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Biomedical subjects

G E Romanos

Publications and source records attributed to G E Romanos.

At least 19 recordsLinked to original sources
PubMed2004

Present status of immediate loading of oral implants.

PROBLEM: Several conditions must be present to obtain implant integration and long-term clinical success when using the one-stage implant placement procedure with immediate loading. These conditions include (1) primary stability, (2) sufficient bone quality, and (3) elimination of micromovement of the implant before osseous integration is complete. PURPOSE: This report presents the results of research on immediate loading using a new and innovative implant design, Ankylos. METHODS: The author reviewed clinical studies of immediate loaading or oral implants, including two treatment options, removable overdentures and fixed reconstructions. RESULTS: Animal studies have demonstrated that successful osseointegration of Ankylos implants can occur (Figure 2D) when implants are placed and loaded immediately in the presence of some specific conditions. The histological findings involving implants that were placed in humans and immediately loaded showed no fibrous tissue formation (encapsulation). The bone-to-implant contact (osseointegration) was found to be excellent between the immediately-loaded implants and the surrounding alveolar bone. CONCLUSION: The Ankylos implant system with its progressive thread design successfully promotes primary, clinical stability at the time of implant placement. Several animal studies have shown that in implant restorations placed in similar areas of poor bone quality (ie, maxilla and the posterior part of the mandible), the concept of immediate loading can result in long-term clinical success, when loading forces are controlled. Immobilization of the implants and soft diet recommendations that reduce micromovement at the bone-to-implant interface will improve long-term clinical success. In summary, the Ankylos implant is well designed for one-stage placement with immediate loading, as well as for two-stage treatment protocols. Both clinical protocols will result in long-term clinical survival.

Animals↗
PubMed2002

Effects of CO2 laser treatment on fibroblast attachment to root surfaces. A scanning electron microscopy analysis.

BACKGROUND: The aim of this study was to analyze the CO2 laser effects on root surfaces affected by periodontal disease in comparison to scaling and root planing for fibroblast attachment. METHODS: Thirty single-rooted human teeth extracted because of advanced periodontal disease were included in this study. A total of 60 specimens, obtained from all selected teeth, were randomly assigned to 3 groups: 1) control (untreated); 2) hand scaling and root planing (SRP); or 3) laser (CO2 defocused pulsed) and ultrasonic scaling. All the specimens were incubated in Petri dishes with fibroblast suspension, and then observed by scanning electron microscopy (SEM). RESULTS: The control group showed the lowest number of attached cells, with no tightly attached fibroblasts. The laser plus scaling group showed the highest number of attached fibroblasts, with the tightly attached fibroblast prevailing. The laser-treated and scaled root specimens did not show any damage or morphologic alteration of the root surfaces. CONCLUSION: CO2 laser treatment in defocused, pulsed mode with a low power of 2W combined with mechanical instrumentation constitutes a useful tool to condition the root surface and increase fibroblast attachment to root surfaces.

Analysis of Variance↗
PubMed2002

Root surface morphological changes after focused versus defocused CO2 laser irradiation: a scanning electron microscopy analysis.

BACKGROUND: Many studies have observed damages to root surfaces treated by CO2 laser in continuous mode with a focused beam. The morphologic changes observed were always associated with temperature increase induced by high energy release. METHODS: The purpose of this study was to analyze by scanning electron microscopy (SEM) the effects of CO2 laser in 2 different modes on root surfaces. Study samples consisted of 30 extracted single-rooted periodontally compromised human teeth. Root specimens were randomly assigned to 3 groups: group A (12) treated with CO2 laser in continuous mode with a focused beam of 0.8 mm; group B (12) treated with CO2 laser in pulsed mode with defocused beam of 4 mm; and group C (6), untreated controls. RESULTS: Group A (continuous mode) showed severe damages to dentin surfaces such as craters and fissures. Group B (defocused mode) did not result in any damages to the root surfaces, showing flat and smooth surfaces with apparent fusion of the smear layer and dentinal tubules almost completely sealed. The untreated control group was characterized by irregular and amorphous surfaces with several shallow depressions. CONCLUSIONS: Although both laser modes resulted in changes to the treated root surface specimens, the changes resulting in a smooth surface from use of defocused pulsed beam may present an advantage in periodontal treatment.

Carbon Dioxide↗
PubMed2000

Effects of diode and Nd:YAG laser irradiation on titanium discs: a scanning electron microscope examination.

BACKGROUND: Dental lasers have been recommended for uncovering submerged implants as well as decontaminating implant surfaces when treating peri-implantitis. The aim of this study was to show the possible alterations in titanium disc surfaces using an Nd:YAG or a diode laser. METHODS: Three different titanium discs were used (sandblasted, titanium plasma-sprayed [TPS], and hydroxyapatite [HA] coated) to determine the effects of laser irradiation on these surfaces using a scanning electron microscope (SEM). The discs were either irradiated with a pulsed Nd:YAG laser with a contact handpiece and power settings of 2.0, 4.0, and 6.0 W or with a diode laser at 5.0, 10.0, and 15.0 W power settings and continuous wave (cw) in the contact handpiece. Irradiated areas were compared with control titanium sites which were not lased. The specimens were prepared for SEM examination after the disc irradiation. RESULTS: The SEM examination demonstrated extensive melting in all of the Nd:YAG laser irradiated areas. Damage was seen in all TPS- and HA-coated discs even at the lowest power setting. Loss of porosity, coating microfractures, and a relatively smooth surface were observed. In contrast, the diode laser did not cause any damage or modify the disc surface. Regardless of the power setting, there was no visible difference between lased and non-lased surfaces after cw irradiation with the diode laser. CONCLUSIONS: From these findings, it was concluded that the diode laser (980 nm) does not damage titanium surfaces, which should be of value when uncovering submerged implants and treating peri-implantitis.

Lasers↗
PubMed1998

Effect of Tissucol on connective tissue matrix during wound healing: an immunohistochemical study in rat skin.

Fibrin sealants are very useful in different surgical fields. Fixation of free gingival grafts, root coverage procedures, and other techniques increasing connective tissue attachment may be associated with the application of Tissucol in periodontology. The aim of this study was to evaluate the influence of the fibrin sealant in the extracellular matrix, as well as alterations of the connective tissue matrix during wound-healing processes. In the back dermis of 15 Net male rats, Tissucol was implanted after intraperitoneal anesthesia. The implant material was placed in subcutaneous pockets (2 cm in length) which were sutured with interproximal sutures (test and control pockets). At 4, 7, 14, 21, and 28 days after surgery, biopsies of the healed and surrounding tissues were taken, frozen in liquid nitrogen, and examined histologically and immunohistochemically with antibodies against collagen types I, III, IV, V, VI, and VII. The findings showed thick and thin collagen type I and III fibers, respectively, with different orientations localized around the implant material. An increased amount of blood vessels and capillaries (their basement membranes containing collagen type IV) was observed during wound healing which may be associated with the implantation of the sealant. Collagen type V fibers were localized from the first days to the 4th postoperative week and, without any inflammatory reaction (according to histologic staining), formed a fibrillar extracellular matrix with high collagenase resistance. Collagen type VI showed a microfibrillar pattern of distribution, and collagen type VII was localized in the dermo epidermo junction and very deep in the connective tissue in the form of anchoring fibers (only in the test group) during the 4 postoperative weeks of healing. The data showed that Tissucol is a biocompatible component which cannot produce any extensive inflammatory reaction in the matrix. New blood vessel formation, an epithelial-connective tissue interface with high stability, as well as matrix alterations with high resistance in the proteolytic enzymes (i.e., collagenases) can be induced in the connective tissue after use of a fibrin sealant. All of these characteristics may be of great importance in connective tissue healing in periodontal surgical procedures.

Animals↗
PubMed1995

Extracellular matrix interactions during the in vivo degradation of collagen membranes in the rat skin: immunohistochemical distribution of collagen types IV, V, and VI.

The role of collagen implant material (CIM) in periodontology is of considerable interest to the clinical dentist because of the capacity of connective tissue (CT) regeneration and partial prevention of epithelial cell migration onto the root surface. The aim of this study was to demonstrate alterations of the CT matrix after the use of CIM in subcutaneous pockets in the rat skin. We used 15 rats in this study. After sedation, two subcutaneous pockets (2 cm in length) were surgically made in the animals' backs. Collagen membranes were implanted in one of the two pockets (test site). The other pocket served as control. Then, 4, 7, 14, 21, and 28 days after implantation, the animals were sacrificed and biopsies preserved for histologic and immunohistochemical examination. Incubation with antibodies against CT matrix components (collagen type IV, V, and VI) were used for immunostaining. Histologically, the CIM was migrated by inflammatory cells in the first 7 days. Newly formed fibroblasts and blood vessels (BV) were present 14 days postimplantation. Collagen type IV was localized in the basement membranes of the epithelium, BV, and nerves. An increase in the BV amount was demonstrated around (and later in) the implant material. Collagen type V was found in a filament pattern of distribution and was inserted into the implant after 4 weeks of healing. Collagen type VI showed a microfibrillar pattern of distribution with a delayed formation in the graft mass. The data showed the alterations of the matrix after implantation of collagen type I membranes in the rat skin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Effects of Nd:YAG laser on wound healing processes: clinical and immunohistochemical findings in rat skin.

BACKGROUND AND OBJECTIVE: The clinical effects of the Nd:YAG laser in the rat skin as well as alterations of the extracellular matrix during healing were presented in this study. STUDY DESIGN/MATERIAL AND METHODS: This study evaluated the clinical effects of the Nd:YAG laser used with different energy parameters (low energy: 1.75 W and 20 pps/high energy: 3.0 W and 30 pps) in a duration 20-40 s in rat skin. Control incisions were performed with a scalpel blade. Rat skin incisions were examined over a period of 28 days by clinical photographs as well as by using immunohistochemical techniques in order to find the distribution and the amount of the extracellular matrix fibrillar components, i.e., collagen types I and III. RESULTS: Low energy laser treatment caused a rapid wound healing without scar tissue formation (compared to the high energy laser group) and clinical signs of scar tissue formation (compared to control incisions with the conventional scalpel). During the study period, the laser-induced lesions healed through reparative synthesis of the matrix proteins, which led to filling of the tissue defects. The regenerative processes were similar in the low-energy laser group and in the control incisions. In the high-energy lased tissues, we observed a delayed replacement of the defects by newly formed extracellular matrix proteins. CONCLUSIONS: This study showed a slower wound healing in the high-energy lased tissues. A similar healing in the low-energy lased tissues and in the incisions with the conventional scalpel was observed. The differences in the distribution of matrix proteins during healing and the coagulation of the tissues, which were exposed to low-energy laser treatment, might be the explanation for the minimal scarring, contraction, and pigmentation of the lased tissues as compared to conventional incisions.

Aluminum Silicates↗
PubMed1995

A comparative histological study of wound healing following Nd:YAG laser with different energy parameters and conventional surgical incision in rat skin.

Wound healing following the use of Nd:YAG laser with different frequencies and energy parameters (20 pps and 1.75 W/30 pps and 3.0 W), and the conventional scalpel incision were studied over a period of 4, 7, 14, 21, and 28 days in the rat skin. The low-energy laser wounds could not be significantly differentiated from the conventional incisions although less damage and inflammatory reaction, increased matrix production, and only a little wound contraction could be demonstrated. In the high-energy lased tissues extensive damage and an increased inflammatory reaction were present. The low-energy Nd:YAG and scalpel incisions established a normal wound healing without scar tissue formation compared to the high-energy Nd:YAG, where the necrosis was higher.

Animals↗
PubMed1994

Distribution of extracellular matrix components in nuchal skin from fetuses carrying trisomy 18 and trisomy 21.

We have investigated histologically the elevations of the skin in dorsal and lateral neck (nuchal) regions of human fetuses carrying karyotypes of trisomy 18 (Edwards' syndrome) and trisomy 21 (Down's syndrome). Cavities filled with interstitial fluid were found in the dermis, epidermal basement membrane and occasionally in the epidermis of trisomy-18 fetuses, but were not delineated by an epithelium or basement membrane as judged by the absence of immunostaining for laminin, collagen IV and collagen VII. Dilated vessels were also found at the interface between dermis and subcutis. Neither normal fetal skin nor that of trisomy-21 fetuses contained cavities or dilated vessels. In order to detect possible alterations of the extracellular matrix in trisomy-18 and trisomy-21 skin, the distribution of glycoproteins, glycosaminoglycans and proteoglycans was studied immunohistochemically. In trisomy-21 and control skin, the dermis stained intensely for fibronectin, whereas the subcutis reacted only weakly. In trisomy-18 skin, the stronger staining for fibronectin appeared in the subcutis, and the prevailing collagen type was collagen III, collagen type I being absent. In the skin of trisomy-21 fetuses, collagen VI was more irregularly arranged and densely packed, whereas collagen I was more widely spaced than in normal fetuses. More hyaluronan was present in the dermis and subcutis of trisomy-21 fetuses than in that of trisomy-18 and control fetuses. A correlation seems to exist between undelimited cavities and collagen III in trisomy-18 skin, and between hyaluronan and the specific arrangement of collagen in trisomy-21 skin.

Chromosomes, Human, Pair 18↗
PubMed1994

Clinical applications of the Nd:YAG laser in oral soft tissue surgery and periodontology.

Different clinical applications of the Nd:YAG laser in periodontology are discussed in this study. Several clinical cases are presented showing the application spectrum of the Nd:YAG laser in oral soft tissue surgery. Literature reports are discussed to present to the clinical practitioner the advantages and disadvantages of laser surgery. Lasers have a useful place in the periodontal and oral surgical techniques, if manufacturer's guidelines are strictly followed.

Equipment Design↗
PubMed1993

Extracellular matrix analysis of nifedipine-induced gingival overgrowth: immunohistochemical distribution of different collagen types as well as the glycoprotein fibronectin.

The purpose of this study was to demonstrate the localization of collagen types I, III, IV, V, VI and VII as well as the glycoprotein fibronectin in nifedipine-induced gingival overgrowth. The slices, after the use of indirect immunofluorescence (incubation with antibodies against these extracellular matrix components), showed a diffuse distribution with the anti-types I and III in the stroma and fluorescent staining of the basement membranes of the epithelium, blood vessels and nerves with collagen type IV antibodies. The increased number of vessels was localized near the surface of the lesion. Collagen type V - seen as a filamentous - and collagen type VI - as microfibrillar - components were also localized in the tissue, showing completely different patterns of distribution. Collagen type V appeared "crater"-like and type VI displayed a "honeycomb"-shaped structural model. The blood vessels were not stained but the area around their walls demonstrated an intense fluorescence with these antibodies. Collagen type VII showed a characteristic linear staining near to the epithelial basement membrane. In contrast to this, fibronectin localized with a varied intensity in the different areas of the tissues and presented a "cloud"-like structure. This shows differences between the matrix components in nifedipine-induced hyperplasia and confirms the heterogeneity of the matrix in health and in gingival alterations.

Adult↗
PubMed1993

Immunohistochemical distribution of extracellular matrix proteins as a diagnostic parameter in healthy and diseased gingiva.

This study showed histopathological findings of the extracellular matrix in healthy, inflamed, and hyperplastic human gingiva with immunohistochemical techniques. The distribution of collagen types V and VI, as well as of glycoprotein fibronectin, shows that they are extracellular matrix structural components which differentiate the tissue pathology. The orientation of the collagen fibers, the intensity of the fluorescent staining, the thickness of the fibrillar component, and the topographical localization of the connective tissue proteins are important parameters for tissue morphology. Therefore, bacterial deposits and the pharmacodynamic properties of drugs associated with gingival hyperplasia lead to an alteration of the matrix compared to the healthy tissues. This may be important in the tissue pathology in cases when the medical history of the patient is not known, as well as in forensic medicine.

Adult↗
PubMed1993

The double lateral bridging flap for coverage of denuded root surface: longitudinal study and clinical evaluation after 5 to 8 years.

Longitudinal results of a 5 to 8 year follow-up study of the double lateral bridging flap for coverage of gingival recessions (GR) are presented. On a total of 75 GR in 18 patients (31 surgical procedures) the majority of the teeth (58%) showed a root denudation reduction of 75% or more. Total coverage was observed on 18 teeth (24%). Examinations did not show a high correlation between the extent of recession and bone dehiscence after surgery, between the degree of root coverage and the initial width of keratinized gingiva, or between the GR before and after surgery. We conclude that neither the quantity of gingival recession nor the quality of the supporting tissues were a prerequisite for the success of this surgical technique.

Adult↗
PubMed1992

Distribution of fibronectin in healthy, inflamed and drug-induced gingival hyperplasia.

The distribution of fibronectin (FN) in the healthy, inflamed and hyperplastic human gingiva was investigated by indirect immunofluorescence. FN appeared as a fibrillar structure in the lamina propria of the healthy gingivae. In the inflamed specimens, FN demonstrated parallel fibres, especially in the coronal areas of the tissue. In the phenytoin gingival overgrowth, tissue FN was observed as thin fibres with variable length. The thin fibres gave the appearance of penetrating the basement membrane of the epithelium. Cyclosporin A gingival enlargement could be differentiated by phenytoin lesions because of the higher length and the parallel distribution of the FN. Finally, FN was observed in the nifedipine gingival overgrowth, where a microfibrillar delicate network gave the appearance of a "cloud"-pattern of distribution. In all of the specimens, blood vessels and nerves could not be stained. These findings show that FN distribution could differentiate the structure of the gingival lesions.

Actin Cytoskeleton↗
PubMed1992

Immunohistochemical localization of collagenous components in healthy periodontal tissues of the rat and marmoset (Callithrix jacchus). I. Distribution of collagen types I and III.

The distribution of collagen types I and III was demonstrated in healthy periodontal tissues of the rat and marmoset using immunofluorescent localization after decalcification of the maxillae and mandiblae in 0.2 N HCl. An intense fluorescence in the alveolar bone and cementum matrix, as well as in the soft periodontal tissue, was demonstrated with anti-collagen type I antibodies. In the gingival connective tissue and in the periodontal ligament thick fibers of collagen type I could be observed. The fluorescent reaction in the rat periodontal ligament was not strong in comparison to the marmoset periodontal ligament. Sharpey's fibers, inserting into the cementum and alveolar bone, were also stained. On the other hand, collagen type III could not be demonstrated in the hard periodontal tissues, but could be in the bone marrow stroma and the incremental lines as well as around the Sharpey's fibers of the cementum, in accordance to previous studies. In the gingival connective tissue a strong staining was evident, especially near the basement membrane. The periodontal ligament showed an intense fluorescence that was, in some areas, continuous with Sharpey's fibers inserting into the cementum. The distribution of collagen types I and III was demonstrated with immunohistochemical techniques in the rat and marmoset periodontium. These results provide necessary information on healthy tissues that will be required for future studies on the effects of pathological, reparative and regenerative processes.

Alveolar Process↗
PubMed1991

Immunohistochemical localization of collagenous components in healthy periodontal tissues of the rat and marmoset (Callithrix jacchus). II. Distribution of collagen types IV, V and VI.

The immunohistochemical distribution of collagen types IV, V and VI has been demonstrated in healthy periodontal tissues of rats and marmosets following decalcification of the maxillae and mandibulae in 0.2 N HCl. An intense fluorescence with anti-collagen type IV antibodies was demonstrated in the basement membranes of the epithelium and of the blood vessels and nerves. In the alveolar bone stroma and in the periodontal ligament (PL) collagen type IV was present only in the basal membranes of the blood vessels and nerves. In comparison, collagen type V was observed in a fibrillar pattern in the gingival connective tissue, as well as the PL. In the PL, type V collagenous fibers demonstrated a parallel distribution with stronger fluorescence near the cementum surface. Collagen type VI could be demonstrated in fine fibers present in the gingival connective tissue and the PL. Blood vessels and nerves were not stained in the marmoset, but were in the rat, where a localization of collagen type VI was demonstrated in these areas. Alveolar bone and cementum, as well as the Sharpey's fibers embedded in these tissues, were not stained with antibodies against collagen type V and type VI, but a pericellular localization of these collagenous components could be observed. Collectively, these results provide basic information on the relative distribution of different collagen types in normal tissues of rats and marmosets that will be required for future studies on the effects of pathological, reparative and regenerative processes.

Animals↗
PubMed1991

[Collagen as a basic element of the periodontium: immunohistochemical aspects in the human and animals. 2. Cementum and periodontal ligament].

Immunohistochemical knowledge of the distribution of the collagen types in the cementum and periodontal ligament were reported in this paper. Because of the different localization of each of these collagenous components in the two periodontal tissues its function in the matrix was explored. It was also possible to clarify the role of collagen in healthy periodontium as well as in regeneration and wound healing mechanisms.

Animals↗