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Biomedical subjects

R G Caffesse

Publications and source records attributed to R G Caffesse.

At least 127 records · Page 7Linked to original sources

Effects of composite restorations on the periodontal membrane in monkeys.

We evaluated the histopathological response of the periodontal membrane to intentionally-replanted teeth carrying composite (experimental) and silver amalgam (control) restorations in the middle third of each root. The study revealed that the amalgam produced, in the periodontal tissues, an initial localized inflammation that subsided with the subsequent formation of a fibrous capsule. However, the periodontal membrane adjacent to the composite resin restorations demonstrated chronic inflammation. It was concluded that the composite evoked chronic inflammatory responses of the periodontal tissues in monkeys.

Animals↗

Effect of Achromycin ointment on healing following periodontal surgery.

This study evaluated the effect of applying 3% Achromycin on healing following periodontal surgery. Twelve patients participated, and 15 contralateral sides with similar disease were compared. The parameters assessed included amounts of gingival crevice fluid quantitated with the Periotron, gingival bleeding tendencies, mobility scores and attachment levels. No significant differences in bleeding tendency, mobility or attachment levels were found. Significant changes were noted on amounts of gingival crevicular fluid, however. The amounts of gingival crevicular fluid collected were significantly lower on the side not treated with Achromycin throughout the observation period. Applying 3% Achromycin did not have a beneficial effect on the healing of periodontal wounds. Whether the application of an antibiotic on sutured flaps limited the bacterial contamination of the gingival tissues through a "wicking effect" of the silk suture material, or if this bacterial contamination had any consequence on gingival healing or reattachment of the periodontal tissues adjacent to the tooth, cannot be determined from this study.

Adult↗

Comparison of results following modified Widman flap surgery with and without surgical dressing.

The clinical effects of a periodontal dressing after modified Widman flap surgery were studied. A total of thirty surgical sites in 13 patients were included in the study. Half of the sites were not covered by a periodontal dressing while the other half were. To effect a blind evaluation, the dressings were placed and removed by someone other than the examiner. Gingival crevicular fluid flow and gingival inflammation were measured prior to surgery, 2 weeks, 1 month and 2 months after surgery. Clinical attachment level and pocket depth were measured prior to surgery, 1 month and 2 months after surgery. All patients were instructed in oral hygiene procedures and received rubber cup prophylaxes and flossing at 1 week, 2 weeks, 1 month and 2 months postoperatively. At the conclusion of the study, a questionnaire was administered to each patient. No significant differences were found between dressed and undressed segments regarding changes in clinical attachment levels, pocket depth, or gingival inflammation. The omission of a dressing did not result in a greater incidence of discomfort. More patients stated preference for no dressing.

Adult↗

Ultrastructural study of induced keratinization in sulcular gingival epithelium in rhesus monkeys.

Gingival sulcular epithelium--which in primates normally does not keratinize--can be induced to undergo keratinization by prolonged intensive antibacterial therapy. Three months before biopsy the teeth of two adult male rhesus monkeys were scaled and polished, and for 5 days the monkeys were given intravenous injections of 75 mg Achromycin daily. Their teeth were subsequently subjected to daily cleaning and polishing. The presumably in-situ-keratinized sulcular epithelium was examined by transmission electron microscopy. It was also compared with oral gingival epithelium from the same two animals and with oral and sulcular epithelium from a rhesus monkey that had not been exposed to local or systemic antibacterial therapy. The results confirmed earlier histological studies, which have shown that under the conditions described the sulcular epithelium becomes parakeratinized. In addition, several other ultrastructural changes were observed, some of which suggest that the treatment given may result in the formation of a more efficient permeability barrier in the sulcular area. The possible clinical significance of such a barrier is briefly discussed.

Animals↗

The effects of different splinting times on replantation of teeth in monkeys.

The purpose of the study was to examine histologically the tissue changes affecting the teeth and surrounding structures after using both 7- and 30-day fixation periods on replanted teeth in monkeys. Eight adult male rhesus monkeys were used. The maxillary central and lateral incisors were extracted, treated endodontically, reimplanted, and temporarily immobilized with an interproximal acid-etch splint. The splints were removed at 1 week in half of the teeth and at 30 days in the other half. The monkeys were killed at 7 and 14 days, and at 1, 2, 3, 4, 5, and 6 months postoperatively. The results showed that replanted teeth that were splinted for 7 days recovered uneventfully, whereas the teeth that were splinted for 30 days demonstrated increased areas of root resorption and ankylosis. Thus, it is suggested that after tooth replantation the periodontium will repair rapidly with a shorter time of splinting (7 days). Extended splinting periods (30 days) seem to induce further root resorption and dentoalveolar ankylosis.

Animals↗

Effect of periodontal treatment on tooth mobility.

The purpose of this study was to compare tooth mobility at different time periods during periodontal treatment and to relate changes in mobility to each method of treatment. Ninety-three patients (2421 teeth) with moderate to severe periodontitis were scored: (1) at initial examination, (2) 1 month following scaling, root planing, instruction in oral hygiene and preliminary occlusal adjustment, (3) 1 month after treatment with pocket elimination or reduction, curettage, modified Widman flap or scaling and root planing by the periodontist, and (4) 1 and 2 years following completed periodontal treatment. After initial nonsurgical treatment there was a significant decrease in tooth mobility. Tooth mobility increased temporarily after pocket reduction surgery but was not altered following curettage, modified Widman flap or scaling and root planing. Two years post-treatment there was a trend toward further decrease in tooth mobility with professional tooth cleaning every 3 months.

Dental Scaling↗

The effect of mechanical stimulation on the keratinization of sulcular epithelium.

This study was designed to evaluate the effect of mechanical stimulation on the keratinization of the sulcular epithelium in four adult Rhesus monkeys. Each animal received a thorough prophylaxis. One week later, each monkey received one of the following modalities of plaque control: (a) daily intravenous tetracycline and rubber cup prophylaxis, (b) daily rubber cup prophylaxis, (c) daily intravenous tetracycline injections; (d) no treatment, as a control. After sacrifice and tissue processing the histologic sections were evaluated for the presence of sulcular keratinization. The keratin width and length were measured, and an Inflammatory Index determined. It was found that all treatment modalities reduced inflammation significantly, when compared to the control. No differences among the three procedures tested were found. Although all permitted keratinization to develop, sulcular keratinization was significantly increased when daily prophylaxes were performed. It was concluded that mechanical stimulation of the sulcular epithelium, seemingly plays a role in promoting its keratinization.

Animals↗

The effect of waxed and unwaxed dental floss on gingival health. Part I. Plaque removal and gingival response.

The purpose of this study was to determine the effectiveness of waxed and unwaxed floss in plaque removal and on gingival health when used in a home oral hygiene program. Eighty patients, having previously received periodontal therapy, were divided into four similar groups, according to the S-OHI. Each group represented four different types of dental floss being tested: Butler waxed, Butler unwaxed, Johnson and Johnson waxed, and Johnson and Johnson unwaxed. After receiving a thorough prophylaxis, each patient received oral hygiene instruction with a video tape, and was given a toothbrush and a quantity of test floss. At 0, 28 and 56 day intervals, The patients were scored for plaque and gingivitis. The data were then analyzed statistically using analysis of variance. It was found that there was no statistical difference among the four different types of tested floss as far as their plaque removal ability or prevention of gingivitis is concerned.

Adult↗

The effect of waxed and unwaxed dental floss on gingival health. Part II. Crevicular fluid flow and gingival bleeding.

Eighty patients, having received periodontal therapy previously, were divided into four groups, corresponding to one of four different types of dental floss being used. Seven to ten days after receiving a thorough prophylaxis, each patient had oral hygiene instruction by video tape, was given a toothbrush and a quantity of the test floss. At 0, 28 and 56 day intervals, the patients were scored for crevicular fluid flow and gingival bleeding. Data were analyzed statistically. Johnson and Johnson unwaxed dental floss was found to be slightly less effective in reducing gingival bleeding at the 56th day. It was also found that crevicular fluid flow was least with waxed floss use at the 56 day session. However, the range of variations was so minimal that no clinical significance could be ascribed to either finding. There were patients in each of the four floss groups with no fluid flow or bleeding during all three sessions.

Adult↗

Four types of periodontal treatment compared over two years.

Results of various modalities of periodontal therapy were studied in 90 subjects (mean age 45 years) with moderate to severe periodontitis. Initial measurements of pocket depth and clinical attachment levels were compared with measurements obtained after the initial hygienic phase of the treatment and measurements of the same areas 1 and 2 years after four different types of periodontal treatment had been applied on a randomized basis to each of the four quadrants of the dentition. These treatments were: (1) surgical pocket elimination or reduction, (2) modified Widman flap surgery. (3) subgingival curettage, (4) scaling and root planing only. The patients were recalled for prophylaxis every 3 months, and rescored annually. One-way analysis of variance and Scheffe's method were used to test the hypothesis of equal treatment effects. The results were analyzed both with initial pocket depth as the baseline and with pocket depth at the hygienic phase as the baseline using a grouping of pockets 1 to 3 mm, 4 to 6 mm, and greater than or equal to 7 mm. For the 1 to 3 mm pockets there was a slight reduction in depth at the hygienic phase, with only minor changes after the various modalities of treatment over 2 years. However, significant losses of attachment after all modalities of periodontal therapy, including scaling alone, were observed at both the 1-year an 2-year intervals. For pockets 4 to 6 mm deep, the main reduction in pocket depth occurred at the hygienic phase, but the pockets also were reduced by further treatment, most by pocket elimination and modified Widman surgery. However, this reduction in pocket depth after surgery had no beneficial influence on maintenance of the attachment level, which actually was maintained best by scaling alone. For deep pockets greater than or equal to 7 mm, significant reduction in pocket depth occurred both at the hygienic phase and 1 to 2 years after treatment, with the greatest initial reduction after pocket elimination surgery. However, again there was no significant difference in attachment results among the four methods.

Adult↗

The effectiveness of subgingival scaling and root planing in calculus removal.

The study presents an evaluation of the effectiveness of subgingival scaling and root planing related to depth of pocket and type of teeth. A total of 199 teeth in 25 patients were selected; 62 were scaled and 57 were used as controls. All teeth were initially scored using the calculus index of the P.D.I. (Ramfjord). Six surface locations were probed to determine pocket depth. The levels of the gingival margin were marked on the teeth to locate supra and subgingival calculus after extraction. The experimental teeth then were scaled. Both scaled and unscaled teeth were extracted immediately after the experimental procedures. The teeth were washed with water and stained with methylene blue. They were viewed under a stereomicroscope which had a tenth grid on its eyepiece. Percent of surface covered by calculus was assessed on both scaled and unscaled teeth. The results demonstrated a high correlation between percent of residual calculus and pocket depth. It was shown that pockets less than 3 mm were the easiest sites for scaling and root planing. Pocket depths between 3 to 5 mm were more difficult to scale and pockets deeper than 5 mm were the most difficult. Tooth type did not influence the results.

Dental Calculus↗

Vascular response of the periodontal membrane after replantation of teeth.

Thirteen replanted maxillary central incisors were studied by means of histologic and cleared sections to evaluate the pattern of revascularization of the periodontal membrane and the modification of its vasculature due to root resorption, dentoalveolar ankylosis, and periapical processes. Early reparative activity was noted in the apical and cervical parts of the replanted membrane where proliferating vessels were intermingling with reparative cells and interrupted collagenous fibers. These areas of the membrane corresponded with those receiving a better vascular supply after replantation. The middle third of the membrane, however, showed a scarcity or absence of reparative cells as a result of delayed revascularization. Root resorption, dentoalveolar ankylosis, or periapical processes changed both the tissue specificity of the replanted membrane and its pattern of vascular supply. Revascularization of the pulps showed vacuolar degeneration due to lack of nutrition.

Alveolar Process↗