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Biomedical subjects

P Trisi

Publications and source records attributed to P Trisi.

At least 19 recordsLinked to original sources
PubMed1998

Vertical ridge augmentation around dental implants using a membrane technique and autogenous bone or allografts in humans.

This study investigated the effect on vertical bone regeneration of the addition of demineralized freeze-dried bone allograft or autogenous bone chips to a membrane technique. Twenty partially edentulous patients with vertical jawbone deficiencies were selected for this study. The patients were divided into two groups of 10 individuals. The 10 patients of Group A received 26 Brånemark implants in 10 surgical sites. The 10 patients of Group B received 32 implants in 12 surgical sites. Fifty-two out of 58 implants (22 in Group A and 30 in Group B) extended 1.5 to 7.5 mm superior to the bone crest. Titanium-reinforced expanded polytetrafluoroethylene membranes were used to cover the implants and, before complete membrane fixation, demineralized freeze-dried bone allograft particles were condensed under the membrane in Group A, and autogenous bone chips were used in Group B. At the reentry after 7 to 11 months the membranes were removed and a small biopsy was collected from 11 sites comprehending the miniscrews. The clinical measurements from Group A demonstrated a mean vertical bone gain of 3.1 mm (SD = 0.9 mm, range 1 to 5 mm) with a mean percentage of bone gain of 124% (SD = 46.6%). The measurements from Group B showed a mean vertical bone gain of 5.02 mm (SD = 2.3 mm, range 1 to 8.5 mm) with a mean percentage of bone gain of 95% (SD = 26.8%). Histomorphometric analysis of the present study clearly demonstrated a direct correlation between the density of the pre-existing bone and the density of the regenerated bone. The mean percentage of new bone-titanium contact was from 39.1% to 63.2%, depending on the quality of the pre-existing bone. Both the clinical and histologic results indicate a beneficial effect of the addition of demineralized freeze-dried bone allograft or autogenous bone particles to vertical ridge augmentation procedures in humans.

Adult↗
PubMed1998

Guided tissue regeneration using a resorbable membrane in gingival recession-type defects: a histologic case report in humans.

This case report clinically and histologically evaluated the regeneration of gingival tissues with the use of resorbable membranes. The study was performed on a premolar for which extraction was planned. The exposed root surface was thoroughly cleaned and planed with curettes and rotary instruments, and two notches were created on the facial aspect of the exposed root surface. A resorbable Resolute membrane (WL Gore) was applied above the defect to allow for gingival regeneration. After a 6-month healing period, a block section containing the root and the regenerated tissues was removed. The biopsy specimen was processed to obtain thin ground sections. The histologic analysis demonstrated the formation of a newly generated periodontal tissue from the deepest notch toward the coronal gingiva. The newly formed tissue was composed of a coronal area of connective tissue attachment and an apical area of bone fibers and cementum. The present report histologically demonstrates the ability of a resorbable membrane to allow complete regeneration of the periodontal ligament in the coverage of gingival recessions.

Absorption↗
PubMed1998

The bone growing chamber: a new model to investigate spontaneous and guided bone regeneration of artificial defects in the human jawbone.

Spontaneous bone repair and regeneration of jawbone defects have been insufficiently studied in the dental literature. The present study analyzes a new human model designed to evaluate the basis for spontaneous bone regeneration in human jawbones. Hollow titanium cylinders, termed "bone growing chambers," were prepared with commercially pure titanium. Ten volunteers undergoing routine implant surgery were enlisted. A properly calibrated drill was used to prepare the bone-growing-chamber bed. The bone growing chamber was inserted inside the bone defect, and care was taken to submerge the cylinder at the level of the bone crest. After an adequate healing period, the bone growing chambers were retrieved with a small quantity of peripheral bone using a calibrated trephine bur. The retrieved specimens were processed to obtain thin undecalcified ground sections. The stable bone growing chambers showed bone tissue inside the growing space. The maturity of the regenerated bone was related to the time of removal. The bone growing chamber provides a well-defined space that is easy to prepare and to retrieve; its dimensions are always identical and it allows quantitative measurements of bone regeneration inside the chamber space.

Alveolar Process↗
PubMed1997

Supracrestal bone regeneration around dental implants using a calcium carbonate and a fibrin-fibronectin sealing system: clinical and histologic evidence.

This study evaluated a new surgical technique for the treatment of an alveolar ridge deficiency in 11 patients. Twenty-two implants were placed, 15 of which presented with a combination of supracrestal and dehiscence kinds of defects, and seven presented only supracrestal bone loss. Surgical procedures were performed utilizing a combination of the resorbable space-making material calcium carbonate stabilized with a fibrin-fibronectin sealing system and the immediate placement of titanium dental implants. After implant placement, the mean height for supracrestal and dehiscence defects measured 2.57 +/- 1.41 mm and 2.47 +/- 1.54 mm, respectively. The defects were filled with calcium carbonate and a fibrin-fibronectin sealing system, and the flaps were sutured, avoiding any compression of the treated area. Healing was uneventful in all instances. At second-stage surgery at 6 months, a hard bone-like tissue was detectable at the defect sites. Histologic examination of four defects confirmed the presence of newly formed bone and revealed residual particles of calcium carbonate. There was a mean gain of 2.05 +/- 1.47 mm in the supracrestal defects and of 2.23 +/- 1.62 mm in the dehiscences. The results indicated that calcium carbonate, combined with a fibrin-fibronectin sealing system, is a viable alternative in the treatment of supracrestal and dehiscence bony defects.

Adult↗
PubMed1996

A histologic study of nonsubmerged titanium plasma-sprayed screw implants retrieved from a patient: a case report.

The authors report on the microscopic findings in two plasma-sprayed nonsubmerged implants retrieved from a patient 6 months after placement. One of the implants had been loaded for 3 months, while the other was left unloaded. Clinically, the peri-implant gingival tissues were in good health. The implants were sectioned according to the cutting-grinding system. Bone lined the titanium surface almost completely with 77.3% +/- 5.1% of contact in the unloaded implant and 86.5% +/- 3.3% of contact in the loaded implant. Signs of bone resorption with many macrophages and osteoclasts were present in the loaded implant, while in the unloaded implant only osteoclast resorption activity was demonstrable.

Alveolar Bone Loss↗
PubMed1996

GBR with an e-PTFE membrane associated with DFDBA: histologic and histochemical analysis in a human implant retrieved after 4 years of loading.

As a result of a fracture to the cemented post and core, a pure titanium implant was extracted from a 54-year-old patient after 4 years of clinical loading. At implantation, the implant was positioned into an extraction socket and the defect was treated with an e-PTFE membrane associated with a DFDBA graft. At retrieval the implant underwent histologic and histochemical examination to assess the characteristics of the regenerated bone after 4 years of prosthetic loading. The implant showed an angular bony defect at the smooth collar, but the bone-implant direct contact rate seemed to be elevated in the remaining implant surface. Normal transmitted and polarized light examinations demonstrated that most of the DFDBA particles were resorbed and substituted by vital newly formed bone. The regenerated bone appeared compact with secondary osteons and large haversian canals; however, some partially mineralized remnants residuated in the spaces, between the osteons. Within the limits of this study, the authors concluded that DFDBA can be substituted by the host bone, but the rate of substitution is very slow and not complete after 4 years. From a clinical point of view, however, the load-bearing capacity of the bone regenerated with the membrane technique associated with DFDBA appeared to be similar to that of normal bone.

Alveolar Bone Loss↗
PubMed1995

Localized chronic suppurative bone infection as a sequel of peri-implantitis in a hydroxyapatite-coated dental implant.

Plaque-induced lesions can produce peri-implant bone loss with ultimate implant loss. Although the peri-implant tissues seem to be more resistant than the periodontal ones to plaque and calculus, they can produce a more extensive spread of the infection to the deeper tissues around implants. The case of a 45-year-old female patient is presented in which, over a three year period, there was a progressive loss of peri-implant bone and the formation of a periapical radiolucency with an external fistula. The implant was removed and examined with the cutting-grinding system. Microscopy examination showed that most of the hydroxyapatite (HA) was still adherent to the metal. There was a detachment in the area of the HA-titanium interface. The implant surface was almost completely covered by bacteria. Bacteria were also present in the bone medullary spaces surrounding the implant. The infection of the periodontal tissues had progressed into the alveolar bone, thus producing a localized bone infection. The cause of the implant failure is probably related to a defective connection of the abutment or to overloading of the implant due to the presence of interlocks in the prosthetic restoration.

Bone Resorption↗
PubMed1995

Bacterial penetration in vitro through GTAM membrane with and without topical chlorhexidine application. A light and scanning electron microscopic study.

Premature exposure of membrane in the oral cavity is considered the most common complication as well as a reason for failure or incomplete success of guided tissue regeneration, as the exposed membrane undergoes plaque accumulation. A method to control, or at least to reduce the bacterial invasion of the membrane allowing a delay in the membrane removal, could be of clinical interest. The purpose of the present study was to evaluate the possibility of treating, with topical chlorhexidine application, the bacterial colonization of exposed membranes. A special device was developed in order to evaluate, under an experimental environment, the bacterial colonization. This device was made from a removable acrylic denture base to which 5 gold cups were attached. The cups consisted of an internal compartment, isolated from the oral cavity by a GTAM membrane, and an external compartment exposed to the oral environment. 3 healthy subjects had this device fitted, bilaterally, in the molar-premolar region of the upper jaw. The cups of one side of each subject had 0.2% chlorhexidine gluconate gel applied 2x a day for 1 min, whereas those of the other side served as controls. 12 cups were removed after 2 weeks and the remainder removed after 1 month. The non-treated control specimens were characterized by greater amounts of plaque accumulation. In all the test sites, plaque deposits increased in thickness and quantity during the 4 weeks of the experiment. Complete invasion of the membrane and initial colonization of its internal surface were observed only in 4-week specimens. A relatively simple flora consisting mainly of cocci and short rods, was found in bacterial deposits forming under the influence of chlorhexidine, whereas in non-treated specimens, it was possible to observe a more mature and complex plaque, composed mostly of filamentous bacteria. In conclusion, topical application of chlorhexidine gel is an effective method of reducing plaque and calculus formation on the surface of GTAM membranes exposed to the oral cavity for up to 4 weeks. This study has, however, failed to demonstrate the capacity of chlorhexidine to prevent or to retard bacterial penetration through the thickness of the inner portion of the membranes.

Acrylic Resins↗
PubMed1995

Cementum growth in impacted teeth.

The authors present a study on the cementum of impacted teeth. It was not possible to correlate the thickness of the cementum and the age of the patients. Significant differences were found, on the other hand, between the thickness and distribution of the cementum in different teeth. Third molars showed in almost all cases an increase in the thickness of cementum.

Adult↗
PubMed1994

A light and laser scanning microscopy study of bone/hydroxyapatite-coated titanium implants interface: histochemical evidence of unmineralized material in humans.

The authors describe a light and laser scanning microscopy study of hydroxyapatite-coated titanium implants retrieved from humans. A histochemical technique, using von Kossa and basic fuchsin, allowed clear differentiation between mineralized bone and unmineralized bone matrix. The bone-hydroxyapatite (HA) interface presented variable features: in some areas the mineralized bone was directly apposed to the HA surface, while in others an unmineralized red-stained material, probably osteoid, was interposed. Laser scanning microscopy confirmed these findings showing a thin layer of fluorescent material at the interface.

Bone and Bones↗
PubMed1994

Histochemical and confocal laser scanning microscopy study of the bone-titanium interface: an experimental study in rabbits.

The aim of our study was an analysis of the presence of an unmineralized bone matrix between mineralized bone and titanium screws in rabbit tibiae. A microscopical analysis, using a histochemical technique, was performed on the titanium-bone interface of commercially pure titanium implants placed in rabbit tibiae and harvested after 2 months. Thin ground sections of the specimens were prepared by the cutting-grinding system and stained using the von Kossa method for calcium salts and basic fuchsin for osteoid. The microscopical and morphometrical evaluation showed that bone covered about 40% (+/- 7.5%) of all implants. Mineralized bone was, however, in direct contact with the titanium surface on only about 10% of the implant, while in the remaining 30% the mineralized bone was separated from the implant by an unmineralized tissue. This basophilic, probably osteoid matrix, could represent the medium that allows the biochemical exchanges between bone and cells under the influence of the implant. A small, optically translucent gap (1-5 microns), probably an artifact, was present in some areas between titanium and bone. Confocal laser scanning microscopy (CLSM) in a fluorescent mode showed the presence at the interface of a fluorescent material. Results from our study showed that light microscopy of thin ground sections allowed a good analysis of the real nature of the titanium-bone interface. Moreover, this double staining technique showed the presence of an unmineralized bone matrix at most of the bone-titanium interface.

Animals↗
PubMed1994

Clear cell odontogenic carcinoma. Report of a case with lymph node and pulmonary metastases.

The authors present a case of a rare type of odontogenic tumour, recently described as "clear cell odontogenic tumour". The patient died 5 years after the initial diagnosis with lymph node and diffuse pulmonary metastases. This fact can support the view that this tumour, histologically characterised by the presence of cells with a clear cytoplasm, can behave in an aggressive way and has true metastatic potential, despite the absence of malignant cellular features.

Adenocarcinoma, Clear Cell↗
PubMed1994

Freeze-dried dura mater for guided tissue regeneration in post-extraction dental implants: a clinical and histologic study.

Soft membranes were used in 69 patients for bone regeneration around implants (blades and screws, submerged and non-submerged) placed into extraction sockets. In about 10% of the patients a prosthetic restoration was completed immediately, while in the remaining patients the prostheses were connected after a healing period of 3 to 6 months; follow-up ranged from 6 to 30 months. In 22 patients a re-entry procedure was done to evaluate the membrane and in 4 patients a bone biopsy was taken from 3 to 6 months after the placement of the membrane. In all cases the peri-implant tissues appeared clinically healthy and it was possible to see radiographically that the newly formed bone closely adapted to the implants. In most cases it was possible at 6 months re-entry to see the membrane and detach it from the underlying tissues. There was a partial dehiscence of the membrane in only 4% of the cases. After 3 months the tissue under the membrane presented macroscopical features similar to mature bone, and bone biopsies in all cases showed a spongious lamellar bone with a high level of activity and a wide band of osteoid tissue.

Adult↗
PubMed1994

A preliminary report on a method for studying the permeability of expanded polytetrafluoroethylene membrane to bacteria in vitro: a scanning electron microscopic and histological study.

The technique of guided tissue regeneration using expanded polytetrafluoroethylene (ePTFE) membranes has been shown to be effective in implant dentistry (bony defects, extremely thin alveolar ridges, and implants placed in fresh extraction sockets). One of the drawbacks associated with the use of membranes is their premature exposure with consequent bacterial contamination. The aim of this study was to examine the possibility that oral bacteria migrate through the occlusive portion of ePTFE membranes and to determine the time needed for microorganisms to pass from the outer surface to the inner surface of the membranes. A removable acrylic device was adapted to the molar-premolar region of one quadrant of the jaws in each of three volunteers. Five cylindrical teflon chambers were glued to the buccal aspect of each device. The chambers were divided into two rooms separated by the inner portion of a ePTFE membrane. The outer room was open to the oral cavity allowing plaque accumulation; the inner room was isolated from the oral cavity by the ePTFE membrane. One of the 5 chambers was completely closed and used as control. The test period lasted for 4 weeks. Every week, one chamber was removed from each device and processed for scanning electron microscopic and histologic examinations. Our study showed the possibility that oral bacteria may contaminate ePTFE membranes exposed to the oral cavity. One specimen showed partial bacterial penetration after 2 and 3 weeks, but after 4 weeks, all membrane specimens demonstrated bacterial contamination.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Composite resin-amalgam compound restorations.

Extensive silver amalgam restorations in premolars and molars occasionally require sacrifice of healthy unsupported enamel walls or cusps. A posterior composite resin-amalgam compound technique has been proposed to conserve these structures. Microleakage was high at the enamel-amalgam interface, moderate at the composite resin-silver amalgam and dentin-composite resin interfaces, and minimal between the inner enamel and the composite resin. Light microscopy and scanning electron microscopy demonstrated that marginal adaptation of the silver amalgam to the composite resin of the cusps was acceptable and that penetration of the inner etched enamel to the composite resin was complete.

Bicuspid↗
PubMed1994

Vertical ridge augmentation using a membrane technique associated with osseointegrated implants.

The purpose of this study was to evaluate: (1) the surgical protocol, effectiveness, and reliability for vertical ridge augmentation using a new titanium-reinforced membrane and osseointegrated implants; and (2) the histologic characteristics of the interface between a pure titanium implant and newly regenerated human bone. Five patients received 15 conical Brånemark-type implants in six different surgical sites requiring vertical augmentation. The implants protruded 4 to 7 mm from the bone crest. Pure titanium miniscrews (1.3 x 10 mm) were positioned distally to the implants, protruding 3 to 4 mm from the bone level. The implants and the miniscrews were covered with a titanium-reinforced membrane, and the flaps were sutured. Membranes were removed at the stage 2 surgery after 9 months of healing. Measurements of biopsy specimens showed a gain in bone height from 3 to 4 mm. Histologic examination showed that all retrieved miniscrews were in direct contact with bone. Histomorphometric analysis of bone contact gave a mean value of 42.5 +/- 3.6% for five of the six examined miniscrews. The results suggest that the placement of implants protruding 3 to 4 mm from the top of resorbed bone surfaces may result in vertical bone regeneration to the top of the implant cylinder and that the regenerated bone is able to osseointegrate pure titanium implants.

Adult↗
PubMed1994

Qualitative and quantitative comparative study on different filling materials used in bone tissue regeneration: a controlled clinical study.

This study compared, in a human model, the ability of (1) expanded polytetrafluorethylene (e-PTFE) membranes plus bone-chip autografts, (2) e-PTFE membranes plus demineralized freeze-dried bone, (3) e-PTFE membranes plus a new form of demineralized allograft bone tissue, and (4) e-PTFE membranes alone to enhance bone regeneration around dental implants placed into recent extraction sockets. The histologic results demonstrated that, in humans, guided tissue regeneration techniques are capable of producing new bone osseointegrated with titanium dental implants. Among the graft materials, autogenous bone provided the densest and the greatest amount of bone formation, but use of demineralized freeze-dried bone and a new form of de-mineralized allogenic bone matrix also improved bone regeneration compared to membranes alone after 6 months of healing.

Alveolar Bone Loss↗