Biomedical subjects

G Pini Prato

Publications and source records attributed to G Pini Prato.

At least 37 records · Page 2Linked to original sources

PubMed1993

Periodontal regeneration of human infrabony defects. III. Diagnostic strategies to detect bone gain.

Assessment of actual treatment outcome by simple and available diagnostic tests represents an important aspect in the evaluation of periodontal regenerative procedures. This report focuses on the diagnostic accuracy of different strategies to detect the original extent of bone loss and bone gain in deep vertical defects following guided tissue regeneration. Characteristics of probing attachment level and radiographic bone linear measurements were compared to a gold standard obtained as intrasurgical clinical measurements at baseline and at the 1 year re-entry operation. Radiographic linear measurements underestimated bone loss (CEJ-BD) in 55% of cases while the estimate was within 1 mm in 25% of cases. The goodness of agreement could be significantly described by a general linear model incorporating measures of defect morphology. The original level of bone loss could be best detected by an approach which consisted of adding 1.5 mm to the measured attachment level loss. Such an approach correctly estimated bone loss within 1 mm in 85% of sites. In terms of ability to detect bone gain, radiographic measurements underestimated bone gain in 55% and overestimated it in 15% of sites. Diagnostic accuracy was assessed at different threshold values of true gain. The sensitivity and specificity plots intersected at a threshold value of 2.7 mm bone gain. Conversely, measures of probing attachment level gain agreed with the gold standard within 1 mm 45% of times. Intersection of the specificity and sensitivity plots occurred at 3 mm. Classification tables are presented for both diagnostic tests at different threshold values.2+é

Adolescent↗

PubMed1992

Fibrinolytic activity of human gingiva in the presence or absence of plaque bacteria.

Activators of fibrinolysis are found in the gingival connective tissue and in the sulcular epithelium. The influence of plaque bacteria and the related inflammatory reaction on the fibrinolytic activity has been evaluated in the human gingiva. An autohistographic technique was applied to sections taken from three groups of 6 specimens each: group A from clinically healthy sites with plaque index = 1 and no bleeding on probing; group B from areas with unambiguous visual signs of gingivitis, with plaque index = 2-3 and bleeding on probing; group C from sites previously treated with professional toothcleaning twice a week for 3 months and with chlorhexidine mouthrinses twice a day for the final 3 wk, in order to obtain a virtually complete elimination of the plaque bacteria. In group C the plaque index was 0 and there was no bleeding on probing. Connective tissue fibrinolytic activity was present in all the sections from the three groups. The sulcular fibrinolytic activity was observed in all the sections taken from the specimens of groups A and B. In contrast, no fibrinolytic activity was observed over the sulcular area in any section taken from the specimens of group C. Therefore, this study does not support previous claims that healthy sulcular epithelium is capable of releasing activators of fibrinolysis. It can be concluded that the presence of any amount of plaque bacteria is associated with sulcular fibrinolytic activity. Contrarily, the elimination of plaque bacteria is associated with the absence of any detectable sign of fibrinolytic activity in the gingival sulcus.

Connective Tissue↗

PubMed1992

Guided tissue regeneration versus mucogingival surgery in the treatment of human buccal gingival recession.

A surgical technique involving membranes was used to treat localized human buccal recessions 3 mm to 8 mm. The results on 25 patients (test group) were evaluated 18 months postoperatively and compared with the results obtained in 25 other patients (control group) having undergone mucogingival surgery. In the test group, a trapezoidal flap with a large base was raised beyond the mucogingival junction. The exposed root surface was scaled thoroughly to a concave shape. A membrane was bent and adapted onto the concave root surface. The flap was sutured far coronally and the membrane removed one month later. The control patients underwent a 2-step procedure, consisting of a free gingival graft and a coronally positioned flap. The amount of root coverage obtained was similar in the 2 groups (test = 72.73%; control = 70.87%), although the clinical attachment gain (test = 5.12 mm; control = 3.56 mm) and pocket variation (test = 1 mm reduction; control = 0.06 mm increase) differed significantly (P < 0.001). The keratinized tissue width was greater in the control group. The regression analysis showed that the amount of covered root surface after treatment was in strict correlation with the depth of the original recession in the test group, while no correlation was found in the control group. The expected root coverage was greater in the test group when the recession was greater than 4.98 mm, while it was greater in the control group when the recession was less than 4.98 mm. These results indicate that a guided tissue regeneration procedure can be used to successfully treat recession. The membrane procedure compared favorably with the mucogingival surgery in the treatment of deep recession.

Adolescent↗

PubMed1992

Guided tissue regeneration in the treatment of human facial recession. A 12-case report.

A guided tissue regeneration procedure was used to treat human buccal recessions, 3 to 7 mm deep, in 12 patients. No procedure for increasing the width of keratinized tissue was performed prior to treatment. A thick bipedicled flap was raised with a semilunar incision in the alveolar mucosa and a marginal incision was extended to the adjacent papilla. The root surface was made concave by curets and burs to create space for regeneration. The membrane was fixed to the cemento-enamel junction and covered by the flap which consisted of the residual gingiva and of alveolar mucosa. The membranes were removed 4 weeks after placement. The patients were recalled 6 months after the reentry procedure. The average reduction in recession was 2.50 mm (P less than 0.01) and the average attachment gain was 2.84 (P less than 0.01). Pocket depth was slightly reduced (0.33 mm), although the degree of reduction was not of statistical significance. The width of keratinized tissue increased slightly (0.83 mm). These results demonstrate the possibility of treating human buccal recessions by means of a guided tissue regeneration procedure, with predictable recession reduction and attachment gain. A minimal amount of keratinized tissue was needed.

Adult↗

PubMed1991