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Biomedical subjects

N F Bissada

Publications and source records attributed to N F Bissada.

At least 37 records · Page 2Linked to original sources
PubMed1989

The effect of local doxycycline with and without tricalcium phosphate on the regenerative healing potential of periodontal osseous defects in dogs.

The purpose of this study was to evaluate the clinical and histological effects of high concentration doxycycline on osseous regeneration in adult beagle dogs. Four 5 mm two-wall periodontal osseous defects were created in the premolar and molar area of each quadrant yielding a total of 48 defects in the three dogs. Ligature-induced periodontitis was maintained for 6 weeks. Two weeks following ligature removal, one of the following graft procedures was randomly assigned to each defect: 1) doxycycline alone (DOX); 2) tricalcium phosphate alone (TCP); 3) a combined graft of DOX plus TCP, or 4), surgically debrided control. All areas received thorough scaling and root planing at the time of surgery. Clinical parameters evaluated at 4, 12, and 20 weeks after the surgical treatment included the gingival index and probing depths. Crevicular fluid was examined at 3, 10, and 28 days postoperatively for tetracycline fluorescence. Direct clinical measurements from the CEJ to a notch placed at the base of the defect and from the CEJ to the alveolar crest were made at the time of surgical treatment and reentry. The reentry procedures were performed at 4, 12, and 20 weeks postoperatively. Immediately following reentry block sections were obtained from each quadrant and prepared for examination with the light microscope. The gingival index and probing depth measurements showed greater improvement in the DOX and DOX + TCP groups. Increased regeneration (new bone, cementum, and periodontal ligament) and reduced alveolar crest resorption were observed more frequently in DOX and DOX + TCP defects, while healing by long junctional epithelium was more common in defects not treated with doxycycline.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗
PubMed1989

Clinical and microbiologic changes following the irrigation of periodontal pockets with metronidazole or stannous fluoride.

The purpose of this investigation was to determine the efficacy of subgingival irrigation with 1.64% stannous fluoride or 0.5% metronidazole solutions on the clinical and microbiologic parameters of adult periodontitis as compared with scaling and root planing. Twelve patients with moderate to advanced periodontitis were selected, and one pocket of a minimum 5-mm probe depth in each quadrant received one of the following treatments: (a) one session of scaling and root planing at the beginning of the experiment, (b) stannous fluoride irrigation, (c) metronidazole irrigation, and (d) saline irrigation. Results showed that scaling and root planing provided significantly better improvement in most of the clinical parameters than did the two tested irrigants. Saline also provided a statistically significant improvement, but only during the first 4 weeks. The four methods of treatment provided a sustained decrease in spirochetes, with a concomitant increase in coccoid cells. It was concluded that although subgingival irrigation with 1.64% stannous fluoride or 0.5% metronidazole solutions improved periodontal health, they never achieved the same efficacy as scaling and root planing and, therefore, should not be substituted for fastidious mechanical subgingival plaque and calculus removal.

Fluorides↗
PubMed1989

Factors influencing periodontal therapy for the geriatric patient.

Anatomic changes in the periodontium occur with aging. There is no indication that these changes predispose to periodontal breakdown. In the United States, there is evidence that older individuals are retaining more teeth and that these teeth have less periodontal disease than previous generations of seniors. Studies comparing the healing of older and younger patients have clearly demonstrated that both groups of patients respond equally well to therapy. Proven methods of periodontal therapy include modified Widman surgery, pocket elimination surgery, or nonsurgical scaling and root planing. Surgical treatment may be used with confidence unless there are medical contraindications. In these cases, nonsurgical therapy may be preferred. If there are physical or mental disabilities that make effective home care difficult, antimicrobial agents, such as the extensively tested chlorhexidine rinse, may be valuable adjuncts. In the future, senior adults can look forward to the benefits of regenerative periodontal procedures that seek to regain lost periodontal support. Age alone should not diminish an individual's right to care because the practitioner has qualms about his or her longevity. Successful treatment of periodontitis by surgical and nonsurgical methods has been extensively documented. Senior patients can benefit from these treatments as much as younger patients, and age is not a barrier to effective periodontal therapy.

Aged↗
PubMed1987

Periodontics in general practice: perspectives on nonsurgical therapy.

Clinical studies have shown that nonsurgical treatment is a highly effective method of periodontal therapy. It can be instituted in both shallow and deep pockets; however, an objective evaluation of post-scaling soft tissue changes should be recorded to determine the response to therapy. Closed scaling and root planing has limitations as a definitive procedure for the removal of calculus from deep pockets and surgical treatment may be indicated for nonresponding sites. The condition of the tissue, not the probing depth, should dictate the course of action. During maintenance therapy all practitioners should recognize unsuccessfully treated or recurrent periodontitis and provide interceptive treatment to avoid a case of "supervised neglect." Periodontal treatments should be provided by the general practitioner. This can result in improved oral health for the patients and constitute a professionally rewarding part of dental practice.

Dental Scaling↗
PubMed1987

Significance of the width of keratinized gingiva on the periodontal status of teeth with submarginal restorations.

The purpose of this clinical study was to evaluate the periodontal condition of teeth having submarginal restorations associated with either narrow or wide zones of keratinized gingiva. Fifty-eight teeth in 26 individuals were selected and then divided into two groups according to the width of the keratinized gingiva at the midfacial aspect of the tested tooth. Group I consisted of 30 teeth with greater than or equal to 2.0 mm, and Group II consisted of 28 teeth with less than 2.0 mm of keratinized gingiva. Each group was equally subdivided into subgroup "A" having teeth with a full coverage, subgingival type of restoration for at least 2 years, and subgroup "B" representing contralateral homologous teeth, in the same individual, with no subgingival restoration. Clinical examination of individual teeth included determination of plaque and gingival indices, gingival fluid, probing depth, bleeding tendency and bone level. Data were subjected to statistical analysis using the Student t test and a two-way analysis of variance to determine any significant differences in variables between teeth with and without subgingival restorations, in narrow and wide zones of keratinized gingiva. The findings were: (1) teeth with subgingival restorations and narrow zones of keratinized gingiva showed statistically significant higher gingival scores than teeth having submarginal restorations with wide zones of keratinized gingiva. (2) Teeth without subgingival restorations showed no statistical difference between narrow and wide zones of keratinized gingiva (P greater than 0.05).

Adult↗
PubMed1987

Clinical evaluation of porous and nonporous hydroxyapatite in the treatment of human periodontal bony defects.

The purpose of this study was to investigate the effectiveness of a synthetic nonporous hydroxyapatite graft material (OrthoMatrix HA-500), a porous replamineform hydroxyapatite graft material (Interpore 200), and a debrided control with respect to defect fill. Twelve adult patients having periodontitis and three similar angular osseous defects as verified by radiographic analysis and clinical probe depths greater than or equal to 5 mm were selected. Clinical parameters gathered prior to surgical intervention and at identified postoperative visits included plaque index, probing depth, and standardized radiographic examination. Customized acrylic stents were used as fixed reference guides for the insertion of endodontic silver points to the base of each defect during both initial and 6-month reentry surgeries. A total of 36 defects were randomly assigned to one of three treatment modalities such that 12 defects received OrthoMatrix HA-500, 12 received Interpore 200, and 12 served as debrided controls. Comparison of nonporous hydroxyapatite, porous replamineform hydroxyapatite, and debrided control treatment modalities revealed a statistically significant improvement (P less than 0.05) in the mean per cent of defect resolved in only those sites treated with nonporous hydroxyapatite. Similar positive trends were seen in the sites treated with nonporous hydroxyapatite for mean reentry defect depth and mean defect fill although these were not statistically significant (P greater than 0.05). No other significant differences were noted.

Adult↗
PubMed1984

Variations in subgingival microflora from healthy and intervention sites using probing depth and bacteriologic identification criteria.

This investigation studied the changes in probing depths and subgingival microbial flora of clinically healthy and diseased sites before and after scaling and root planing. Thirty-six sites in 18 individuals were studied in two groups of patients, Group I (9 patients) had received no periodontal surgery, while group II had received surgery within the previous 4 years. Neither group had had professional prophylaxis or scaling and root planing within the previous 6 months. Group I had an average probing depth of greater than or equal to 5 mm and group II had an average of less than or equal to 4 mm. Scaling and root planing was performed on both groups at the beginning of the experiment and all patients were instructed in oral hygiene. Plaque and gingival indices, gingival fluid measurements, probing depths and dark field microscopic examination of subgingival plaque were evaluated immediately before scaling and root planing (baseline) and then once every 2 weeks for 2 months. For descriptive analysis of the data, all sites in both groups were classified according to probing depth or bacteriologic criteria. Sites with either greater than or equal to 85% nonmotile bacteria or less than or equal to 4 mm probing depth were presumed "healthy" and others were considered "diseased".(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Periodontal disease in juvenile and adult diabetic patients: a review of the literature.

Epidemiologic studies have suggested that the severity of periodontitis is greater in juvenile and adult onset diabetes. In juvenile diabetic patients, the periodontal disease seems to be initiated around puberty and progresses by age. Reviewing the medical literature indicates a similar age of onset for known systemic complications resulting from diabetes. Angiopathy, abnormal collagen metabolism, abnormal PMN function, and altered sulcular microbial flora have been found to be closely associated with the severity of periodontitis in diabetic patients. The association between abnormal neutrophil function and severity of periodontal disease in diabetic patients provides an opportunity for examining the role of neutrophil in periodontal disease. Future investigation in the function of sulcular PMN may shed light on the complex mechanism of periodontal disease.

Adolescent↗
PubMed1982

Endotoxin penetration into root cementum of periodontally healthy and diseased human teeth.

This study was undertaken to determine the extent of in vitro penetration of E. coli endotoxin into the root cementum of periodontally healthy and diseased teeth. Freshly extracted teeth were washed in distilled water, scaled and divided into two groups of 16 teeth each. Nine diseased and five healthy teeth in the first group were immersed in various concentrations of E. coli endotoxin for 2 to 12 weeks. They were then prepared for indirect immunofluorescence examination after treatment with anti-endotoxin antibody and rhodamine conjugated secondary antibody. Teeth in the second group were prepared for autoradiographic examination by immersing nine diseased and five healthy teeth in tritium labelled E. coli endotoxin for 2 to 12 weeks. The latter technique also allowed for semi-quantitative study of the depth of endotoxin penetration by creating facets on the root at various depths after endotoxin exposure. This technique was also used to investigate the strength of endotoxin binding to the tooth surface by brushing for 1 minute and re-examining the tooth for the presence of endotoxin. Controls included periodontally diseased and healthy teeth. Results of the study showed that (1) endotoxin adheres to the tooth surface without penetration into the root cementum of either periodontally healthy or diseased teeth, and (2) the binding of the endotoxin to the root surface appears to be weak.

Adolescent↗