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Biomedical subjects

C P Marinello

Publications and source records attributed to C P Marinello.

At least 19 recordsLinked to original sources
PubMed2006

A cost-effectiveness analysis of implant overdentures.

Placement of dental implants may improve the retention and stability of complete dentures in edentulous patients. Treatment costs, however, substantially increase with implant treatment. We therefore performed a stochastic cost-effectiveness analysis, comparing implant-supported over-denture prostheses (4 implants), implant-retained overdentures (2 implants), and complete dentures, from the patient's perspective in Switzerland, to assess whether implant treatment in the mandible represents value for money spent. Twenty patients were included in each treatment group and were followed up for three years. Health outcomes were expressed in Quality-adjusted Prosthesis Years, and dental health care costs and time costs were recorded in year 2000 Swiss Francs (CHF 100 = US dollars 61). The cost per Quality-adjusted Prosthesis Year gained for implant treatment was CHF 9100 (2 implants) and CHF 19,800 (4 implants) over 3 years. Over a ten-year period, these threshold ratios were reduced to CHF 3800 (2 implants) and CHF 7100 (4 implants) per Quality-adjusted Prosthesis Year gained.

Adult↗
PubMed2002

Expression of endothelial adhesion molecules in the alveolar ridge mucosa, gingiva and periimplant mucosa.

OBJECTIVES: The purpose of this study was to analyze the expression of adhesion molecules on endothelial cells in the alveolar ridge mucosa, the gingiva and the periimplant mucosa in humans. MATERIAL AND METHODS: Twelve partially edentulous subjects were included in the study. In each subject, one soft tissue biopsy was harvested from the edentulous alveolar ridge mucosa, one from a tooth site and one from an implant site. After 3 weeks of undisturbed plaque accumulation, an additional biopsy was obtained from one tooth and one implant site in each subject. The tissue samples were snap frozen and prepared for immunohistochemical analysis. RESULTS: In the alveolar ridge mucosa, smaller proportions of endothelial cells expressing ICAM-1, ELAM-1 and VCAM-1 were observed than in the gingiva. ELAM-1-positive cells occurred in lower numbers than in periimplant mucosa. After 21 days of plaque accumulation, ELAM-1 was increased in tooth sites, but decreased in periimplant mucosa. CONCLUSION: The results of the present study indicated that the proportions of activated endothelial cells and the extravasation of leukocytes is larger in gingiva and periimplant mucosa than in alveolar ridge mucosa. This might be due to the less permeable keratinized epithelial layer in the edentulous ridge mucosa, which offers proper protection against microbial pathogens. The greater expression of endothelial cell adhesion molecules during experimental gingivitis, compared to periimplant mucositis, may reflect its longer history of repeated antigenic assaults.

Aged↗
PubMed2001

Experimental peri-implant mucositis in man.

OBJECTIVES: The purpose of this study was to examine reactions of gingiva and peri-implant mucosa (PiM) to de novo plaque accumulation in humans. MATERIAL AND METHODS: Prior to the start of the study, which included 12 partially edentulous subjects, a 3-week plaque control program was performed. Ethical approval was granted by the local ethics committee. On day 0, 2 soft tissue biopsies were harvested, 1 from a tooth and 1 from an implant site in every subject. After 3 weeks of undisturbed plaque accumulation (day 21), 2 additional biopsies were obtained from the gingiva and PiM in each subject. The tissue samples, each 4x4 mm in size, were snap frozen and prepared for immunohistochemical analysis. RESULTS: The size of the infiltrate (ICT) in the day 0 biopsies, was about 0.03 mm2 in both the gingiva and PiM. At the end of the plaque accumulation period, the size of the lesion had significantly increased in both groups and occupied an area of 0.26 mm2 in the gingiva and 0.14 mm2 in PiM. In the biopsies presenting day 0, the proportions of the various cell populations examined were similar in the gingiva and in PiM. The tissue fractions of almost all types of cells increased during the 3 weeks, but the mean change for each cell type was greater in the gingiva than in PiM. The CD3/CD19 ratio decreased in the gingiva between day 0 and 21, but increased in PiM. CONCLUSION: The results of the present study indicated that plaque accumulation induced an inflammatory response characterized by increased proportions of T- and B-cells in the ICT of both the gingiva and the PiM. Although not statistically significant, the host response in the gingiva tended to be more pronounced than in the peri-implant mucosa.

Aged↗
PubMed2001

Alveolar ridge augmentation with Bio-Oss: a histologic study in humans.

The aim of the present study was to investigate the healing of alveolar ridge defects augmented with cancellous bovine bone mineral. In six partially edentulous patients, bone augmentation was necessary prior to implant placement because of severe alveolar ridge resorption. The defect sites, all located in the maxilla, were filled with Bio-Oss and covered with the resorbable collagen membrane Bio-Gide. Biopsies were obtained from the defect sites 6 to 7 months following grafting and were processed for ground sectioning. The histologic analysis revealed that the Bio-Oss particles occupied 31% of the total biopsy area. An intimate contact between woven bone and Bio-Oss was detected along 37% of the particle surfaces. A mixed type of bone was found; it contained woven bone and parallel-fibered bone, which demonstrates features of remodeling activity. Signs of resorption of the grafting material were observed in the histologic sections, which indicates that the material takes part in the remodeling process. It is suggested that Bio-Oss may be a very suitable material for staged localized ridge augmentation in humans.

Adult↗
PubMed2001

[Tooth loss, dental restorations and dental attendance in Switzerland].

The aim of this study is to report about the dental health situation in Switzerland and to evaluate frequencies of dental visits. Data were obtained from the first and second national Health Survey of the Federal Office for Statistics in 1992/3 and 1997. Based on a random sample of the population aged from 15 to 74 years, 71% participated in an oral interviews and of this group of individuals, 75% later filled in a written questionnaire in 1992/3. Data analysis showed that the proportion of the fully dentate population (28 remaining teeth) is 41%, while almost 50% had some prosthetic treatment. 31% were treated with fixed prostheses, i.e.crowns and/or bridges, and 19% with removable prostheses, i.e. partial and/or full dentures. With increasing age the number of missing teeth and the frequency of prosthetic treatment went up. The population with prosthodontic reconstruction increased mainly in the third and forth decades. In the elderly population (age 65-74 years), a shift was observed from fixed to removable prostheses; two thirds in this groups was restored with removable prostheses. The proportion of subjects visiting the dentist was by 70% in 1992/3 and declined to 65% in 1997. Subjects wearing removable prostheses had apparently lower frequencies (43%) in dental visits than subjects with fixed prostheses (80%). A potential concern exists for the edentulous population who presented a limited need for dental visits of only 22% during the year preceding the study.

Adolescent↗
PubMed2000

Treatment outcomes of fixed or removable implant-supported prostheses in the edentulous maxilla. Part I: patients' assessments.

STATEMENT OF PROBLEM: Distinct clinical parameters determine whether fixed or removable implant-supported prostheses are indicated to restore the edentulous maxilla. However, there is a strong belief that fixed implant prostheses meet with greater patient acceptance and satisfaction, but this may differ from the patients' perceptions, their psychological responses to treatment, and their assessments of the treatment outcome. PURPOSE: This prospective clinical study compared the treatment outcomes of fixed and removable implant-supported restorations in the edentulous maxilla with the main emphasis on the patient's point of view. MATERIAL AND METHODS: Twenty patients who requested an implant-supported superstructure to restore the edentulous maxilla were asked to complete a questionnaire measuring their satisfaction with the present situation and the psychologic impact of their oral health status with their responses marked on a Visual Analog Scale (VAS). Ten patients were treated with a fixed, screw-retained implant prosthesis (group 1), and 10 were treated with a removable, implant-supported and bar-retained overdenture (group 2). Six months after prosthetic rehabilitation, patients were again given the questionnaire to assess their psychologic well-being and satisfaction with the implant-supported restoration. RESULTS: Both prosthesis designs were associated with significant improvements in comfort and retention, function, esthetics and appearance, taste, speech, and self-esteem. No difference was found between the 2 groups with respect to how the patients assessed the implant therapy. However, the results indicated that patients in group 2 experienced greater differences between pretreatment and posttreatment scores for the parameters esthetics, taste, and speech. Treatment costs per unit were significantly higher in group 1 than in group 2. CONCLUSION: Patients in groups 1 and 2 were similarly satisfied with their implant-supported prostheses in the edentulous maxilla with regard to their well-being and the cost-utility, irrespective of whether the restoration was fixed or removable.

Adult↗
PubMed2000

Treatment outcomes of fixed or removable implant-supported prostheses in the edentulous maxilla. Part II: clinical findings.

STATEMENT OF PROBLEM: There is a widespread belief that maxillary overdenture prostheses are associated with a higher frequency of complications and require more maintenance than fixed implant prostheses. PURPOSE: This prospective clinical study compared the treatment outcomes of fixed and removable implant-supported restorations in the edentulous maxilla with the main emphasis on the clinician's point of view. MATERIAL AND METHODS: Ten patients were treated with fixed screw-retained implant prostheses (group 1), and 10 patients were treated with removable implant-supported overdentures (group 2) in the edentulous maxilla. Recall was scheduled at 6-month intervals to investigate the prosthodontic treatment outcomes, including implant survival, prosthesis time until retreatment, and maintenance issues. Clinical parameters gingival index (GI), plaque index (PI), the clinical attachment level, and radiographic marginal bone levels measured, along with any biologic and mechanical complications were recorded. RESULTS: Patients were followed over a mean period of 39 months (SD=7; group 1) and 27 months (SD=10; group 2) after implant placement. Cumulative implant survival was 97.6% for group 1 and 94.4% for group 2 after an 18-month observation period. The mean time until retreatment after prostheses insertion was 23.4 months for group 1 and 19.8 months for group 2 (n.s.). In both groups, the increase over time in the radiographically investigated bone level was found to be significant. The indices given for the mucosal health and oral hygiene status (GI and PI) were highly correlated in both groups at each recall appointment, but no significant differences were found between groups 1 and 2. CONCLUSION: In groups 1 and 2, comparable prosthodontic treatment outcomes were achieved. The majority of mechanical complications could be managed chairside during recall visits and did not require additional appointments, so that the time and costs involved in providing maintenance were kept down.

Alveolar Process↗
PubMed2000

[The aspiration and swallowing of foreign bodies. The management of the aspiration or swallowing of foreign bodies during dental treatment].

The purpose of this article is to draw attention to the possible complications of foreign body ingestion or aspiration associated with dental treatment, especially oral implant treatment. A guide for the management of swallowed or inhaled objects is given. When the object cannot be coughed out, then it is mandatory to take frontal and lateral chest roentgenograms to identify the object's position in the intestinal system or in the tracheobronchial tree. In case of ingestion, attempts should be made to recover the foreign object by esophagoscopy. Aspirated foreign bodies should be removed within 24 hours. Acute obstruction can be life threatening and delaying the removal of foreign objects may make a bronchoscopy technically more difficult. The clinician must be aware of the complications involved in accidentally inhaling or ingesting foreign bodies during dental treatment. Patients at greater risk of swallowing or aspirating foreign objects need to be identified and extra preventive steps must be taken to avoid such complications.

Aged↗
PubMed2000

Fixed or removable implant-supported restorations in the edentulous maxilla: literature review.

Among the prosthesis designs used to treat the edentulous maxilla are fixed or removable implant-supported restorations. Since the aesthetic requirements and preoperative situation of each patient varies, controversy exists regarding prostheses' success rates and complications. The purpose of this article is to compare the treatment options and prosthesis designs with their indications and to compare implant and prosthesis success and treatment expense. This objective was accomplished through the review of reports with regard to varying design considerations and factors that influence the decision-making process and treatment outcomes.

Cementation↗
PubMed1999

Treatment plan for restoring the edentulous maxilla with implant-supported restorations: removable overdenture versus fixed partial denture design.

STATEMENT OF PROBLEM: Restoring the edentulous maxilla with a fixed complete denture or a removable overdenture is a complex and challenging procedure. PURPOSE: This article presents and discusses the crucial factors involved in deciding whether a fixed or removable implant prosthesis should be planned in fulfilling the patient's preference for optimal esthetics, phonetics, comfort, and function. METHODS AND MATERIAL: A concept for treatment planning is presented that enables the practitioner to check the decisive parameters during the first examination and to make the final decision with the help of the reformatted computerized tomography scan. CONCLUSION: If this treatment plan is followed, implants can be placed to comply with the selected prosthetic solution and compromised solutions can be avoided. The fixed design for implant prosthesis is only appropriate for patients with minimal resorption of the alveolar bone and an optimal maxillomandibular relationship. The removable overdenture may be indicated from the outset and is no longer restricted to patients with a compromised situation in which fixed implant prostheses are not feasible.

Alveolar Bone Loss↗
PubMed1999

Factors influencing the success of GBR. Smoking, timing of implant placement, implant location, bone quality and provisional restoration.

The aim of this retrospective clinical study was to evaluate the influence of different factors on the outcome of GBR treatment. 75 patients, who were not randomly assigned to the investigated parameters for clinical reasons, were included in the study. They presented with defect sites around implants and were treated with a xenogenic grafting material and a resorbable collagen membrane. The defect morphology was described, its dimension was measured and calculated at the time of implant installation and at re-entry. The success of GBR treatment was related to several clinical variables and possible correlations were evaluated. Defect sites around maxillary implants showed significantly more bone fill (96%) compared to those in the mandible (78%). The insertion of a provisional restoration during the healing period was also associated with significantly better results than when no provisional was inserted. Immediate and short-term delayed implant placements showed the best results both with 92% bone fill, when compared with long-term delayed placements with 80% bone fill (n.s.). In sites with type I bone quality (compact bone), a reduced bone fill was observed (64%). The results indicate that successful bone fill can be achieved with GBR; this is more feasible in the maxilla, when a provisional restoration is used. Early implant placement timings seem to be preferable due to the alveolar ridge preservation, more favorable defect morphologies and a higher regenerative capacity.

Absorbable Implants↗
PubMed1999

Periodontitis associated bacteria in supragingival plaque of dental hygienists: stability of carrier state and clinical development.

The purpose of this study was the clinical and microbiological re-examination of dental hygienists, who, 30 months before, had shown remarkably high supragingival levels of periodontitis-associated micro-organisms. Interdental plaque was collected from the same molar sites and investigated by the same immunofluorescence assay with taxa-specific monoclonal antibodies as at the initial examination. On average, the 15 re-examined subjects showed slightly increased plaque levels but unchanged bleeding on probing scores (0.3-1.4). Pocket formation was restricted to a single subject. Prevotella intermedia/P. nigrescens and Peptostreptococcus micros were present in every plaque sample. Prevalences of Actinobacillus actinomycetemcomitans, Bacteroides forsythus and Campylobacter rectus were again between 20-40%, but some fluctuation within subjects was noted. The data confirm supragingival plaque as a natural habitat for periodontitis-associated bacteria in periodontially healthy persons, and indicate that colonization with A. actinomycetemcomitans, B. forsythus or C. rectus is mostly stable in spite of better than average personal plaque control.

Adult↗
PubMed1999

[The Procera Allceram all-ceramic system. The clinical and technical laboratory aspects in the use of a new all-ceramic system].

The aim of this article was to present the CAD/CAM-assisted Procera system as a new all-ceramic full-coverage crown system. New technologies need to be evaluated technically and clinically to be able to fulfill the requests for aesthetics, physical strength and biocompatibility when restoring the anterior and posterior region. The Procera AllCeram system offers the opportunity to fabricate densely sintered, high-purity, tooth-colored copings. Mechanical properties of the Procera alumina coping, indications and contraindications and additional applications are discussed. The clinical and technical procedures and any specific limitations and peculiarities are summarized and documented with clinical cases in a step-by-step illustration.

Cementation↗
PubMed1999

Anterior single-tooth replacement: clinical examination and treatment planning.

The replacement of a single anterior tooth is a complex, challenging procedure that can be accomplished with implant-supported restorations as well as conventional porcelain-fused-to-metal and resin-bonded fixed partial dentures. A comprehensive diagnostic form may be beneficial in determining the most effective means of rendering treatment for each patient. This article demonstrates the use of this form, diagnostic models, and radiographs to diagnose and restore three patients who presented for the replacement of a single tooth in the anterior maxilla.

Adult↗
PubMed1996

Corrosion considerations in the brazing repair of cobalt-based partial dentures.

Cobalt-based alloys (Co-Cr-Mo) are usually used in dentistry as frameworks for removable partial dentures. In their basic form these structures function successfully. However, modifications or repairs of the frameworks may reduce their resistance to corrosion and, as a consequence, may provoke biologic reactions in the soft tissues. These reactions may be the result of different types of alloys that contact each other and, in the presence of saliva (based on potential differences), produce a galvanic cell. In this study, a clinical situation after repair of a removable partial denture was examined. The metallographic study of the prosthesis revealed a brazed zone where a gold braze was joining the Co-Cr-Mo framework with a Co-Cr-Ni type alloy (without Mo). The latter revealed signs of corrosion. Various electrochemical parameters (Ecorr, Ecouple, icorr, icouple) of these alloys were analyzed in the laboratory. The Co-Cr-Ni alloy had the lowest nobility and underwent galvanic corrosion in a galvanic couple with gold braze.

Chromium Alloys↗