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Biomedical subjects

K L Kalkwarf

Publications and source records attributed to K L Kalkwarf.

At least 37 records · Page 2Linked to original sources
PubMed1990

Responses of four tooth and site groupings to periodontal therapy.

The responses of four tooth/site groupings to periodontal therapy were evaluated. Eighty-two patients with periodontitis were treated in a split mouth design with coronal scaling, root planing, modified Widman surgery, and flap with osseous resectional surgery. Patients were evaluated prior to therapy, 4 weeks post-Phase I therapy, 10 weeks post-Phase II therapy, and at yearly intervals during 2 years of maintenance therapy. The tooth/site groupings evaluated were: 1) interproximal sites of single rooted teeth (T1), 2) facial and lingual sites of single rooted teeth (T2), 3) nonfurcation sites of molar teeth (T3), and 4) furcation sites of molar teeth (T4). Following 2 years of maintenance, no clinically significant differences in probing depth reduction or probing attachment loss were present between the four tooth/site groupings in 1 mm to 4 mm sites. T2 had the greatest decrease of probing depth in 5 mm to 6 mm sites followed by T1, T3 and T4. T1 and T2 showed a greater gain of probing attachment followed by T3 and T4. T1 and T2 had the greatest decrease of probing followed by T3 which was greater than T4 in greater than or equal to 7 mm sites. T4 had significantly less probing attachment gain than the other groups. There was a trend for T1 and T2 to have less gingival bleeding post-therapy and for T2 to have less plaque accumulation than the other groups at both pre- and post-therapy examinations.

Bicuspid↗
PubMed1990

Relationship of gingival bleeding, gingival suppuration, and supragingival plaque to attachment loss.

This study evaluated the relationship between the presence of gingival bleeding, gingival suppuration, and supragingival plaque at 3 month appointments to the incidence of probing attachment loss during a 2-year period of maintenance therapy. The data included in this report were taken during the second and third year of maintenance from 75 periodontal patients who had previously received active therapy in an ongoing longitudinal study. The diagnostic sensitivity, specificity, and positive and negative predictive values were calculated for different frequencies of positive responses for each clinical parameter in relation to sites demonstrating greater than or equal to 2 mm probing attachment loss. Gingival bleeding and plaque were not prognosticators and gingival suppuration was a weak prognosticator of attachment loss during a 2 year maintenance period.

Dental Plaque↗
PubMed1990

Evaluation of gingival suppuration and supragingival plaque following 4 modalities of periodontal therapy.

This study evaluated the effect of coronal scaling (CS), root planing (RP), modified Widman surgery (MW) and flap with osseous resectional surgery (FO) upon the presence of gingival suppuration and supragingival plaque. 75 patients completed split-mouth therapy and 2 years of maintenance care. Data were collected prior to the initiation of therapy, following initial therapy, following surgical therapy and yearly during 2 years of maintenance care. All 4 types of therapy reduced the prevalence of suppuration with RP, MW and FO producing a greater reduction than CS in sites greater than or equal to 5 mm. Sites were grouped according to presence of suppuration at 2 consecutive examinations. The mean changes in probing depth and probing attachment level for each time period were compared. Sites that began to suppurate between 2 exams or were suppurating at both exams had a less favorable response in mean probing depth reduction and mean probing attachment gain when compared to sites that stopped suppurating between exams or did not suppurate at either exam. The prevalence of supragingival plaque decreased during active therapy and 2 years of maintenance. There was no difference in the prevalence between the therapy groups except for FO-treated sites showing more plaque accumulation after surgical therapy. The presence or absence of supragingival plaque at specific sites was dynamic, frequently converting to a new status between 2 examinations.

Alveoloplasty↗
PubMed1989

Impaired tooth root development after treatment of a cerebellar astrocytoma: a case report.

A young man, previously treated by surgical resection of a grade III cerebellar astrocytoma in combination with irradiation and chemotherapy, was found to display severe generalized root agenesis. This patient also exhibited secondary hypothyroidism and decreased levels of growth hormone. These factors are discussed in relation to their possible role in impaired root development.

Adolescent↗
PubMed1989

Evaluation of gingival bleeding following 4 types of periodontal therapy.

This study evaluated the effects of 4 types of periodontal therapy (coronal scaling (CS), root planning (RP), modified Widman surgery (MW), and flap with osseous resectional surgery (FO] and subsequent maintenance care upon bleeding on probing (BOP). 75 individuals completed split mouth therapy and 2 years of maintenance followup. Data were obtained by 1 calibrated examiner prior to the initiation of therapy, following the hygienic phase and surgical phase of active therapy and yearly during maintenance care. All types of therapy reduced the prevalence of BOP. At the end of 2 years of maintenance therapy, regions greater than 5 mm treated by CS demonstrated a significantly (p less than 0.05) greater prevalence of BOP sites than regions treated by the other modalities. Generally, sites associated with deeper probing depths exhibited a greater tendency to bleed and sites with associated plaque accumulation bled more frequently. RP resulted in a significantly (p less than 0.05) higher % of bleeding sites that stopped following active therapy than did CS. Throughout the study, BOP was extremely dynamic, with 15-88% of sites converting to a new status between any 2 examination periods. This dynamic nature may explain the inability of previous investigations to establish BOP as a reliable predictor of periodontal breakdown.

Alveoloplasty↗
PubMed1988

Self-sterilization of the electrosurgery electrode.

Sterilization of the electrode used in electrosurgery has been assumed to occur at the instant of contact of the energized electrode tip to a grounded source. This study evaluated whether the time of electrode activation or the amount of energy delivered is important in the self-sterilization process. Standard bacteriologic culturing techniques were employed to assess sterility of the electrode tip following activation. Total time of application of the current and the energy used were recorded on audiotape and later tabulated. The data indicate that the time of energizing and the energy units used are critical in the sterilization of the electrode tip. These results confirm that self-sterilization of the electrosurgery electrode tip occurs, but full confidence is not realized with the time intervals commonly employed in clinical practice. The electrode tip must be considered a potential source of bacterial contamination of electrosurgically managed dental procedures.

Electric Conductivity↗
PubMed1988

Evaluation of four modalities of periodontal therapy. Mean probing depth, probing attachment level and recession changes.

Eighty-two periodontally involved patients were treated in a split mouth design such that one quadrant received coronal scaling (CS), root planing (RP), modified Widman surgery (MW), and flap with osseous resection surgery (FO). The therapy was performed in three phases: Phase I: the teeth previously designated to receive RP, MW, and FO were thoroughly root planed and the teeth designated to receive CS were scaled with no subgingival instrumentation, plaque control was initiated and reinforced for the entire mouth; Phase II: the designated teeth received MW or FO surgery; and Phase III: maintenance therapy every three months. The CS teeth received coronal scaling and polishing during maintenance appointments, while RP, MW, and FO teeth received supragingival instrumentation, subgingival instrumentation and polishing. Clinical measurements were taken initially, four weeks post-Phase I, 10 weeks post-Phase II, and after each of two years of maintenance care. All therapy modalities resulted in a decrease of mean probing depth with the FO producing the greatest decrease followed by MW, RP, and CS. The deeper the initial probing depth, the greater was the mean reduction of probing depth. FO created a loss of mean probing attachment in the 1 to 4 mm category. RP and MW produced the greatest gain of mean probing attachment in the 5 to 6 mm category. RP, MW, and FO produced similar gains in the greater than or equal to 7 mm category. FO created the most gingival recession followed by MW, RP, and CS.

Adult↗
PubMed1988

Evaluation of furcation region response to periodontal therapy.

Five hundred fifty-eight molars were treated with one of four types of periodontal therapy: coronal scaling (CS); root planing (RP); modified Widman surgery (MW); or flap with osseous resectional surgery (FO). This report presents the probing depth and probing attachment changes in the furcation region following therapy and two years of maintenance follow-up. All types of therapy were effective in reducing probing depths. FO was the most effective in reducing probing depth followed by MW, RP, and CS. Reduction in probing depth was primarily due to gingival recession. FO resulted in a loss of probing attachment in both a vertical and horizontal direction following therapy. Following two years of maintenance care, sites treated with FO continued to exhibit a mean net loss of vertical probing attachment. A mean net loss of horizontal probing attachment was present after two years of maintenance care, regardless of the treatment modality employed. Many more sites were initially removed during osseous resectional surgery to achieve treatment criteria than were initially removed from the other groups. FO treated teeth demonstrated a lesser percentage of furcation sites demonstrating clinically significant breakdown during the two years of maintenance care.

Dental Scaling↗
PubMed1988

The furcation problem. Current controversies and future directions.

Effective management of furcation regions affected by periodontal destruction includes accurate assessment of etiologic factors, careful diagnosis of furcation involvement, and an appropriate plan of therapy. Many forms of therapy have been advocated; most have been designed to allow adequate professional and personal removal of plaque from the furcation. All types of traditional therapy have disadvantages that must be carefully considered by the therapist and the patient. Newer treatment modalities attempt to regenerate periodontal attachment in the furcation. The techniques do not have sufficient controlled documentation at this time to warrant unqualified support, but they appear to be biologically feasible and hold considerable clinical promise. At this time, guidelines for management of a periodontally involved furcation region must stress application of the simplest therapy that is likely to provide clinical stability. Longitudinal data from carefully controlled clinical trials comparing therapy techniques are needed to refine our clinical judgment.

Alveoloplasty↗
PubMed1987

Histologic evaluation of gingival response to an electrosurgical blade.

Lateral heat production during the use of electrosurgical procedures in the oral cavity causes denaturation of the connective tissue adjacent to the incision line. This study evaluated the denatured zone following electrosurgery incision in dog gingiva with a traditional tungston wire electrode and a no. 15 surgical blade adapted for electrosurgery use. The effects of using a passive electrode during surgical procedures and using an "autosensor" circuit to control power adjustment were also evaluated. It was found that a surgical blade adapted for electrosurgery produces a zone of denatured tissue that is not statistically different from that produced with a wire electrode. Moreover, no differences were noted between incisions produced with manual power adjustment and those with power controlled by the "autosensor" circuit. A significantly wider zone of denatured tissue was produced when incisions were made without a passive electrode in place.

Animals↗
PubMed1987

Electrosurgery--a biological approach.

Electrosurgery has been used in dentistry for more than 50 years. Both opponents and advocates of electrosurgery have presented a variety of clinical studies in favour of their respective opinions, which are discussed in the following review. In some studies, wounds created by electrosurgical techniques were observed through the healing stages, in comparison to those following incision by a surgical blade, with no significant difference being discovered. Other studies reported that the histologic response of oral connective tissue to electrosurgery was adverse in some animal and human models. However, neither of these groups used methods that allowed documentation or control of operating variables. A critical evaluation of controlled clinical studies shows that adverse responses of (connective) tissue, epithelium, bone, cementum, and periodontal attachment are related to an excessive lateral heat production during the procedure. With electrosurgery, the clinician can control the inherent variables. Waveform, frequency, size of the electrode, time of contact and cooling periods are some of those considered to be of importance in the studies. On the basis of the research reports, clinical guidelines have been developed to give practical advice to the clinician using electrosurgery. Providing that these safeguards are adhered to, scientific evidence supports the biological compatibility of electrosurgery for intraoral surgical procedures.

Animals↗
PubMed1987

The use of sodium bicarbonate and hydrogen peroxide in periodontal therapy: a review.

The comparative benefits from the use of sodium bicarbonate and hydrogen peroxide over the use of a commercial dentifrice in periodontal therapy is controversial. The consensus of the clinical research indicates that application by patients of sodium bicarbonate and hydrogen peroxide offers no advantage over the preestablished, properly performed home oral hygiene procedures. Any improvements in clinical and microbial parameters generally were attributed to scaling and root planing. The studies that have reported beneficial results with sodium bicarbonate and hydrogen peroxide have used additional antimicrobial agents, concomitant professional application of these substances, and scaling and root planing. In one of these reports, inorganic salts and chloramine-T were delivered subgingivally throughout root-planing procedures, in addition to home application of inorganic salts. Most of these patients also received at least one course of systemic tetracycline therapy. Because this study had no control group, it is impossible to determine whether this program is more effective than are other periodontal therapy programs. A more controlled clinical study involving professional application of sodium bicarbonate, sodium chloride, hydrogen peroxide, and povidone-iodine has shown greater gains in clinical attachment and bone mass than has brushing with toothpaste and water. Again, subgingival scaling and root planing were necessary to attain these results. Because multiple topical agents were applied in both of these reports and systemic antimicrobial agents were used by the Keyes group, it is impossible to determine which agent was responsible for the improvements. Further, professional application may be the crucial factor.(ABSTRACT TRUNCATED AT 250 WORDS)

Bicarbonates↗
PubMed1987

Drug-induced gingival hyperplasia: phenytoin, cyclosporine, and nifedipine.

This article has summarized observations and results of controlled laboratory and clinical studies of drug-induced gingival hyperplasia associated with phenytoin, cyclosporine, and nifedipine use. Furthermore, information regarding the pharmacologic aspects of these medications is presented. More information is needed for a greater understanding of drug-induced gingival hyperplasia. It appears that the primary preventive measure is to maintain a high standard of oral hygiene and the elimination of gingival irritation. As stated by Tyldesley and Rotter, because the structures of the three drugs are different, the gingival changes may result from a metabolic by-product rather than the drugs themselves. Similarly acting metabolites of all the drugs may be involved. Further laboratory investigations and controlled clinical trials are needed for more understanding of this phenomenon.

Adult↗
PubMed1986

Comparison of manual and pressure-controlled periodontal probing.

Over 25,000 sites around natural teeth in three stages of periodontal therapy (prior to instrumentation, following closed subgingival instrumentation and following surgical therapy) were independently probed by two examiners. Examiner A used a conventional periodontal probe with uncontrolled pressure. Examiner B used an identical probe tip mounted in a handle which controlled vertical probing force at 50 g. The pressure-controlled technique produced significantly deeper clinical probing measurements on the direct facial and lingual aspects of teeth regardless of the stage of periodontal therapy that had been completed. Manual probing obtained deeper measurements on the distal-lingual aspects of teeth in the posterior regions which had not received surgical therapy. The percentage match between probing depths obtained by the two methods declined as the probing depths increased. Control of vertical force during probing may provide a more objective method of monitoring periodontal status during longitudinal trials.

Adult↗