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Biomedical subjects

M E Gher

Publications and source records attributed to M E Gher.

28 records · Page 2Linked to original sources
PubMed1991

The use of a synthetic skin substitute as a physical barrier to enhance healing in human periodontal furcation defects: a follow-up report.

The purpose of this investigation is to compare the clinical response of guided tissue regeneration using a synthetic wound dressing with open flap debridement versus open flap debridement alone in the treatment of human furcation defects. The study group was composed of 19 patients with moderate to advanced adult periodontitis and at least one bilateral pair of Class II molar furcation defects. After the hygiene phase of therapy was completed, measurements were made with calibrated periodontal probes of the clinical attachment levels, probing depths, and soft tissue recession. Paired sites were randomly selected for treatment with either open flap debridement alone (control) or open flap debridement and placement of the synthetic wound dressing over the furcation (experimental). At the time of surgery, measurements of vertical and horizontal open probing attachment were recorded. The dressing was removed 5 to 6 weeks post-surgery. The sites were reentered at 6 months to evaluate healing and to repeat all measurements. Statistical comparisons using the Wilcoxon Sign Rank Test were made between the control and experimental sites. The results of 19 pairs of Class II molar furcation defects reveal statistically significant differences between the experimental and control sites in attachment levels, probing depths, and horizontal open probing attachment. These differences were of such small magnitude that they may not be clinically relevant. There were no other significant differences for any other clinical parameter, and none of the furcations in either group was completely closed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Clinical evaluation of the use of decalcified freeze-dried bone allograft with guided tissue regeneration in the treatment of molar furcation invasions.

The purpose of this study is to evaluate the potential of decalcified freeze-dried bone allograft (DFDBA) combined with a barrier material in the treatment of human molar furcation defects (experimental) as compared to the barrier technique alone (control). Fifteen pairs of Class II or III furcation invasion defects comprised the study group. Measurements with calibrated periodontal probes were made to determine soft tissue recession, probing depth, and attachment levels. Defects from each pair were randomly selected to be treated with an expanded polytetrafluoroethylene membrane (e-PTFE) and DFDBA or the membrane alone. Additional measurements were made during surgery to determine crestal resorption, and vertical and horizontal open probing attachment. The membrane was removed 4 to 6 weeks post-insertion. Six months post-treatment, each site was surgically reentered and measurements repeated. Following either treatment, recession was minimal with statistically significant improvement in probing depth reduction and clinical attachment level gain favoring the combined technique. Hard tissue changes were comparable for alveolar crestal resorption, however, there was a distinct difference, statistically, for both horizontal and vertical bone repair favoring the use of the demineralized bone graft in combination with the e-PTFE membrane.

Bone Transplantation↗
PubMed1991

Clinical evaluation of guided tissue regeneration in the treatment of maxillary class II molar furcation invasions.

This investigation assessed and compared the clinical efficacy of combined open flap debridement/occlusive membrane therapy versus open flap debridement therapy alone, in the treatment of maxillary periodontal furcation defects. Seventeen patients presenting with advanced adult periodontitis, including at least one pair of Class II maxillary furcal defects, comprised the study group. Following completion of a hygienic phase of treatment, measurements were made with calibrated periodontal probes to determine soft tissue recession, probing pocket depths, and attachment levels. Each pair of furcation defects was surgically exposed and hard tissue measurements obtained. Defects were treated with either open flap debridement and a polytetrafluoroethylene periodontal membrane or open flap debridement alone. Membranes were removed at 4 to 6 weeks. Six months postsurgery, soft tissue measurements were repeated and all sites were surgically re-entered to obtain hard tissue measurements. No statistically significant differences were found in recession, probing depth reductions, clinical attachment gains, or resorption of alveolar crest height between test and control groups. Results for these parameters were inconsistent and unpredictable. Statistically significant improvements were found, however, in horizontal open probing attachment (HOPA) and vertical open probing attachment (VOPA) between experimental and control sites. The GTR procedure as used in this study likely has limited application as a therapeutic modality for Class II furcations of maxillary molars. Modifications or improvements in the procedure may result in more predictable healing of these lesions.

Adult↗
PubMed1987

Clinical survey of fractured teeth.

Through a standardized procedure using clinical examination, interviews, and dental history, this 2-year study documents 100 cases of tooth fracture in 98 patients. For comparison, pertinent information was also recorded for more than 2,000 teeth in a randomly selected sample population. Two chief types of fracture were found: incomplete crown-root fractures and root fractures associated with earlier endodontic therapy.

Adult↗
PubMed1985

Root surface measurements of the mandibular first molar.

The root surface area (RSA) per millimeter of root length was determined for 20 extracted mandibular first molars. The molars were cross-sectioned at 1-mm increments, and each section photographed, projected and measured with a calibrated opisometer. The RSA and per cent RSA were calculated for each 1 mm of root length (1-mm section), the root trunk and the individual roots. Also measured was the location of the root separations from the root trunk, the location of the first detectable root concavity, and the prevalence of "intermediate bifurcation ridges" (IBRs). Mean measurements indicated that the greatest RSA per millimeter of root length was 4 to 7 mm apical to the cementoenamel junction (CEJ) in the area of the furcation. Of the total RSA, 48.7% was located in the coronal 6 mm of a root (mean length, 14.4 mm). Root separation occurred 4.0 mm apical to the CEJ with no tooth having a root trunk longer than 6 mm. Buccal and lingual root concavities were first present 0.7 mm and 0.3 mm apical to the CEJ, respectively. Fourteen (70%) of the 20 teeth had IBRs. According to the mean measurements, the mesial root was larger than the distal root by a ratio of 1.0:0.88. Horizontal attachment loss of 6 mm affecting both the buccal and lingual surfaces of the mandibular first molar would have resulted in a through and through (grade 3) furcation involvement of all the teeth studied.

Humans↗
PubMed1983

The potential attachment area of the maxillary first molar.

The assumption that the palatal (PAL) root of maxillary molars has significantly greater attachment area than either the mesiobuccal (MB) or the distobuccal (DB) root was tested by documenting the root surface area of the individual roots and root trunks of 20 extracted maxillary first molars. Each molar was cross sectioned every millimeter, and the circumference of each root and root trunk section was measured with a calibrated opisometer. Mean circumferential measurements from each 1-mm section were summed to give the surface area for each root and root trunk. The DB root had significantly less surface area than either the MB or PAL root or the root trunk. There was no significant difference between the surface areas of the MB and PAL roots. The surface area of the root trunk, which was significantly greater than that of any of the three individual roots, averaged 32% of the total root surface area of the maxillary first molar.

Humans↗
PubMed1982

Evaluation of the immunogenicity of freeze-dried skin allografts in humans: cell-mediated response.

PATIENTS RECEIVING freeze-dried skin (FDS) allografts were evaluated for cell-mediated response by a lymphocytotoxicity test. Eleven patients received single or multiple FDS allografts from a donor typed for human leukocyte antigen (HLA). Heparinized blood samples were drawn before the procedure and at 2, 4, and 8 weeks after grafting. Mononuclear cells were isolated by Ficoll-Hypaque gradients. Cell-mediated lymphocytotoxicity tests were conducted, with mononuclear cells from the FDS allograft recipients used as effector cells. Phytohemagglutinin-stimulated blast target cells of the same HLA type as that of the skin donor were labeled with chromium 51. Lympholysis was evaluated by measuring the amount of 51Cr release after 18 hours' incubation with target/effector cell ratios of 1:100, 1:50, and 1:25. Negative control wells contained target cells alone. Positive control wells contained target cells and effector cells sensitized in vitro against the target cells. Viability of effector cells was tested by trypan-blud dye exclusion and response to phytohemagglutinin. None of the experimental blood samples showed 51Cr release significantly greater than shown by the negative controls. Our findings of no cell-mediated response and the findings of a previous study showing no production of anti-HLA antibody in response to FDS allografts indicate that allogeneic FDS is an immunologically safe material for use in periodontal surgical procedures.

Cytotoxicity, Immunologic↗
PubMed1980

Root morphology--clinical significance in pathogenesis and treatment of periodontal disease.

Root morphology is a seldom considered yet extremely important factor in the treatment of periodontal disease. The shape of the roots may contribute to development of periodontal defects by providing an environment favorable to the retention of plaque. The practitioner should periodically review root morphology and give it appropriate importance during planning and treatment. In this study, teeth with representative root anatomy were sectioned and photographed. The photographs are intended as a visual presentation of various root morphologies and their potential implications in the practice of periodontics.

Alveolectomy↗
PubMed1980

Evaluation of the immunogenicity of freeze-dried skin allografts in humans.

A study was undertaken to evaluate the antigenic potential of allogeneic freeze-dried skin (FDS) when used as a grafting material and to examine the clinical results when FDS is used for the correction of mucogingival problems in humans. FDS was obtained from an HLA-tissue-type donor according to Navy Tissue Bank protocol. Allogeneic FDS grafts were performed to correct mucogingival problems. In addition, periosteal fenestration was used in conjunction with approximately one-half of the grafts. Documentation with a standardized periodontal probe consisted of clinical measurements taken preoperatively and 8 weeks postoperatively. Blood samples were drawn prior to and at 1, 2, 3, 5, and 8 weeks postsurgically. Testing of blood samples for anti-HLA antibody was performed by use of a modified microcytotoxicity assay. Thirty-one patients received 36 FDS grafts involving 148 tooth sites. The FDS allografts resulted in a significant (P < 0.001) increase in the width of attached-type tissue (mean gain = 3.80 mm). Clinically, there was no sign of graft rejection, and serologically, all serum samples tested were nagative for the presence of anti-HLA antibody. FDS grafts used for the treatment of mucogingival problems in humans are nonimmunogenic as evaluated for anti-HLA antibody. The surgical procedure performed using FDS as a graft material resulted in a significant increase in the width of attached-type tissue.

Antibody Formation↗