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Biomedical subjects

G P Prato

Publications and source records attributed to G P Prato.

At least 19 recordsLinked to original sources
PubMed2001

Oral Acanthosis nigricans as a marker of internal malignancy. A case report.

BACKGROUND: Acanthosis nigricans (AN) is a rare mucocutaneous condition that can involve the oral tissues. There are 2 clinical forms of AN: benign and malignant. Benign AN is related to systemic diseases such as diabetes and obesity or can be induced by drugs such as systemic corticosteroids, nicotinic acid, estrogens, insulin, and fusidic acid. Malignant AN appears in association with tumors such as lung, ovarian, breast, and gastric carcinoma. METHODS: A rare case of malignant AN that initially manifested in the oral cavity of a 73-year-old patient is reported. RESULTS: A bladder and lung carcinoma were detected following the diagnosis of AN. CONCLUSIONS: The diagnostic importance of oral AN is emphasized because, in our patient, its recognition led to the detection of 2 occult malignant tumors.

Acanthosis Nigricans↗
PubMed2000

Advances in mucogingival surgery.

The term Mucogingival Surgery was proposed by Friedman in 1957 to indicate any surgery "designed to preserve attached gingiva, to remove frena or muscle attachment, and to increase the depth of the vestibule". The aim of this type of surgery was to maintain an adequate amount of attached gingiva and to prevent continuous loss of attachment. This philosophy was supported by many horizontal observations in humans that confirmed the need for a certain band of attached gingiva to maintain periodontal tissue in a healthy state. Subsequently, clinical and experimental studies by Wennström and Lindhe (1983) demonstrated that as long as plaque buildup is kept under careful control there is no minimum width of keratinised gingiva necessary to prevent the development of periodontal disease. These observations reduce the importance of Mucogingival Surgery. Surgical techniques are used mostly to solve aesthetic problems, since the term "Periodontal Plastic Surgery" has been suggested to indicate surgical procedures performed to correct or eliminate anatomical, developmental or traumatic deformities of the gingiva or alveolar mucosa. More recently the Consensus Report of the American Academy of Periodontology (1996) defines Mucogingival Therapy as "non surgical and surgical correction of the defects in morphology, position and/or amount of soft tissue and underlying bone". This assigns importance to non-surgical therapy and to the bone condition because of its influence on the morphology of the defects. In this respect the Mucogingival Therapy includes: Root coverage procedures, Gingival augmentation, Augmentation of the edentulous ridge, Removing of the aberrant frenulum, Prevention of ridge collapse associated with tooth extraction, Crown lengthening, Teeth that are not likely to erupt, Loss of interdental papilla which presents an aesthetic and/or phonetic problem.

Dental Plaque↗
PubMed1999

Localized soft tissue ridge augmentation at phase 2 implant surgery: a case report.

A case of congenitally missing maxillary lateral incisors is presented to illustrate a modification of Abrams's roll technique. Buccal releasing incisions are avoided by using an intrasulcular incision on the adjacent teeth. The tissue overlying the cover screw is transferred between the buccal cortical bone and the buccal masticatory mucosa, thus correcting the localized buccal ridge atrophy.

Adult↗
PubMed1999

The simplified papilla preservation flap. A novel surgical approach for the management of soft tissues in regenerative procedures.

A novel surgical procedure specifically designed to access interdental spaces in the regenerative treatment of deep intrabony defects is presented. This procedure (simplified papilla preservation flap, SPPF) was designed to provide surgical access to interproximal bony defects while preserving interdental soft tissues, even in narrow interdental spaces and posterior teeth. A modified mattress suture allows coronal positioning of the buccal flap and primary closure of the interdental space without tension. The modified mattress suture minimizes the collapse of the membrane into the defect. An experimental population of 18 patients in good general health who presented with one intrabony defect each was selected for this clinical study. The application of the SPPF in combination with bioresorbable membranes resulted in clinical attachment level (CAL) gains of 4.9 +/- 1.8 mm at 1 year. The difference between baseline CAL and 1 year CAL was highly clinically and statistically significant. The residual pockets at 1 year measured 3.6 +/- 1.2 mm. A slight increase in gingival recession was noted. Primary closure of the flap in the interdental space over the membrane was obtained in 100% of the cases after completion of surgery and maintained in 67% of the cases during the healing period. The application of SPPF in combination with bioresorbable barrier membranes allowed primary closure of the interdental space in most of the treated sites and resulted in consistent CAL gains at 1 year.

Absorbable Implants↗
PubMed1998

A protocol for maintaining or increasing the width of masticatory mucosa around submerged implants: a 1-year prospective study on 53 patients.

Masticatory mucosa around implants may be useful to enhance esthetics and/or plaque control. This study proposes simplified guidelines for maintaining or obtaining a minimal amount of masticatory mucosa around submerged implants in cases of partial edentulism, and for keeping the need for additional surgery to a minimum. Free gingival grafts were used in the mandibular arch when the width of buccal masticatory mucosa was less than 2 mm. The width of masticatory mucosa expected to be available for attachment to the bone surface buccal to implants was estimated by measuring the distance between the emergence of the implant from bone and the mucogingival junction. When this distance was 3 mm or less, the use of an apically positioned flap for implant exposure was preferred over gingivectomy. The amount of masticatory mucosa buccal to implants was measured 2 weeks, 6 months, and 12 months after implant exposure. In no case was the width of masticatory mucosa less than 2 mm at 1 year. Therefore, this protocol is recommended for the treatment of cases where the presence of an adequate amount of masticatory mucosa is necessary to ensure a satisfying appearance or is useful for facilitating oral hygiene.

Adult↗
PubMed1996

Factors affecting the healing response of intrabony defects following guided tissue regeneration and access flap surgery.

Identification and control of significant factors determining clinical outcomes is of paramount importance to improve expected results of a variety of therapeutic procedures. The aim of this investigation was to identify, with a multivariate approach, factors associated with healing outcomes of 3 periodontal surgical procedures in deep intrabony defects. 45 patients with evidence of deep intrabony defects were randomly assigned to 3 treatment groups: access flap (group C), conventional guided tissue regeneration (GTR) with non-resorbable expanded polytetrafluoroethilene (ePTFE) membranes (group B), and GTR with self supporting membranes combined with the modified papilla preservation technique (group A). In both GTR procedures, membranes were positioned coronal to the interproxymal alveolar crest. Primary outcome variables (i.e., probing attachment level gains at 1 year and the amount of newly formed tissue present at membrane removal) were explained in terms of a series of patient, defect morphology and surgical factors, using a multivariate approach. Highly significant treatment effects were observed, indicating that the 3 tested therapeutic modalities resulted in significant differences in primary outcome variables. Detailed analysis assessing the significance of the tested factors in determining the healing outcomes following each procedure was performed with a stepwise elimination approach of non-significant factors. The results indicated that: (i) the need to create and maintain space should be a key objective of regenerative approaches based upon the principles of guided tissue regeneration; (ii) control of patient's oral hygiene and residual periodontal infection in the oral cavity are strongly associated with clinical outcomes of both regenerative and conventional surgical procedures and should receive proper attention.

Adult↗
PubMed1995

The modified papilla preservation technique. A new surgical approach for interproximal regenerative procedures.

A modification of the papilla preservation technique has been applied to achieve primary closure of the interproximal tissue over barrier membranes placed coronal to the alveolar crest. Fifteen patients with deep intrabony interproximal defects were treated. Defects had a probing attachment level loss of 9.9 +/- 3.2 mm and a recession of the gingival margin of 1.7 +/- 1.6 mm. The depth of the intrabony component was 5.5 +/- 2.9 mm; while the suprabony component was 5.9 +/- 2.0 mm. Titanium-reinforced teflon membranes were placed 1.3 +/- 0.7 mm from the cemento-enamel junction, 4.5 +/- 1.6 mm coronal to the interproximal alveolar bone crest. Primary closure over the interproximal portion of the membrane was obtained in 93% of cases. In 73% of the cases complete coverage of the membrane was maintained until its removal at 6 weeks. These data indicate that the modified papilla preservation technique can be successfully applied to obtain primary closure of the interdental space in regenerative procedures with barrier membranes.

Adult↗
PubMed1995

Resorbable membrane in the treatment of human buccal recession: a nine-case report.

Recent studies have reported the successful use of guided tissue regeneration procedures with nonresorbable barrier membranes to treat buccal recession in humans. Nonresorbable membranes, however, require a reentry procedure for removal, disturbing the delicate healing process. Resorbable membranes were used in a guided tissue regeneration procedure in nine patients with one site of buccal recession each. The resorbable barrier yielded satisfactory clinical results, providing significant gains in probing attachment and root coverage. However, both the surgical technique and the design of the barrier used require improvement for application at sites of buccal recession.

Adult↗
PubMed1994

Guided tissue regeneration with a rubber dam: a five-case report.

Five cases are presented to document the use of an unusual barrier in the treatment of infrabony defects according to the principles of guided tissue regeneration. A rubber dam was positioned after flap elevation, defect debridement, and root planing to cover the defect and the surrounding bone. The dam was covered with the surgical flap and removed after 5 weeks. The 1-year clinical measurements and reentry procedure demonstrated the efficacy of the rubber dam as a barrier in guided tissue regeneration procedures.

Alveolar Bone Loss↗
PubMed1993

Histologic assessment of new attachment following the treatment of a human buccal recession by means of a guided tissue regeneration procedure.

A deep, long-standing recession on a mandibular incisor was treated in a 56-year-old female patient. The tooth was tilted buccally and was scheduled for extraction. The recession was 8 mm deep, with a pocket depth of 1 mm and no keratinized tissue. The recession was treated by guided tissue regeneration; the membrane was left in place for 4 weeks. The tooth was extracted along with marginal tissues 5 months after the removal of the membrane. At the time of extraction, 4 mm of root coverage had been achieved and 3 mm of keratinized tissue were measured buccally. Histologic measurements showed that 3.66 mm of new connective tissue attachment had been obtained associated with newly formed cementum (2.48 mm) and bone growth (1.84 mm). The crestal bone level after treatment was located coronal to the preoperative location of the gingival margin.

Alveolar Process↗
PubMed1993

Guided tissue regeneration and a free gingival graft for the management of buccal recession: a case report.

Five patients with buccal gingival recession (4 to 6 mm) underwent surgical treatment consisting of a guided tissue regeneration procedure associated with a free gingival graft. The graft was used to cover the newly formed tissue on the root surface at the reentry. Root coverage was complete in three patients, while 1 mm of recession remained in the other two patients. The free gingival graft reconstructed the keratinized tissue, which had been lost because of recession. Moreover, it allowed the mucogingival junction, which had been displaced coronally during the first surgery, to be realigned, therefore preventing a shallowing of the vestibule.

Adult↗
PubMed1993

Root resection and root amputation.

Attachment loss in furcal areas is a challenge for the clinician. Root resection and root amputation techniques have been used to overcome the instrumentation problems that these areas pose. Recent reports indicate that this approach is effective and reliable but extremely technique-sensitive and expensive for endodontic and prosthetic involvement. A more conservative approach, such as scaling and root planing, is suggested only for shallow class II furcation. Guided tissue regeneration in deep class II and class III furcation seems to be unpredictable and the efficacy of this therapy in such areas is still questionable.

Apicoectomy↗
PubMed1992

Periodontal regenerative therapy with coverage of previously restored root surfaces: case reports.

Two case reports are presented to demonstrate a treatment that restores proper esthetics, cures hypersensitivity, and enhances periodontal support for cases of root caries or failing Class V restorations associated with gingival recessions. The procedure involves removing the existing restoration, elevating a trapezium-shaped full thickness flap, root planing to achieve a desired concave shape, and placing a barrier membrane. In both cases, satisfying clinical results have been maintained for 18 months.

Adult↗
PubMed1986

Healing after application of tissue-adhesive material to denuded and citric acid-treated root surfaces.

This study was undertaken to evaluate the effects of a commercially available tissue adhesive upon healing of the coronal periodontium. In four squirrel monkeys, 24 teeth were extracted, and the coronal third of the roots planed free of fibers and cementum. Eight teeth were replanted without further alteration and eight were coated with tissue adhesive prior to replantation. In the remaining eight teeth, the planed surface was decalcified, coated with tissue adhesive and replanted. Histological observations were made at 1 and 7 days after replantation. In the teeth replanted after root planing alone and root planing plus tissue adhesive, epithelium migrated apically and was within the ligament space lining the denuded root at 7 days. In contrast, those teeth which were decalcified prior to application of tissue adhesive demonstrated fiber attachment to the planed root surface and little or no epithelial downgrowth.

Animals↗