :
;
.
5.
:
;

.
6. .
7. .
8.
.
9.
.

(Saadoun,LeGall, 1998)
1. .
2. .
3. (Oschenbein,
Ross, 1969; Weisgold, 1977).
4
(Tarnow et al,
1992, 2003; Cho H-S et al, 2006).
5. .
6.

(),

()
(Tarnow et al, 2000; Gastaldo et al,
2004).
Kois (1994, 1998) Spear (1999)
1,5-2,5
(3 ) (4,55,5 )
. Kois (1998) :

,
3
, .





()
(Kois,
1998).

;
,
:
.
.
.
.
.
II.
,
. 23.1.
.

1.
.
2.
:

;
,
.

(. 23.1).

,

.
4.
:
;
;
- .

,

.

1.
2.
3.
4.
5.

.

.
.

.
.

1. .
2. .
3.

.
4.

.

(Sottosanti, 2003)

:
1. .
2. :
;
.
3. :
.

(. 23.2),
,
.

.
1.
(Langer, Calangar,
1980) (. 23.3-23.8).
2.

(Landsberg, Bichacho, 1994)

(. 23-9).
3. Bio-Col (Sklar, 1999) (. 23.10).
4.
(. 23-1123-15):
;
:

(4-6 .);

(4-6 .).
5. (Misch, 1998)
(. Alloderm).
6.
(. 23.15):
(Misch, 1998; Kois,
Kan, 2001) (. 23.16);

(Kois, 1998; Spear,

1999; Sklar, 1999) (. 23.17,
23.18).

.
.

.
1. :
15;
;
;

:
Neumeyer-;
701L.
2.
15

(
).


.
2.

2-3
.
3. .
4.



,
.
5. ,

.
.

. 23.2 . ( ) () . ( ) . ( )
() . CD)
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. 23.3. , . { ) . 12- 22-

. ( ) . ( )

. 23.3. ( ). (D)
. ()
3 . (F )


; -
. (G )

. ,

. () ;
.

Dr. Richard Rossman, Randolph, MA

. 23.4. . ( ) . () 12- 21-

; . ()
. (D) . ()
. ( F )
. (G ) . ()
. .
Prosthetics courtesy of Dr William Irving, Needham, MA

. 23.5, . ( ) 13 , .
( ) . ( ) . ( D )
. ( )
. (F) . (G)
. . ()
. Richard Rossman, Randolph, MA

, 23.6. . 04) . ( ) - 24. ()

. ( D ) .
4-0 5-0 2 . ( F ) 4 .

()

. 23.7. . () .

() . () .
. (D) . ()
. (F )
. (G) . () .
. Dr. David Edward,
Bridgewater, MA

404

. 23.8. , . ( )
(); . ( )
21 22 (). ( ) 21 - 22- . CD)

. ( ) . (F )
. (G , H ) .
. ( Dr. Michael Katz, Westport, MA)

. 23.9. / . () . () 11
. () . (D )
. () . (F) . (G) .
(. )

. 23.10. . Bio-Cal. ( , ) .
12, 21 . .
()
. (D) ( 12 -
; 21 Bio-Oss). ( ) Collaplug .
. ( F )
. ( G , ) .
.

. 23.11.
. () . (,
) : . (D)
. ( )
. . ,

, (),
. .
(F ) . (G )
. ( )
. ( I J ) , .

.
, (Gore-)

!1

408

. 23.12. /


. ( ) . ()
;
. ( )


. (D) ,

(Gore-TEX). ( )
. ( F )
: ,
100%- .
( G )
. ()
.
Dr William Irving,
Needham, MA

. 23.13. , () . 21, : . ( )
, . , . () () .
22. ( D ) 6 . .
( ) .
. ( F ) , . (G )
. () .

. 23.14. . () .
31 41. () 31 41;
. ,
. () ( Rocky
Mountain). (D) Gore-Tex. ( ) .
( F ) Gore-Tex 2 . . (G ) .
{) .

. 23.15. . 04) .

() . () ,
. (D) -
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, 23.16.

. (4) .
11 21
. ( ) 11 21.

. ( ) .
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. ( F )
.

.
( G ) .
()
.
. S.
Silverman, Massachusetts

. 23.17. . () . ( ) ;
11 - . ( )
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. . ( )
(3-4 ).
. ( G , G ' ) -

. 23.18. , . ( ) . ( ) ;
. (C , D ) . ()
. (F )
. (3-4 ). (G ) , ()
. . ( I ) . ( ] )
. ( ) . (L ) .
, . Dr. David Edward,
Bridgewater, MA
.

.

6.

,


.

.
. Horowitz ( 2 0 0 6 )
.

7.

.

Neumeyer
701L
-
.
.

8.



.

.


(
(. . 23.2, ).
,
CaS0 (
)
-
2

.
12.
.
(Sottosanti, 2003; Guarnieri, 2004).
9. . ' .
, (/ Bio-Oss
/ - CaSOj. 4:1 (.
. 23.2, ).
.

13-

(CollaPlug),

(
.

) ,

.
,
10.

-
,

(. . 23.2, ).
< 1 p H ;; ,
3-4 .
,
()
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.

,
14.
,
(. . 23.2, E,F).

15.
.

-
,



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1,5
.
.
11.
16. 4 .

1 .

23-1.

23.2. ,


( ,
, ,
, )

Meln ick n Camargo (2004).

416

,

. ,
,

(Takei, 1996; Azzi et al 1999,
2001) Neurcovsky
(2001)

.

onepai Takei
(1996)
,

.

, Azzi .
( Azzi) (1999)
.

3.

(360)
(
15).
4.
,

,

.
5.
360 .
,

6.
3-5 -
,

.
.

7.
,


.
8.
.

2.
-

-

.
, EDTA.

9.

.
10.



Orban.
.

11.


,
,
.
12.


,

3-0
4-0.
.

,
. .

.

1.

13.

,

(4-0 5-0, -3,
Vicryl) .

,
.

14.

(
4-0, 5-0)
.

. ,
.

. 24.1-24.3.

,
( )
,
.

.


(Sclar, 2003)
.

(Sciar, 2003 )

1.
.
2.
.
3. .
4.
.
5. .
6.
.
7.
.
8.
.

1. 10 .
2. 4
.
3. .
4. > 4-5 .

-
1. 15

, 24,1, { , )

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. 24.2. ( Azzi)
. ( ) : . ( - D )
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Orban. . ( . { ] ) .
D . ( ) . 23-

. 24.3. . Azzi. (, ) ,
5 - , 22- 23- . (\ ')
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.
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(
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.

5.


.
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8-10 .

1.
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2-3
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15 .
3.



.
4.

15

.

7.

()
Prich
ard
.
8.
,

,

.
9.
;

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,

(Sclar,
2004).
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.
,

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, .

,
.
12.
.

.
11.

13.

:
.
,

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. 22
>>),
,

.

.
.

-




,

.



.

.


.

.
,
(CollaCote, CollaTape, CollaPlug
[Integra Lifesciences Corp. Plainsboro, NJ]),
.

. 24.4-24.6.

. 24.4. . ( ) ;
. . () -
( ) . ( )
. ( D ) . ( )
. ( )

. 24.5. . ( ) . ( )
. ( D ) . ( ) .
(. F ) . ( G ) . ()
. (/) .
(/) . ( ) . ( L )

. 24.$, (). () . . (N, )

. (, Q) 4 .; . (R, S) ;
.

. 24.6. . ( , ) . ()
. (>) . ( ) . ( F , G ) ,
. () . (I ) . (/)
. ( K , L ) . .
12 11

-.

):
1. :

.
2.

:
.
3.
:
.
4. :
.


,

(Erikson, 1938; Fastlicht, 1959).


(2:1),
(Johnston, 1969; Gensior, Strauss,
1974),
(2/) (Bass, 1967). ,
,

(Smukler et
al 1987):

1.
.
2.
.
3.
.

:
1. (Stock,
1938).
2.

(Clark, 1971).
3. (Von der
Heydt, 1975).
4. (Prescott, Boldberg, 1969).
5- (Hunt
er, 1983).
6. (Ziegler,
1977).

:
1.
(Lappin, 1951);
2.
(Gensior, Strauss, 1974).
3. (Vanarsdall, Corn, 1977).


.

,


.

,

. Vanarsdall
Corn (1977), ,

(Clark, D. 1971), -,

.

:
1. .
2.
.
3. .

- .

, ,


(Richards, 1980). Clark
(19)
(,
)
(. 25.1, 25.2).

,
. 25.1. Clark,

. /!

,
.



30
.
.

,
:
27 (

30

).

,
( , .
-
)
, .
,
.
,

,
.

,

.
, ,
, .

1. ,
,

.
2.
:
: 1:100 000
1:50 000 ;

,

;

. 25.2. . () . ()
, . ( ) , .

;
;

;
4-0 5-0
-3;
.

,
, , .

.


.

,


.

1.
- .
2.
.
3.
2-3
-
.

1. .
2.
.
3.
-
.

1. Kirkland
15
.
2.
,
, .
II

1.
- .
2.
.
3. .

1.
.

1.

15 15.
.
2.
,

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.
3.
,

.
4. ,


.
,
.

5.

,
.
6.
.
7.
4-0 5-0

(. 25.3-25.5).
. -

. - ,
.

, ,
(Kokich.
Mathews, 1993):
1.
.
2. .
3.

.

,
.

1.
15 15

.
2.

.
3. 2-3
.
4. ,

.
5.


,
(Smukler et
at., 1987).
6.


,
,
,
.
7.


.
.

. (. 25.6).

( ) . ( ) .
( ) . ( D ) / . ( )
4-0 5-0 , (i 7 )

. 25.3. .

( ) .
. ( ) 5-0 . ( )
. . (D) . ( ) . (F ) .

. 25.4. .

. 25.S. . ( , ) . [ , )
. ( , ) .
, . [ D , D )
.

( ) .
.
(C)
, . ( D ) . { )

. 25.6. .

(B)

.
,


.

:
1. (Lappin,
1951; Kokich, Mathews, 1993).
2.

(Smukleret al., 1987).

*
.
,


,
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. -
.

1.
15 15

.

2.

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).
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1.
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,
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U-
.
3.

.
4.

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1.


.
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3.



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4.
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.
5.
.

5.

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.
6.

.

:

1:50 000;

(1:50 000) ;

;

:

,
,
,

.

7.

.

- (Kokich,
Mathews, 1993).

1.
.
2.
.
3. 15

,
.
4.
.
5.
.

1.
.
2. 15

.
3. .
:
: I' 1

.

.

1. 0-5%.
2.
.

. 25.7, 25.8.

110 , ,
.
,
.

, 25.7 , . -
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()
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. . (F ) 2 . .

. 25.8, . () . ( )
. ( ) , . ( D )
. ( ) . ( F ) .
. { G , H ) . ,
. ( 1 J ) . ( K . L )

'

-~ ~-~~1!11^^

.



,

(
),

:
1. IllIV
(Zitzmann et al., 1985; Jaffin, Bermann, 1995).
2.
(Zitzmann, Scharer, 1988; Misch,
1990):
* ;
;
* .
3.
(Jaffin, Berman,
1991).
4.
(Chanaverz, 1990, 1995;
Smiler et al., 1992; Coatam, 1997a,
1997b; Smiler, 1997):
* :

;
*

;
.
:
5. .
1) ;
6. (Adell et al., 1981,1990).2) ;
7. (Bahat, 1993).
3) ;
. 27 4) ;
^ 5) .
Caldwell-Luc.
- ,
,
,
Summers (1994)
.
,
.

,
Summers (1994), ,
Tatum (1977),

.
. ,
,
, -

.


:
. ,
1)

;
(Summers, 1994)- 2)

;
, 3) ;
4)
:
.
1. .

2.

.
3. .

4. .
.

Reiser . (2001)

,

4-5 (6-8 )
(24%)
(. 26). ,

.

26.1.

, 1

II
0

6-8

10 2

Reiser . (2001).
: I < 2 ; II > 2 .

:
1.
.
2.
2-

1 (
Reiser).

3.

,
,
.
4.

.
5.
,


.



4-5 .
Nkenke . (2002)

, ,

. ,


3 .

Fugazxotto (2003)
(. 26.2)
,

85-100%
> 3,5 (
1 7 ).


,
(> 3,5
>11 ).

.
Emmerich . (2005)
1139 (8
)
(> 3 )
(96%) .

(
).
Summers (1994)


, ,

26.2. ,

.
* : , (13

5,3%).
.
Tatum (1977), Summers.
, .


99 143 >13
(
). Misch (1999)
10-12 , Jensen (1999) 7-10 ,
Zitzmann Scharer (1999) > 6
.
Rosen . (1998)
,


> 4
(. 26.3).

43

(Del Fabbro et al 2004; Wallace,

Froum, 2004).
1 i II . - ,

(Jaffin,
.1995),
10-11,5 . , ,
> 3.5 ,
,
, > 6-7 .

.

, > 6-7
.

26.3.

<4
5-6
>7

14
50

12

85,7

48

96,0

110

106

96,4

Rosen et al. (1999).

Toffler (2004),
73%
> 4 94,6% < 5 .
Deporter . (2000)
> 3
, ,
100 % ,

6,9 4,56 .
, ,


,
,


.
:
1. .
2.
.
3. .
4. .
5.
.
6. ,
.
7.
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.
(. 26.1)



.
, ,

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.

1.
:
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.
2.
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:

;
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;
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,
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.

. 26.1,

. (4) (3-I). ( )

1.


.
2. :
;

:
;

()

.

:

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.

1.

. -


.
2.
.

6.

.
7.

.
8.

.
9.

.

1. :
, . .

.

2. ,

.

3. ,
,
,
.

4. .
5. ,
- ,
,
, /.


.
6. :
1.
.
7.
(Yildirim et al.,
.
1998).
8. 2.

IV (Glauser et al., 1998).
3.
(Nkenke et al., 2002).
.
9. 4.
(Roc
cuzzo, Wilson, 2002).
,
.

10.

.
1.

.
2.
.
1.
3.
IV .
2.
.
4.

10-15

.

3. (

,

.
,

).

4.
.
.
5.
.
.

(Summers, 1994)
,

1-2 .

9-10 .

1.
1-2 ,
(



).
2. ,
.

.
.
1.

.
2.

1 .
.

,
.
,
,
.


.
,
,

,
.
,
,
(. 26.2).

1.

.
2.

< 4 > 5 (Jen
sen, 1996;

, 1996; Rosen et al., 1998;
Toffler, 2004).
3.
.

1. 4 .
2. ().
3.

.

(Lazzara et al.,
1999; Cavicchia et al., 2001; Toffler, 2004).


(Summers, 1994)

.



.

1. .
2. .
3. .
4. (
).
5.
.
6. .

(IV )

.

3.
4.

5.
6.

I! , IV X; 2
3 3 (
Reiser).

7.

3- .

8. .

,


.
,
,
.
11 . .

9. (Toffler, 2004).

Reiser.
,

1.
.
,
11 ('
.
.
2.
.
,
3.
Valsalva ,
.

4.
.
.
I ,
,
IV .

. 26.2,
.
.
,
,

2.

.

2-3

.
1 ,
2- .

2-
.
3- .
1 ,
3- .

1.

-

,
.

1 1 ( .

.

Valsalva.

,

.




.
.
2.
13.

4-6 (Reiser et

1 2- .
al., 2001; Lazzara, 2004).
14.
3.

.

2-xMM
Summers 4
,

. 1
5.
15.

,
.
. 11 . ,
.
,

(Reiser et al., 2001).
Reiser.
. 16.
,

4. ,
,
, 7-8 .

.
.
.
17.
5.
:


;
1 .
.
;
6.
;
1-2 ,
,


.
.

V .
. Bio-Oss -

.
.
. .
0T0M0B:

V: 3.3-3,75 :
10.

1
Nft 4 - 4,0-4,-5 ;
Summers
jVa 5 4,8-5, 0 .
,
3 (31 Implant Innovation, Palm

Beach, FL)
.


7.

.
20.3,
26.4.


,
-


.
( ).

8.

2 3,

.

.

IV
.
9.

1-1.5 .
,


11,

Reiser

.
Summers

3.
3
. ,
s s }1 >1 ,


1. ( 8-17).
2
-
,
.

12.
-

. 26.5 ,

26.7.
.


.
,

4 . (Davarpanah
et al, 2000). Toffler (2004) ,
Nkenke . (2002)

. Toffler (2004)
,
(, 1992; Baumann, Ewers,
1999; Reiser et al., 2001)


.

. 26.3. . . ( , )

> 5 . ( )
. (D)
1 . () 2- 2- . (F ) 1
3- . (G ) 3- . ()
. . (/)
. 0,5-1 .
. (/) ,
. ( ) . (L )
7-8 11,5- . () 10 .
. (N, )

, 26.4,

. ()

7 .
()
1
2-
. ( ) 2-
.
(D )
3- .

.
,

. ( )
5 . ,
5-6 ,
3-4
. ( )

. 26.S. , . ( , )

, . (C , D )
. ()
1 . (F ) , . (G) (
Summers 3 N 2 4, 31) . ( ) .
(I ) . ( ] ) ,
. ( ) , . . (L )

. 26.5. (). (M , N ) ,
. () . ( ) . ( Q , R )
12 . . . D

. 26,6 (, ,

). ( ) . ( )
(
27). ( ) ,
Summers. (D )
, 10 . ( )
7 . . (F )
26 . . Eiji
Funakoshi, Osaka,

. 26.7.

(, ,
). ()


(
27).
()

(5 )
,
. ()


. (D)

2
.

Eiji Funakoshi, Osaka,

,

(< 4 ),


,

, :
1.
Caldwell-Luc.
2. FSD.

, ,

1.

.
2.
5 FS (Sum
mers).
,

.
,
6 . Fugazzato (2002, 2003)
3- .
(3-6 ).

3.

.
4.
FS

.
.
.

, Valsalva
(
).
5.

,

,

.

. ,
.

6.
,
,

.
7.

,

.

.
,
5-8 .

8.

,

.

. 26.8, 26.9.

. 26.8. , . ( )

. ( ) 6-
1 . () (3I-FS)
. ( D , E ) .
( F ) 6-8 . , . ( G ) .
. ,

. 26.9.
. 04)
. ( )
4
. ( )
. ( ) )
- . ( )
( )
6-

. 26.9. ( ).

(F) . (G)
. () . ( I ) .
{ ] ) . ( ) . (L)
. () . (N) 8 . .
() (11,5 5 Osteotite, 31). () . (Q)
3 .

448

,
20 % ( 18 )


(. 27.1). . 27.1, 27.2

,

. 3. (Smil
er et al., 1992):

;
:

1.
.
( III IV ) (Jaffin, Berman, 4.

(Tatum, 1986,1989);
1991).
2. 5.
(Watzel et al.,
(Zimmer, Small, 1999).
1998);

. 27.1. . () . ( ) . ( )

6.

(Rangert et al., 1997,
1998).




(Fugazzatto, Vlassis, 1998; Jensen et al., 1998; Khoury,
1999; Fugazzatto, 2003).


. Ta
tum (1977, 1986)
,
Boyne James (1980)

.

,


(. 27.2).

(Chanavaz, 1990),


.
,

//
38 33 38 (Schaf
fer, 1920).

,

(
).
,
.

,

(Chanavaz, 1990).

. 27.2. , . () . ( )
. ( ) ( ). (D ) (
()). ( ) . (F )


,

(Misch, 1999).

,

. (
) ,
.


.


(Ulm et al., 1995) (Tallgren, 1972).

,
-
.

.

.

. ,

(Chanavaz, 1990).

,


,
.

.

.

,
.


,

.

.
, ( ),
,
,
.

( )


.
,

.


,
(Schaeffer, 1910).

Chavanez (1990)


,
,

(),
. Underwood (19)
:
1.

:
;
;
.
2. ,

- ,

.
3. ,
,

.

:
1. .
2.
-
.


,


:

1.

.
2. ,
,

(Chanavez, 1990).
Underwood (1910) 66%
(30 45 )
6,5 13 ,
,
(3:1). Ulm . (1995)
,
31,7% (13 41 ),
7,9 .
Kim . (2006),

100 (200
),
26%
(53/200).
:
25,4% , 50,8%
23,7 % .


.
. ,
,
3-4 .
,
,
.


(. 27.3).

1.
.
2.
.
3. .
4 , ,
.

1. - .
2.
-
.

1. .

451

, 27.3. . 04)
, . ( - D )
(
, )
,
.

2. .
3. .

(< 5 )

:
1. .
2. .
3. .

1. :
* ;

;
.
2. ,
.
3. .
4. .
5. , .
6.
.
7. .
8.
.
9.
.
10. .
11. .
12. .
13.
.

14.
15.

.
>2:1.

1=

.

,

.

, :
1. .
2.
().
> 2:1,


.
3. .


.
4. ,

(
).
5. ! .

5-7 .

,

(Misch, 1987):

;


;

.
6. .

(Engstrom
et al., 1988; Moskow, 1992) -


(Eberhardt et al., 1992)

( > 0,50)
,
:

(Evian et al., 2004).
Beaumont . (2005 )
, 41 % ,

, .





(. 27.4).

,
,

20-25 %


(Fredholm et al., 1993):
1.
.
2. .
3. .
4. .
5. .

()


.
,
,

.

(Rothman
et al., 1988: Solar et al., 1992; Ulm et al
1995).

(. 27.5, 27.6).

, 27.4, . () . ()
(> 1:1). () . (D) - . ()
. ( F )

. 27.5. .
()
.
. ( )
.

. ()
.

. ( D ) .
( )
. (F )
,
,

. 27.6. . ( )
. ( ) . ( )
. ( D )
, ,

, ,
()
/

.

1. :
;
.
2. :
;
;
.

3. :
;
;
;
;
.
4. :
();
(,
).
5. :

6.
7.
8.
9.

;
.
.

(Misch, 1984).
(
).
:
;

.

, 2 7 . 7 . (SA)
Misch.

. ( , ) SA-I. { C , D ) SA-2.
( E , F ) SA-3. ( G , H ) SA-4

I.

27.1,

Misch (1984, 1987)

,

(, 27.7).
2 .

SA - .

1. :
> 5 .
(. 27.1).
2. :
2,5 5 .



.
. Ulm . (1995) ,


, .

Misch (1999) ,
(SA-3 SA4; . . 27.1)
1993 .,

:
1.

.
2.
.
3.
.
4.
,
.
5.
,
.
6.
.
".

.

,
> 5
.

27.2.
VRH-1 > 12

VRH-2 >7-10

VRH-3 > 5 , < 7

(
)

VRH-4 < 4

6-8 .
6 .

VRH . , VRH-3 VRH-4

.

273.

500
()

1 . 3
710

150
()

300 1 .
150 3 7

, ,
, (Montgomery, 1985; Peterson, 1990; Misch, 1992).

1.
.
2. .
3. .
4. .
5.
.

. 27.2




.
*

Peleg .
(1998) Winter . (2002) ,

1 .

II.

(
(Sinus Consensus Con
ference), 1996; Del Fabbro et al., 2004;
Wallace, Froum, 2004).

:

. , ,
,
,
,
(Del Fabbro et
al., 2004; Wallace, Froum, 2004).

Misch (1992)


,

/
. ,

,
(. 27.3).

(Misch, Moore, 1989)
3 :

1. 9
.
2. 6 1-
.
3. 3 2-

Medrol:
6
.
:

1. (400-800 3
).
2. ()
6 .

1. ().
2. : 1 3
, 1
2
.


1. 0,05% 1
.
2. 1 %.

5

,
(
, ).
,
,

.

. 27.8, 27.9.

I.

1.
,
:
3-5
;
*

,

.
.
,
,
.

2.
(.
Langer . 7
)

.
8-10


,

().
.

, ,
,
.

.

.
3.

(. . 27.9, A-D):
.

,



.
,


.
.

,

.
4.
.

Molt (Smiler, 1992).

-

- ,

,
. ,

,
,
.
,

,

.

5.

3-0 4-0,

(Misch,
1992).

if.

1.
.

:
,
;
;

,
;

;

.
2. (
) (Rosenlicht, 1992).
-
,

,
,

,
.
3.


6 8

(50 000 ).

,

.

,

.

,
,
(
).
, . .

.


,
.
.

(Vesson, Petrik, 1992).

. 27.8. . ,
, , . (, )
. (, D) . ,
, , . ( E . F )
. (G , ) , .
( I ) . (/) .
. . (A',L ) ,
.


. 27.8. (). () , 360. (N)

. () . ( ) :
. : ,
. (Q ) , . (R ) ,
. ( S, ) ,
. (U, V) ,
. (W) . ( X)
CollaTape

. 27.8. (). () . ( Z ) . ( )

, . ,
. ( ) , . ( )
. ( D D ) . ( )
(F F ) . ( G G )
. (,) . (]])

[). ( )
. (LL)

. ( )

. ( N N )
10-12 . (00) 26.

. . ( )
,

. (QQ,RR) .
( S S )
. 27.8.

. 27.9. ( ). () . () .

() , . ,
10 . (D) . ,
. (,F) . . ( G)

. () .
. () . (/)
. () . ( L)
360

4.
3-4
,

.
20 .
,

,

,

,
.

,
(Smiler et al.,
1992).

.
I 3 (
)
.

5.

,

5

( ). (N) .

. () ,
. ()
. (Q)
, . ( R )

. (S, )
.

,


. 27.9.

. -

,

.
6.

20
.

,

.
. , ,
!.

7. (
)
10-15

(VRH-3
VRH-4; . . 27.2).

,


.
4-5
,
,

(,
)

(. . 27.9, ).
3-5
,
,
,
.


5
(. . 27.9, F).
8. ,

.
,

.
,

.
,

(. . 27.9, G, ).



.
,
()

.


, ,
,
.

(
)
(
).

10.

,
(Fugazzotto, 1994; Garg, Quinones, 1997).
,
- (. . 27.9,/,).
,

, :


.
,

.
,

Molton,


, .
.

, . .
,
,

. ,
( ).
,
.

.

,
,
.
(Garg, 1997,1999).

1.

.
2.
1:50 .
3. .
Gelfoam.
Surgicel.
Avatine.
.

1.

.
2.
,
, .

-
.

III.

(. . 27.8, J)

1.
,
.

,
(. . 27.8, L , M ) .
2.
,

,



.

,

.

, ,


.

,
,
.
(,
)
.



.
.

.

3. .



360.


/
,

, .
.

,
.

,
.

4.


.
,
.
, . .
.

,
.
5.

-
. ,
,

.

, 5-10 ,

,
,

.


(Friedman)
.
6.
,


, 16-20
(Misch, 1999).
.

,
,
.

7.
,

(Misch, 1996;
Tarnow, 2004) (. . 27.9, N ) .

-

(Jensen et al., 1994; Wheeler et al
1996; Froum et al., 1998; Mazor et al.,
1999; Misch, 1999; Pikos, 1999). Chanavez (2000) ,


()



,
. Proussaefs . (2004)


(14,17%)
(33,58%).

.
.

Misch (1999)
,


,

.

,
,
,
. Fugazzotto Vlassis (2003)
,

.



.
,
.

. 27.10. .
( )
. ( )
(
). ()
. ( D )
. ( )

,
(. 27.10).

60
(Tarnow, 2004). ,


.


.

.
. .
:
1.
.
2. .
3.
.
:
1.


.
2.

Gelfoam, Surgicel Collatape
(Garg et al., 1992; Rosenlicht, 1992;
Fugazzotto, 2003)

. .
1.

Collatape
(
)

(Biomend,
Resolute Adapt, BioGuide, Ossix). (Vassos,
Petrik, 1992)
,
,

.
.

,
.
.

2.



,

(Biomend,
Resolute Adapt, BioGuide, Ossix).
3. ,

(3-4 .) .

. ,
.
,

,

(.
.
. 27.9).

 Loma Linda
(. 27.11).
Proussafs Lozada (2003) ,

,
,

.


.

Loma Linda ,
,

(Proussafs, Lozada, 2003).
,


,
,


.

(),

.
,

,



(. . 27.10). Fugazzotto
Vlassis (2003)
,
Loma Linda,
,
,

().
,
,

,
-
.

IV.
()

:
1) /
2) .


(Boyne et al., 1980; Smiler et al.,
1994; Lundgren et al., 1996; Chanavaz,
1996, 2000; Valentini et al., 1997, 2000;
Jensen et al., 1998; Tong et al., 1998;
Wood, Moore, 1988; Del Fabbro et al.,
2004; Wallace, Froum, 2004).
Ll3
,


.
(
),
,
,

(Vlassis et al., 1993).
,


;


...
,

,
,
(Nevins
et al., 1996). Misch (1996) Wallace
Froum (2004)

,
,
.

( , . ,
,

,
,
Pikos (1999). ,
)


,

.
, ,

,
. , ,

, ,

,
,
()
(94,88 % )
(95,98%)
(94%)


(< 10-12 .)

(Wallace,
1996; Froum et al., 1998; Jensen et al.,
1998; Misch, 1999; Valentini et al., 2000;
Del Fabbro et al., 2004 ; Froum, Wallace,
2004).
.

1. :
:
;

;

;

.
2. :

;

;
;

:
.
.

1. :
(
);
;
;

:
;
.
2. :
;

.
(CaSO+),

^. 27.11. Loma Linda. () ,

. ( ) .

, , ,
. () . ( D )
. . ( )
. ( F ) (),
. () .
() . (/)
. (/) ,
. (), .
( ) . ( )
, , .
Dr. Perklias Proussaefs, Loma Linda, CA, Quintessence Publishing Co

 27=4


(
CaSO, 4:1) (Sottosanti, Horowitz, |

, %
2003; Guarnieri et al., 2004);
Jensen et al., 1998
2 997
1 007
90
1.
Tong et al., 1998
1 097
295
93

Wallace, Froum, 2004

5 277
2 178
92,6
.
Del Fabbro et al., 2004
2 046
6 990
91,5
'
2. (
, (> 10-12 .)
) .
. Tarnowc . (1998) , 24% ( 9-34%)
3.
6- 9- ., 33% ( 10-65%)
12- 15- .
()
.

4. .
, ,
5.

.
() .

Tarnow (2004) ,
(92,3 83,3%).
4.


.
:

1. (> 12-15 .).

(93,6
2. :
;
88,7%).

5.
*
(. . 27.9, ).
4.
.


3. .
(897

89,6/).

w ..
6.
,

(Smiler, Holms, 1987).
, .
,
,
.

.

.

( )
.

, 1.
U -'-- : ; ' - / 1 -
()

,
- .
(. 27.4).
.

2.
5.
:
(

1.
500 , 150 ).

,

.

,



,

.


3.
,
(92 95,1 %),

, . .
,

1
.
,
, /
,
IV (Jaffin, Berman, 1991) , 1- ,
(92 65 %).

Cera Med Surgical Supply.
2.

( >;

,
,

, .
, ,
15 (Gargand Quinones, .
1997),
(95,111
,
, 6. ,
82,4%).

3. ()
.


(. . 27.9, 0).

470
300 3 .

,

.

.
, ,
,



.

1.

Caldwell-Luc,

-,

.
2.

* ^ * <

3.

, :
*
;

;
*
.
4.
,

.
,

12-14 .
.

. .
, ,
.

. 27.12-27.15.

v: ft a s' s a

. 27.12. , . (,)

. (, D ) - , .
() . (F) , .
. (G) , . () . (/) .
6 .; , , ; ;
. (/) . ( )
. (L) , .

. 27.13, -
,
. 27.12.
. :
(4) 24; ( ) 25; ( ) 26.
: (/) 24; (') 25
() 26

, 27,14. -, . (,)
. () . (I )) . ()
. (). (F ) .
. (G) ,
. () . ( I )

. 27.14, (). { ] )
. ( ) Gore-Tex
. (L )

. ( )
12 . . (N )
Gore-Tex
. ()
.
. ( )

. 27,15. . . ( )
. ( ) . ( )
. ( D ) , . ( ) ,
. (F ) . . (G ) .
-. () ( ) ,
. (/) . {/)

. 27.15. ( ) . ( ) (13).
. ( L )
( ) . (
() . ( )
. . ( Q )
. ( R ) 2 .
. . ( S )
. ( , U ) 5

,

.


,
( ),

.

,

.

()
,


() .


4 7 ,
15
20 (
1-3 )
10 .

,

21 10 7 .




,
.

,
III (
, )

( ),
(

()

/
). ,

,
,


,
.


4 , 30
10 .




.

,
. ,

,
,


.

. ,



.
,
,

.
.

,

.

,


.



,


.
(
)
,

,

.
,



.

,


. . 27.1

(),

27.1.

( )

, 1

-
> 1 3
< 1 '

2 > 1
()


/

I.

.
1. .
2. .
3.

.
4.

.
5. .
6.

.
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500

Abrams L. Augmentation of the deformed residual eden

tulous ridge for fixed prosthesis. Compend Contin

American Academy of Periodontology. Annals of peri

odontology. World Workshop in Periodontics 1996.

postextraction with HTR grafting material. Oral Surg

American Academy of Periodontology. 1999 Internation

Educ Gen Dent 1980;1:205-13.

Adell R, Eriksson B, Lekholm U, et al. A long-term fol
low-up study of osseointegrated implants in the treat
ment of the totally edentulous jaw. Int J Oral Maxil

al Workshop for a Classification of Periodontal Dis

eases and Conditions. Ann Periodontol 1999;4:102-7.
American

Academy

of

Periodontology.

Parameters

Oral Med Oral Pathol 1985; 60(2):146-153Awood, I)A. Post extraction changes in the adult mandi
ble as illustrated by microradiographs and mid-sagit

of

care. J Periodontol 2000;71 Suppl:873-5.

lofac Implants 1990;5:347-59-

Ashman A, Bruins P. Prevention of alveolar bone loss

tal section and serial cephalometric roentgengraphs.

J Prosth Dent 1963;13:810-16.

dental

American Academy of Periodontology. Glossary of peri

Aukhil !, Iglhaut J. Periodontal ligament cell kinetics fol

aesthetics: restorative principles. Pract Periodont Aes

odontal terms. 4th ed. Chicago: American Academy

lowing experimental regenerative procedures. J Clin

thet Dent 1998;10:813-22.

of Periodontology: 2001. American Academy of Peri

Ahmad

I.

Geometric

considerations

in

anterior

Periodontol 1988;15:374-82.

Aichelmann-Reidy MB, Yukna RA, Mayer ET. Acellular

odontology. Tissue banking of bone allografts used

dermal matrix used for root coverage [abstract], J

in periodontal regeneration [position paper]. J Peri

age and papilla reconstruction in Class IV recession.

Periodontol 1999:70:223.

odontol 2001;72:834-8.

A case report. Int J Periodontics Restorative Dent

Aichelmann-Reidy MB, Yukna RA, Evans GH, et al. Clin

ical evaluation of acellular allograft dermis for the
treatment of human gingival recession. J Periodontol
Al Ali W, Bissada NF, Greenwell H. The effect of local
with

and

without

tricalcium

phosphate

on the regenerative healing potential of periodontal

osseous defects in dogs. J Periodontol 1989;60:582-90.
Aleo JJ, De Renzis FA, Farber PA, Varboncoeur AP. The
presence and biologic activity of cementumbound en
Aleo JJ, De Renzis FA, Farber PA. In vitro attachment of
human gingival fibroblasts to root surfaces. J Peri

of

Periodontal

Periodontology.
regeneration.

PositionPeriodontol

2005;76:1601-22.
of

Oral

and

Maxillofacial

Sur

1999;15:1-16.
investigation

of

human

alveolar

sock

et healing 'in undisturbed extraction wounds. J Am

Dent Assoc I960; 61:32-44.
WFJ,

technique,

Smith
and

DH.

expectations.

curettage:

Dent

Clin

rationale,
North

Am

1976;20:215-26.
tion of the use of decalcified freeze-dried bone al

tologic evaluation of new attachment in periodon

lograft with guided tissue regeneration in the treat

tally

ment

diseased

human
and

roots

treated

fibronectin.

with
J

tetracy-

Periodontol

1990;61:447-55.
Allen EP. Use of mucogingival surgical procedures to en
hance esthetics. Dent Clin North Am 1988;32:307-30.
Allen EP, Gainza AC, Farthing GG, Newbold DA. Improved
technique for localized ridge augmentationa report
of 21 cases. J Periodontol 1985;56:187.
Allen EP,Miller PI) Jr. Coronal positioning of existing gin
giva: short term results in the treatment of shallow
marginal tissue recession. J Periodontol 1989;60:316-9.
Allen EP. Surgical crown lengthening for function and es
thetic. Dent Clin North Am 1993;37:163-79

of

molar

furcation

invasions.

fundamental

principles

of

Periodontol

1991;62:264-8.
Ante

IH.

The

seous integrated implants. Int J Periodontics Restor

ative Dent 1993;13:255-75.
bone height after flap curettage. 1. Study involving
six patients. J Periodontol Restorative Dent 2006;2:9.
Baker DL, Seymour GJ. The possible pathogenesis of gin

Alger FA, Solt CW, Vuddhakanok S, Miles K. The his

cline-hydrochloride

hard and soft tissues for optimal placement of os

Bahat O. The influence of soft tissue on the interdental

Flap

Anderegg CR,Martin SJ, Gray JL, et al. Clinical evalua

odontol 1975;46:639-45.

and connective tissue grafts. Int J Periodontics Re

storative Dent 2001;21:141-7.
Bahat O, Fontanesi RV, Preston J. Reconstructin of the

Amler MG, Johnson PL, Salman I. Histological and histochemical

1999;19:449-55.
Azzi R, Takei HH, Etienne D, Carranza FA. Root coverage
and papilla reconstruction using autogenous osseous

Association

geons. Orthognathic surgery. AAOMS Surgical Update

Ammons

dotoxin. J Periodontol 1974;45:672-5.

Academy

paper.
American

2001;172:998-1005.
doxycycline

American

Azzi R, Etienne D, Sauvan JL, Miller PD. Root cover

gival recession. A histological study of induced re

cession in the rat. J Clin Periodontol 1976;3:208-19.
Baker PJ, Evans RT, Coburn RA, Genco RJ. Tetracycline
and its derivatives strongly bind to and are released
from the tooth surface in active form. J Periodontol

abutments

Michigan Dent Soc Bull 1926;8:14-23Ariaudo AA, Tyrell H. Elimination of pockets extending
to or beyond the mucogingival junction. Dent Clin
North Am 1960;4:67.

1983;54:580-5.
Bang G, Urist MR. Bone induction in excavation cham
bers

in

matrix

of

decalcified

dentin.

Arch

Surg

1967;94:781-9.
Barnett JD, Mellonig JT, Gray JL, Towle I1J. Comparison

Arnett W, Bergman RT. Facial keys to orthodontic diag

of freeze-dried bone allograft and porous hydroxyl-

nosis and treatment planningpart I. Am J Orthod

apatite in human periodontal defects. J Periodontol

Dentofacial Orthop 1993;103:299-312.

Arnett W, Bergman RT. Facial keys to orthodontic diag

1989;60:231-7.
Barros RR,Novaes AB, Grisi MF, Souza SL, Taba MJ, Pal-

nosis and treatment planningpart II. Am J Orthod

ioto DB. A 6-month comparative clinical study of a

Dentofacial Orthop 1993;103:395-410.

conventional and a new surgical approach for root

501
coverage with acellular dermal matrix. J Periodontol
2004; 75(10):1350-1356.
Barsky AJ, Kahn S, Simon BD. Principles and practice of
plastic surgery. New York: McGraw-Hill; 1964.
Bass T.Observations on the misplaced upper canine tooth
Dental Practitioner 1967;18:25-34.
Baum BJ,Wright WE. Demonstration of fibronectin as a

Bichacho N, Landsberg CJ. A modified surgical/prosthet

ic approach for an optimal single implant-supported
crown. Part II. The cervical contouring concept. Pract
Periodontics Aesthet Dent 1994; 6(4)35-41.
Bjorn H. Free transplantation of gingival propria. Sven
Tandlak Tidskr 1963;22:684.
Bjorndal AM, Henderson WG, Skidmore AE, Kellner

mandibular Class II furcations: part I. J Periodon

tol 2003;74:1255-68.
Boyne PJ. Analysis of performance of root-form endosseous implants placed in the maxillary sinus. J Long
Term Effects Med Implants 1993;3:143-59
Boyko GA, Brunette DM, Melcher AH. Cell attachment to
demineralized root surfaces in vitro. J Periodontal

major extracellular protein of human gingival fibro

FH. Anatomic measurements of human teeth ex

blasts. J Dent Res 1980;59:631-7.

tracted from males between the ages of 17 and

Res 1980;15:297-303.
Boyne PJ, Janies RA. Grafting of the maxillary sinus

Baumann A, Ewers R. Minimally invasive sinus lift. Lim

21 years. Oral Surg Oral Med Oral Pathol 1974;

floor with autogenous marrow and bone. J Oral Surg

its and possibilities in the atrophic maxilla [in Ger

38(5)791-803.
Bjorvatn K. In vitro study by fluorescence microscopy

Bragger U, Lauchenauer I), Lang NP. Surgical lengthening

man], Mund Kiefer Gesichtschir (Berlin) 1999;3 Suppl 1:S703Beaumont C, Zafiropoulos GG, Rohmann K, Tatakis DN.

and microradiography of tetracycline-tooth interac

tion. Scand J Dent Res 1983;91:417-24.

1980; 38(8):613-616.

of the clinical crowm. J Clin Periodontol 1992938-

63.

Black G. Descriptive Anatomy of the Human Teeth. 4th

Brion M. Anorganic bone plus collagen in the tretment of

ities m patients scheduled for sinus lift procedures. J

Ed. ed. Philadelphia: S.S.White Dental Manufacturing

Periodontol 2005;76(3):46l467.

Co., 2006.

periodontal intrabony lesions. J Periodontl 62. 1990.

Abstract

Prevalence of maxillary sinus disease and abnormal

Becker W, Becker BE, Berg LE. Periodontal treatment

Blomlof J, Lindskog S. Periodontal tissue-vitality af

without maintenance. A retrospective study in 44 pa

ter different etching modalities. J Clin Periodontol

tients. J Periodontol 1984;55(9):505-509-

1995;22:464-8.

Becker BE, Becker W. Use of connective tissue autografts

Blomlof J, Blomluf L, Lindskog S. Smear layer formed by

for treatment of mucogingival problems. Int J Peri

different root planing modalities and its removal by

odontics Restorative Dent 1986;6:88-94.

an ethylenediaminertertraacetic acid gel preparation.

Becker W, Becker BE, Berg L. Repair of intrabony defects

as a result of open debridement procedures. Report
of 36 treated cases. Int J Periodontics Restorative
Dent 1986;6:8-21.

Int J Periodontics Restorative Dent 1997;17:242-9.

Blomlof J, Jansson L, Blomluf L, Lindskog S. Root sur
face etching at neutral pH promotoes periodontal
healing. J Clin Periodontol 1996;23:50-5.

Becker W, Becker BE, Berg L, et al. New attachmentaf-

Blomlof L, Jonsson B, Blomluf J, Lindskog S. A clinical

ter treatment with root isolation procedures: report

study of root surface conditioning with an EDTA gel

for treated Class III and Class II furcations and ver

II. Surgical periodontal treatment. Int J Periodontics

tical osseous defects. Int J Periodontics Restorative

Restorative Dent 2000;20:566-73.

Dent 1988;8:8-23.
Becker W, Becker BE. Guided tissue regeneration for im

Blomlof L, Bergman E, Forsgardh A, et al. A clinical

study of root surface conditioning with an EDTA gel

plants placed into extraction sockets and for implant

I. Non-surgical periodontal treatment. Int J Periodon

dehiscences: surgical techniques and case report. Int

tics Restorative Dent 2000;20:560-5.

J Periodontics Restorative Dent 1990;10:376-91.

Becker W, Urist MR, Tucker LM, Becker BE, Oclisenbein C. Human demineralized freezedried bone: in
adequate induced bone formation in athymic mice.

Bogle G,Adams D, Crigger M, et al.New attachment af

ter surgical treatment and acid conditioning of roots
in naturally occurring periodontal disease in dogs. J
Periodontal Res 1981;16:130-3.

Buchanan SA, Robertson PB. Calculus removal by scal

ing/root planing with and without surgical access. J
Periodontol 1987;58:159-63.
Bunyaratavej P, Wang HL. Collagen membranes: a review.
J Periodontol 2001;72:215-29.
Burgett F, Ramfjord S, Nissle R, et al. A randomized trial
of occlusal adjustment in the treatment of periodon
titis patients. J Clin Periodontol 1992; 19381-7.
Burns WT, Peacock ME, Cuenin MF, Hokett SD. Gingival
recession treatment using a bilayer collagen mem
brane. J Periodontol 2000;71(8):13481352.
Buser D, Bragger U, Lang NP, Nyman S. Regeneration and
enlargement of jaw bone using guided tissue regener
ation. Clin Oral Implants Res 1990;1:22-32.
Buser D.Warrer K, Karring T. Formation of a periodon
tal ligament around titanium implants. J Periodon
tol 1990;61:597-601.
Buser D, Warrer K, Karring ', Stich H. Titanium implants
with a true periodontal ligament: an alternative to
osseointegrated implants? Int J Oral Maxillofac Im
plants 1990;5:113-6.
Buser D, Schenk RK, Steinemann S, Fiorellini JP, Fox CH.

A preliminary report. J Periodontol 1995; 66(9):822-

Bogle G, Garrett S. Crigger M, Egelberg J. New connective

Stich H. Influence of surface characteristics on bone

828.
Becker W, Ochsenbein C, Tibbetts L, Becker BE. Alveolar

tissue attachment in beagles with advanced natural

integration of titanium implants. A histomorphomet-

periodontitis. J Periodontal Res 1983; 18(2):220-228.

ric study in miniature pigs. J Biomed Mater Res 1991;

bone anatomic profiles as measured from dry skulls.

Clinical ramifications J Clin Periodontol 1997;24:727-31Becker W, Ochsenbein C, Becker BE. Crown lengthening:

Bohannan HM. Studies in alteration of vestibular depth.

Buser D, Dula K, Belser U, et al. Localized ridge aug

Borghetti A.Mattout P.Mattout C. How much root plan

mentation using guided bone regeneration. 1. Surgi

new burs to make the procedur epredictable and eas

ing is necessary to remove the cementum from the

ier. Esthet Dent 1998;4:1-7

root surface? Int J Periodontics Restorative Dent

Bell WH. Resorption characteristics of bone and bone sub

stitutes. Oral Surg Oral Med Oral Pathol 1964;17:650-7.
Benke D, Olah A, Muliler H. Protein-chemical analysis of
Bio-Oss bone substitute and evidence of its carbonate
content. Biomaterials 2001;22:19-30.
Berglundh T, Marinello CP, Lindlie J, Thilander B, Liljenberg B. Periodontal tissue reactions to orthodontic
extrusion. An experimental study in the dog. J Clin
Periodontol 1991; 18(5)330-336.
Berglundh T, Lindhe J, Ericsson I,Marinello CP, Liljenberg
B, Thomsen P. The soft tissue barrier at implants and
teeth. Clin Oral Implants Res 1991;2(2):81-90.
Bernimoulin JP, Luscher B, Muhlemann HR. Coronally
repositioned periodontal flap. Clinical evaluation af
ter one year. J Clin Periodontol 1975;2:1-13.
Berry F. is the theory of temperament the foundation to

1987;7:23-9.
Borghetti A, Gardella JP. Thick gingival autograft for the
coverage of gingival recession: a clinical evaluation.
Int J Periodontics Restorative Dent 1990;10:216-29.
Bowen JA, Mellonig JT, Gray JL, Towde HT. Comparison
of decalcified freeze-dried bone allograft and porous
particulate hydroxyapatite in human periodontal os
seous defects. J Periodontol 1989;60:647-54.
Bowers G. A study of the width of attached gingiva. J
Periodontol 1963; 34:201-209.
Bowers GM, Schallhorn RG, Mellonig JT. Histologic evalu
ation of new attachment in human intrabony defects.
A literature review'. J Periodontol 1982;53:509-14.

with and without citric acid demineralization. Int J

Periodontics Restorative Dent 1988;8:64-77.

cal procedure in the maxilla. Int J Periodontics Re

storative Dent 1993;13:29-45.
Caffesse RG, Sweeney PL, Smith BA. Scaling and root
planing with and without periodontal flap surgery. J
Clin Periodontol 1986;13:205-10.
Caffesse RG, Smith BA, Nasjleti CE, Lopatin DE. Cell pro
liferation after flap surgery, root conditioning and
fibronectin application. J Periodontol 1987;58:661-6.
Caffesse RG, Nasjleti CE, Anderson GB, et al. Periodon
tal healing following guided tissue regeneration with
citric acid and fibronectin application. J Periodon
tol 1991;62:21-9.
Callan D. Use of human freeze-dried skin allograft ma
terial in dental implant treatment, Part II. Pract Peri
odontics Aesthet Dent 1990; 2:43-46.

Bowers GM, Chadroff B, Carnevale R, et al. Histologic

Camelo M, Nevins ML, Schenk RK, et al. Clinical, ra

evaluation of new attachment apparatus formation

diographic, and histologic evaluation of human peri

in humans. Part III. J Periodontol 1989;60:683-93-

odontal defects treated with Bio-Oss and Bio-Gide.

the study of prosthetic art? Dent Mag 1905; 61:405-409. Bowers GM, Granet M, Stevens M, et al. Histologic evalu
ation of new attachment in humans. A preliminary
Bertrand PM, Dunlap RM. Coverage of deep, wide gingi
val clefts with free gingival autografts: root planing

25(7):889-902.

II. Periosteum retention. J Periodontol 1963;34:1455.

report. J Periodontol 1985;56:381-96.

Bowers GM, Schallhorn RG,McClain PK, et al. Factors in
fluencing the outcome of regenerative therapy in

Int J Periodontics Restorative Dent 1998;18:321-31.

Camelo M,Nevins ML, Schenk RK, et al. Periodontal re
generation with an autogenous bone Bio-Oss compos
ite graft and a Bio-Gide membrane. Int J Periodon
tics Restorative Dent 2001;21:109-19.

502
Carranza FA Jr. Glickmans clinical periodontology. 6th
ed. Philadelphia:W.B. Saunders; 1984.

Corn H. Periosteal separationits clinical significance. J

Periodontol 1462:33:140.

Carvalho JCM. Clinical observations of suture techniques

used for free gingival grafts. Rev Fac Odont S Pau
lo 1972;10:121.

nique for osseous implants. J Periodontol 1972;43:295-7.

Corn H. Technique for repositioning the frenum in peri

odontal problems. J Clin North Am 1964; 8:79
using Gore regenerative membranes in intrabony de

nective tissue pedicle flap with a free finfival graft to

fects. Flagstaff (AZ): WL Gore and Associates; 2005.

cover localized gingival recession. Int J Periodontics

Cortellini P, Pini Prato GP, DeSanctis M, et al. Guided

Restorative Dent 1982;4:27.

Dordick B, Coslet JG, Seibert JS. Clinical evaluation of

free

Cortellini P. Technical tips to increase predictability when

Carvalho JC, Pustiglioni FE, Kon S. Combination of a con

Diem CR, Bowers GM, Moffitt WC. Bone blending: a tech

tissue regeneration procedure in the treatment of a

autogenous

gengival

grafts

placed

on

alveo

lar bone. Part I. Clinical predictability. J Periodon

tol 1976;47:559-67.
Dorfman HS, Kennedy JE, Bird WC. Longitudinal evalu
ation of free autogenous gingival grafts. J Clin Peri
odontol 1980;7:316-24.

Cavicchia F, Brevi F, Petrelli G. Localized augmentation of

bone dehiscence associated with a gingival recession:

Dragoo MR, Sullivan HC. A clinical and histological

the maxillary sinus floor to a coronal approach for

a case report. Int J Periodontics Restorative Dent

evaluation of autogenous iliac bone grafts in hu

the placement of implants. Int J Periodontics Restor

1991;11:460-7.

mans. I.Wound healing 2 to 8 months. J Periodon

Cortellini P, Pini Prato G, Tonetti MS. Periodontal regen

ative Dent 2001;21:475-85.

Chaiken RW. Elements of surgical treatment in the de
livery of periodontal therapy. Chicago: Quintessence;

eration of human infrabony defects. I. Clinical mea

sures. J Periodontol 1993;64:254-60.

Dragoo MR, Sullivan HC. A clinical and histological eval

uation of autogenous iliac bone grafts in humans. II.

Cortellini P, Prato GP, Tonetti MS. The modified papillary

1977.

tol 1973;44:599-613.

External root resorption. J Periodontol 1973;44:614-25.

Chanavaz M. Maxillary sinus: anatomy, physiology, sur

preservation technique. A new surgical approach for

gery, and bone grafting related to implantologyelev

interproximal regenerative procedures. J Periodontol

treatment of periodontal intraosseous defects. IV. Ef

en years of surgical experience (1979-1990). J Oral

1995;66:261-6.

fect of a non-resective versus a partially resective ap

Cortellini P, Pini PG, Tonetti MS. Periodontal regeneration

Implantol 1990;15:199-209.
Chanavaz M. Anatomy and histophysiology of the perios

of human intrabony defects with titanium reinforced

teum: quantification of the periosteal blood supply to

membranes. A controlled clinical trial. J Periodontol

the adjacent bone with 85Sr and gamma spectrome

1995; 66(9) 797-803.

Chavanaz M. Sinus grafting related to implantology. Sta

generative strategy for intrabony defects. Scientif

tistical analysis of 15 years of surgical experience

ic evidence and clinical experience. J Periodontol

(1970-1994). J Oral Implantol 1996;12:119-30.

2005;76:341-50.
Coslet JG, Vanarsdall R, Weisgold A. Diagnosis and classi

ry. A review of 21 years of surgical experience (1979-

fication of delayed passive eruption of the dentogingival junction in the adult. Alpha Omegan 1977;70:24-30.

2000). Implant Dent 2000;9:197-203.

iologic eruption. J Am Dent Assoc 1971; 82(4):836Clergeau LP, Danan M, Clergeau-Guerithault S, Brion M.
Healing response to anorganic bone implantation in
periodontal intrabony defects in dogs. Part I. Bone
regeneration.A microradiographic study. J Periodon
tol 1996; 67(2):140-149Coatoam GW, Behrents RG, Bissada NF. The width of
keratinized gingiva during orthodontic treatment: its
significance and impact on periodontal status. J Peri

J Periodontol 1965;36:188-92.

Coatoam GW', Krieger JT. A four-year study examining the

results of indirect sinus augmentation procedures. J
Cogen RB, Garrison DC,Weatherford TW. Effect of vari
ous root surface treatments on the viability and at
tachment of human gingival fibroblasts. J Periodon

surface

treatments

on

the

attachment

and growth of human gingival fibroblasts: histologic

and scanning electron microscopic evaluation. J Clin
Periodontol 1984;11:531-9Cohen DW. Lecture, Walter Reed Medical Center; 1962
June 3.
Cohen R, Tobaly K, Danan M, Pare C, Sauven J, Brion M.

Cranham J. The functional esthetic interface. Compend

Contin Educ Dent 1999; 20(6):584-6, 588, 590.

human

clinical

studies.

periodontal therapy. Int Dent J 2006;13:593.

in new attachment attempts in intrabony defects in

cal citric acid application on the healing of experi

sues after treatment of intrabony lesions. J Periodon

mental furcation defects in dogs. J Periodontal Res

1978;13:538-49.
Cummings IX, Kaldahl WB, Allen EP. Histologic evalu
dermal matrix grafts in humans. J Periodontol 2005;
76(2):178-186.

Clin North Am 1969;13:149-59-

Periodontol 1982;9:386-92.
Davis

procedure

based

WP.

Lewis

retardation

of

epithelial

Ellegaard B, Karring T, Loe H. Retardation of epithelial

defects in monkeys. J Clin Periodontol 1976;3:23-37.
Erickson BE. Impactions and pseudoimpactions Am J Or
Ethicon. W'ound closure manual. 9- Somerville, NJ. 1985.
Evian, et al. Retrospective analysis of implant surviv
al and the influence of periodontal disease and im

practice

of

surgery.

Hagerstown:W.F. Prior Co.; 1966.

Davis JS, Kitlowski EA. The immediate contraction of cu
taneous grafts and its cause. Arch Surg 1931;23:954.
de Trey E, Bernimoulin JP. Influence of free gingival
grafts on the health of the marginal gingiva. J Clin
Periodontol 1980;7:381-93.

Periodontol 2004;75:1288-94.

Cohen ES. Atlas of Cosmetic and Reconstructive Peri

Del Faborro M, et al. Systematic review of survival rates

odontal Surgery, 2nd Ed. 1999, Philadelphia, PA; Lip-

for implants placed in the grafted maxillary sinus.

Int J Periodontics Restorative Dent 2004;24:565-77.

mediate placement and long-term results. Int J Oral

Maxillofac Implants 2004;19:393-8.
Ewen J. Bone swagging. J Periodontol 1965;36:57-63.
Eastlicht S. Treatment of impacted canines Am j Orthod
1959;40:891.
Fernyhough W, Page RC. Attachment, growth and synthe
sis by human gingival fibroblasts on demineralized
or

fibronectin-treated

and

diseased

tooth

Fine DH, Morris ML, Tabak L, Cole JD. Preliminary

characterization

of

material

eluted

from

the

roots

of periodontally diseased teeth. J Periodontal Res

1980;15:10-9.

Deporter D, Todescan R, Caudry S. Simplifying manage

attachment of laterally positioned flaps. J Periodon

ment of the posterior maxilla using short, porous

preservation.

tol 1983;54:9-18.

surfaced dental implants and simultaneous indirect

2003; 8(1):321327.

sinus elevation. Int J Periodontics Restorative Dent

normal

roots. J Periodontol 1983;54:133-40.

Common J, McFall WT Jr. The effects of citric acid on

2000;20:477-85-

on

migration. J Clin Periodontol 1974;1: 75-88.

thod 1039;24:1019-

Daly CG. Anti-bacterial effect of citric acid treatment of

JS,

ment

migration in new attachment attempts in intrabony

erations about each in periodontal flap surgery. Dent

Davis

tol 1971;42:648-52.
Ellegaard B, Karring T, Loe H. New periodontal attach

for crown lengthening: a 6-month clinical study. J

surgery. Periodontics 1964;2:229-

Munksgaard;

monkeys. J Clin Periodontol 1983;10:399-

vine bone plus collage. Entretiens de Bichat. Odontol-

Corn H. Edentulous area pedicle grafts in mucogingival

Copenhagen:

1992.

Ellegaard B, Loe H. New attachment of periodontal tis

Deas DE, Moritz AJ, McDonnel HT, et al. Osseous surgery

pincott Williams and Wilkins.

Clin Periodontol 1974;1:185-96.

Egelberg J. Periodontics the scientific way. Synopsis of

Crigger M, Bogle G, Nilveus R, et al. The effect of topi

Treatment of intraosseous lesions with anorganic bo

ogie et Stomatologie 1990; xx:9I-94.

apicies of the maxillary teeth. 1992;73:345-6.

Edel A. Clinical evaluation of free connective tissue grafts

Ellegaard B, et al. Retardation of epithelial migration

periodontally diseased root surfaces in vitro. J Clin

tol 1983;54:277-82.
Cogen RB, Al Joburi W, Gantt DG, Denys FR. Effect of
root

Contin Educ 1999;20:584-95.

Dahlberg WH. Incisions and suturing: some basic consid

Oral Implantol 1997;23:117-27.

distances between the maxillary sinus floor and the

Elden A.Mejchar B. Plastic surgery of the vesibulum in

ation of autogenous connective tissue and acellular

odontol 1981;52:307-13.

various

Cowan A. Sulcus deepening incorporating mucosal graft.

Cranham J. The functional esthetic interface. Compend

840.

J Periodontol 1967;38:112-8.

used to increase the width of keratinised gingiva. J

Chanavaz M. Sinus graft procedures and implant dentist

Clark D. The management of impacted canines: free phys

proach. J Clin Periodontol 1985;12:525-39Easley JR.Methods of determining alveolar osseous form.

Eberhardt JA, et al. A computed tomographic study of the

Cortellini P, Tonetti MS. Clinical performance of a re

try. J Oral Implantol 1995;21(3) 2l4-219-

Durwin A, Chamberlain H, Garrett S, et al. Healing after

Fiorellmi JP, Nevins ML. Localized ridge augmentation/

A

systematic

review.Ann

Periodontol

Fisher M, Bowers G, Bergquist J. Effectiveness of the re

verse bevel incision used in the modified W'idman

503
flap procedure in removing pocket epithelium in hu
mans. J Periodontics Restorative Dent 1982;3:33.
Francetti L, Del Fabbro M, Calace S, et al.Microsurgical
treatment of gingival recession: a controlled clinical
study. 2005;25:181-8.
Fredholm U, Bolin , Andersson L. Preimplant radio-

Gargiulo A, Wentz F, Orban B. Dimensions of the dento-

Golub LM, Ramamurthy N, McNamara TF, et al. Tetracy

gingival junction in humans. J Periodontol 196l;32:26l.

clines inhibit tissue collagenase activity. A new mech

Gargiulo AW, Arrocha R. Histo-clinical evaluation of free

gingival grafts. Periodontics
Garraway R, Young WG, Daley T, Harbrow D, Bartold
PM. An assessment of the osteoinductive potential of

graphic assessment of available maxillary bone sup

commercial demineralized freezedried bone in the

port. Comparison of tomographic and panoramic

murine thigh muscle implantation model. J Periodon

technique Swed Dent J 1993;17:103-9-

tol 1998; 69(12):1325-1336.1967;5:285-91.

Garrett JS, Crigger M, Egelberg J, Effects of citric acid on

Fredi P, Rosenfeld W. Excisional new attachment proce

diseased root surfaces. J Periodontal Res 19783155-

dure. J Missouri Dent 1977;57:22.

Friedman N. Periodontal osseous surgery: osteoplasty and
osteoectomy. J Periodontol 1955;26:257.
Friedman

N.

Mucogingival

surgery.

Texas

Dent

1957;75:358.
Friedman N. Mucogingival surgery: The apicallv reposi
tioned flap. J Periodontol 1962;33:328.
Frisch J, Jones RA, Bhaskar SN. Conservation of maxil
lary anterior esthetics: a modified surgical approach.
J Periodontol 1967;38:11-7.
Froum SJ, Thaler R, Scopp IW, Stahl SS. Osseous auto
grafts. II. Histological responses to osseous coagu-

63.
Garrett S. Periodontal regeneration around natural teeth.
Ann Periodontol 1996;1:621-66.
Gastaldo JF, Cury PR, Sendyk WR. Effect of the vertical
and horizontal distances between adjacent implants
and between a tooth and an implant on the inci
dence of interproximal papilla. J Periodontol 2004;
75(9):1242-1246.
Genon P, Bender JC. [An esthetic periodontal access flap].
Inf Dent 1984;66:1047-55.
Gensior AM, Strauss RE. The direct bonding technique

lum-bone blend grafts. J Periodontol 1975;46(11):656-

applied to management of maxillary impacted ca

661.

nine J Am Dent Assoc 1974;89:1332-7.

Froum SJ, Thaler R, Scopp IW, Stahl SS. Osseous auto

Ghiai S, Bissada NF. The reliability of various periodontal

grafts. I. Clinical responses to bone blend or hip mar

parameters for predicting the outcome of periodon-

row grafts. J Periodontol 1975; 46(9):515-521.

tally-treated teeth. J Dent Res 1994:73:164.

Froum SJ, Thaler R, Scopp IW, Stahl SS. Osseous auto

Glickman I, Smulow JB. Alterations in the pathway of

grafts. I. Clinical responses to bone blend or hip mar

gingival inflammation into the underlying tissues

row grafts. J Periodontol 1975:46:515-21.

induced by exceesive occlusal forces. J Periodontol

Froum SJ, Ortiz M,Witkin RT, et al. Osseous autografts. III.

Comparison of osseous coagulumbone blend implants
with open curetage. J Periodontol 1976;47:287-94.
Froum SJ, Kushner L, Scopp IW, Stahl SS. Human clini

1962;33:7-13.
Glickman I, Smulow JB. Effects of excessive occlusal forc
es upon the pathway of gingival inflammation in hu
mans. J Periodontol. 1965;36:141-7.

cal and histologic responses to Durapatite implants

Glickman I, Smulow JB. Further observations on th

in intraosseous lesions. Case reports. J Periodontol

eeffects of trauma from occlusion. J Periodontol

1982;53:719-25.
Froum SJ, Tarnow DN,Wallace SS, et al. Sinus floor eleva

1967;38:280-93.
Goldman H. A rationale for the treatment of the intrabo

tion using anorganic bovine bone matrix (Osteograf/N)

ny pocket: one method of treatmentsubgingival cu

with and without autogenous bone. A clinical, histo

rettage. J Periodontol 1949;20:83.

logic, radiographic, and histomorphometric analysis

Goldman H. Periodontia. 3rd ed. St. Louis: CV Mosbv;

part 2 of an ongoing prospective study. Int J Peri

1953.
Goldman II. Therapy of the incipient bifurcation involve

odontics Restorative Dent 1998;18:529-43.

Frush JP, Fisher RD. The age factor in dentinogenetics. J
Prosthet Dent 1957;7:5-13
Frush JP, Fisher RD. The dynesthetic interpretation of the
dentogenic concept. J Prosthet Dent 1958;8:558.
Fugazzotto PA. Augmentation of the posterior maxilla.
A proposed hierarchy of treatment selection. J Peri
odontol 2003;74:1682-91.
Fugazzotto PA, Vlassis J. A simplified classification and

ment. J Periodontol 1958;29:112.

Goldman H. The infrabony pocket: classification and
treatment. J Periodontol 1958;29:272.
Goldman H. Periodontal therapy. 6th ed. St. Louis: CV
Mosby; 1979 "
Goldman 11, Schluger S, Fox L, Cohen D. Periodontal ther
apy. 3rd ed. St. Louis: CV Mosby; 1964.
Goldman H, Shuman A. Atlas of the surgical manage

repair system for sinus membrane perforations. J

ment of periodontal disease. Chicago: Quintessence;

Periodontol 2003;10:1534-41.

1982.

Gantes B, Martin M, Garrett S. Egelberg J. Treatment

Goldman HM. The development of physiologic gingival

of periodontal furcation defects. (II). Bone regenera

contours by gingivoplasty. Oral Surg Oral Med Oral

tion in mandibular class II defects. J Clin Periodon

Pathol 1950:3:879-88.

tol 1988;15:232-9.
Gantes BG, Svnowski BN, Garrett S, Egelberg JH. Treat
ment of periodontal furcation defects. Mandibular
class III defects. J Periodontol 1991;62:361-5.
Garber DA, Rosenberg ES. The edentulous ridge in
fixed prosthodontics. Compend Contin Educ Dent
1981;2:212-23.
Garg AK. Augmentation grafting of the maxillayr sinus
for placement of dental implants: anatomy, physiolo
gy, and procedures. Implant Dent 1999;8:36-45.
Garg AK, Quin onez CR.Augmentation of the maxillary
sinus. A surgical technique Regen Rep 1997;9:211-29.

Goldman HM, Cohen DW. Periodontal therapy. 4"1 ed. St.

Louis: CV Mosby; 1968.
Goldman HM, Smukler H. Controlled surgical stimulation
of periosteum. J Periodontol 1978; 49:518-22.
Goldstein RE. Esthetics in dentistry. 2nd ed. Hamilton
(ON): BC Decker; 1998.
Goldstein M, Nasatzky E, Goultschin J, Boyan BD,
Schwartz Z. Coverage of previously carious roots is as
predictable a procedure as coverage of intact roots. J
Periodontol 2002; 73(12):1419-1426.
Golub J. Entire smile pivotal to tooth design Clin Dent
1988;33:27-33-

anism in the treatment of periodontal disease. J Peri

odontal Res 1984;19:651-5.
Gorman WJ. Prevalence and etiology of gingival reces
sion. J Periodontol 1967;38:316-22.
Gottlieb B, Orban B. Active and passive continuous erup
tion of the teeth. J Dent Res 1933; 13:214-222.
Gottlieb B, Orban B. Active and passive continuous erup
tions of teeth. J Dent 1933;13:214-9.
Gottlow J, Nyman S, Karring T, Lindhe J. New attachment
formation as the result of controlled tissue regenera
tion. J Clin Periodontol 1984;11:494-503.
Gottlow J,Nyman S, Lindhe J, et al.New attachment for
mation in the human periodontium by guided tis
sue regeneration. Case reports. I Clin Periodontol
1986;13:604-16.
Gottlow J,Nyman S, Karring T.Maintenance of new at
tachment gained through guided tissue regeneration.
J Clin Periodontol 1992;19:315-7.
Gottseggen R. Frenum position and vestibule depth in re
lation to gingival health. Oral Surg Oral Med Oral
Pathol 1954;7:1069-78.
Graves M. The art of color and design. New York: McGraw-Hill; 1951.
Greenstein G, Jaffin RA, Hilsen KL, Berman CL. Repair
of anterior gingival deformity with durapatite. A case
report. J Periodontol 1985;56:200-3.
Gross JS. Bone grafting materials for dental applica
tions: a practical guide Compend Contin Educ Dent
1997;18:1013-46.
Grupe HE. Modified technique for the sliding flap opera
tion. J Periodontol 1966;37:491-5.
Grupe HE, Warren R. Repair of gingival defects by sliding
flap operation. J Periodontol 1956;27:92.
Guarnieri R, Aldim NN, Pecora G, Fini M, Giardino R. Medial-grade calcium sulfate hemihydrate (surgiplaster)
in healing of a human extraction socket-histologic observation at 3 months: a case report. Int J Oral
Maxillofac Implants 2005; 20(4):636-64l.
Gulamerian NB The languages of a work of art. Art
and Art Function Studies Division, Utrecht Linens Inc:
1963.
Haffajee AD, Socransky S, Goodson JM. Clinical parame
ters as predictors of destructive periodontal disease
activity. J Clin Periodontol 1983;10:257-65.
Haffajee AD, Socransky SS. Attachment level changes in
destructive periodontal diseases. J Clin Periodontol
1986; 13(5):46l-475.
Haggerty PC. The use of a free gingival graft to create a
healthy environment for full crown preparation. Case
history. Periodontics 1966;4:329-31.
Hall WB. Present status of soft tissue grafting. J Peri
odontol 1977;48:587-97.
Hallmon WW, Harrel SK. Occlusal analysis diagnosis and
management in practice of periodontics. Periodontol
ogy 2000 2004;34:151-64.
Hammarstrom L. Enamel matrix, cementum development,
and regeneration. J Clin Periodontol 1997;24:658-68.
Hammarstrom L, Heijl L, Gestrelius S. Periodontal regen
eration in a buccal dehiscence model in monkeys af
ter application of enamel matrix proteins. J Clin Peri
odontol 1997,24:669-77.
Handelsman M, Davarpanah M, Celletti R. Guided tissue
regeneration with and without citric acid treatment
in vertical osseous defects. Int J Periodontics Restor
ative Dent 1991;11:350-63.

504
Hanes PJ, OBrien NJ, Garnick JJ. A morphological com
parison of radicular dentin following root planing
and treatment with citric acid or tetracycline HC1. J
Clin Periodontol 1991;18:660-8.

sites with angular bone defects. A series of case re

ports. J Clin Periodontol 1999; 26(12):855-860.

cept in periodontics and restorative dentistry. Alpha

Heden G. A case report study of 72 consecutive Eindogain-treated intrabony periodontal defects: clinical

Hanes PJ, Poison AM. Cell and fiber attachment to demineralized cementum from normal root surfaces. J
Periodontol 1989;60:188-98.

Ingber FJS, Rose LF, Coslet JG. The biologic width. A con

and radiographic findings after 1 year. Int J Peri

odontics Restorative Dent 2000; 20(2):127-139-

Omegan 1977;10:62-5.
Ingle J. Periodontal currettement in the premaxilla. J
Periodontol 1952;23:143Isella JM. Ridge preservation with freeze-dried bone al

Heijl L, Gestrelius S. Treatment of intrabony defectrs with

lograft and a collagen membrane compared to ex

Hangorsky U, Bissada NF. Clinical assessment of free gin

periodontal surgery and adjunctive Emdogain. A re

traction alone for implant site development. A clin

gival graft effectiveness on the maintenance of peri

view and meta-analysis involving all studies with at

ical and histologic study in humans. J Periodontol

odontal health. J Periodontol 1980;51:274-8.

least 10 patients published between 1998 and January

2003;74:990-9-

Harrel SK. Occlusal forces as risk factor for periodontal

disease. Periodontology 2000 2003;32:111-7.

2001. Chicago: Biora; 2001.

Istdor F, Karring T, Nyman S, Lindhe J. The signifi

Heijl L.Henden G, Svardstrom G, Ostgren A. Enam

Harrel SK, Nunn M. The effect of occlusal discrepancies

el

matrix

derivative

(Emdogain)

in

the

treatment

on treated and untreated periodontitis. II. Relation

of mfrabony periodontal defects. J Clin Periodontol

ship of occlusal treatment to the progression of peri

1997;24:705-14.

odontal status of patients with moderate to severe

periodontal disease receiving no treatment, non-surgical treatment, and surgical treatment utilizing indi
vidual sites for analysis. J Periodontol 2001;72:1509-19-

prognosis

of

sue for new attachment formation. J Clin Periodon

tol 1986;13:145-50.
Jaffin RA, Berman CL. The excessive loss of Branemark

Hellden LB, Elliot A, Steffensen B, Steffensen JE. The

odontal disease. J Periodontol 2001;72:495-595.

Harrel SK, Nunn M. Longitudinal comparison of the peri

cance of coronal growth of periodontal ligament tis

tunnel

preparations

in

treatment

of

class III furcations. A follow-up study. J Periodon

tol 1989;60:182-7.

fixtures in type IV bone: a 5-year analysis. J Peri

odontol 1991; 62(1):24.
Jahnke PV, Sandifer JB, Glier ME, et al. Thick free gin
gival and connective tissue autografts for root cover

Herrmann JB. Tensile strength and knot security of sur

gical suture materials. Am Surg 1971;37:209-17.

age. J Periodontol 1993;64:315-22.

James RA, Klein E. A histopathologic report on the na

Harring T, et al. Healing following implantation of peri

Henderson RD, Greenwell H, Drisko C, et al. Predictable

ture of the epithelium and underlying connective tis

odontitis affected roots into bone tissue. J Periodon

multiple site root coverage using an acellular dermal

sue with surrounding oral implants. J Biomed Mater

tol 19 8 0; 2:9 6.

matrix allograft. J Periodontol 2001;72:571-82.

Harris RJ. Root coverage with a connective tissue with

Hiatt WH, Schallhorn RG. Intraoral transplants of cancel

partial thickness double pedicle graft and an acel

lous bone and marrow in periodontal lesions. J Peri

lular

odontol 1973;44:194-208.

dermal

matrix

graft:

clinical

and

histo

logical evaluation of a case report. J Periodontol

1998;69:1305-11.
Harris RJ. A comparison of root coverage obtained with
a connective tissue graft versus an acellular dermal

Hileman A. Surgical repositioning of the vestibule and

hisence defects and delayed extraction sockets. In:

frenums in periodontal surgery. Dent Clin North Am

Guided bone regeneration in implant dentistry. Car

1960;4:55.

ol Stream (IL): Quintessence Publishing Co.; 1994. p.

Hirschfeld L. Subgingival curettage in periodontal treat

Holbrook T, Ochsenbein C. Complete coverage of the de

with an acellular dermal matrix versus a connective

nuded root surface with a one-stage gingival graft.

consecutively treated patients. Int J Periodontics Re

Harris RJ Cellular dermal matrix used for root coverage:
18-month follow-up observation. Int J Periodontic Re

mal matrix: human histologic evaluation of a case

placement of the graft on periosteum. Int J Periodon

mal matrix: human histologic evaluation of a case

placement of the graft on bone. Int J Periodontics
Harris RJ. The connective tissue and partial thickness
double pedicle graft: a predictable method of obtain
ing root coverage. J Periodontol 1992; 63:477-86.
extraction

wound

healing

in

Hart TC, Kornman KS. Genetic factors in the pathogene

sis of periodontitis Periodontology 2000 1997;14:2002215.
Harvey PM. Management of advanced periodontitis. I.
Preliminary report of a method of surgical recon
struction. N Z Dent J 1965;61:180-7.
Hatfield CG, Baumhammers A. Cytotoxic effects of perisurfaces

of

human

teeth.

Arch

Oral Biol 1971;16:465-8.

Hawley CE, Staffileno H. Clinical evaluation of free gin
gival

grafts

in

periodontal

reimplantation

in

the

monkey.

surgery.

Periodontol

1970;41:105-12.
Heden G,Wennstrom J, Lindhe J. Periodontal tissue alter
ations following Emdogain treatment of periodontal

for anterior single-tooth implant restoration. Com

pend Contin Educ Dent 1995;16:746-62.
Jensen , et al. Report of sinus consensus conference
1996. Int J Oral Maxillofac Implants 1998;13 Suppl:5-41.
Jensen , Shulman LB, Block MS, Iacono VJ. Report of
the Sinus Consensus Conference of 1996. Int J Oral
Maxillofac Implants 1998 Suppl 1:11-45.
Jensen , Sindet-Pedersen S, Oliver AJ. Varying treatment
strategies for reconstruction of maxillary atrophy with
implants. J Oral Maxillofac Surgl994;52:210-6.
Jepsen S, Eberhard J,Herrera D,Needleman I. A systemat

Clin

Periodontol

1985;12:716-27.
Hwang D,Wang HL. Flap thickness as a predictor of root
77(101:1625-1634.
Hughes GA. Facial types and tooth arrangement. J Pros
Hunter S. Treatment of the unerupted maxillary caries.
Br Dent J 1983;254:294-6.
Hutchens L. Periodontal suturing: A review of needles,

rats. Acta Odontol Scand 1972;30: 511-22.

involved

tal Art.W'hittier: M.M. House, 1939.

thet Dent 1951;1:82-95.

Hars E, Massler M. Effects of fluorides, corticosteroids

odontally

House M, Loop J. Form and Color Harmony in the Den

coverage: a systematic review. J Periodontol 2006;

Restorative Dent 2001; 21(l):69-75.

on

barrier-protected extraction sockets. 2005;26:703-26.

Houston F, Sarhed G, Nyman S, et al. Healing after root

tics Restorative Dent 2004;24:378-85.

Harris RJ. Gingival augmentation with an acellular der

tetracyclines

odontology Meeting. 2003, San Francisco, California.

Horowitz RA. Extraction environment enhancement: crit
ical evaluation of early socket healing in long term

storative Dent 2002;22:156-63.

Harris RJ. Gingival augmentation with an accelular der

and

Int J Periodontics Restorative Dent 1983;3:8-27.

Horowitz, RA. Preservation of the extraction socket. Sottosanti Lecture at the American Academy of Peri

storative Dent 2000;20:51-9-

155-88.
Jensen CE, W'eisgold A. Presurgical treatment planning

Harris RJ. A comparative study of root coverage obtained

tissue graft. The results of 107 recession defects in 50

goldenproportion. Dent Today 2002;95-100.

Javanovic SA, Buser D. Guided bone regeneration in de-

ment. J Am Dent Assoc 1952;44:454.

matrix [abstract], J Periodontol 1999; 70:235.

Res 1974;5:373-82.
Javaheri DS, Shahnavaz S. Utilizing the concept of the

materials and techniques. Postgrad Dent 1995; 2:1-15.

Ibbott CG, Oles RD, Laverty WH. Effects of citric acid

ic review of guided tissue regeneration for periodon

tal furcation defects. What is the effect of guided
tissue regeneration compared with surgical debride
ment in the treatment of furcation defects? J Clin
Periodontol 2002; 29 Suppl 3103-116.
Jin LJ, Cao CE. Clinical diagnosis of trauma from occlu
sion and its relation with severity of periodontitis. J
Clin Periodontol 1992; 19(2):92-97.
Johnson GK, Sivers JE. Forced eruption in crownlengthening procedures. J Prosthet Dent 1986;86:424-7.
Johnston

WD. Treatment

of palatally impacted canine

teeth. Am J Orthod 1969;56:589-96.

Jones WA, OLeary TJ. The effectiveness of in vivo root

treatment on autogenous free graft coverage of local

planing

ized recession. J Periodontol 1985;56:662-5.

roots of periodontally involved teeth. J Periodontol

Ingber JS. Force eruption. Part Ia method of treating

in

removing

bacterial

endotoxin

from

the

1978;49:337-42.

isolated one- and two-wall infrabony osseous defects:

Jovanovic M. Technical tips to increase the predictability

rationale and case report. J Periodontol 1975;45:199-

when using Gore regenerative membranes. 2004.W.L

204.

Gore and Associates, Inc. Ref Type: Pamphlet

Ingber JS. Forced eruption. Part IIa method of treating

Kaldahl WB, Tussing GJ, Wentz FM, Walker JA. Achiev

nonrestorable teeth: periodontal and restorative con

ing an esthetic appearance with a fixed prosthesis by

siderations. J Periodontol 1976; 47:203-7.

Ingber JS. Forced eruption: alteration of soft tissue cos

submucosal grafts. J Am Dent Assoc 1982;104:449-52.

Kaldahl

WB,

et

al.

Levels

of

cigarette

consumption

metic deformities. Int J Periodontics Restorative Dent

and response to periodontal therapy. J Periodontol

1989;9:417-25.

1996;67:675-81.

505
Kantor M, Poison AM, Zander HA. Alveolar bone regen

Kokich VO Jr, Kiyak A, Shapiro PA. Comparing the per

Levine HL, Stahl SS. Repair following periodontal flap

eration after removal of inflammatory and traumat

ception of dentists and lay people to altered dental

surgery with the retention of gingival fibers. J Peri

ic factors J Periodontol 1976;47:687-5.

esthetics. J Esthet Dent 1999;11:311-24.

odontol 1972;43:99-103-

Karring T, Ellegaard B. New attachment attempts based

Kornman KS, et al. The interleukin-1 genotype as a se

Levine RA, McGuire M. The diagnosis and treatment

on prevention of epithelial downgrowth in humans. J

verity factor in adult periodontal disease. J Clin Peri

Clin Periodontol 1976;3:44.

odontol 1997;24:72-7.

of the gummy smile. Compend Contin Educ Dent

1977;18:757-66.

Karring T, Lang NP, Loe H. Role of connective tissue

Kornman KS, Knobehnan C, Wang HY. Is periodontitis

in determining epithelial specificity. J Dent Res

genetic? The answer may be yes. J Mass Dent Soc

term effect of apically repositioned flap surgery on

2000;49:26-30.

the composition of the subgingival microbiota. Int J

1972;51:1303.
Karring T, Lang NP, Loe H. The role of connective tissue

Kozlovsky A, Tal H, Lieberman M. Forced eruption com

in determining epithelial differentiation. J Periodon

bined with gingival fiberotomy. A technique for clini

tol Res 1974;10:1.

cal crown lengthening. J Clin Periodontol 1988;15:534-

Karring T, Ostergaard E, Loe H. Conservation of tissue

specificity after heterotopic transplantation of gingiva
and alveolar mucosa. J Periodontal Res 1971;6:28293.
Kennedy JE, Bird WC, Palcanis KG, Dorfman HS. A longi
tudinal evaluation of varying widths of attached gin
giva. J Clin Periodontol 1985;12:667-75.
Keougli B. Occlusion-based treatment planning for com
plex dental restoration: part I. Int J Periodontics Re
storative Dent 2003;23:237-47.
Kersten BG, Chamberlain AD, Khorsandi S, et al. Heal
ing of the intrabony periodontal lesion following root
conditioning with citric acid and wound closure in
cluding an expanded PTFE membrane, j Periodontol
1992;63:876-82.
King K, Pennel B. Evaluation of attempts to increase th
ewidth of attached gingiva. Presented at meeting of
Phildelphia Society of Periodontology 1964; April.
Kinoshita S,Wen R. Color atlas of periodontics. St. Louis:
Mosby Yearbook; 1985.
Kirch J, Baderstein A, Egelberg J. Longitudinal observa
tion of unattached, mobile gingival areas. J Clin
Periodontol 1986;13:131.
Kirkland O. The suppurative periodontal pus pocket; its
treatment by the modified flap operation. J Am Dent
Assoc 1936;18:1462.
Kirkland 0. Surgical flap and semiflap technique in peri
odontal surgery. Dent Dig 1936;42:125.
Kleinman HK, Klebe RJ,Martin GR. Role of collagenous
matrices in the adhesion and growth of cells J Cell
Biol 1981;88:473-85.
Kleinman HK,McGoodwin EB. Localization of the cell at
tachment region in types I and II collagens. Biochem
Biophys Res Commun 1976;72:426-32.
Kois JC. Altering gingival levels: the restorative connec
tion. Part I: biologic variables. J Esthet Dent 1994;6:3-9
Kois JC. New paradigms for anterior tooth prepara
tion: rationale and technique. Contemp Esthet Dent
1996:2:1-8.

8.
Kramer G, Schwartz M. A technique to obtain primary in
tention healing in pocket elimination adjacent to an
edentulous area. Periodontics 1964;2:252.
Kronfeld R. Condition of alveolar bone underlying peri
odontal pockets. J Periodontol 1935;6:22.
Kure K, et al. Influences of attached gingiva on plaque
accumulation and gingival inflammation in monkeys.
J Dent Res 1985:63:555.
Lang NP, Tonetti MS, Suter J, et al. Effect of interleukin-1
gene polymorphisms on gingival inflammatory as
sessed by bleeding on probing in a periodontal main
tenance population. J Periodontal Res 2000;35:102-7.
Lange N, Loe H. The relationship between the width of
keratinized gingiva and gingival health. J Periodon
tol 1972;43:623Langer B, Calagna L. The subepithelial connective tissue
graft. J Prosthet Dent 1980;44:363-7.
Langer B, Calagna LJ. The subepithelial connective tissue
graft. A new approach to the enhancement of an
terior cosmetics. Int J Periodontics Restorative Dent
1982;2:22-33.
Lanning Sk, Waldrop TC, Gunsolley JC, Maynard JG. Sur
gical crown-lengthening: evaluation of biologic width.
J Periodontol 2003;74:468-74.
Lappin M. Practical management of impacted maxillary
cuspid. Am J Orthod 1951; 37:769-778.
Laurell L, Gattlow J, Zvbutz M, Persson R. Treatment of
intrabony defects by different surgical procedures. A
literature review. J Periodontol 1998;69:303-13
Leblebicioglu B, Ersanli S, Karabuda C, Tosun T, Gokdeniz H. Radiographic evaluation of dental implants

Levy RM, Grannobile WV, Feres M, et al. The short

Periodontics Restorative Dent 1999;19:555-67.

Lie T. Periodontal surgery for the maxillary anterior
area. Int J Periodontics Restorative Dent 1992;12:7281.
Lieb N, Silverman SI. An analysis of soft tissue contour
of the lips in relation to the maxillary cuspids J
Prosthet Dent 1967;18:292-303.
Lieb ND, Silverman SI, Garfinkel L. An analysis of soft
tissue contours of the lips in relation to the max
illary cuspids. J Prosthet Dent 1967;18(4):292-303.
Lindhe J. Textbook of clinical periodontology. Copenha
gen: Munksgaard; 1983.
Lindhe J,Hamp S, Loe H. Experimental periodontitis in
the beagle dog. J Periodontal Res 1973;8:1-10.
Lindhe J, Nyman S. Alterations of the position of the
marginal soft tissue following periodontal surgery.
J Clin Periodontol 1980;7:525-30.
Lindhe J, Nyman S, Karring T. Connective tissue reat
tachment as related to presence or absence of alve
olar bone. J Clin Periodontol 1984;11:33-40.
Lindhe J, Karring T, Lang NP. Clinical periodontology
and implant dentistry. 4th ed. Oxford (UK): Blackwell Munksgaard Publishing Co.; 2003.
Listgarten MA, Rosenberg MM. Histological study of re
pair following new attachment procedures in hu
man

periodontal

lesions.

Periodontol

1979;

50(7):333-344.
Livesey SA, Herdon DN, Hollyoak MA, et al. Transplant
ed acellular allograft dermal matrix. Transplanta
tion 1995;60:1-9.
Livingston HL. Total coverage of multiple and adjacent
denuded root surfaces with a free gingival auto
graft. A case report. J Periodontol 1975:46:209-16.
Loe II. Experimental gingivitis in man. J Periodontol
1965;36:177

placed using an osteotome technique. J Periodontol

Lombardi RE. The principles of visual perception and

2005; 76(3):385-390.
Leighton J. Collagen-coated cellulose sponge. In: Kruse

their clinical application to denture esthetics. I

PJ, Patterson'MJ, editors. Tissue culture, methods and

applications. New York: Academic Press; 1982. p. 36771.
Lekovic V, Kenney EB, Kovacevic K, Carranza FA Jr. Eval

Prosthet Dent 1973;29:358-82.

Lopez NJ, Belvederessi M, de la SR. Inflammatory ef
fects of periodontally diseased cementum studied
by autogenous dental root implants in humans. J

Kois JC. Esthetic extraction site development: the biologic

uation of guided tissue regeneration in Class II fur

Periodontol 1980;51:582-93.
Louise F, Borghetti A, Kerebel B. Histologic case reports

variables Contemp Esthet Restorative Pract 1998;4:10-

cation defects. A clinical re-entry study. J Periodon

of coralline hydroxyapatite grafts placed in human

().

tol 1989:60:694-8.

intraosseous lesions: results 6 to 36 months post

Kois JC, Kan JYK. Predictable peri-implant gingival es

Lekovic V. Treatment of Grade II furcation defects using

thetics. Surgical and prosthetic rationales. Pract

porous HA in conjunction with a PTFE membrane. J

Proced Aesthet Dent 2001;13:691-8.

Periodontol 1990; 62:575.

Kokich VG. Anterior dental esthetics: an orthodontic per

Lekovic V, Kenney EB, Carranza FA Jr, Danilovic V. Treat

spective. I. Crown length. J Esthet Dent 1993;5:19-23-

ment of class II furcation defects using porous hy-

Kokich VG. Anterior dental esthetics: an orthodontic

droxylapatite in conjunction with a polytetrafluoro-

perspective. II. Vertical relationships. J Esthet Dent

1993:5:174:8.
Kokich VG Anterior dental esthetics: an orthodontic per
spective. 111. Mediolateral relationships. J Esthet Dent
1993;5:200-7.
Kokich VG,Matthews DP. Surgical and orthodontic man
agement of impacted teeth. Dent Clin North Am
1993;37:181-204.

ethylene membrane. J Periodontol 1990;61:575-8.

Lekovic V, Kenney EB.Weinlander M, et al. A bone regen

implantation. Int J Periodontics Restorative Dent

1992;12:474-85.
Lu HK. Topographical characteristics of root trunk
length related to guided tissue regeneration. J Peri
odontol 1992;63:215-9Macht SI), Krizek TJ. Sutures and suturingcurrent con
cepts. J Oral Surg 1978;36:710-12.
Mahn Dll. Treatment of gingival recession with a mod

erative approach to alveiolar ridge maintenance fol

ified tunnel technique and an acellular dermal

lowing tooth extraction J Periodontol 1997;68:563-70.

connective tissue allograft. Pract Proced Aesthet

Levin El. Dental esthetics and the golden proportion. J

Prosthet Dent 1978;40:244-52.
Levine RA. Forced eruption in the esthetic zone Compen
Contin Educ Dent 1997;18:795-803.

Dent 2001;13:69-74.
Mahn DH. Correction of lingual gingival recession us
ing an acellular dermal connective tissue allograft.
Pract Periodontics Aesthet Dent 2002;14:507-10.

506
Maitia J. Efficiency of scaling of the molar function area
with and without surgical access. J Periodontics Re
storative Dent 1986;6:52.
section procedures in maxillary first molars. J Peri
odontol 1992;63:290-6.
JD.

Passive

lografts. Dent Clin North Am 1980;24: 719-37.

eruption.

Dent

Pract

Dent

Rec

lografts in periodontal osseous defects. J Dent Rest

1981;60:388.

Mariotti A. Efficacy of clinical root surface modifiers in

the treatment of periodontal disease. A systematic re
view. Ann Periodontol 2003;8:205-26.

sign. JADA 2001;132:39-45.

Morman W, Meier C, Firestone A. Gingival blood circula

implant material in human periodontal defects. Int J

tion after experimental wounds in man. J Clin Peri

odontol 1979;6:417.

Mellonig J. Bone grafting (lecture). Boston, Yankee Den

tal Conference 1992.
rived bone xenograft in treatment of periodontal os

treatment of root surfaces on the formation of new

seous defects. Int J Periodontics Restorative Dent

connective

2000;20:19-29.

tissue

attachment.

Clin

Periodontol

Martin M, Gantes B, Garrett S, Egelberg J. Treatment of

periodontal furcation defects. (I). Review of the liter
ature and description of a regenerative surgical tech

dimensions and interproximal papillae through periodonjtal procedures: Long term results. Contemp Esthet Restor Pract 2004; 8:16-26.

Masada MP, Fersson R, Kenney JS, et al. Measurement

of interleukin-la and -lb in gingival crevicular fluid:
implications for the pathogenesis of periodontal dis

esthetic effect. J Periodontol 1979:50:320.

nectic and conditioned medium as chemoattractants.

prevalence and therapy in children. J Periodontol

1975;46:543-52.
Maynard JG Jr,Wilson RD. Physiologic dimensions of the
periodontium significant to the restorative dentist. J

cation invasions. J Periodontol 1991;62:354.

McClain PK, Schallhorn RG. Long-term assessment of

Periodontol 2003;8:303-20.
tol 1954;25:38.
Nabers CL, Reed OM, Hamner JE, III. Gross and histolog
postoperatively. J Periodontol 1972; 43(ll):702-704.
Nabers C, OLeary J. Autogenous bone graft: case report.

laminar reconstructive procedure for the coverage of

denuded root surfaces. J Periodontol 1987; 58(2):95-

Miller P Root coverage using a free soft tissue autoge

odontics Restorative Dent 1982;2:65.

102 .

Nevins M,

Skurow HM. The intracrevicular restorative

margin, the biologic width, and the maintenance of

carious root. J Periodont Rest Dent 1983;2:9.

the gingival margin. Int J Periodontics Restorative

Dent 1984; 4(3):30-49.
Nevins M, Mellonig JT. Enhancement of the damaged

Miller P. A classification of marginal tissue recession. Int

J Periodontics Restorative Dent 1985;2:9-

edentulous ridge to receive dental implants: a com

bination of allograft and the GORE-TEX membrane.

Miller P. Root coverage using free soft tissue autofrafts

McGuire MK. Reconstruction of bone on facial surfaces: a

ed. Philadelphia: Lea and Febiger; 1990.

Murphy KG, Gunsolley JC. Guided tissue regeneration for

1979;41:657-60.

following citric acid application. II. Treatment of the

maintenance care. J Periodontol 1991;62:51-8.

Moss-Salentign L, Klvvert M. Dental and oral tissue. 3rd

dental midline to the facial midline. J Prosthet Dent

Miller P. Root coverage using a soft free tissue autograft

term survey of 100 treated periodontal patients under

thetics: a rationale for smile analysis and treatment.

Periodontics 1975;5:251-

ing, and guided tissue regeneration. Int J Periodon

tics Restorative Dent 1993;13:9-27.

Moskowitz ME, Nayyar A. Determinants of dental es

Nelson SW. The subpedicle connective tissue graft. A bi-

combined osseous composite grafting, root condition

McGuire MK. Prognosis versus actual outcome: a long

sinus

Miller EL, Jamison HC. A study of the relationship of the

nous graft following citric acid application. J Peri

Periodontol 1979;50:170-4.

maxillary

ic evaluation of an autogenous bone graft 57 months

Metzler D. Clinical evaluation of guided tissue regenera

tion in the treatment of maxillary class II molar fur

gival grafts. J Periodontol 1976;47:574-9.

Maynard JG Jr, Ochsenbein C. Mucogingival problems,

the

Nabers C. Repositioning the attached gingiva. I Periodon

Mensing H. A study of fibroblast chemotaxis using fibroEur J Cell Biol 1983;29:268.

ease. J Periodontal Res 1990;26:56-63.

Matter J, Cimasoni G. Creeping attachment after free gin

on

the treatment of periodontal osseous defects. Ann

Meltzer J. Edentulous area tissue graft correction of an

nique. J Clin Periodontol 1988;15:227-31.

inflammation

mucosa. J Periodontol 1992;63:674-81.

Compend Contin Educ 1995;16:1164-86.

Melnick PR, Camargo PM. Preservation of alveolar ridge

1986;13:109-16.

Moskow BS. A histomorphologic study of the effects of

periodontal

Mellonig JT. Human histologic evaluation of bovine-de-

Marks SC Jr, Mehta NR. Lack of effect of citric acid

Pharmacology and therapeutics for dentistry.

Morley J, Eubank J.Macroesthetic elements of smile de

Mellonig JT.Decalcified freeze-dried bone allografts as an

Periodontics Restorative Dent 1984;6:4l.

1963;14:2-9.

Montgomery EII. Principles and mechanism of antibiotic

therapy. In: Neidle EA, Kruger DC, Yagiela JA, editors.

Mellonig JT. Histologic evaluation of freeze-dried bone al

Majzoub Z, Kon S. Tooth morphology following root re

Manson

Mellonig JT. Alveolar bone induction: autografts and al

following citric acid application. III. A successful and

Int J Periodontics Restorative Dent 1992; 12(2):96-111.

Nevins M, et al. Bone formation in the goat maxillary si

series of case reports. Int J Periodontics Restorative

predictable procedure in areas of deep-wide reces

Dent 1992;12:133-43.

sion. Int J Periodontics Restorative Dent 1985;2:15.

impregnated with recombinant human bone morpho-

Miller PD Jr, Allen EP. The development of periodon

gemc protein-2. Int J Periodontics Restorative Dent

McGuire MK. Prognosis vs outcome: predicting tooth sur

tal plastic surgery. Periodontology 2000 1996;11:7-17.

vival. Compendium 2000;21:217-28.

McGuire MK, Nunn ME. Prognosis versus actual outcome.
II. The effectiveness of commonly taught clinical pa
rameters in developing an accurate prognosis. J Peri

Misch CE. Contemporary implant dentistry. 2nd ed. CV

Mosby.

McGuire MK, Nunn ME. Prognosis versus actual out

come III. The effectiveness of clinical parameters

approach,

healing,

and

progressive

boen

loading. Int J Oral Implantol 1990; 6(2):23-31.

Misch CE. The maxillary sinus lift and sinus graft sur
gery. In: Contemporary implant dentistry. St. Louis:

tol 1996;67:666-74.

Mosby; 1999- p. 469-95.

IV.

The

effectiveness

of

clinical

paramenters

and

IL-1 genotype in accurately predicting prognoses and

from

healing

periodontal

pockets.

Misch CE,Moore P. Steroids and reduction of pain, ede

ma, and dysfunction in implant dentistry. Int J Oral
Implants 1989;6:27-31.

Periodontol

1988;59:750-7.
Meisel, et al. Dose-effect relation of smoking and inter
leukin-1 gene polymorphism in periodontal disease. J
Periodontol 2004;75:236-42.
Mejias JE, Griffin TJ. The absorbable synthetic sutures.
Compend Contin Educ Dent 1983; 4(6):567-572.
Melcher A, Dreyer C. Protection of the blood clot in heal

illary

sinus

elevation

surgery.

Oral

Implantol

1992;18:15-23.
Misch CM. The extracted tooth-pontic-provisional replace

Current

status

of

the

management

of

52(9):559-568.
sented at the American Acedemy of Periodontology,
New Orleans (October) 1984.
clinical risk factors with treatment outcomes. J Peri
odontol 1994;65:489-97.
Nieri M, et al. The prognostic value of several periodon
tal factors measured as radiographic bone level vari

ment during bone graft and implant healing. Pract

ation. A 10-year retrospective multilevel analysis of

Periodont Aesthet Dent 1998;10:711-8.

treated and maintained periodontal patients. J Peri

Mlinek A, Smukler H, Buchner A. The use of free gingi

val grafts for the coverage of denuded roots. J Peri
odontol 1973;44:248-54.
Monnet-Corti V, Santini A, Glise JM, Fouque-Deruelle C,
Dillier FL, Liebart MF et al. Connective tissue graft

1962;44:424,

for gingival recession treatment: assessment of the

sues. J Periodontol 1976; 47(5):256-260.

DH.

teeth with furcation invasions. J Periodontol 1981;

Newman MG, Kornman KS, Holtzman S. Association of

ing circumscribed bone defects. J Bone Joint Surg

Melcher AH. On the repair potential of periodontal tis

port. J Periodontics Restorative Dent 2003;23:9-17.

Newell D. The management of furcation invasions. Pre

Misch CM. The pharmacological management of max

tooth survival. J Periodontol 1999;70:49-56.

McHugh WD. The effects of exclusion of epithelium

fects with Bio-Oss collagen: a human histologic re

Newell

in accurately predicting tooth survival. J Periodon

McGuire NK, Nunn ME. Prognosis versus actual outcome.

1996;16:9-19.
Nevins ML, Camelo M, Lynch SE, et al. Evaluation of peri
odontal regeneration following grafting intrabony de

Misch CE. Density of bone: effect on treatment plans,

surgical

odontol 1996;67:658-65.

nus induced by absorbable collagen sponge implants

maximum graft dimensions at the palatal vault as a

donor site. J Periodontol 2006; 77(5):899-902.

odontol 2002;73:1485-93Nilveus R, Bogle G, Crigger M, Egelberg J, Selvig KA. The

effect of topical citric acid application on the healing
of experimental furcation defects in dogs. II. Heal
ing after repeated surgery. J Periodontal Res 1980;
15(5)544-550.
Nkenke E, Kloss F, Wiltfang J, et al. Histomorphometric and fluorescence microscopic analysis of bone

507
remodelling after

installation of implants using

an osteotome technique. Clin Oral Implants Res

2002;13:595-602.
Nkenke E, Schlegel A, Schultze-Mosgau S, et al. The endo-

Page RC, Kornman KS. The pathogenesis of periodontitis.

Periodontology 2000 1997:14:112-57.
Pagliaro U, Nieri M. Francesehi I), Clauser C, Pini-Prato G.
Evidence-based mucogingival therapy. Part 1: A crit

scopically controlled osteotome sinus floor elevation:

ical review of the literature on root coverage proce

a preliminary prospective study. Int J Oral Maxillofac

dures. | Periodontol 2003; 74(5)709-740.

Implants 2002;17:557-66.
Novaes AB Jr, Grisi DC, Molina GO, et al. Comparative

6-month clinical study of a subepithelial connec

tive tissue graft and acellular dermal matrix graft

Paul SJ. Simple analysis and face-bow transfer: enhanc

ing esthetic restorative treatment. Pract Proced Aesthet Dent 2001;13:217-22.
Peleg M,Maxor Z, Chaushu G, Gark AK. Sinus floor

Pontoriero R. Guided tissue regeneration in the treatment

of furcation defects in mandibular molars. A clinical
study of degree III involvements. Int J Periodont Rest
Dent 1980; 16:170.
Pontoriero R. Guided tissue regeneration in surgically
produced furcation defects. An experimental study in
the beagle dog. Int J Periodont Rest Dent 1992; 19:159.
Pontoriero R, Carnevale G. Surgical crown lengthening: a
12-month clinical wound healing study. J Periodon
tol 2001;72:841-8.

for the treatment of gingival recession. J Periodon-

augmentation with simultaneous implant place

tol 2001;72:1477-84.

ment in the severely atrophic maxilla. J Periodontol

branes and enamel matrix derivative in the treatment

1948;69:1397-403.

of angular bone defects. A prospective controlled

Nunn M, Harrel SK. The effect of occlusal discrepancies

on treated and untreated periodontitis. I. Relation
ship of initial occlusal discrepancies to initial clinical
parameters. J Periodontol 2001;72:485-94.
Nyman S, Karring T, Lindhe J, Planten S. Healing follow
ing implantation of periodontitis-affected roots into

Peleg M.Maxor Z, Garg AK. Augmentation grafting of the

maxillary sinus and simultaneous implant placement

Pontoriero R, Wennstrom J, Lindhe J. The use of mem

clinical study. J Clin Periodontol 1999;26:833-40.

m patients with three to five millimeteres of resid

Postlethwait R. Wound Healing and Surgery. Somerville,

New Jersey, Ethicon, Inc 1971.

ual alveolar bone height. Int J Oral Maxillofac Im-

Pound E. Applying harmony in selecting and arranging

plantsl999;14:549-56.

teeth. Dent Clin North Am 1962; March:24l.

gingival connective tissue. J Clin Periodontol 1080;

Pennel B, et al. Oblique rotated flap. J Periodontol I960;

Pound E. Let S be your guide. J Prosthet Dent

7(5)394-401.

36:305.
Pennel B. Free masticatory mucosa graft. J Periodontol

Prato G. Human fibrin glue versus sutures in periodontal

Nyman S, Gottlow J, Karring T, Lindhe J. The regenera

tive potential of the periodontal ligament. An experi
mental study in the monkey. J Clin Periodontol 1982;

1969; 40:162.
Peterson LJ. Antibiotic prophylaxis against wound infec

9<3):257-265.
Nyman S, Lindhe J, Karring T, Rylander H. New attach

tions m oral and maxillofacial surgery. J Oral Maxil

lofac Surg 1990;48:617-20.

ment following surgical treatment of human peri

Pietrokovski J.Massler M. Alveolar ridge resorption follow

odontal disease. J Clin Periodontol 1982; 9(4):290296 .

Obwegeser H. Operationstechnik der submukosen mundvorhofplastik in der Underkieferfront. Dtsch Zahnarztl Z 1956; 11:11282.
Ochsenbein C. Osseous resection in periodontal therapy.
J Periodontol 1958; 29:15.
Ochsenbein C, Bohannan H. The palatal approach to os

ing tooth extraction. J Prosthet Dent 1967; 17(l):21-27.

Pihlstrom BL, Anderson KA, Aeppli D, Schaffer EM. Asso
ciation between signs of trauma from occlusion and
periodontitis. J Periodontol 1986;57:1-6.
Pikos MA.Maxillary sinus membrane repair: report of
a technique for large perforations. Implant Dent
1999;8:29-34.
Pini Prato G, Clauser C, Cortellini P. Guided tissue regen

seous surgery. I. Rationale. J Periodontol 1963; 34:60.

eration and a free gingival graft for the management

Ochsenbein C, Bohannan H. The palatal approach to os

of buccal recession: a case report. Int J Periodontics

seous surgery. II. Clinical application. J Periodontol

1964; 35:54.

Restorative Dent 1993;13:486-93.

Pini Prato GP, Baldi C, Nieri M, Franseschi D, Cortellini P,

Ochsenbein C. Current status of osseous surgery. J Peri

Clauser et al. Coronally advanced flap: the post-sur

odontol 1977; 45:577.

Ochsenbein C, Ross S. A reevaluation of osseous surgery.

gical position of the gingival margin is an important

Dent Clin North Am 1969; 13(11:87-102.

Ochsenbein C. A primer for osseous surgery. Int J Peri
odontics Restorative Dent 1986; 6fl):847.
Ochsenbein C, Ross S. A concept of osseous surgery and
its clinical application. In War,; HL, Thomas CC, edi
tors. A periodontal point of view.
Olsen C, Ammons W, van Belle G. A longitudinal study
comparing apically repositioned flaps, with and with
out osseous surgery. Int J Periodont Rest Dent 1985;
44:11.
Olsson M, Lindhe J. Periodontal characteristics in indi
viduals with varying forms of the upper central inci
sors. J Clin Periodontol 1991;18:78-82.
Orban B. Oral History and Embryology. 6th Ed. ed. St.
Louis: C.V.Mosby, 1966.
Oreamuno S, Lekovic V, Kenney EB, Carranza FA, Jr.,
Takei HH, Prokic B. Comparative clinical study of
porous hydroxvapatite and decalcified freeze-dried

factor for achieving complete root coverage. J Peri

odontol 2005; 76(5)713-722.
Poison AM. Trauma and progression of marginal peri
odontitis in squirrel monkeys. II. Codestructive dactors of periodontitis and mechanically produced inju
ry. | Periodontol Res 1974;9:108-13.
Poison AM, Meitner SW, Zander HA. Trauma and progres
sion of marginal periodontitis in squirel monkeys. III.
Adaptation of interproximal alveolar bone to repeti
tive injury. J Periodontol Res 1976;11:290-7.
Poison AM, Caton J. Factors influencing periodontal re
pair and regeneration. J Periodontol 1982; 53(10):6l7625.
Poison AM, Prove MP. Effect of root surface alterations on
periodontal healing. II. Citric acid treatment of the
denuded root. J Clin Periodontol 1082; 9(6)441-454.
Poison AM, Prove MP. Fibrin linkage: a precursor for new
attachment. J Periodontol 1983; 54(3)141-147.
Poison AM, Frederick GT, Ladenheim S, Hanes PJ. The

bone in human periodontal defects. J Periodontol

production of a root surface smear layer by instru

1990; 61(7) 399-404

mentation and its removal by citric acid. J Periodon

Orth CF. A modification of the connective tissue graft

procedure for the treatment of type II and type III
ridge deformities. Int J Periodontics Restorative Dent
1996; 16(3):266277
Ortman HR, Tsao DH. Relationship of the incisive papil

tol 1084; 55(81:443-446.

Pontoriero R, et al. Rapid extrusion with fiber resection:
A combined orthodontic - periodontic treatment mo
dality. Int J Periodont Rest Dent 1987; 5:31.

1977;38:482.
surgery. J Periodontol 1987; 58:420.
Prato G, et al. Periodontal regeneration therapy with cov
erage of previously restored root surfaces. Case re
ports. Int J Periodont Rest Dent 1992; 12:451.
Prescott M, Goldberg M. Controlled eruption of impact
ed teet with threaded pms. j Oral Surg 1960;27:615-8.
Price P. Stress, shear, and suture. Ann Surg 1948; 128:408.
Prichard JF, The diagnosis and management of vertical
bony defects. J Periodontol 1983; 54(l):29-35.
Prichard J. The infrabony technique as a predictable pro
cedure. J Periodontol 1957; 28:202.
Prichard J. Advanced Periodontal Disease. 2ne Ed. ed.
Philadelphia:W.B Saunders, 1965.
Prichard J. The etiology, diagnosis and treatment of the
infrabony defect. J Periodontol 1967 ; 38:455.
Proceedings of the World Workshop in Clinical Periodon
tics. Chicago: The American Academy of Periodontol
ogy; 1989:111-15-22.
Proussaefs P, Lozada J The Loma Linda Pouch: a tech
nique for repairing the perforated sinus membrane.
Int J Periodontics Restorative Dent 2003;23:593-7.
Proussaefs P, et al. Repair of the perforated sinus mem
brane with a resorbable collagen membrane: a human
study. Int J Oral Maxillofac Implants 2004;19:413-20.
Prove MP, Poison AM. Effect of root surface alterations
on periodontal healing. I. Surgical denudation. J Clin
Periodontol 1982; 9(6)428-440.
Raghoebar GM, Brouwer TJ, Reintsema H, Van Oort RP.
Augmentation of the maxillary sinus floor with au
togenous bone for the placement of endosseous im
plants: a preliminary report. J Oral Maxillofac Surg
1993; 51(11) 1198-1203.
Ramfjord S. Experimental periodontal reattachment in
Rhesus monkey. J Periodontol 1971; 22:67.
Ramfjord S, Nissle R. The modified Widman flap. J Peri
odontol 1974; 45:601.
Rangert BR, Sullivan RM, Jemt TM. Load factor control
for implants in the posterior partially edentulous seg
ment. Int J Oral Maxillofac Implants 1997; 12(3)360370.
Rasperini G, Silvestri M, Ricci G. Long-term clinical ob
servation of treatment of intrabony defects with
enamel matrix derivative (Emdogain): surgical re-entry. 2005;25:121-7.

Pontoriero R. Guided tissue regeneration in the treatment

Rateitschak KH, Egli U, Fringeli G. Recession: a 4-year

la to the maxillar central incisors. J Prosthet Dent

of furcation defects in man: Short communication.

longitudinal study after free gingival grafts. J Clin

1979;42:492-6.

Int J Periodont Rest Dent 1987; 14:619

Periodontol 1979; 6(3)158-164.

508
Rawlinson A. Duerden BI, Goodwin L. Effects of sur
gical

treatment

of

the

microbial

flora

in

residual

periodontal pockets. Eur J Prosthet Restorative Dent

1995;3:155-61.

Rubin M. A biologic rationale for gingival reconstruc

tion by grafting procedures. Quintessence 1979; 11:47.
Rufenacht CR. Fundamentals of esthetics. Chicago: Quin
tessence; 1990.

Register AA. Bone and cementum induction by dentin, de

mineralized in situ. J Periodontol 1973; 44(l):49-54.

tion. Coll Rel Res 1980; 15:314.

cementogenesis to dentin, demineralized in situ. I.

comparison of freeze-dried bone allograft and de

Optimum range. J Periodontol 1975; 46(ll):646-655.

mineralized

freeze-dried

periodontal

osseous

bone

defects.

allograft
J

in

Periodontol

human
1989;

60(12):655-663-

N.

Immunohistochemical

regenerative periodontal

treatment of experimental furcation pockets in dog;

J Periodontal Res 1981; 16(1):123-129.

CL Surgical treatment of the short clinical crown in

di

SS.

Scanning

40.

an area of inadequate keratinized gingiva. Compend

of

cell

populations

Contin Educ Dent 1983; 4(1)71-79.

membranes

Saadoun AP, Le Gall MG. Periodontal implications in im

conditioning of the root surface. J Clin Periodontol

plant treatment

1981; 8(6):459-473.

Periodont Aesthetic Dent 1998;10:655-64.

planning for esthetic results. Pract

Saffar JL, Colombier ML, Detienville R. Bone formation

in

traosseous defects. VI. Factors influencing the heal

lesions. Histological observations in humans. J Peri

ing response. J Clin Periodontol 1985; 12(9)707-715.

phosphate-filled

periodontal

intrabony

odontol 1990; 6l(4):209216.

Salkin LM, Freedman AL, Stein MI), Bassiouny MA. A lon

Gunsolley JC. The effect of bone replacement grafts

gitudinal study of untreated mucogingival defects. J

in the treatment of periodontal osseous defects. A

electron

used

for

and

microscopic
bacterial

guided

observation

contamination

periodontal

tissue

re

generation in humans. J Periodontol 1990; 6l(8):515

520.
Koch RW. Clinical evaluation of freeze-dried bon
allografts

in

periodontal

osseous

defects-part

II.

Periodontol 1978; 49(1):9-14.

Shefter GJ, McFall WY Jr Occlusal relations and peri

Reynolds MA, Aichelmann-Reidy ME, Branch-Mays GL,

systematic review. Ann Periodontol 2003;8:227-65.

Selvig KA, Nilveus RE, Fitzmorris L, Kersten B, Khorsan

Sepe WW, Bowers GM, Lawrence JJ, Friedlaender GE

berg J. Healing after treatment of periodontal in

tricalcium

monkey:

of new connective tissue attachment following aci

Saadoun AP, Fox DJ, Rosenberg ES, Weisgold AS, Evian

Renvert S, Garrett S, Nilveus R, Chamberlain AD, Egel

in

Selvig KA, Ririe CM, Nilveus R, Egelberg J. Fine structur

cadavers. Int J Oral Maxillofac Implants 2001;l6:833-

odontal intraosseous defects. II. Effect of citric acid

treatment

Clin Oral Investig 2002; 6(3)175-182.

tion with the crestal osteotome technique in human

Renvert S, Egelberg J. Mealing after treatment of peri

evaluation of m;

trix molecules associated with wound healing follow

ing

Rummelhart JM, Mellonig JT, Gray JL, Towle HJ. A

maxillary sinus membrane response following eleva

Sculean A, Junker R, Donos N, Berakdar M, Brecx i\

Dunker

Ruoslahti E. Current concepts of its structure and func

Register AA, Burdick FA. Accelerated reattachment with

Reiser GM, Rabinovitz Z, Bruno J, et al Evaluation of

tein derivative on human teeth following periodont;

surgery. Clin Oral Investig 2002; 6(3) 183-187.

Periodontol 1987; 58(3):l64-l66.

odontal

status

in

human

adults.

Periodonto

1984;55:368-74.
Shiloah J. The clinical effects of citric acid and lateral

Sanders JJ, Sepe WW, Bowers GM, Koch RW, Williams JE,

ly positioned pedicle grafts in the treatment of de

Richardson CR, Mellonig JT, Brunsvold MA, McDonnell

Lekas JS et al. Clinical evaluation of freeze-dried bone

nuded root surfaces. A pilot study. J Periodontol 1980

HT, Cochran DL. Clinical evaluation of Bio-Oss: a bo-

allografts in periodontal osseous defects. Part III. Com

vine-derived xenograft for the treatment of periodon

posite freeze-dried bone allografts with and without

tal osseous defects in humans. J Clin Periodontol

autogenous bone grafts. J Periodontol 1983; 54(l):l-8.

tulous ridges, using full thickness onlay grafts. Par

Saroff S. Free soft tissue autografts, hemostasis and pro

1999; 26(7):421-428
Rifkin R. Facial analysis: a comprehensive approach to
treatment planning in aesthetic dentistry. Pract Peri

51(ll):652-654.
Seibert JS. Reconstruction of deformed, partially eden

tection of the palatal donor site with a microfibril

lar collagen preparation. J Periodontol 1980; 53:425.

II. Prosthetic/periodontal interrelationships. Compenc

Contin Educ Dent 1983; 4(6):549-562.
Seibert JS. Reconstruction of deformed, partially edentu

Sato K, Yoneyama T, Okamoto II, Dahlen G, Lindhe J.

lous ridges, using full thickness onlay grafts. Part I

Ririe CM, Crigger M, Selvig KA. Healing of periodontal

The effect of subgingival debridement 011 periodontal

Technique and wound healing. Compend Contin Educ

connective tissues following surgical wounding and

disease parameters and the subgingival microbiota. J

application of citric acid in dogs. J Periodontal Res

Clin Periodontol 1993; 20(5):359-365.

odont Aesthet Dent 2000;12:865-71.

Dent 1983; 4(5):437-453.

Siebert, JR. Surgical alternative for correcting soft tissue

Schenk RK, Buser D,Hardwick WR, Dahlin C.Healing pat

ridge deformaties. Presented at the 5"' International

Robbins JW. Differential diagnosis and treatment of ex

tern of bone regeneration in membraneprotected de

Symposium on Periodontics and restorative Dentist

cess gingival display. Pract Periodont Aesthet Dent

fects: a histologic study in the canine mandible. Int J

1999;11:265-72.

Oral Maxillofac Implants 1994; 9(l):13-29-

1980; 15(3):3l4-327.

Robinson RE. The distal wedge operation. Periodontics

Robinson R. Periosteal fenestration in mucogingival sur
gery. J West Soc Periodont 1961; 9:4.
Robinson R. The distal wedge operation. Presented to the
Western Society of Periodontology. Palm Springs (No
for bone induction. J

Periodontol 1969; 40:503Roccuzzo M,Wilson TG. A prospective study evaluating a

changes following single tooth extraction: a clinical

Silverstein LH, Callan DP. A 11 acellular dermal matrix al

lograft substitute for palatal donor tissue. Postgrad

Periodontics Restorative Dent 2003; 23:313-23.

Dent 1996;3:14-21.

commercial

demineralized

freeze-dried

bone

al

lograft to induce new bone formation. J Periodon

tol 1996;67:918-26.
Schwartz Z, Mellonig JT, Carnes DL, Jr., de la FJ, Cochran

the posterior maxilla: one year results. Clin Oral Im

DL, Dean DD et al. Ability of commercial demineral

plants Res 2002;13:502-7.

ized freeze-dried bone allograft to induce new bone

osteotome sinus floor elevation technique: multi-cen

Dent 1996; 16(4):310321.

and radiographic 12-month prospective study. Int J

protocol for 6 weeks loading of SLA implants in

Rosen PS, Summers R, Mellado JR, et al. The bone added

lizing a combination onlay-interpositional graft pro

cedure: a case report. Int J Periodontics Restorative

Schropp L, et al. Bone healing and soft tissue contour

Schwartz Z, .Mellonig JT, Carnes I)L Jr, et al. Ability of

vember) 1963 .
Robinson R. Osseous coagulum

Schiffman P. Relation to the maxillary canine and the in

cisive papilla. J Prosthet Dent 1984;14:469-76.

1966; 4(5):256-264.

ry.: June 1995.

Seibert JS, Louis JV. Soft tissue ridge augmentation uti

formation. J Periodontol 1996; 67(9):918-926.

Schwartz Z, Somers A, Mellonig JT, Carnes DL, Jr., Dean

Silverstein LH, Kurtzman GM. A review' of dental suturing

for optimal soft-tissue management. Compend Contin
Educ Dent 2005; 26(3):l63-170.
Silverstein L. Principles of Dental Suturing: The Com
plete GUide to Surgical Closure. Mahwah: Montage
Media, 1999.
Silvestri M, Ricci G, Rasperini G, et al.Comparison of
treatments of intrabony defects with enamel matrix
derivative, guided tissue regeneration with a non-re-

ter restrospective report of consecutively treated pa

DD, Cochran DL et al. Ability of commercial deminer

sorbable

tients. Int J Oral Maxillofac Implants 1999;14:853-8.

alized freeze-dried bone allograft to induce new bone

Clin Periodontol 2000;27:603-10.

Rosenberg ES, Garber DA, Evian Cl. Tooth lengthening

formation is dependent on donor age but not gender.

procedures. Compend Contin Educ Gen Dent 1980;

I(3):l6l172.
Rosenberg ES, Cho S, Garber DA. Crown lengthening re
visited. Compend Contin Educ Dent 1999;20:527-40.
Rosenlicht JL. Sinus lift procedure (subantral augmenta
tion). Implants 1992;2:3-8.
Ross SE, Cohen I)W. The fate of a free osseous tissue au
tograft. A clinical and histologic case report. Peri
odontics 1968; 6(4):145-151.

J Periodontol 1998; 69(4):470-478.

membrane

and

Widman

modified

flap.

Simion M, Jovanovic SA, Tinti C, Parma Benefenati S.

Long-term evaluation of osseointegrated implants in

Sclar AG. Ridge preservation for optimum esthetics and

serted at the time or after vertical ridge augmenta

functions. The bio-cal technique. Pract Periodont Aes

tion. A restrospective study on 123 implants 1-5 years

thet Dent 1999;11:1-11.

follow-up. Clin Oral Implants Res 2001;12:35-45.

Sclar AG. Soft tissue and esthetic considerations in im

Simon BI, Goldman HM, Ruben MP, Baker E. The role

plant dentistry. Carol Stream (IL): Quintessence Pub

of endotoxin in periodontal disease II. Correlation of

lishing Co.; 2003.

Sculean A, Windisch P, Keglevich T, Fabi B, Lundgren E,
Lyngstadaas PS. Presence of an enamel matrix pro

the quantity of endotoxin in human gingival exudate

with the clinical degree of inflammation. J Periodon
tol 1970; 4l(2):8186.

509
Simon BI, Goldman IIM, Ruben MP, Baker E. The role
of endotoxin in periodontal disease. 3- Correlation of
the amount of endotoxin in human gingival exudate

teflon barrier membranes. 7 histologic case reports.

Tarnow, et al. Vertical distance from the crest of the bone

J Clin Periodontol 1991; 18(8):605-6l0.

to the height of the interproximal papilla between

Stahl SS, Froum SJ. Healing of human suprabony lesions

adjacent implants. J Periodontol 2003;74:1785-8.

with the histologic degree of inflammation. J Peri

treated with guided tissue regeneration and coronal-

Tarnow D.What we know, what we think we know, and

odontol 1971; 42(4):210-216.

ly anchored flaps. Case reports. J Clin Periodontol

what we think about the sinus lift procedure. The 8th

1991; 18(l):69-74.

International Symposium on Periodontics and Restor

Smiler DG, Holmes RE. Sinus lift procedure using porous

hydroxyapatite: a preliminary clinical report. J Oral
Implantol 1987; 13(2):239-253Smiler I)G. The sinus lift graft. Basic technique and vari

Stashenko P, Fujiyoshi P, Obernesser MS, et al. Levels of

interleukin-lb in tissue from sites of active periodon

ative Dent 2004.

Tatum II, Jr. Maxillary and sinus implant reconstruc

tal disease. J Clin Periodontol 1991;18:548-54.

tions. Dent Clin North Am 1986;30(2):207-229.

ations. Pract Periodontics Aesthet Dent 1997;9:885-93

Stein MD, Salkin LM, Freedman AL, Glushko V. Collagen

Smiler DG, Johnson PW, Lozada JL, et al. Sinus lift and

sponge as a topical hemostatic agent in mucogingival

Tatum H. Lectures presented at the Alabama Implant

Study Group. 1997.

surgery J Periodontol 1985; 56(l):35-38.

Tatum OJ. Osseous grafts in intraoral sites. J Oral Im

endosseous implants: treatment of the atrophic pos

terior maxilla. Dent Clin North Am 1992;36:151-86.
Smith GP. Objectives of a partial denture. J Prosthet Dent
196l;ll:463Smith BA, Smith JS, Caffesse RG, Nasjleti CE, Lopatin
DE,

Kowalski CJ. Effect of citric acid and various

concentrations of fibronectin on healing following

periodontal flap surgery in dogs. J Periodontol 1987;
58(10):667-673
Smukler H, Castelluci G. Surgical management of palatally impacted cuspids. Compend Contin Educ Dent
1987;8:10-6.
Smukler H, Chaibi M. Periodontal and dental consid
erations in clinical crown extension. A rational ba
sis for treatment. Int J Periodontics Restorative Dent
1997;17:464-77.
Soehren SE, Allen AL, Cutright DE, Seibert JS. Clinical
and histologic studies of donor tissues utilized for
free grafts of masticatory mucosa. J Periodontol 1973;
44(12):727-74l.
Somcrman MJ, Foster RA, Vorsteg GM, Progebin K, Wynn
RL. Effects of minocycline on fibroblast attachment
and spreading. J Periodontal Res 1988; 23(2):154-159Spear F. Facially generated treatment planning: a restor
ative viewpoint. Presented at the American Academy
of Esthetic Dentistry 16th Annual Meeting; 1991 Aug

8; Santa, Barbara, CA.

Spear F. The esthetic management of dental midline
problems with restorative dentistry Compend Contin
Educ 1999;20:912-8.
Spear FM. Maintenance of the interdental papilla follow
ing anterior tooth removal. Pract Periodontics Aesthet
Dent 1999;11:21-8.
Staffileno HJ. Management of gingival recession and root
exposure problems associated with periodontal dis
ease. Dent Clin North Am 1964; 8:113.

Stetler KJ, Bissada NF. Significance of the width of kera

tinized gingiva on the periodontal status of teeth and

plantol 1996;22:51-2.
Taylor I. Surgical knots. Ann Surg 1938; 107:458.

submarginal restorations. J Periodontol 1987;58:696-703. Terranova VP, Franzetti LC, Hie S, DiFlorio RM, Lyall RM,
Stewart H. Partial removal of cementum and decalcifi

Wikesjo UM et al. A biochemical approach to peri

cation of the tooth in the treatment of pyorrhea al-

odontal regeneration: tetracycline treatment of den

veaolaris. Dent Cosmos 1899; 41:617.

tin promotes fibroblast adhesion and growth. J Peri

Stewart J. Reattachment of vestibular mucosa as an aid

in periodontal therapy. J Am Dent Assoc 1954; 19:283.

odontal Res 1986; 21(4):330-337.

Terranova VP, Hie S, Franzetti L, Lyall RM,Wikesjo UM.

Strub JR, Turp JC. Esthetics in dental prosthetics: funda

A biochemical approach to periodontal regeneration.

mentals and treatment concepts.

Studer S, Zellweger U, Scharer P. The aesthetic guidelines
of the mucogingival complex for fixed prosthodontics.
Pract Periodontics Aesthet Dent 1996;8:333-41.

AFSCM: assays for specific cell migration. J Periodon

tol 1987; 58(4):247-257.
Thacker JG, Rodeheaver G, Moore JW, Kauzlarich JJ.
Kurtz L, Edgerton MT et al. Mechanical performance

Subtelny JD.A longitudinal study of soft tissue facial

of surgical sutures. Am J Surg 1975; 130(3):374-380.

structures and their profile characteristics, defined

Theilade E. Experimental gingivitis in man. II. A longitu

in relation to their underlying skeletal structures. Am

dinal clinical and bacteriologic investigation. J Peri

J Orthod 1959;45:481-507.
Sullivan HC, Atkins JH. Free autogenous gingival grafts.
3. Utilization of grafts in the treatment of gingival re
cession. Periodontics 1968; 6(4):152-l60.

odont Res 1966; 1:1.

Tibbets L, Ochsenbein C. Lingual approach to mandibu
lar osseous surgery. Dent Clin North Am 1976; 20:61.
Tinti C,Vincenzi G, Cortellini P, Pini PG, Clauser C. Guid

Sullivan HC, Atkins JH. Freeutogenous gingival grafts. 1. Prin

ed tissue regeneration in the treatment of human fa

ciples of successful grafting. Periodontics 1968; 6(1):5-13Summers RB. A new concept in maxillary implant sur
gery: the osteotome technique. Compend Contin Educ
Dent 1994;15:152-8.

cial recession. A 12-case report. J Periodontol 1992;

63(6):554-560.

Tjan AHL.Milier GD. The JG: some exthetic factors in a

smile. J Prosthet Dent 1984;51:24-8.

Summers RB. The osteotome technique: part 2the ridge

Toffler M. Osteotome-mediated sinus floor elevation:

expansion osteotomy (REO) procedure. Compend

a clinical report. Int J Oral Maxillofac Implants

Contin Educ Dent 1994;15:422-6.

Summers RB. The osteotome technique: part 3less in

2004;19:266-73Tolmie PN, Rubins RP, Buck GS, Vagianos V, Lanz JC. The

vasive methods of elevating the sinus floor. Compend

predictability of root coverage by w'ay of free gingi

Contin Educ Dent 1994;15:698-704.

val autografts and citric acid application: an evalua

Struck M. A new' approach to the unerupted tooth by sur

gery and orthodontics. Am J Orthod Oral Surg 1938;
24:626-636.
Takei HH, Han TJ, Carranza FA, Jr., Kenney EB, Lekov-

tion by multiple clinicians. Int J Periodontics Restor

ative Dent 1991; ll(4):26l271.
Tonetti MS, Pini PG,Williams RC, Cortellini P. Periodon
tal regeneration of human infrabony defects. III. Di

Staffileno HJ. Palatal flap surgery: Mucosal flap (split

ic V. Flap tethnique for periodontal bone implants.

agnostic strategies to detect bone gain. J Periodontol

thickness) and its advantages over the mucoperioste-

Papilla preservation technique. J Periodontol 1985;

al flap. J Periodontol 1969;40(547).

56(4):204-210.

1993; 64(4):269-277.
Tonetti MS, Lang NP, Cortellini P, Suvan JE, Adriaens P.

Stahl SS. Healing following simulated fiber retention pro

Takei HH. Surgical techniques for reconstructive peri

Dubravec D et al. Enamel matrix proteins in the re

cedures in rats. J Periodontol 1977; 48(2):67-73-

odontics. Dent Clin North Am 1991; 35(3):531-539

Tal H, Moses O, Zohar R, et al. Root coverage of advanced

generative therapy of deep intrabony defects. J Clin

Stahl SS. Repair potential of the soft tissue-root interface.

J Periodontol 1977; 48(9):545-552.
Stahl SS, Froum SJ. Human clinical and histologic repair
responses following the use of citric acid in peri
odontal therapy. J Periodontol 1977; 48(5):26l-266.
Stahl SS, Tarnow D. Root resorption leading to linkage of
dentinal collagen and gingival fibers? A case report.
J Clin Periodontol 1985; 12(5): 399-404.
Stahl SS. Speculations on periodontal attachment loss. J
Clin Periodontol 1986; 13(l):l-5.

gingival recession; a comparative study between acellular dermal matrix allograft and subepithelial con
nective tissue grafts. J Periodontol 2002;73:1405-11.
Tarnow D, Fletcher P. Classification of the vertical com
ponent of furcation involvement. J Periodontol 1984;
55(5):283-284.
Tarnow DP. Semilunar coronally repositioned flap. J Clin
Periodontol 1986; 13(3):182-185.
Tarnow DP,Magner AW, Fletcher P. The effect of the dis

Periodontol 2002; 29(4):317-325.

Townsencl-Olsen C, Ammons WF, Van Belle C. A longi
tudinal study comparing apically repositioned flaps
with and without osseous surgery. Int J Periodontics
Restorative Dent 1985;5:11-22.
Ulm CW, Solar P, Gsellmann B, Matejka M,Watzek G.
The edentulous maxillary alveolar process in the
region of the maxillary sinusa study of phys
ical dimension. Int J Oral Maxillofac Surg 1995;
24(4):279-282.

tance from the contact point to the crest of bone on

Urist MR, MacDonald N, Jow'sey J. The function of the do

following root demineralization and coronal flap an

the presence or absence of the interproximal dental

nor tissue in experimental operations with radioac

chorage.Histologic responses in 7 sites. J Clin Peri

papilla. J Periodontol 1992; 63(12):995-996.

Stahl SS, Froum S. Human suprabony healing responses

odontol 1991; 18(9):685-689.

Stahl SS, Froum S. Human intrabony lesion responses
to debridement, porous hydroxyapatite implants and

Tarnow, et al. The effect of inter-implant distance on

tive bone grafts. Ann Surg 1958; 147:129.

Urist MR. Bone histogenesis and morphogenesis in im

the height of inter-implant bone crest. J Periodon

plants of demineralized enamel and dentin. J Oral

tol 2000;71:546-9-

Surg 1971; 29(2):88-102.

510
Urist M, McLean F. Osteogenic potency and new bone
formation by induction in transplants to the anteri
or chamber of the eye. J Bone and Joint Surg 1952;
34:443.
Urist M, Lietze A. A non-enzymatic method of prepara
tion of soluble bone morphogenetic protein (BMP). J
Dent Res 1980; (Special Issue).
Vacek JS, et al. The dimensions of the human dentogingival junction. Int J Periodontics Restorative Dent
1004;14:155-65.
Valentini P, Abensur D.Wenz B, Peetz M, Schenk R. Sinus
grafting with porous bone mineral (Bio-Oss) for im
plant placement: a 5-year study on 15 patients. Int
J Periodontics Restorative Dent 2000; 20(3) 245-253Vanarsdall RL, Corn H. Soft-tissue management of labiallv positioned, unerupted teeth Am J Orthod
1977:72:55-64.
Varma S, Ferguson HL, Breen H, Lumb WV. Comparison
of seven suture materials in infected woundsan ex
perimental study. J Surg Res 1974; 17(3):l65-170.

Wang HL, et al. The influence of molar furcation involve

using localized management of the sinus floor:

ment and mobility on future clinical periodontal at

preliminary study. Int J Oral Maxillofac Implar

tachment loss. J Periodontol 1994;65:25-9.

Wang HL, Bunyaratavej P, Labadie M, Shyr Y, Mac-Neil
RL. Comparison of 2 clinical techniques for treat

2002;17:687-95.
Wirthlin MR. The current status of new attachment th<
apy. J Periodontol 1981; 52(9)529-544.

ment of gingival recession. J Periodontol 2001;

Woodyard JG, Greemvell H, Hill M, Drisko C, lasella J

72(10):1301-1311Ward VJ. A clinical assessment of the use of the free

Scheetz J. The clinical effect of acellular dermal m

gingival graft for correcting localized recession asso

ciated with frenal pull. J Periodontol 1974; 45(2)78-

trix on gingival thickness and root coverage cor

pared to coronally positioned flap alone. J Periodo
tol 2004; 75(1):4456.

83.
Watzek G, Ulm C,Haas R. Anatomic and physiologic fun

Yildirim M, F.delhoff D, Hanisch O, Spiekermann H. Tl

damentals of sinus floor augmentation. In: Jensen

O, editor. The Sinus Bone Graft. Chicago: Quintes

conventional sinus floor elevation. Zeitschr Zahnart

sence, 1998.
Weinberg MA, Eskow RN. On overview of delayed passive
eruption. Compend Contin Educ Dent 2000;21:511-20.
Weisgold AS. Contours of the full crown restoration. Al
pha Omegan 1977; 70(3):77-89.
Wennstrom J, Lindhe J, Nyman S. Role of keratinized

internal sinus liftan adequate alternative to tl

Implantol 1998;14:124-35.
Yukna RA, Bowers GM, Lawrence JJ, Fedi PF, Jr. A clii
ical study of healing in humans following the e
cisional new attachment procedure. J Periodont
1976; 47(12):696-700.
Yukna RA, Tow JD, Carroll PH, et al. Evaluation of tl
use of freeze-dried skin allografts in the treatmei

Vassos DM, Petrik PK. The sinus lift procedure: an alter

gingiva for gingival health. Clinical and histologic

native to the maxillary subperiosteal implant. Pract

study of normal and regenerated gingival tissue in

dogs. J Clin Periodontol 1981; 8(4):311-328.

1977;48:187-93.
Yukna RA, Lawrence JJ. Gingival surgery for soft ti

Wennstrom J, Lindhe J, Nyman S. The role of keratin

sue new attachment. Dent Clin North Am 1981

Periodontics Aesthet Dent 1992; 4(9)14-19.

Volchansky A, Cleaton-Jones P, Fatti LP. A 3-year longitu
dinal study of the position of the gingival margin in

ized gingiva in plaque-associated gingivitis in dogs. J

man. J Clin Periodontol 1979;6:231-7.

Clin Periodontol 1982; 9(l):75-85.

of

human

mucogingival problems. J Periodont

24(4)705-718.
Yukna RA, Sepe W'W. Clinical evaluation of localize

von der HK. The surgical uncovering and orthodontic po

Wennstrom J, Lindhe J. Plaque-induced gingival inflam

sitioning of unerupted maxillary canines. Am J Or

mation in the absence of attached gingiva in dogs. J

periodontosis defects treated with freezedried bon

allografts combined with local and systemic tetr;

Clin Periodontol 1983; 10(3) 266-276.

cyclines. Int J Periodontics Restorative Dent 198:

thod 1975; 68(3):256-276.

Wainwright D, Madden M, Luterman A, et al. Clinical
evaluation of acellular allograft dermal matrix in full
thickness burns. Burn Care Rehabil 1996;17:124-36.
Waerhaug J. Review of Cohen. Role of periodontal sur
gery J Dent Res 1971; 50(2):219-224.
Waerhaug J. Healing of the dento-epithelial junction fol
lowing subgingival plaque control. II: As observed on
extracted teeth. J Periodontol 1978; 49(3):119-134.
Waerhaug J. The furcation problem. Etiology, pathogene
sis, diagnosis, therapy and prognosis. J Clin Periodon
tol 1980; 7(2)73-95.
Wagenberg BD, Eskow RN, Langer B. Exposing adequate
tooth structure for restorative dentistry. Int J Peri
odontics Restorative Dent 1989; 9(5):322-331Walker A, Ash M. A study of root planing by scanning
electron microscopy. Dent Hygiene 1976; 50:109.
Wainwright D, Nag A, Call T, et al. Normal histologic fea
tures persist in an acellular dermal transplant graft
ed in full-thickness burns. Presented at the Federa
tion of American Societies for Experimental Biology
Summer Research Conference, Repair and Regenera
tion: At the Interface; 1994 July 9-14.
Wallace SS, Froum SJ. The effect of maxillary sinus
augmentation on the survival of endosseous den
tal implants. A systematic review. Ann Periodontol
2003;8:328-43.

Wennstrom J. Status of the art of mucogingival surgery.

Acta Paradontologica 1985; 14:181.
Wenz B, Oesch B, Horst M. Analysis of the risk of trans
mitting bovine spongiform encephalopathy through
bone grafts derived from bovine bone. Biomaterials
2001; 22(12):1599-l606.
Wheeler RC. Dental anatomy and physiology. Philadel
phia: WB Saunders; 1969.

2(5)821.

Yukna RA. HTR polymer grafts in human periodont;

osseous defects. I. 6-month clinical results. J Per
odontol 1990; 6l(10):633-642.
Yukna RA, Mellonig JT. Histologic evaluation of per
odontal healing in humans following regenerativ
therapy with enamel matrix derivative. A 10-case se
ries. J Periodontol 2000; 71(5)752-759.

Wheeler SL. Holmes RE, Cahlum CJ. Six-year clinical and

Yukna RA, Vastardis S. Comparative evaluation of dc

histologic study of sinus-lift grafts. Int J Oral Maxil-

calcified and noil-decalcified freeze-dried bone al

lofac Implants 1996;11:26-34.

Wikesjo UM, Baker PJ, Christersson LA, Genco RJ, Lyall
RM,IIic S et al. A biochemical approach to periodon
tal regeneration: tetracycline treatment conditions
dentin surfaces. J Periodontal Res 1986; 21(4):322329.
Wikesjo UM, Claffev N, Egelberg J. Periodontal repair in
dogs. Effect of heparin treatment of the root surface.
J Clin Periodontol 1991; 18(l):60-64.
Wilderman M. Exposure of bone in periodontal surgery.
Dent Clin North Am 1964; 8:23.
Williams J. A new classification of human tooth forms
with a special reference to a new system of artificial
teeth. Dent Cosmos 1914; 56:627-631.
Winter AA, Pollac AS, Odrich RB. Placement of im
plants in the severely atrophic posterior maxilla

lografts in rhesus monkeys. I. Histologic findings.

Periodontol 2005; 76(1) 57-65Zemsky J. Surgical treatment of periodontical disease
with the authors open-view operation for advancei
cases of dental periclasia. JAMA 1918; 71:1530.
Ziegler T. A modified technique for ligating impacted ca
nines. Am J Orthod 1977; 73:651-670.
Zinner I, Small S. Prosthetic management of the si
nus graft case. In: Jensen O, editor. The Sinus Bom
Graft. Chicago: Quintessence, 1998.
Zitzmann NU, Schaner. Sinus elevation procedures 111 tin
resorbed posterior maxilla. 1998; 85:8-17.
Zitzmann NU, Scharer P. Sinus elevation procedures ir
the resorbed posterior maxilla. Comparison of tin
crestal and lateral approaches.Oral Surg Oral Met
Oral Pathol Oral Radiol Endod 1998; 85(0:8-17.

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