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Biomedical subjects

R G Caffesse

Publications and source records attributed to R G Caffesse.

At least 109 records · Page 6Linked to original sources
PubMed1986

Scaling and root planing with and without periodontal flap surgery.

Complete removal of calculus is a primary part of achieving a "biologically acceptable" tooth surface in the treatment of periodontitis. Rabbani et al. reported that a single episode of scaling did not completely remove subgingival calculus and that the deeper the periodontal pocket, the less complete the calculus removal. The purpose of the present study was to evaluate the effectiveness of scaling relative to calculus removal following reflection of a periodontal flap. Each of 21 patients who required multiple extractions had 2 teeth scaled, 2 teeth scaled following the reflection of a periodontal flap, and 2 teeth serve as controls. Local anesthesia was used. Following extraction, the % of subgingival tooth surfaces free of calculus was determined using the method described by Rabbani with a stereomicroscope. Results showed that while scaling only (SO) and scaling with a flap (SF) increased the % of root surface without calculus, scaling following the reflection of a flap aided calculus removal in pockets 4mm and deeper. Comparison of SO versus SF at various pocket depths for % of tooth surfaces completely free of calculus showed 1 to 3 mm pockets to be 86% versus 86%, 4 to 6 mm pockets to be 43% versus 76% and greater than 6 mm pockets to be 32% versus 50%. The extent of residual calculus was directly related to pocket depth, was greater following scaling only, and was greatest at the CEJ or in association with grooves, fossae or furcations. No differences were noted between anterior and posterior teeth or between different tooth surfaces.

Adult↗
PubMed1986

In vitro effectiveness of dental floss in plaque removal.

This study was designed to determine whether there was any measurable difference in the effectiveness of bacterial plaque removal between 4 commercially available dental flosses. By means of a highly standardized and controlled in vitro experimental model technique utilizing 50 freshly extracted third molars, the possibility of intra- and inter-individual variability was eliminated. Each tooth was individually mounted in a formatray block and the surface was finished to either a "planed" or "unplaned" surface configuration. The "planed" root surface (dentin) was achieved by using 600 grit wet-sandpaper for tooth surface reduction while the "unplaned" root surface was achieved by using 600 gift wet-sandpaper. The teeth were then individually processed to effect the growth of bacterial plaque (S. mutans) on the prepared surfaces. Each tooth was subsequently disclosed, flossed and photographed without interruption. The flossing was carried out on a flossing machine utilizing a controlled force of 50 g. A controlled direction of the stroke perpendicular to the long axis of the tooth, and a controlled frequency of flossing (2 strokes per trial) was used. The results of the clinical trials were evaluated utilizing Ektachrome slides of the previously flossed and disclosed tooth surfaces. The photographs were projected, measured, and statistically analyzed (Student t-test and paired t-test) for the effectiveness of plaque removal of the 4 dental flosses and the effect of root surface roughness on the ability of the flosses to remove bacterial plaque. It was found that on smooth, "planed" root surfaces, there were no measurable difference among the 4 flosses.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Devices, Home Care↗
PubMed1986

Effect of lyophilized autologous plasma on periodontal healing of replanted teeth.

The purpose of this histologic and autoradiographic study of replanted teeth was to evaluate the beneficial effect, if any, of lyophilized autologous plasma (LAP) application on periodontal healing and to re-examine rates of repair in different areas of the associated periodontium following replantation. Maxillary and mandibular incisors and premolars of three rhesus monkeys were used. Teeth were extracted with forceps and placed in sterile physiologic saline. After 5 minutes each tooth was returned to its socket and immobilized by interproximal acid-etch splints. Splints were removed after 1 week. Of the 48 replants performed, 24 (controls) were replanted as described. Of the 24 experimental teeth, during the 5 minute interval between tooth extraction and replantation, the root surface and the inner socket walls were bathed with 1 ml of the reconstituted LAP-saline solution (800 mg/ml). Replants and animal sacrifice were scheduled to provide observations at 1, 3, 7, 14, 28 and 45 days following replantation. One hour prior to sacrifice, each monkey received an intravenous injection of tritiated thymidine, 1 microCi/gm body weight. Tissue specimens were processed for evaluation following standard procedures. Eight replanted teeth were available for evaluation for each of the six time-points. Four teeth were treated with LAP and four without it. Histologically, tissue sections were examined for epithelial proliferation and attachment, periodontal fibers organization and maturation, inflammatory cell types, presence or absence of cementum resorption and dentoalveolar ankylosis and degree of vascularity of the tissues. For autoradiographic evaluation, the periodontium associated with the replanted tooth was divided into nine spatial cell compartments. In each compartment, labeled tissue cells, epithelial or connective, were counted and recorded. Differences between the control (untreated) replanted teeth and the LAP-treated teeth, at each time-point and within each compartment, were analyzed for significance using the paired t-test. The findings of this study indicate that LAP use enhanced healing by early replacement of the fibrin clot, increased connective tissue cell proliferation, reduction of the inflammatory response and inhibition of root cementum resorption. Periodontal healing and repair occurred more rapidly in the supracrestal or transseptal connective tissue region than within the periodontal membrane space.

Alveolar Process↗
PubMed1985

Histopathologic findings in temporomandibular joints of aged individuals.

Twenty-four TMJs from well preserved 62- to 97-year-old human cadavers, 12 men and 12 women, were used in this study. The TMJs were routinely processed to identify (1) the histologic and histopathologic changes present in the articulations and (2) the components of the joint most frequently affected by these changes. The most significant histopathologic findings were (1) intense fibrocartilaginous proliferations of the condylar head and articular eminence linings, (2) neovascularization or myxomatoid degenerative changes in articular disks, and (3) proliferation of synovial villi, subsynovial tissue, and muscular fibers. The components of the joint most frequently affected were (1) the condylar head (30.4%), (2) the articular disk (21.7%), (3) the synovial lining (13%), (4) the articular eminence (8.6%), and (5) the lining of the articular fossa (4.3%). Five joints were considered to be within normal histologic limits, and one joint was excluded from the study because of metastatic malignancy.

Aged↗
PubMed1985

Healing and revascularization of apical periodontium and dental pulps in apicoectomized and nonapicoectomized tooth replants in monkeys. A study of fully developed teeth.

This report primarily concerns an experimental study of the effect of apicoectomy on the healing and revascularization of the periodontal membrane and dental pulps in tooth replants. Five rhesus monkeys (Macaca mulatta) were subjected to surgical procedures in which twenty incisor teeth were extracted and immediately replanted. Ten of these incisors were subjected to apicoectomy. Healing and revascularization of periapical tissues and dental pulps were evaluated by histologic and India-ink-perfusion techniques. Apicoectomized replants were characterized by (1) loss of dental substance (tooth apex) and creation of large periapical spaces, (2) exposure of dental pulps and production of periapical inflammatory processes with destruction of alveolar bone, and (3) blocking of normal healing because of persistence of chronic periapical inflammatory processes. In contrast, nonapicoectomized replants depicted short-lived primary inflammatory responses and healing processes characterized by variable histologic responses.

Animals↗
PubMed1985

The effect of citric acid and fibronectin application on healing following surgical treatment of naturally occurring periodontal disease in beagle dogs.

It has recently been suggested that following the exposure of root surface collagen with citric acid, the addition of topically applied fibronectin might promote healing with a fibrous re-attachment. The purpose of this study was to determine the benefit of citric acid demineralization and fibronectin application in the surgical treatment of severe, naturally occurring periodontal disease in Beagle dogs. The 4 treatment modalities employed were: (1) surgery alone (mucoperiosteal flaps); (2) surgery plus fibronectin; (3) surgery plus citric acid; (4) surgery plus citric acid followed by fibronectin application. Coronal and root surface notches were used as biometric and histometric reference points. Final clinical measurements were recorded 6 weeks post surgically, on the day of sacrifice. Significantly increased amounts of connective tissue reattachment were observed in the areas treated with the citric acid/fibronectin combination. Fibrous re-attachment was enhanced at the expense of epithelial downgrowth and occurred directly to both new and old cementum and exposed dentin, often in a functional manner, i.e., perpendicular to the root surface. Areas treated with the surgery and citric acid technique attained moderate amounts of fibrous re-attachment while the other treatment modalities were associated with a long junctional epithelium. The enhanced fibrous re-attachment may be the product of an accelerated coalescing of exposed soft tissue and root surface collagen fibrils, while under the mediating effect of fibronectin.

Animals↗
PubMed1985

The therapeutic effect of toothbrushing on naturally occurring gingivitis.

A majority of previous toothbrushing studies have examined proposed virtues of particular brushing techniques or the relative cleaning ability of various toothbrushes. A smaller number were concerned with their role in prevention of gingivitis. Whether toothbrushing could be therapeutic in naturally occurring gingivitis was tested in 40 teenagers aged 12 to 14 years. Groups from two public schools were examined for gingivitis and plaque. Students from both groups were given a soft multi-tufted toothbrush and nonfluoridated toothpaste to be used daily. Students at one school were given a single intensive oral hygiene session. All students were reexamined 42 days later and given a thorough prophylaxis. Final readings were obtained 84 days after baseline and the results analyzed statistically. Sign test analysis disclosed a significant (P less than .01) improvement in plaque and gingivitis scores for both groups. Wilcoxon tests of patient means revealed a significant improvement in plaque scores, whereas gingivitis means were more variable. Chi square analysis between groups showed that the groups receiving oral hygiene instructions had significantly better (P less than .01) plaque and gingivitis scores at session 2. Gingivitis differences were generally significant at session 3. Toothbrushing has a therapeutic effect on naturally occurring gingivitis, enhanced by oral hygiene instruction.

Adolescent↗
PubMed1985

Carrageenan-induced inflammation and its effects on mitotic activity and keratinization of gingival epithelium. A histologic and autoradiographic study.

This study was undertaken in order to: evaluate the cell population in carrageenan-induced inflammation and investigate the extent to which this inflammation modified mitotic activity, and keratinization of the sulcular epithelium induced by daily prophylaxes in monkeys. Normal-keratinized oral gingival epithelium was also evaluated for these processes in the same gingival specimens. Each of three adult Rhesus monkeys received a thorough prophylaxis 1 week prior to the experiment. Over the 10-week experimental period, each monkey received daily rubber cup prophylaxes. In addition, during the last 10 days, daily gingival injections of a 1% carrageenan saline solution and normal saline solution were given. One hour prior to sacrifice, each monkey received an intravenous injection of tritiated thymidine, 1 microCi/gram of body weight. After sacrifice and tissue processing, the histologic sections were evaluated. It was found that the carrageenan solution injected into gingival tissues produced an acute inflammatory response consisting of polymorphonuclear leukocytes PMNs (61.3%), lymphocytes (5.2%), monocytes/macrophages (23.5%), plasma cells (2.0%) and unidentified cells (3.8%). An Inflammatory Index and a Mitotic Activity Index were determined, and keratin length and widths were measured. Data were analyzed statistically using analysis of variance. Pairwise comparisons were also made using Scheffe's method of multiple comparisons. The study showed that: carrageenan solutions injected into gingival tissues elicited an acute inflammation; acute inflammation present in gingival connective tissue stimulated an increase in mitotic activity in subjacent gingival epithelium; acute inflammation within gingival tissues did not modify the induced-keratinized sulcular epithelium, or the normally-keratinized oral gingival epithelium; and acute inflammation may not necessarily affect tissue keratinization, if bacterial plaque is removed daily.

Animals↗
PubMed1985

Periodontal aspects of porcelain restorations.

At present, no man-made restorative can match the biologic acceptance of a hygienic natural tooth surface. Ideally, no restorative material would approach the gingival apparatus. However, as case demands often dictate violating this ideal, careful adherence to the principles discussed will minimize the damage to the periodontium. Ultimately, the response of the periodontal tissue will give the final approval or disapproval of any restorative procedure. The principles discussed must be considered at all phases of any restorative procedure. They must always be of primary concern.

Animals↗
PubMed1984

Revascularization following a combined gingival flap-split thickness flap procedure in monkeys.

A combined technique (gingival flap-split thickness flap) was performed in monkeys. The clinical, histological and microvascular aspects of healing were studied, mainly focusing on the gingival flap, since some of the vessels supplying this area were severed during the second phase of the procedure. The animals were perfused with a combined solution of Pelikan carbon black and 10% formalin solution and killed from 1 to 35 days postoperatively. Cleared specimens and regular histology were obtained. It was concluded that: (1) the remaining periosteal vessels and surrounding structures provided enough nutrition for the survival of the gingival flap, (2) the microvascularization was normal at the 14 days postoperative period in both the gingival flap and the apically positioned split areas and (3) the exposed connective tissue remained narrow and exhibited an irregular vascular arrangement throughout the experiment.

Animals↗
PubMed1984

Revascularization following the lateral sliding flap procedure.

Two young adult rhesus monkeys, with an average weight of 12 pounds were used. Anesthesia with Nembutal 30 mg/kg of body weight was given to perform the surgeries. Artificial defects were created by raising a flap and removing about 5 X 7 mm of the buccal alveolar plate and suturing the flaps exposing the alveolar crest. These defects were left untreated for 2 months. Then, mucogingival lateral sliding flaps were performed to cover the recessions. Postoperative periods of 1, 9, 14, 21, 28 and 35 days were obtained when the animals were killed. A combined solution of Pelikan carbon black and 10% buffered formalin was perfused through the exposed and cannulated external carotid arteries to evaluate revascularization. After killing, blocks, including the operated teeth and the surrounding tissues, were fixed in 10% formalin and then partially decalcified in EDTA. Two blocks per time interval were obtained. One of the blocks was processed for regular histology, and sectioned bucco-lingually. In these sections it was found that the new attachment to the root was mediated by a combination of connective tissue attachment and a long junctional epithelium. The other blocks were cut cross-sectionally at about 1-mm thickness. Sections were selected from three different areas: (a) at the most coronal part of the laterally displaced flap, (b) at the middle of the localized defect and (c) at the bottom of the defect. They were cleared following the Spalteholtz method.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Dextran penetration through nonkeratinized and keratinized epithelia in monkeys.

The purpose of this study was to determine if polysaccharide dextrans would pass through intact-nonkeratinized and induced-keratinized sulcular epithelia in monkeys. Dextran penetration through normally keratinized oral gingival epithelium also was evaluated in the same gingival specimens. Each of three Rhesus monkeys received a thorough prophylaxis 1 week prior to the experiment. During this week, the monkeys also received daily IV injections of Achromycin. After the antibiotic treatment, the teeth were polished and cleaned with a rubber cup using prophylactic paste for 2 consecutive months, as follows: (1) the right maxillary and mandibular teeth received daily prophylaxes on weekdays and (2) the left maxillary and mandibular teeth received one prophylaxis weekly. These frequencies of plaque removal on one-half of the mouth maintained clinically healthy gingiva and produced keratinization of the sulcular epithelium. At the end of the 2-month prophylaxes, a 5% solution of dextrans derived from Leuconostoc mesenteroides was applied topically to the gingiva once daily for 3 consecutive weeks. During this time, the monkeys continued having dental prophylaxes following the previous time schedule. The study showed that induced-keratinized sulcular epithelium as well as normally keratinized oral gingival epithelium resisted penetration of dextrans, whereas intact-nonkeratinized sulcular epithelium apparently lacked a surface layer resistant to penetration.

Administration, Topical↗
PubMed1984

Dextran-induced inflammation and its effect on keratinized gingival epithelium in monkeys.

The cell population present during dextran-induced inflammation and its effect upon induced keratinization of the sulcular epithelium was investigated in two young adult male Rhesus monkeys. Keratinization of the sulcus epithelium was induced by a combined regimen of scaling, an intravenous injection of achromycin and daily rubber cup prophylaxes. After keratinization was confirmed by means of biopsies, inflammation was induced either by injecting 200 microliters of a 5% dextran saline solution or by applying the solution topically on the marginal gingiva for 2 weeks. Clinical grade dextran, molecular weight 70,000, was used. Physiologic saline solution, either injected or topical, was also used. At the same time, the daily prophylaxes were continued. After the 2 weeks, gingival biopsies were taken from each tooth treated with the different regimens. One-half of each biopsy was routinely processed and stained with hematoxylin and eosin or Rhodamine B, while the other half was processed for and stained with alcoholic and aqueous PAS to detect dextran in tissues. Histologic evaluation was carried out in three areas: a crestal zone, a cervical zone and an oral gingival zone. An Inflammatory Index (II) was determined and the width and length of keratin were measured. Dextran, either topical or injected, produced mainly a chronic inflammatory response characterized by lymphocytes (30-35%), monocytes-macrophages (5-10%), plasma cells (10%), polymorphonuclear leukocytes (PMNs) (15%) and unidentified cells (35%). Conversely, the physiologic saline-induced inflammation showed PMNs (75%), lymphocytes (5%) and unidentified cells (20%). The II for injected areas was significantly higher than for those topically treated or for nontreated controls. However, the increased II did not affect the degree of keratinization achieved.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1983

Effects of gingival curettage when performed 1 month after root instrumentation. A biometric evaluation.

The purpose of the present study was to evaluate biometrically the periodontal response to gingival curettage. 15 subjects having suprabony pockets were selected. Gingival Index (GI) was initially determined for the selected teeth. Measurements of probing depth, and the distance from the free gingival margin to the cemento-enamel junction were also taken at that time, as well as immediately after scaling and root planing of the selected teeth. 4 weeks after scaling and root planing, the clinical parameters were recorded. A split mouth design was used to select 2 quadrants of the mouth in which gingival curettage was to be performed. Immediately after, experimental measurements were again recorded. 5 weeks after gingival curettage, gingival inflammation, probing depth and the location of the free gingival margin were recorded for the last time. All data were analyzed statistically. It was shown that gingival inflammation, the distance from the free gingival margin to the cemento-enamel junction, and the probing depth were reduced after 4 and 9 weeks. The level of clinical attachment improved after 9 weeks. All these changes were statistically significant. These results were observed after scaling and root planing, as well as after scaling, root planing and gingival curettage. No differences were found between both treatment modalities in any of the parameters analyzed. Gingival curettage did not improve the condition of the periodontal tissues more significantly than scaling and root planing.

Adult↗