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Biomedical subjects

G P Prato

Publications and source records attributed to G P Prato.

At least 19 recordsLinked to original sources
PubMed1996

Factors affecting the healing response of intrabony defects following guided tissue regeneration and access flap surgery.

Identification and control of significant factors determining clinical outcomes is of paramount importance to improve expected results of a variety of therapeutic procedures. The aim of this investigation was to identify, with a multivariate approach, factors associated with healing outcomes of 3 periodontal surgical procedures in deep intrabony defects. 45 patients with evidence of deep intrabony defects were randomly assigned to 3 treatment groups: access flap (group C), conventional guided tissue regeneration (GTR) with non-resorbable expanded polytetrafluoroethilene (ePTFE) membranes (group B), and GTR with self supporting membranes combined with the modified papilla preservation technique (group A). In both GTR procedures, membranes were positioned coronal to the interproxymal alveolar crest. Primary outcome variables (i.e., probing attachment level gains at 1 year and the amount of newly formed tissue present at membrane removal) were explained in terms of a series of patient, defect morphology and surgical factors, using a multivariate approach. Highly significant treatment effects were observed, indicating that the 3 tested therapeutic modalities resulted in significant differences in primary outcome variables. Detailed analysis assessing the significance of the tested factors in determining the healing outcomes following each procedure was performed with a stepwise elimination approach of non-significant factors. The results indicated that: (i) the need to create and maintain space should be a key objective of regenerative approaches based upon the principles of guided tissue regeneration; (ii) control of patient's oral hygiene and residual periodontal infection in the oral cavity are strongly associated with clinical outcomes of both regenerative and conventional surgical procedures and should receive proper attention.

Adult↗
PubMed1995

The modified papilla preservation technique. A new surgical approach for interproximal regenerative procedures.

A modification of the papilla preservation technique has been applied to achieve primary closure of the interproximal tissue over barrier membranes placed coronal to the alveolar crest. Fifteen patients with deep intrabony interproximal defects were treated. Defects had a probing attachment level loss of 9.9 +/- 3.2 mm and a recession of the gingival margin of 1.7 +/- 1.6 mm. The depth of the intrabony component was 5.5 +/- 2.9 mm; while the suprabony component was 5.9 +/- 2.0 mm. Titanium-reinforced teflon membranes were placed 1.3 +/- 0.7 mm from the cemento-enamel junction, 4.5 +/- 1.6 mm coronal to the interproximal alveolar bone crest. Primary closure over the interproximal portion of the membrane was obtained in 93% of cases. In 73% of the cases complete coverage of the membrane was maintained until its removal at 6 weeks. These data indicate that the modified papilla preservation technique can be successfully applied to obtain primary closure of the interdental space in regenerative procedures with barrier membranes.

Adult↗
PubMed1995

Resorbable membrane in the treatment of human buccal recession: a nine-case report.

Recent studies have reported the successful use of guided tissue regeneration procedures with nonresorbable barrier membranes to treat buccal recession in humans. Nonresorbable membranes, however, require a reentry procedure for removal, disturbing the delicate healing process. Resorbable membranes were used in a guided tissue regeneration procedure in nine patients with one site of buccal recession each. The resorbable barrier yielded satisfactory clinical results, providing significant gains in probing attachment and root coverage. However, both the surgical technique and the design of the barrier used require improvement for application at sites of buccal recession.

Adult↗
PubMed1994

Guided tissue regeneration with a rubber dam: a five-case report.

Five cases are presented to document the use of an unusual barrier in the treatment of infrabony defects according to the principles of guided tissue regeneration. A rubber dam was positioned after flap elevation, defect debridement, and root planing to cover the defect and the surrounding bone. The dam was covered with the surgical flap and removed after 5 weeks. The 1-year clinical measurements and reentry procedure demonstrated the efficacy of the rubber dam as a barrier in guided tissue regeneration procedures.

Alveolar Bone Loss↗
PubMed1993

Histologic assessment of new attachment following the treatment of a human buccal recession by means of a guided tissue regeneration procedure.

A deep, long-standing recession on a mandibular incisor was treated in a 56-year-old female patient. The tooth was tilted buccally and was scheduled for extraction. The recession was 8 mm deep, with a pocket depth of 1 mm and no keratinized tissue. The recession was treated by guided tissue regeneration; the membrane was left in place for 4 weeks. The tooth was extracted along with marginal tissues 5 months after the removal of the membrane. At the time of extraction, 4 mm of root coverage had been achieved and 3 mm of keratinized tissue were measured buccally. Histologic measurements showed that 3.66 mm of new connective tissue attachment had been obtained associated with newly formed cementum (2.48 mm) and bone growth (1.84 mm). The crestal bone level after treatment was located coronal to the preoperative location of the gingival margin.

Alveolar Process↗
PubMed1993

Guided tissue regeneration and a free gingival graft for the management of buccal recession: a case report.

Five patients with buccal gingival recession (4 to 6 mm) underwent surgical treatment consisting of a guided tissue regeneration procedure associated with a free gingival graft. The graft was used to cover the newly formed tissue on the root surface at the reentry. Root coverage was complete in three patients, while 1 mm of recession remained in the other two patients. The free gingival graft reconstructed the keratinized tissue, which had been lost because of recession. Moreover, it allowed the mucogingival junction, which had been displaced coronally during the first surgery, to be realigned, therefore preventing a shallowing of the vestibule.

Adult↗
PubMed1993

Root resection and root amputation.

Attachment loss in furcal areas is a challenge for the clinician. Root resection and root amputation techniques have been used to overcome the instrumentation problems that these areas pose. Recent reports indicate that this approach is effective and reliable but extremely technique-sensitive and expensive for endodontic and prosthetic involvement. A more conservative approach, such as scaling and root planing, is suggested only for shallow class II furcation. Guided tissue regeneration in deep class II and class III furcation seems to be unpredictable and the efficacy of this therapy in such areas is still questionable.

Apicoectomy↗
PubMed1992

Periodontal regenerative therapy with coverage of previously restored root surfaces: case reports.

Two case reports are presented to demonstrate a treatment that restores proper esthetics, cures hypersensitivity, and enhances periodontal support for cases of root caries or failing Class V restorations associated with gingival recessions. The procedure involves removing the existing restoration, elevating a trapezium-shaped full thickness flap, root planing to achieve a desired concave shape, and placing a barrier membrane. In both cases, satisfying clinical results have been maintained for 18 months.

Adult↗
PubMed1986

Healing after application of tissue-adhesive material to denuded and citric acid-treated root surfaces.

This study was undertaken to evaluate the effects of a commercially available tissue adhesive upon healing of the coronal periodontium. In four squirrel monkeys, 24 teeth were extracted, and the coronal third of the roots planed free of fibers and cementum. Eight teeth were replanted without further alteration and eight were coated with tissue adhesive prior to replantation. In the remaining eight teeth, the planed surface was decalcified, coated with tissue adhesive and replanted. Histological observations were made at 1 and 7 days after replantation. In the teeth replanted after root planing alone and root planing plus tissue adhesive, epithelium migrated apically and was within the ligament space lining the denuded root at 7 days. In contrast, those teeth which were decalcified prior to application of tissue adhesive demonstrated fiber attachment to the planed root surface and little or no epithelial downgrowth.

Animals↗