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Biomedical subjects

K L Kalkwarf

Publications and source records attributed to K L Kalkwarf.

At least 55 records · Page 3Linked to original sources
PubMed1984

Etidocaine HCl local anesthetic for periodontal flap surgery.

Long acting local anesthetics have been used successfully during third molar extractions and endodontic procedures. They were shown to provide longer duration of anesthesia and contribute to less postoperative pain. This study evaluated the effectiveness of one long acting local anesthetic agent (etidocaine) for periodontal flap procedures. A double-blind, split mouth design treated 17 matched contralateral pairs of posterior sextants. One region was treated following administration of 1.5% etidocaine HCl with 1:200,000 epinephrine. The matched control region was treated following administration of 2% lidocaine with 1:100,000 epinephrine. The results indicate that, while etidocaine provided a longer duration of anesthesia (P less than 0.005), no difference was noted in the number of pain pills patients took or the period of time over which they took them. Inadequate hemostasis was a recurrent problem with etidocaine anesthesia. The use of 1.5% etidocaine HCl with 1:200,000, epinephrine offers no significant advantages over traditional anesthetic solutions.

Acetanilides↗
PubMed1983

Lateral heat production secondary to electrosurgical incisions.

Adverse healing responses, including necrosis of soft tissue and sequestration of alveolar bone, have been reported following the use of electrosurgery for intraoral incisions. These responses are usually attributed to excessive heat accumulation during the surgical procedure. The purpose of this investigation was to measure temperature changes in subadjacent connective tissue during intraoral electrosurgical incisions in palatal mucosa of miniature swine. Results indicate that single electrosurgical incisions should be accomplished at a speed of approximately 7 mm. per second and that successive incisions should be separated by a cooling interval of 8 to 10 seconds to avoid generation of heat sufficient to initiate an adverse healing response.

Animals↗
PubMed1983

Subjacent heat production during tissue excision with electrosurgery.

A study was designed to document heat production subjacent to tissue excision by electrosurgery. In Phase I of the study, 20 electrosurgery excisions were made with a loop electrode in the palatal mucosa of miniature swine. Subjacent heat production was measured with implantation thermistors. Temperature measurements adjacent to 20 single incisions made with a needle electrode were used for comparison. Energy used and duration of active electrode contact with the tissue were recorded for each procedure with an electronic measuring device. In Phase II, 20 sets of excisions consisting of three successive excisions were performed. The following intraexcisional cooling periods were used for four sets each: 1 second, 5 seconds, 8 seconds, 10 seconds, and 15 seconds. Results indicate that single electrosurgery excisions with a loop electrode generate more energy than incisions made with a needle electrode. Subjacent heat production, however, is not significantly different. Cooling intervals of at least 15 seconds between successive electrosurgery excisions made with a loop electrode are necessary to prevent heat build-up of a magnitude capable of initiating destructive alveolar changes.

Animals↗
PubMed1983

Epithelial and connective tissue healing following electrosurgical incisions in human gingiva.

Electrosurgery is used for intraoral incisions by many clinicians. Much controversy surrounds the effect of lateral heat produced during the electrosurgical incision upon the healing of adjacent connective tissue. Ten electrosurgical incisions were made in the gingiva in each of five adult male volunteers. The duration of incision and actual energy production for each incision were calculated. Excisional biopsies of the incisions were obtained at 0-504 hours. At the light microscopic level, epithelium, totally degenerated immediately following the electrosurgery incision, showed extensive activity at 24-48 hours and had covered all wounds by 72 hours. Early hour specimens showed a homogenous connective tissue region, adjacent to the wound site, devoid of cells and fibers. This zone of denatured connective tissue gradually diminished until it was no longer present at 396 hours.

Adult↗
PubMed1983

Chronic mucogingival defects in miniature swine.

Controversy surrounds the importance of keratinized gingiva in maintaining periodontal health. A well-defined animal model system is necessary to evaluate longitudinally the role of keratinized gingiva when plaque control is inadequate or where dental procedures (restorative, prosthetic or orthodontic) alter the periodontal environment. Facial gingiva was excised from eight primary incisors in miniature swine. Contralateral teeth were used as controls. The experimental teeth exhibited mucogingival defects at 3 and 6 month observation periods. The secondary teeth erupting into the experimental regions also exhibited recession and chronic mucogingival defects. The marginal tissue in regions devoid of keratinized gingiva demonstrated clinical signs of inflammation. No progressive gingival recession was present. Excision of keratinized gingiva to produce mucogingival defects in swine provides a convenient model system for evaluating the effect of dental procedures on periodontal health where little or no keratinized gingiva is present.

Animals↗
PubMed1983

Effect of inflammation on periodontal attachment levels in miniature swine with mucogingival defects.

Previous authors have postulated that a dense band of keratinized, attached gingiva prevents the spread of inflammation from the gingival margin to the subjacent attachment apparatus. Chronically inflamed mucogingival defects were created over the vestibular surface of 12 central incisors in miniature swine. The untreated contralateral incisors were identified as paired controls. Placement of horizontal reference notches on the tooth surfaces was followed by measurement of Probing Depth (PD) and Probing Attachment Level (PAL) on the vestibular aspect of each experimental and control tooth. No plaque removal was accomplished at any time during the study. One year following the attainment of baseline data, all measurements were repeated. Results show an increase in PD and a loss of PAL in both experimental and control regions. No difference in increase of PD or loss of PAL between the groups could be discerned.

Animals↗
PubMed1983

Evaluation of periodontal probing forces.

The purpose of this study was to evaluate interexaminer and intraexaminer probing force variations in various regions of the mouth and adjacent to different tooth surfaces. Fifty-eight dental clinicians composed of 13 periodontists, 15 general dentists, 15 hygienists and 15 senior dental students probed the facial surfaces of periodontally healthy volunteers with a modified pressure-sensitive periodontal probe. The forces used during probing were calculated and analyzed by analysis of variance and t-statistics. There was wide variation in probing forces used by individuals within each clinician group. No statistical differences between the groups in mean probing force or absolute range of probing force could be detected. When pooled data were analyzed, it was found that the clinicians: (1) used probing forces ranging from 5 to 135 g, (2) probed in posterior regions with greater force than in anterior regions, and (3) probed midfacial, mesial and distal gingival units with different force. Midfacial regions were probed with the lightest force and distal regions with the heaviest force.

Adult↗
PubMed1983

Endocarditis prophylaxis for patients with periodontal disease.

Since periodontal disease provides a portal of entry for oral microorganisms during such common events as toothbrushing and mastication, treatment must resolve the inflammatory response if the teeth are to be maintained safely in patients at risk of infectious endocarditis. Prophylactic antibiotics should be administered during periodontal treatment such as debridement of the periodontal pocket and surgical repair of anatomic defects, as well as during oral hygiene training. If optimal periodontal health is achieved and maintained, the risk of systemic bacteremia is minimal.

Adult↗
PubMed1982

Management of the dental patient receiving corticosteroid medications.

Patients who have undergone therapy with glucocorticoids present unique problems for the dentist. Persons currently receiving steroid therapy have altered responses to infection and wound healing. More important, many patients who are taking or have taken glucocorticoids have a high risk of developing acute adrenal insufficiency when placed in a stressful situation. When treating patients with a history of glucocorticoid therapy, one must obtain precise information from the medical history to determine the relative risk of pituitary-adrenal suppression. If the patient is at risk, the dentist must determine the need for the following prophylactic measures: (1) systemic antibiotic therapy, (2) anxiety control, and (3) increased administration of glucocorticoids (steroid prep). If a patient experiences adrenal crisis, the dentist must be capable of interpreting the signs and administering appropriate therapy.

Adrenal Cortex↗
PubMed1982

Histologic evaluation of gingival curettage facilitated by sodium hypochlorite solution.

Gingival curettage has long been used as a modality in periodontal therapy. Recent longitudinal studies have shown that diligent curettage of periodontal pockets may aid in maintaining the attachment levels around periodontally involved teeth. This study was designed to histologically evaluate the controlled use of concentrated sodium hypochlorite solution to facilitate gingival curettage therapy. The results indicate that the action of sodium hypochlorite solution may be adequately controlled to provide predictable chemolysis of the soft tissue wall of a periodontal pocket with minimal effect upon the adjacent tissues. The action of the solution appears to have no detrimental effect upon healing. Reduction of inflammation prior to the procedure and careful technique are important to assure predictability. The use of gingival curettage augmented by sodium hypochlorite solution may aid in the management of patients undergoing periodontal maintenance.

Gingiva↗