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Biomedical subjects

Terrence J Griffin

Publications and source records attributed to Terrence J Griffin.

9 recordsLinked to original sources
PubMed2006

Postoperative complications following gingival augmentation procedures.

BACKGROUND: Postoperative pain, swelling, and bleeding are the most common complications following soft tissue grafting procedures; however, detailed documentation is sparse in the literature. The aims of this prospective study were as follows: 1) to compare the frequency of complication occurrence after free soft tissue grafting (FSTG) or subepithelial connective tissue grafting (SCTG) procedures; 2) to evaluate the use of an acellular dermal matrix (ADM) as the donor tissue alternative to an FSTG or SCTG; and 3) to identify possible predictors for these complications. METHODS: Seventy-five FSTG and 256 SCTG procedures were performed in 228 patients by a single operator. In five free soft tissue and 84 bilaminar graft procedures, an ADM was used instead of autogenous tissue. Variables such as the duration and location of procedures, smoking history, gender, and age were recorded. Patients were asked to fill out a questionnaire 1 week after the surgeries regarding postoperative pain, swelling, and bleeding. Data were analyzed using the chi2 test and logistic regression analysis. Odds ratios were calculated for moderate and severe adverse outcomes grouped together. RESULTS: The duration of surgical procedures was highly correlated with pain or swelling post-surgically (P = 0.001). Current smokers were three times more likely to experience post-surgical swelling (P = 0.01). Patients who underwent FSTG procedures were three times more likely to develop post-surgical pain (P = 0.002) or bleeding (P = 0.03) compared to those who received SCTG procedures. When an ADM was applied instead of autogenous tissue, the probability of swelling or bleeding was significantly reduced (odds ratio [OR] = 0.46, P = 0.02 and OR = 0.3, P = 0.001, respectively). CONCLUSIONS: Long surgical procedures and smoking may increase the severity and frequency of certain post-surgical complications after gingival augmentation procedures. FSTG procedures incur a higher likelihood for postoperative pain or bleeding than SCTG procedures, whereas the application of an ADM may significantly reduce the probability of swelling and bleeding.

Adult↗
PubMed2005

Reconstructive surgical management of an amalgam tattoo using an acellular dermal matrix graft: case reports.

Amalgam tattoos in the gingiva and mucosa can interfere with esthetics and present a barrier to surface-to-bone contact at implant sites. Two clinical cases are used to illustrate the effectiveness of acellular dermal matrix allografts in the treatment of these lesions. Very esthetic results were obtained with minimal discomfort and postoperative complications because of the prevention of a second surgical site or additional procedure.

Aged, 80 and over↗
PubMed2004

The use of short, wide implants in posterior areas with reduced bone height: a retrospective investigation.

STATEMENT OF PROBLEM: Reduced bone height frequently presents a challenge for implant-assisted tooth replacement in partially edentulous patients. PURPOSE: This retrospective study evaluated the success rate of short, wide hydroxyapatite (HA)-coated implants placed in mandibular and maxillary molar areas with reduced bone height. MATERIAL AND METHODS: A total of 168 HA-coated implants (6-mm diameter x 8-mm length) were placed in 167 patients in a private-practice setting. A minimal 6-mm workable ridge height and 8-mm ridge width was available in all situations. Patients were referred back to 1 of 7 referring restorative dentists for restoration of the implants. No attempt was made to standardize the restoration of the implants except to avoid working and nonworking contacts in lateral excursions. Implant success was evaluated according to the following criteria: (1) absence of complaints, (2) absence of recurring peri-implant infection or suppuration, (3) absence of perceptible implant mobility, and (4) absence of radiolucencies at implant-bone junction. The data were analyzed with descriptive statistics. RESULTS: Fifty-four (32.1%), 35 (20.8%), 36 (21.4%), and 42 (25.0%) implants replaced maxillary first and second and mandibular first and second molars, respectively. There were 128 implant-supported single crowns. Thirty-eight implants served as abutments for fixed partial dentures connected to other implants of various sizes. Two implants were involved in cantilevered fixed partial dentures. Patients were followed for up to 68 months (mean=34.9 months) after loading of implants. The overall cumulative success rate was found to be 100%. CONCLUSIONS: For residual ridges with minimal height but adequate width, the use of short, wide HA-coated implants may offer a simple and predictable treatment alternative in posterior areas.

Adult↗
PubMed2004

A comparative study of root coverage with connective tissue and platelet concentrate grafts: 8-month results.

BACKGROUND: Gingival recession presents destruction of both soft and hard tissues. The objectives of this randomized clinical trial were to assess the clinical efficacy of platelet concentrate grafts (PCG) in the treatment of Miller Class I or II buccal gingival defects and to compare their soft tissue healing with those of subepithelial connective tissue grafts (SCTG). METHODS: Seventeen arches in 15 patients with bilateral gingival recessions were treated with SCTG and PCG covered by coronally advanced flaps. Vertical recession depth (VRD), clinical attachment level (CAL), clinical probing depth (PD), and width of keratinized tissue (KTW) were measured preoperatively and 8 months postsurgery. Surveys on post-surgical discomfort level (PSDL) and manual platelet count were also performed. Esthetic outcomes were also evaluated. Paired t test, repeated measures analysis of variance (ANOVA), and chi-square and signed-rank tests were used to access statistical significance (alpha = 0.05). RESULTS: Mean VRD statistically significantly decreased from 2.43 mm presurgery to 0.48 mm with PCG (80% root coverage) and from 2.48 mm to 0.17 mm with SCTG (95% root coverage). No statistically significant differences between the treatments were found for VRD, CAL, and KTW, while mean PD was significantly shallower in the PCG group (1.05 mm) than that in the SCTG group (1.79 mm). Complete coverage was achieved in 60% of the PCG group and in 65.5% of the SCTG group. PSDL was significantly lower in the PCG group 1 month post-surgery. Platelet counts demonstrated a five-fold increase in PC. Soft tissue in the PCG group demonstrated superior contour and texture matching when compared to the SCTG group. CONCLUSIONS: The platelet concentrate graft may be an alternative graft material for treating gingival recession. Treatment with this graft may result in better esthetic appearance.

Adult↗
PubMed2004

Hard and soft tissue augmentation in implant therapy using acellular dermal matrix.

The use of acellular dermal matrix to correct soft and hard tissue defects involving implants is described through three case reports. Correction of a ridge deformity caused by a root fracture, submerging of an existing implant and correction of recession defects around adjacent teeth, and ridge preservation for implant placement are presented. The use of acellular dermal matrix prevented the need for a second surgical site for donor material and the possible attendant postoperative complications. It also enhanced patient comfort and satisfaction with the procedure. All three cases demonstrated excellent functional and esthetic results for both the patients and professionals involved in the therapy.

Adult↗
PubMed2004

Treatment of gingival recession with a platelet concentrate graft: a report of two cases.

The goal of this report is to present a novel treatment strategy for mucogingival defects. The use of platelet concentrate gel in a collagen sponge carrier, combined with a coronally positioned flap procedure, is presented in two cases. Complete root coverage was achieved in both cases. Optimal esthetic results, with excellent soft tissue contour and texture, were observed. The patients were satisfied with the appearance. This technique warrants further investigation.

Adult↗
PubMedDate not supplied

Quantitative evaluation of bone density using the Hounsfield index.

PURPOSE: The primary aims of this retrospective study were to: (1) evaluate bone quality in different segments of the edentulous jaw and correlate it with demographic data and (2) establish a quantitative and objective assessment of bone quality based on the Hounsfield scale. MATERIALS AND METHODS: One hundred one randomly selected computerized tomographic (CT) scans were used for the analysis. Edentulous segments ranging from 10 to 30 mm were selected for evaluation, and the findings were analyzed and correlated to demographics. Implant recipient sites were evaluated visually for bone classification by 2 independent examiners. The same sites were subsequently evaluated digitally using the Hounsfield scale, and the results were correlated with the visual classification. RESULTS: The 4 quadrants of the mouth displayed Hounsfield unit (HU) values ranging from -240 HU to 1,159 HU. The highest unit/mean density value (559 +/- 208 HU) was found in the anterior mandible, followed by 517 +/- 177 HU for the anterior maxilla, 333 +/- 199 HU for the posterior maxilla, and 321 +/- 132 HU for the posterior mandible. There was no association between the Hounsfield value and density and age or gender. When subjective bone quality was correlated to Hounsfield index findings, only the relationship between HU and type 4 bone was found to be significant. CONCLUSIONS: Knowledge of the Hounsfield value as a quantitative measurement of bone density can be helpful as a diagnostic tool. It can provide the implant surgeon with an objective assessment of bone density, which could result in modification of surgical techniques or extended healing time, especially in situations where poor bone quality is suspected.

Adolescent↗