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Biomedical subjects

R G Caffesse

Publications and source records attributed to R G Caffesse.

At least 91 records · Page 5Linked to original sources
PubMed1988

Clinical evaluation of the use of citric acid and autologous fibronectin in periodontal surgery.

This study evaluated the effects of citric acid demineralization and autologous fibronectin application in association with a modified Widman flap in the treatment of periodontitis. The study population comprised 29 patients under treatment for moderate to advanced periodontitis who reached the one-year posttherapy evaluation. After thorough scaling and root planing, a split mouth design was used in which two quadrants were treated by modified Widman flap alone, and the other two randomly assigned quadrants were treated by modified Widman flap combined with citric acid demineralization and autologous fibronectin application. Fibronectin, which had previously been isolated from the patient's own plasma, was applied with a tuberculin syringe on the citric acid demineralized root surfaces and the inner aspect of the flap. After suturing provided good flap adaptation, additional fibronectin was again applied under the flap and external pressure was applied. Patients were clinically evaluated at baseline and at one year. Statistical evaluation of the data using paired t test and Chi-square analysis indicated that both approaches, modified Widman flap alone or in combination with citric acid and fibronectin, significantly reduced probing pocket depth and increased clinical attachment. However, the changes achieved with citric acid and fibronectin were statistically greater than those obtained with the flap alone. Furthermore, the number of sites gaining 2 mm or more of clinical attachment were significantly increased. The results suggest that the use of citric acid and fibronectin holds promise in promoting reattachment after periodontal therapy.

Adult↗
PubMed1988

New attachment achieved by guided tissue regeneration in beagle dogs.

This study tested the effects of using a Gore-Tex periodontal material on new connective tissue attachment in beagle dogs with natural periodontitis. Seven female beagle dogs with advanced periodontitis were selected and given thorough root debridement. Under general anesthesia four weeks later, mucoperiosteal flaps were raised involving all mandibular premolars and first molars. Gore-Tex periodontal material was adapted to all premolars, and the flaps were sutured tightly, keeping the material covered. The first molars acted as controls, receiving only surgery. Some material was removed in one month, while other materials were removed eight to 10 weeks after surgery. All dogs were sacrificed at three months. After processing, descriptive histology and histometrics were carried out, evaluating new connective tissue attachment, bone response and epithelial downgrowth. Results were statistically analyzed, using paired t tests. They showed new connective tissue attachment with cementum deposition in areas where the material was used. Also, the epithelial downgrowth was reduced in these areas. In the controls, minimal connective tissue attachment was found, with the area healing by a long junctional epithelium. Statistical analysis showed significant differences (P less than 0.05) favoring experimental areas both in the increase of new connective tissue attachment and in the decrease of epithelial downgrowth. No differences were found between areas where the material was removed in one month or left longer in place. No difference in bone response was found. Gore-Tex material was effective in blocking gingival epithelial downgrowth and connective tissue proliferation, promoting new attachment according to the principle of "guided tissue regeneration."

Alveolar Process↗
PubMed1987

Effect of fibronectin on healing of replanted teeth in monkeys: a histologic and autoradiographic study.

The purpose of this study was to evaluate the effect of fibronectin application on healing of replanted teeth. Three rhesus monkeys were used. Maxillary and mandibular incisors and premolars were extracted and replanted. Teeth were extracted with forceps and placed in saline solution. After 5 minutes, each tooth was returned to its socket and immobilized by interproximal acid-etch splints, which were removed after 1 week. Of the forty-eight teeth replanted, twenty-four control teeth were replanted as described. On each of the remaining teeth, the root surface and the inner walls of the socket were bathed with 1 ml of fibronectin in saline solution (400 micrograms/ml) during the 5-minute interval between tooth extraction and its replantation. Replanted teeth and animal killings were scheduled to provide observations 1, 3, 7, 14, 28, and 45 days after replantation. Each monkey received an intravenous injection of tritiated thymidine, 1 microCi/g body weight, 1 hour before it was killed. Tissue specimens were processed for histologic and autoradiographic evaluation following standard procedures. For each of the six points of time, four pairs of contralateral teeth were available for evaluation; four teeth were treated with fibronectin and four without it. The findings of this study indicate that fibronectin use resulted in enhanced healing by early replacement of the fibrin clot, increased connective tissue cell proliferation, reduction of the inflammatory response, and inhibition of both cementum resorption and dentoalveolar ankylosis.

Animals↗
PubMed1987

Repair of periodontal angular bony defects evaluated by one- and two-dimensional radiographic analysis.

The healing of eighteen angular periodontal bony defects was evaluated radiographically 1 year after treatment. The pretreatment and posttreatment radiographs were exposed and processed in such a way that identical images were obtained. There was no correlation between one- and two-dimensional expressions of healing in such defects, and relative area changes were consistently larger than relative linear changes of the same defects. The area gain of bone was strongly correlated to the following morphologic variables: length of bone surface, original defect area, and height of the defect.

Alveolar Process↗
PubMed1987

4 modalities of periodontal treatment compared over 5 years.

The purpose of the present study was to assess in a clinical trial over 5 years the results following 4 different modalities of periodontal therapy (pocket elimination or reduction surgery, modified Widman flap surgery, subgingival curettage, and scaling and rool planing). 90 patients were treated. The treatment methods were applied on a random basis to each of the 4 quadrants of the dentition. The patients were given professional tooth cleaning and oral hygiene instructions every 3 months. Pocket depth and attachment levels were scored once a year. 72 patients completed the 5 years of observation. Both patient means for pocket depth and attachment level as well as % distribution of sites with loss of attachment greater than or equal to 2 mm and greater than or equal to 3 mm were compared. For 1-3 mm probing depth, scaling and root planing, as well as subgingival curettage led to significantly less attachment loss than pocket elimination and modified Widman flap surgery. For 4-6 mm pockets, scaling and root planing and curettage had better attachment results than pocket elimination surgery. For the 7-12 mm pockets, there was no statistically significant difference among the results following the various procedures.

Clinical Trials as Topic↗
PubMed1987

Cell proliferation after flap surgery, root conditioning and fibronectin application.

This study evaluated the effects of citric acid demineralization and autologous fibronectin application on cell proliferation after mucoperiosteal flap surgery. Three adult rhesus monkeys were used. After flaps were raised, the roots were surgically exposed and planed. Surfaces on the experimental sides were decalcified with citric acid, and after thorough rinsing, the inner aspect of the flaps and the roots were bathed with 1 ml of autologous plasma fibronectin in normal saline (400 micrograms m/ml) and the flaps sutured. Contralateral teeth, acting as controls, were treated only with the surgical procedure. One hour prior to sacrifice, the animals were injected with an intravenous injection of tritiated thymidine (1 microCi/gm body weight). Surgeries were staggered to produce the following time periods: 3, 7, 15, 21 and 28 days. After processing, autoradiographs were obtained for evaluation, and labeled cells were counted in five compartments at 400 x: (1) oral epithelium, (2) crevicular area, (3) supracrestal connective tissue, (4) coronal periodontal membrane and (5) coronal bone marrow. Forty tissue sections per procedure (20 slides per tooth) were counted and means obtained for the three monkeys. Differences between experimental and control values were statistically evaluated for each component, at each time interval, using pairwise t tests. Fibronectin-treated areas showed significantly increased cellular proliferation (P less than 0.01) during the first 2 weeks, affecting mainly all the supracrestal tissues. Histologically, the establishment of a well-organized fibrinous clot at 3 days was noted in these areas. Results show a faster healing after surgery with the use of citric acid and fibronectin. It was concluded that citric acid followed by fibronectin enhanced cellular proliferation.

Animals↗
PubMed1987

Effect of citric acid and various concentrations of fibronectin on healing following periodontal flap surgery in dogs.

The purpose of this histologic and histometric study was to examine the effect of citric acid and increasing concentrations of fibronectin on new connective tissue attachment following periodontal flap surgery. Full thickness, mucoperiosteal flaps were elevated in six healthy mongrel dogs. Two to 3 mm of alveolar bone were removed along the buccal aspect of the teeth in the mandible and into the interproximal areas of each surgical site. Cementum was removed from the exposed root surfaces and reference notches were inscribed into the roots at the margin of the recontoured bone. Citric acid, pH 1.0, was applied to the instrumented root surfaces for 3 minutes and rinsed with sterile saline. Both the root surfaces and the inner surface of the flap were then bathed in either sterile saline or increasing concentrations (0.38, 0.75 and 1.5 mg/ml saline) or exogenous fibronectin. All the flaps were returned to their original preoperative positions, secured using figure 8 sutures with 4-0 braided silk and allowed to heal. Two dogs per time-point were sacrificed at 1, 2 and 6 weeks after surgery. Block specimens of the surgical sites were demineralized and serial sections prepared for histologic and histometric evaluations. Histologically, tissue sections were examined for: (1) epithelial proliferation and attachment, (2) periodontal fiber organization and maturation, (3) inflammatory cell types, (4) presence or absence of new cementum deposition and (5) degree of vascularity of the tissues. Histometric measurements were taken: (1) from the root surface notch to the apical extent of the junctional epithelium and (2) from the apical extent of the junctional epithelium to the free gingival margin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Effect of citric acid and lyophilized autologous plasma on healing following periodontal flap surgery in monkeys.

The purpose of this histologic, histometric, and autoradiographic study was to examine the effect of citric acid conditioning and lyophilized autologous plasma (LAP) application on healing following periodontal flap surgery. Mucoperiosteal flaps were elevated in six rhesus monkeys using the modified Widman flap procedure. A total of 24 quadrants were treated, each included the first and second premolar and first and second molar teeth. Cementum was removed from the exposed root surfaces, and reference notches were inscribed into the roots at the alveolar bone margin. Two treatment modalities were employed: (1) surgery plus citric acid conditioning, to serve as control and (2) surgery plus citric acid followed by LAP application (400 mg/ml saline). Flaps were returned to their preoperative positions and sutured. Animal sacrifices were scheduled to provide observations 3, 7, 14, 21, 28, and 45 days after surgery. Each monkey received an intravenous injection of tritiated thymidine, 1 microCi/gm of body weight, 1 hour before it was killed. Tissue specimens were processed for evaluation following standard procedures. Histologically, tissue sections were examined for: (1) proliferation and attachment of epithelium, (2) organization and maturation of periodontal fibers, (3) inflammatory cell types, (4) presence or absence of new cementum deposition, and (5) degree of vascularity of the tissues. For histometric evaluation, the radicular notches were used as reference points. The distances examined histometrically were: (1) from the root surface notch to the alveolar bone crest, (2) from the root surface notch to the apical extent of the junctional epithelium, and (3) from the free gingival margin to the apical extent of the junctional epithelium. For autoradiographic evaluation labeled cells were counted in five spatial compartments at 400 X magnification: (1) oral epithelium, (2) crevicular area, (3) supracrestal connective tissue, (4) coronal periodontal membrane, and (5) coronal bone marrow. For each the histometric and autoradiographic evaluation involved a total of 36 tissue sections per quadrant (9 sections per tooth). Tooth and quadrant means were obtained for each monkey. The plasma-treated and control quadrants were compared at each time point by the paired t test. N = 2 monkeys were used for each comparison. Histologic results showed that in teeth that were acid-conditioned after root planing, the epithelium often migrated apically reaching the radicular notch. Those teeth that were conditioned and subsequently treated with LAP demonstrated fiber attachment to the planed root surface and little or no epithelial downgrowth.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1987

Histologic evaluation of periodontal implants in a biologically "closed" model.

To study the biologic response, three commercial calcium phosphate implant materials (Calcitite, Periograf, Synthograft) were implanted in cuspid root "windows" in four beagle dogs. No implant material was placed in the fourth cuspid window which served as a control. Following mucoperiosteal flap elevation, windows were chiseled in bone to the root surface which allowed implant particles to contact bone, fibrous connective tissue, cementum and dentin without exposure to the oral environment. Animals were sacrificed after 1, 3, 5 and 6 months. Histologically, all implant materials were well tolerated. At 1 month, implant particles were surrounded by fibrous tissue. Fibrous tissues filled the control defect. At 3 months, implant sites exhibited partial bony repair with connective tissue surrounding implant particles. A ring of osteoid surrounded Synthograft particles. Control defect repair was complete. At 5 and 6 months, implant sites exhibited advanced, though incomplete, bony repair. New bone encompassed the Synthograft particles. It was concluded: Control sites healed most rapidly. Calcitite and Periograft were well tolerated space occupiers. Synthograft was a nidus for bone deposition.

Alveolar Process↗
PubMed1987

Mucoperiosteal flaps with and without removal of the pocket epithelium.

The purpose of this study was to clinically evaluate the need for elimination of the pocket epithelium during mucoperiosteal flap surgery aimed at reattachment or readaptation. A split mouth design was used in 13 patients with two bicuspids and two molars included in each quadrant. Two surgical techniques were compared. One of the quadrants received a modified Widman flap with removal of the pocket epithelium, while the contralateral side received a crevicular flap without removing the pocket epithelium. One month after the hygienic phase was completed, the following measurements were taken: Gingival Index, Plaque Index, gingival crevicular fluid flow, mobility, furcation involvement, level of attachment, pocket depth and gingival recession. In addition to these measurements, which were taken immediately prior to the surgery (baseline), 1- and 3-month postsurgical measurements were also taken. Gingival recession was recorded immediately after the flaps were replaced and sutured. All data were analyzed statistically using paired t test and sign test. The biometric results showed that without the removal of the pocket epithelium, good clinical results relative to gain in clinical attachment levels and reduction in probing depth were achieved. Greater gingival recession occurred on the crevicular flap side postsurgically when compared to the modified Widman flap. The other clinical parameters remained the same at the three time intervals. This was true within each technique and when both techniques were compared.

Adult↗
PubMed1986

In vitro polishing effectiveness of interdental aids on root surfaces.

The purpose of this study was: to determine whether polishing standardized proximal root surfaces with dental floss, Superfloss, wood and plastic interdental cleaners, using a polishing paste, produces any significant change on root surface roughness; and to determine the effectiveness of different number of strokes in polishing. 80 tooth specimens were prepared, 10 in each of 8 sample groups. Each proximal root surface was standardized with 600A grit silicone carbide paper and polished with either waxed dental floss, Superfloss, wood or plastic interdental cleaners, using alkali aluminum silicate polishing paste. All specimens were mounted on a flossing machine and polished with 10 or 20 strokes. Before and after polishing, measurements were recorded with the Surfanalyzer 150 System to produce profile and average roughness tracings. Average maximum peak heights, mean number of peaks, and mean average roughness values were calculated from the tracings. The data were analyzed statistically by paired t-test and Student t-test. No significant mean differences were found between the number of strokes used. No significant differences were found for waxed dental floss in relation to the values analyzed. Significant differences were found for maximum peak heights for Superfloss following 20 strokes of polishing. However, no significant differences were found for Superfloss for mean number of peaks and average roughness. Significant differences were found for average roughness values, maximum peak heights, and mean number of peaks for the wood and plastic interdental cleaners. It was concluded that root surface roughness increased significantly with the use of wood and plastic interdental cleaners but not with waxed dental floss or Superfloss.

Carbon↗
PubMed1986

The effectiveness of citric acid as an adjunct to surgical re-attachment procedures in humans.

The purpose of this study was to clinically evaluate the effect of citric acid on re-attachment and re-adaptation in conjunction with periodontal surgery. A split-mouth design was used in 10 patients involving 30 quadrants of surgery. A total of 120 teeth were treated. Each quadrant consisted of at least 2 teeth from cuspid to second molar. One quadrant was treated with a modified Widman flap alone while the root surfaces of the contralateral side were also treated with a 3 min application of citric acid. Immediately following hygienic phase and at 3 and 6 months postsurgically, the following measurements were taken in this sequence: gingival index, gingival crevicular fluid flow, plaque index, furcation involvement, level of attachment and probing depth. All the data were statistically analyzed using the paired t-test, chi 2 and Fisher exact probability test. The biometric results showed that both surgical techniques resulted in a loss of attachment in shallow pockets and a gain in deeper pockets. Both techniques resulted in similar amounts of recession and probing depth reduction at 6 months. Gingival index, plaque index and furcation values decreased at 3 and 6 months postsurgically. The gingival crevicular fluid values remained essentially the same up to 6 months postsurgically.

Adult↗