Biomedical subjects

L Trombelli

Publications and source records attributed to L Trombelli.

At least 37 records · Page 2Linked to original sources

PubMed1998

Subpedicle connective tissue graft versus guided tissue regeneration with bioabsorbable membrane in the treatment of human gingival recession defects.

The purpose of the present clinical study was to evaluate the effect of guided tissue regeneration (GTR) in comparison to subpedicle connective tissue graft (SCTG) in the treatment of gingival recession defects. A total of 12 patients, each contributing a pair of Miller's Class I or II buccal gingival recessions, was treated. According to a randomization list, one defect in each patient received a polyglycolide/lactide bioabsorbable membrane, while the paired defect received a SCTG. Treatment effect was evaluated 6 months postsurgery. Clinical recordings included full-mouth and defect-specific oral hygiene standards and gingival health, recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), and keratinized tissue width (KT). Mean RD significantly decreased from 3.1 mm presurgery to 1.5 mm at 6 months postsurgery for the GTR group (48% root coverage), and from 3.0 mm to 0.5 mm for the SCTG group (81% root coverage). RD reduction and root coverage were significantly greater in SCTG group compared to GTR group. Mean CAL gain amounted to 1.7 mm for the GTR group, and 2.3 mm in the SCTG group. No significant differences in PD changes were observed within and between groups. KT increased significantly from presurgery for both treatment groups, however gingival augmentation was significantly greater in the SCTG group compared to GTR group. Results indicate that: 1) treatment of human gingival recession defects by means of both GTR and SCTG procedures results in clinically and statistically significant improvement of the soft tissue conditions of the defect; and 2) treatment outcome was significantly better following SCTG compared to GTR in terms of recession depth reduction, root coverage, and keratinized tissue increase.

Absorbable Implants↗

PubMed1997

Retrospective analysis of factors related to clinical outcome of guided tissue regeneration procedures in intrabony defects.

The purpose of this retrospective study was to determine factors affecting clinical outcome of guided tissue regeneration (GTR) in the treatment of intrabony periodontal defects. 38 patients each contributing 1 isolated intrabony defect treated with GTR were included in this analysis. Patient and defect characteristics, and defect-specific recordings relative to clinical outcome 6 months postsurgery were assessed. GTR treatment resulted in clinically and statistically significant improved probing depths (PD), clinical attachment levels (CAL), and probing bone levels (PBL). Presurgery PD and PBL were of predictive value for CAL gain and PBL gain, respectively. CAL and PBL gain did not correlate to defect depth or configuration. Cigarette smoking exhibited a highly significant negative correlation to parameters of clinical outcome.

Adult↗

PubMed1997

Healing response of gingival recession defects following guided tissue regeneration procedures in smokers and non-smokers.

This retrospective study evaluated healing response in gingival recession defects following guided tissue regeneration (GTR) in smokers. 22 systemically healthy patients who had been treated for deep (> or = 4 mm), buccal, Miller's class I or II gingival recession defects with ePTFE membranes were included. Patients were regarded as smokers if they smoked more than 10 cigarettes/day at the time of surgical procedure. Occasional and former smokers were excluded. 9 patients (6 male, mean age 29 years) were smokers, while 13 patients (4 male, mean age 35 years) were non-smokers. Clinical parameters, recorded presurgery and at 6 months postsurgery, included defect-specific plaque (DP1) and bleeding on probing (BoP) scores, recession depth (RD), probing depth (PD), clinical attachment level (CAL), and keratinized tissue width (KG). Extent of membrane exposure (ME) and newly formed tissue (NFT) gain were assessed at membrane removal. Statistical analysis revealed no significant differences between smokers and non-smokers in demographic and presurgery defect characteristics. DP1 and BoP scores were similar presurgery and remained almost unchanged throughout the observation interval in both groups. ME was significantly greater in smokers (2.6 +/- 1.4 mm) than in non-smokers (1.3 +/- 0.6 mm). NFT gain was 2.8 +/- 1.0 mm in smokers and 3.6 +/- 1.4 mm in non-smokers, the difference being not statistically significant. Smokers showed significantly less RD reduction and root coverage (2.5 +/- 1.2 mm and 57%, respectively) compared to non-smokers (3.6 +/- 1.1 mm and 78%, respectively). In conclusion, the results indicate that treatment outcome following GTR in gingival recession defects is impaired in cigarette smokers.

Adult↗

PubMed1997

Comparison of mucogingival changes following treatment with coronally positioned flap and guided tissue regeneration procedures.

This study compared the variation in anatomic width of the mucogingival unit following coronally positioned flap or guided tissue regeneration procedures in deep (greater than or equal to 4 mm) buccal maxillary gingival recession defects 12 months postsurgery. Eighteen patients, 10 treated with guided tissue regeneration procedures and eight treated with coronally positioned flap procedures, were retrospectively analyzed. The results demonstrated that both treatments led to consistent recession depth reduction and coronal shift of the mucogingival junction. A significant increase in the amount of keratinized gingiva was observed for the guided tissue regeneration procedure, but a decrease that was not statistically significant was observed for the coronally positioned flap procedure.

Adult↗

PubMed1996

Effect of pretreatment with ketorolac tromethamine on post-operative pain following periodontal surgery.

A double-blind, randomized, single-dose clinical trial to evaluate the analgesic efficacy of preoperative ketorolac tromethamine administration on periodontal postoperative pain was designed. One group received 20 mg ketorolac immediately before periodontal flap surgery, and the other group received placebo. Naproxen sodium was allowed postoperatively as rescue medication. The visual analog scale was used to estimate pain. Postoperative pain was assessed hourly for the first 10 h on the day of surgery, and 4 x daily on the 1st and 2nd postsurgical days. Timing and dose of rescue analgesic remedication were also recorded. Results indicated that preoperative treatment with ketorolac significantly reduced initial pain intensity and delayed the onset of postoperative pain as compared to placebo. Incidence and amount of naproxen consumption was similarly small in both ketorolac- and placebo-treated groups. No adverse reactions related to preoperative medication were observed.

Adult↗

PubMed1996

Fibrin glue application in conjunction with tetracycline root conditioning and coronally positioned flap procedure in the treatment of human gingival recession defects.

A split-mouth clinical study was designed to determine the effect of fibrin glue (FG) in addition to tetracycline HCI (TTC) root conditioning and the coronally positioned flap (CPF) procedure in the treatment of maxillary buccal recession defects. 11 patients presenting with a pair of Class I or II recession defects were selected. After initial therapy, defect-specific and full-mouth oral hygiene standards and gingival condition, recession depth, recession width, probing depth, attachment level, and width of keratinized gingiva were recorded. The surgical procedure included elevation of a full split thickness flap, root debridement and root conditioning with a 10 mg/ml TTC solution for 4 minutes. According to a randomization list, in each patient, 1 defect was treated with topical FG application, while the paired defect did not receive FG. The flap was adapted and sutured coronally to the cemento-enamel junction without tension. Healing was evaluated 6 months postsurgery. Significant recession depth reduction and attachment gain were observed for both treatments. Average root coverage amounted to 65% in FG treated defects and 55% in defects treated with TTC conditioning only. There were no clinical and statistical significant differences between the treatments for any parameter considered. This study suggests that FG may not meaningfully enhance the outcome of the CPF procedure with TTC root conditioning.

Administration, Topical↗

PubMed1996

Clinical effect of tetracycline demineralization and fibrin-fibronectin sealing system application on healing response following flap debridement surgery.

The aim of this controlled clinical trial was to assess the effect on healing following tetracycline (TTC) conditioning and fibrin-fibronectin sealing system (FFSS) application in association with flap debridement surgery (FDS) in 11 patients under treatment for moderate to severe periodontitis. Selection criteria included the presence of two bilateral, homologous, non-molar, interproximal sites with probing depth > or = 5 mm. The areas bilateral to the trial sites were matched for number and type of the teeth, and similar periodontal involvement. After initial therapy, a split-mouth design was used in which one area was treated by flap debridement surgery alone (control), and the contralateral area was treated following surgery with a 4-minute burnishing application of 100 mg/ml TTC solution and FFSS (test). Fibrin glue was applied with a syringe on the demineralized root surfaces and surrounding bone margins. Healing by primary intention was encouraged by flap repositioning with interrupted sutures left in place for 14 days. A monthly maintenance recall program was followed. Patients were clinically evaluated at baseline and 6 months and the following measurements were taken: gingival index, plaque control record, clinical attachment level, probing depth, recession, bleeding on probing. Statistical evaluation indicated that both approaches resulted in significant probing depth reduction and clinical attachment gain. However, the differences in healing between the test and control groups were not clinically nor statistically significant. These results suggest there is no additional benefit with TTC demineralization and topical FFSS application in conjunction with flap debridement surgery.

Adult↗

PubMed1996

Burning mouth syndrome: the role of contact hypersensitivity.

The burning mouth syndrome is characterized by an unpleasant sensation of burning in the oral cavity, without clinical signs. Causal factors may be psychogenic, systemic or local. The aim of the study was to determine the significance of contact allergy in the pathogenesis of burning mouth syndrome. Fifteen patients with burning mouth syndrome were studied through anamnesis and laboratory analysis. Epicutaneous patch tests were performed with the Italian standard series (GIRDCA - Gruppo Italiano di Ricerca Dermatiti da Contatto ed Ambientali), preservative and dental series. The same tests were carried out in 12 healthy age- and sex-matched subjects. The number of patients affected by burning mouth syndrome with a positive reaction to patchtesting was 6 out of 15, while the number of allergic patients in the control group was 3 out of 12. No association could be found between positive reaction at patchtesting and exposure to allergens. Contact allergy in burning mouth syndrome seems not to play a primary role; nevertheless, it is advisable to perform patch tests in selected patients to identify a possible aetiological agent.

Aged↗

PubMed1996

Granular cell myoblastoma. Review of the literature and report of a case.

The origin and nature of granular cell myoblastoma (GCM) have been debated since the original description of a granular cell tumor by Abrikossoff in 1926. Many cell types have been implicated in its histogenesis, including muscle cells, histiocytes, fibroblasts, neural sheath cells and undifferentiated mesenchymal cells, but the origin of the lesion remains still controversial. The authors present a review of the clinical features and the histopathologic and histochemical findings of this nebulous entity. They also report a case of granular cell myoblastoma of the tongue.

Biopsy↗

PubMed1996

Clinical effect of subgingival tetracycline irrigation and tetracycline-loaded fiber application in the treatment of adult periodontitis.

A controlled clinical trial was carried out to compare the clinical effect of combined antimicrobial-mechanical treatment modalities on moderate-to-deep periodontal pockets in patients with adult periodontitis. Twelve patients having at least three nonadjacent sites of periodontitis were included in the split-mouth study. Gingival Index, Plaque Record, bleeding on probing, probing depth, attachment level, and recession depth were recorded immediately before treatment. In the control site, supragingival and subgingival scaling was performed with an ultrasonic scaler. One experimental site received supplemental irrigation with 15 mL of a 100-mg/mL tetracycline solution, while the other received a tetracycline-loaded fiber after mechanical instrumentation. Fibers were left in place for 10 days. Reevaluation 30 and 60 days after treatment showed that all three treatment modalities were effective in improving clinical parameters. No adjunctive effect on the healing response was obtained by augmenting mechanical debridement with tetracycline.

Administration, Topical↗

PubMed1995

Healing response of human buccal gingival recessions treated with expanded polytetrafluoroethylene membranes. A retrospective report.

Twenty-four (24) deep wide buccal gingival recessions were treated with ePTFE membrane according to guided tissue regeneration principles (GTR). Factors affecting the surgical outcome of the regenerative procedure were retrospectively analyzed. In 16 cases, the barrier membrane was used in conjunction with tetracycline root conditioning and fibrin-fibronectin system application, and 8 cases were treated with the membrane alone. Healing response was evaluated 12 months after surgery. Since no difference was observed between the two treatment protocols, all available data were grouped. Mean recession depth was reduced from 4.6 mm to 1.3 mm postoperatively, which represents an average root coverage of 71.7%. Fifty percent (50%) of the cases showed clinical attachment gain greater than or equal to 4 mm and a mean increase of keratinized tissue of 1.0 mm was observed. Baseline recession depth and extent of membrane exposure at the reentry procedure significantly influenced the amount of newly-formed tissue under the membrane. Recession reduction positively correlated with the preoperative recession depth and the regenerated tissue gain. Treatment was also affected by tooth location, recession reduction, and attachment gain, being significantly greater in upper than lower archs. Results suggest that GTR technique represents a predictable procedure to improve the soft tissue conditions of deep mucogingival defects. Randomized controlled trials of other forms of management of mucogingival defects as compared to the GTR technique will be necessary to fully evaluate the utility of the GTR technique.

Adult↗

PubMed1995

Effects of tetracycline HCl conditioning and fibrin-fibronectin system application in the treatment of buccal gingival recession with guided tissue regeneration.

A split-mouth clinical trial was designed to evaluate the effect of treating deep wide buccal gingival recession with guided tissue regeneration using expanded polytetrafluoroethylene membrane combined with tetracycline HCl (TTC) root conditioning and fibrin-fibronectin sealing system (FFSS) application. Eight patients, aged 25 to 57 years, each presenting two similar mucogingival defects, were selected. The two bilateral recessions were randomly assigned in each patient to either test or control treatment procedure. After initial therapy, each patient was examined for assessment of plaque, gingivitis, recession depth (RD), probing depth (PD), probing attachment level (PAL), and keratinized tissue width (KT). The test procedure included the elevation of mucoperiosteal flap at the buccal aspect of the alveolar process. The root was debrided and demineralized with 100 mg/ml TTC solution for 4 minutes using a burnishing technique with cotton pellets. A teflon membrane was secured and a film of FFSS was applied between the membrane and the root surface. The buccal flap was sutured to completely submerge the membrane. Control treatment included gingival flap surgery with barrier membrane alone. After 6 weeks, the membrane was removed. Healing was evaluated 6 months after surgery. Both test and control procedures resulted in highly significant recession reduction (3.0 mm +/- 1.1 and 2.6 mm +/- 1.2, respectively) and attachment gain (3.6 mm +/- 1.7 and 2.6 mm +/- 1.1, respectively). Mean root coverage was of 67% in the TTC + FFSS treated sites and 60% in membrane-only treated sites. However, only treatment with TTC + FFSS significantly reduced PD and increased KT (P < 0.05). When treatments were compared, changes in PD and PAL were significantly greater in TTC + FFSS treated sites (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

Effect of tetracycline HCl on periodontally-affected human root surfaces.

Scanning electron microscopy was used to evaluate surface characteristics of periodontitis-exposed instrumented human cementum and dentin surfaces following topical application of tetracycline HCl (TTC). Specimens were randomly assigned to application of sterile saline for 1 minute (control); TTC (10 mg/ml) for 1 minute and 4 minutes, respectively; and TTC (100 mg/ml) for 1 minute and 4 minutes, respectively. Solutions were applied with a cotton pellet using a burnishing technique. Control specimens exhibited an amorphous irregular surface smear layer. TTC treatment of cementum for 1 minute resulted in a relatively debris-free, nonhomogeneous surface. The 4-minute application resulted in a surface exhibiting a densely fibrillar, mat-like texture. Dentin specimens conditioned for 1 minute showed a smooth surface with many tubule openings partially occluded by debris. The 4-minute treatment exposed a 3-dimensional network of intertubular and peritubular collagen fibrils. No consistent morphologic differences were observed between cementum or dentin specimens treated with TTC at concentrations of 10 and 100 mg/ml, respectively. The results suggest that topical application of TTC produces morphologic alterations of periodontitis-exposed cementum and dentin that appear related to application interval rather than concentration of the drug.

Actin Cytoskeleton↗

PubMed1994

Combined guided tissue regeneration, root conditioning, and fibrin-fibronectin system application in the treatment of gingival recession. A 15-case report.

This paper describes a surgical technique to achieve root coverage in deep, wide gingival recessions using a root isolation procedure with ePTFE membrane, combined with tetracycline conditioning of the root surface and fibrin-fibronectin sealing system application. The technique was used on 15 patients with isolated mucogingival defects 4 to 6 mm deep. A large trapezium-shaped flap was raised 3 to 4 mm apical to the margin of the bone dehiscence. The root surface was thoroughly scaled by hand and rotating instruments. Tetracycline HCl solution (100 mg/ml) was topically applied for 4 minutes. Expanded polytetrafluoroethylene (ePTFE) membrane was adapted at least 1 mm coronal to the CEJ and retained in position by sling sutures. A film of fibrin-fibronectin sealing system was injected between the membrane and the root surface. The flap was sutured coronally and the membrane removed 6 weeks later. The patients were reevaluated 6 months after the reentry procedure. The mean recession depth decreased from 4.7 mm initially to 1.1 mm at the final postoperative appointment. This represents a mean root coverage of 77.4%. Mean probing depth reduction was 0.9 mm and the mean width of keratinized tissue increased from 1.8 mm preoperatively to 2.9 mm 6 months after surgery. These findings show that the treatment of buccal gingival recession using guided tissue regeneration procedure plus tetracycline root demineralization and fibrin-fibronectin glue application results in a consistent and predictable improvement of mucogingival defects.

Adult↗

PubMed1994

Nondiseased cementum and dentin root surface following tetracycline hydrochloride conditioning: SEM study of the effects of solution concentration and application time.

Tetracycline hydrochloride treatment of cementum and dentin surfaces derived from human teeth not affected by periodontitis resulted in the removal of the smear layer and uncovered a fibrillar collagen substrate. In cementum specimens, the amount of exposure of the organic matrix appeared to be more related to morphologic structure of the cementum and mechanical instrumentation of the root surface rather than to concentration and time of application of tetracycline solution. Time-dependent changes were observed in dentin surfaces, the intertubular "matted" collagen matrix being evident only in the 4-minute specimens.

Dental Cementum↗

PubMed1994

[Gingival overgrowth in patients under cyclosporin-A treatment. A clinical study].

The aim of the present study was to investigate possible background factors causing gingival overgrowth (GO) among transplant patients treated with cyclosporine-A (Cy-A). Nineteen subjects were evaluated with regard to Cy-A therapy including: whole blood concentration, oral dosage, duration of therapy, cumulative exposure factor. Periodontal condition was assessed using Plaque Index, probing depth and probing attachment level. GO was assessed on plaster study models by a semiquantitative method. The occurrence of GO was 88%, with a total 35.9% of gingival sites presenting overgrowth. Statistical analysis showed no correlation between GO score on one hand, oral dosage, exposure factor and plaque score on the other. ANOVA revealed a significant relationship between GO score and percentage of affected sites.

Adolescent↗

PubMed1994

[The psychological aspects of patients with the burning mouth syndrome].

Burning mouth syndrome (BMS) is a distinct clinical entity characterized by a chief complaint of unremitting oral burning concomitant with no oral mucosal clinically observable lesions. Numerous causes of this condition have been suggested, including local factors, systemic factors, and psychogenic disorders. A total of 33 consecutive subjects, 29 women and 4 men, complaining of BMS, who had attended the Dental Clinic of the University of Ferrara during a period of 2 years, was studied. The results obtained using a specific questionnaire to assess the psychological status of BMS patients were reported. Psychological factors were present in more than two thirds of the subjects (67%). Anxiety was the predominant disorder and the most recalcitrant obstacle to cure. On the other side, an improvement of the psychogenic state was observed in relation to burning reduction. Furthermore, a remission or resolution of the oral symptoms following a reassurance alone as to the benign nature of the condition was found in 24% of the patients. These results seem to suggest an association between oral complaint and personality disturbance. However, whether the psychogenic disorder is causative or whether it is a result of the burning sensation is still uncertain.

Adult↗

PubMed1993

Postoperative pain and discomfort with and without periodontal dressing in conjunction with 0.2% chlorhexidine mouthwash after apically positioned flap procedure.

The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of a periodontal dressing in combination with a 0.2% chlorhexidine mouthwash after internal bevelled, full thickness, apically positioned flap procedure. Twenty-four patients requiring comparable bilateral flap procedures were selected. Using a split-mouth design, one site received a periodontal dressing while the other site did not. A 0.2% chlorhexidine mouthwash (10 ml for 1 minute twice daily) was prescribed postoperatively for all patients. Pain assessment was made according to a structured, categorized scale (0 = no pain; 1 = mild pain; 2 = moderate pain; and 3 = severe pain). Analgesic drug consumption was recorded during the first postoperative week. After at least a one-month period, the second flap procedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered. Results indicated a similar trend for mean pain scores as assessed by patients for both dressed and undressed sides during the 7-day postoperative period. Statistical analysis revealed no significant differences between treatment groups with respect to frequency distribution of patients who did or did not take analgesics or the daily and total consumption of analgesic drops. Although patients with dressing frequently experienced eating difficulty, most stated a psychological feeling of protection and well-being with its use.

Adult↗