Search PubMed⌕ Search

Biomedical subjects

R Caffesse

Publications and source records attributed to R Caffesse.

9 recordsLinked to original sources
PubMed1992

A comparison of ePTFE membranes alone or in combination with platelet-derived growth factors and insulin-like growth factor-I or demineralized freeze-dried bone in promoting bone formation around immediate extraction socket implants.

The purpose of this study was to compare bone promotion around implants which were augmented with ePTFE membranes alone or in combination with cortical demineralized freeze-dried bone (DFDB) or the combination of platelet derived growth factor-BB (PDGF) and insulin like growth factor I (PDGF/IGF-I). Membranes were placed over titanium implants which had been inserted into fresh extraction sockets with large buccal dehiscences. Twenty-four implants were placed in 4 dogs. At 18 weeks clinical bone height measurements were taken, the animals were sacrificed, and all specimens retrieved for histologic evaluation. Clinically, a significant gain in bone levels was present in both the ePTFE membrane alone group (P < 0.005) and PTFE plus PDGF/IGF-I group (P < 0.01), but not in the PTFE plus DFDB group. Results from histometric measurements revealed an approximately 2-fold increase in the percentage of implant surface in contact with bone, area of bone adjacent to the implant surface, and in the total length of the implant surface in contact with bone in the dehiscence defects treated with ePTFE plus PDGF/IGF-I compared to the defects receiving ePTFE membranes alone (each P < 0.05). The response to the DFDB was highly variable and it did not significantly improve the efficacy of the PTFE membranes for any parameter measured. The distance from the outer surface of the new bone to the implant surface was statistically significant for ePTFE membranes alone and membranes plus PDGF/IGF-I. The results demonstrated that clinically, ePTFE membranes alone or ePTFE membranes with PDGF/IGF-I were equally effective in promoting bone growth around the implants. Histologic measurements demonstrated that sites treated with ePTFE membranes plus PDGF/IGF-I had the highest bone density compared with sites which received ePTFE membranes alone or with ePTFE membranes and DFDB. The results of this study question the use of DFDB and support the use of ePTFE membranes alone or with PDG-F-BB/IGF-I as potential methods of promoting bone formation around dental implants.

Alveolar Bone Loss↗
PubMed1992

The effect of citric acid application on periodontally involved root surfaces. 1. An in vitro light microscopic study.

This study investigated the effect of citric acid application on periodontally involved root surfaces. Forty periodontally involved teeth were randomly divided into four groups of ten teeth each: no treatment, citric acid treatment, root planing alone, and root planing in conjunction with citric acid treatment. Ten nondiseased, untreated teeth served as controls. After treatment, each tooth was split along its long axis; half was examined under light microscopy and half under scanning electron microscopy (part II of the paper). Light microscopy revealed that the effects obtained by scaling and root planing were not altered after citric acid application. Moreover, the cementum layer was not entirely removed without careful and thorough planing of the root surface. Citric acid application alone had no effect on the diseased root surface. Citric acid did not penetrate the dentinal tubules, nor did it alter the collagen content of the roots obtained by scaling and root planing.

Analysis of Variance↗
PubMed1991

Effects of metronidazole on periodontal treatment needs.

Periodontitis, a common cause of tooth loss in adult populations, is an inflammatory response to the overgrowth of anaerobic organisms such as spirochetes and bacteroides and, in some cases, micro-aerophilic organisms in the subgingival plaque. In the present investigation, using a double-blind clinical design, we sought to determine whether 1 week of metronidazole treatment plus debridement of the tooth surfaces was superior to 1 week of placebo treatment plus debridement (positive control) in reducing the subsequent amount of periodontal surgery given to the patients. Thirty-nine patients were randomly assigned to either the metronidazole or placebo (positive control) groups. All patients were given the necessary scaling and root planing and were unsupervised in their usage of the medication. After the completion of this treatment, they were reexamined and it was found that the metronidazole regimen caused a significant reduction in surgical needs of about 5 teeth per patient compared to the positive control (difference before and after treatment 8.3 +/- 6.8 teeth metronidazole versus 2.9 +/- 4.8 positive control, P = 0.007). The difference between groups was maintained during the 2 to 3 years' recall period. Metronidazole had a significant effect on the site specific reduction of spirochetes: 90% of the sites in the metronidazole group versus 64% in the positive-control group had a decrease in the percentage of spirochetes (P less than 0.05). We conclude that systemic metronidazole given 250 mg tid for 7 days in conjunction with debridement of the tooth surfaces can significantly reduce the need for periodontal surgery compared to the standard regimen which included only debridement.

Alveolar Bone Loss↗
PubMed1988

A longitudinal study comparing scaling, osseous surgery and modified Widman procedures. Results after one year.

The purpose of this study was to compare, longitudinally, the effectiveness of scaling and root planing, osseous surgery, and the modified Widman procedures. The study was carried out in a private practice setting. Sixteen adult patients with moderate to advanced adult periodontitis were treated with initial scaling and oral hygiene procedures. Posthygiene data were used for comparison of changes in probing depth, clinical attachment levels and gingival recession. The initial examination data were used to compare changes in plaque and gingival indices. Frequency distributions were used to compare changes that occurred at individual sites. At one year, plaque and gingival indices were significantly reduced when compared with the initial examination. At one year, shallow pockets (1-3 mm) were reduced when compared to posthygiene. Four- to six-millimeter pockets were significantly reduced by the three procedures. Osseous surgery and modified Widman had significantly greater pocket reduction when compared with scaling. For pockets greater than 7 mm, osseous surgery and the modified Widman had significantly greater reduction when compared with scaling. For pockets 1-3 mm at one year osseous surgery had significantly greater clinical attachment loss when compared with scaling. For 4-6 mm pockets at one year, the three procedures had slight gains in clinical attachment levels. The results were similar for pockets with greater than 7 mm. Interproximal soft tissue craters were measured for six postoperative weeks. Initially, the modified Widman had a higher percentage of soft tissue craters when compared with osseous surgery. At six weeks, however, there were no significant differences when the surgical procedures were compared. Recession was measured at each examination. Recession for 1-3 mm pockets at one year was greater for osseous surgery when compared with scaling and the modified Widman. Recession for 4-6 mm and greater than 7 pockets was greater for the surgical procedures than scaling. The results from this study indicate that with three-month maintenance recalls, both the modified Widman and osseous surgery are effective for pocket reduction, and each will produce a slight gain of clinical attachment over one year. Scaling was effective at maintaining attachment levels but was not as effective in reducing pocket depth.

Adult↗
PubMed1987

Effects of citric acid and fibronectin and laminin application in treating periodontitis.

To determine the effect on new connective tissue attachment of citric acid conditioning and fibronectin-laminin application in treating naturally occurring periodontitis, all 4 quadrants in each of 2 Beagle dogs were used. Each quadrant included: P2, P3, P4, and M1 teeth. 2 treatment modalities were employed and comparatively analyzed for differences in histological healing respponses at 120 days after surgery. The treatments were: (1) surgery (mucoperiosteal flaps) plus citric acid; (2) surgery plus citric acid followed by fibronectin-laminin application. After scaling and root planing, coronal and root surface reference notches were placed for histometric measurements. Following each of the randomly assigned treatments, flaps were sutured. After sacrifice, tissue blocks of treated areas were decalcified and serially cut, obtaining bucco-lingual and mesiodistal sections. Using a Filar micrometer, 5 distances were masured on the buccal aspect: (1) from root surface notch to alveolar bone crest; (2) from root surface notch to coronal extent of the cementum; (3) from root surface notch to apical extent of the junctional epithelium; 84) from free gingival margin to apical extent of junctional epithelium; (5) from the coronal notch to the alveolar bone crest. Results showed no differences among the 5 measurements between the 2 treatments tested. On mesio-distal sections, surface area determinations were made in the furcations, evaluating the space occupied by new connective tissue, with or without bone, or by epithelium. For this, images were digitized using a Zeiss IBAS Image analysis system with a 4mB of array processor memory coupled to a Newvicon TV camera and a microcomputer.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Root isolation for new attachment procedures. A surgical and suturing method: three case reports.

A surgical and suturing method is described for the subgingival placement of Gore-tex periodontal material during new attachment procedures. The periodontal material isolates the root surface from epithelium and gingival connective tissue. Three cases were treated. Clinical new attachment was evident from clinical probings and reentry. The term "open probing new attachment" describes the type of tissue that was evident at reentry after treatment of a Class III furcation. A combination of new bone and "open probing new attachment" was evident after one-wall defects were treated adjacent to a mandibular cuspid. A two-wall defect was treated and biopsied three months later. A reference notch was placed 1 mm coronal to the apical aspect of the defect. Histologic examination of the biopsy showed new bone, cementum and periodontal fibers coronal to the notch. Clinical and histologic new attachment was achieved using the technique for root isolation. The long-term predictability and stability of this type of new attachment is not known at this time.

Connective Tissue↗