Biomedical subjects

G Rebitski

Publications and source records attributed to G Rebitski.

10 recordsLinked to original sources

PubMed2001

A comparison of porous and non-porous teflon membranes plus demineralized freeze-dried bone allograft in the treatment of class II buccal/lingual furcation defects: a clinical reentry study.

BACKGROUND: The aim of this 9-month reentry study was to compare the regenerative healing using porous (P) and non-porous (NP) teflon barrier membranes plus demineralized freeze dried bone allografts (DFDBA) in Class II buccal/lingual furcation defects. METHODS: Twenty-four patients, 13 males and 11 females, ages 38 to 75 (mean 54 +/- 10), were included in this study. Each patient had adult periodontitis and one Class II furcation defect measuring > or = 3 mm open horizontal probing depth. Twelve patients were randomly selected to receive the NP treatment and 12 received the P membrane. All defects received a DFDBA graft. Measurements were performed by a masked examiner. RESULTS: No statistically significant differences (P>0.05) were found between NP and P groups at any time with respect to any open or closed measure. Improvement in mean open horizontal probing depth was significant for both the NP (2.33 +/- 0.78 mm) and P (2.75 +/- 0.75 mm) groups. Mean clinical attachment level gains at 9 months were significant for both NP (1.50 +/- 1.62 mm) and P (2.50 +/- 2.11 mm) groups. Seventeen of 24 defects had an intrabony component and > or = 50% fill was obtained in 100% of these defects. CONCLUSIONS: The results of this 9-month reentry study comparing the use of porous and non-porous barrier membranes with a DFDBA graft indicate that there were no statistically significant differences between groups. Both groups showed a statistically significant improvement following the treatment of Class II furcation defects in humans.

Adult↗

PubMed2001

Predictable multiple site root coverage using an acellular dermal matrix allograft.

BACKGROUND: The primary aim of this randomized, controlled, blinded clinical investigation was to determine if orientation of an acellular dermal matrix (ADM) allograft, basement membrane side against the tooth or connective tissue side against the tooth, affected the percent root coverage. Additional aims were to: 1) compare results of this study with results obtained from other root coverage studies; 2) determine if multiple additional sites could be successfully covered with the same surgery; 3) determine the effect of the procedure on keratinized tissue; and 4) evaluate the amount of creeping attachment obtained. METHODS: Ten patients with 2 Miller Class I or II buccal recession defects > or =3 mm were treated with a coronally positioned flap plus ADM and followed for 12 months. Test sites received ADM with the basement membrane side against the root (AB), while the control sites received the connective tissue side against the root (AC). Multiple additional recession sites were treated with the same flap procedure. RESULTS: Mean baseline recession for the AB sites was 4.2 mm and for the AC sites, 3.7 mm. Mean root coverage of 95% was obtained for both AB and AC sites. Sixty-eight additional Class I or II AB and AC sites obtained about 93% root coverage. The mean increase in keratinized tissue for both treatments was 0.80 mm. No additional root coverage was gained due to creeping attachment between 2 and 12 months. CONCLUSIONS: Treatment with ADM was an effective and predictable procedure for root coverage. The orientation of the material did not affect the treatment outcome for any of the parameters tested.

Adult↗

PubMed2000

Ridge preservation utilizing an acellular dermal allograft and demineralized freeze-dried bone allograft: Part I. A report of 2 cases.

Alveolar ridge deformities are usually the result of trauma, periodontal disease, surgical insult, or developmental defects. Preventing ridge collapse with the extraction of maxillary anterior teeth is vital to an esthetic restorative result. Several techniques are available to prevent ridge collapse. In these case presentations, ridge preservation was achieved utilizing an acellular dermal matrix as a barrier membrane with a demineralized freeze-dried bone allograft. This report demonstrated an acceptable esthetic result with no loss of ridge height or width. Soft tissue dimensions were also preserved. The two graft materials were well accepted by the body and healing was rapid and without significant discomfort. The technique illustrated provides the surgeon with another option to prevent ridge collapse and ultimately improve esthetics.

Adult↗

PubMed2000

Ridge preservation utilizing an acellular dermal allograft and demineralized freeze-dried bone allograft: Part II. Immediate endosseous implant placement.

When maxillary anterior teeth are extracted, subsequent ridge collapse can significantly compromise esthetics. Preservation of an adequate volume of bone is vital to successful implant placement. Ridge preservation achieved utilizing an acellular dermal matrix as a barrier membrane with a demineralized freeze-dried bone allograft has been previously reported. In this case presentation, guided bone regeneration was achieved around an immediate endosseous implant when this same technique was used. As in the previous case reports, this technique demonstrated an acceptable esthetic result with virtually no loss of ridge height or width. Soft tissue dimensions were also preserved. Both the hard and soft tissue grafts were well accepted by the body and healing was rapid and without significant discomfort. This surgical technique provides the clinician with an option to provide immediate implant therapy when primary closure cannot be achieved.

Adult↗

PubMed2000

Improved closure rate of Class III furcations using a layered GTR technique.

In this study, 24 furcation defects in 12 patients were treated by either (1) a polylactide resorbable membrane (Guidor) plus a polyglactin mesh (Vicryl) and demineralized freeze-dried bone allograft (DFDBA), or (2) a polylactide resorbable membrane and DFDBA. All defects were reentered after 9 months. Class III furcations closed 66% of the time when treated by the first method, while the closure rate was only 33% when treated by the second method (no polyglactin mesh). Defects with a vertical opening of < or = 4 mm closed 74% of the time, while those with vertical openings > 4 mm closed only 11% of the time.

Absorbable Implants↗

PubMed2000

Hard tissue ridge augmentation using a resorbable membrane and a particulate graft without complete flap closure.

Twelve patients with isolated alveolar ridge defects bordered by teeth on each side were treated and followed for 12 months. The treatment involved use of a resorbable membrane and a particulate graft without complete flap closure. Measurements taken at 12 months showed a significant mean osseous gain of 3.27 +/- 3.73 mm in mid-defect ridge width and an increase in height of 1.90 +/- 2.50 mm.

Absorbable Implants↗

PubMed2000

Improved bone regeneration and root coverage using a resorbable membrane with physically assisted cell migration and DFDBA.

Twelve patients with 2 Miller Class I or II buccal recession defects measuring > or = 3.0 mm were treated using the principles of guided tissue regeneration and followed for 12 months. The effectiveness of a polylactide (Guidor) resorbable membrane (GA sites) was compared to a combination treatment of polylactide membrane plus polyglactin root-lining mesh (Vicryl) and demineralized freeze-dried bone allograft (DFDBA) (GVB sites) designed to enhance cell migration and bone regeneration. There was 90% mean soft tissue root coverage for the GVB sites and 78% for the GA sites. The mean osseous dehiscence area coverage with hard tissue was 75% for GVB sites and 30% for GA sites.

Absorbable Implants↗

PubMed1999

The effect of postsurgical naproxen and a bioabsorbable membrane on osseous healing in intrabony defects.

BACKGROUND: Previous reports in the literature have shown that non-steroidal anti-inflammatory drugs (NSAID) may affect osseous tissues by either stimulating or inhibiting bone formation. This effect can be drug specific and different NSAIDs may produce opposite results. There are also reports showing that NSAIDs inhibit bone loss due to inflammatory disease process. The purpose of this randomized, controlled, blinded, clinical investigation was to determine the effect of a one week course of postsurgical naproxen on the osseous healing in intrabony defects. METHODS: Twenty-four vertical osseous defects in 24 patients were treated with either a bioabsorbable membrane plus twice daily postsurgical naproxen 500 mg for one week (test or GPN group) or with a polylactide bioabsorbable membrane alone (control or GA group). Twelve patients were included in each group. Treatment was performed on either 2- or 3-wall or combination defects. All measurements were taken from a stent by a calibrated, blinded examiner and open measurements were repeated at the 9-month second stage surgery. Power analysis to determine superiority of naproxen treatment showed that a 12 per group sample size would yield 87% power to detect a 2.0 mm difference and 64% power to detect a 1.5 mm difference. RESULTS: Open defect measurements from baseline to 9 months showed a statistically significant (P < 0.05) mean defect fill of 1.96 +/- 1.27 mm and 2.04 +/- 1.71 for the GPN and GA groups, respectively. This corresponded to a mean defect fill of 42% and a mean defect resolution of approximately 75% for both groups. The differences between GPN and GA groups were not statistically significant (P > 0.05). Defect fill of > or = 50% was seen in 6 defects (50%) in the GPN group and in 5 defects (42%) in the GA group. CONCLUSIONS: The administration of postsurgical naproxen failed to produce osseous healing that was statistically superior to that obtained with polylactide bioabsorbable membranes alone.

Absorbable Implants↗

PubMed1999

The effect of postsurgical antibiotics and a bioabsorbable membrane on regenerative healing in Class II furcation defects.

BACKGROUND: The purpose of this randomized, controlled, blinded, clinical investigation was to determine the effect of postsurgical antibiotics on osseous healing in Class II furcation defects. METHODS: Twenty-four Class II furcation defects in 24 patients were treated with either a polylactide bioabsorbable membrane, demineralized freeze-dried bone allograft (DFDBA) plus antibiotics (GBA or test group) or with a polylactide membrane and DFDBA alone (GB or control group). Twelve patients were included in each group. The antibiotic regimen consisted of ciprofloxacin 250 mg twice daily and metronidazole 250 mg tid for 1 week followed by a 7-week regimen of doxycycline hyclate 50 mg daily. Treatment was performed on either mandibular buccal or lingual, or maxillary buccal Class II furcation defects. Defects were randomly selected by a coin toss for treatment and all open and closed measurements were performed by a blinded examiner. Final open and closed measures from a stent were repeated at the 9-month second stage surgery. Power analysis to determine superiority of antibiotic treatment showed that a 12 per group sample size would yield 93% power to detect a 1.5 mm difference and 64% power to detect a 1 mm difference. RESULTS: Mean open horizontal probing depth reductions at 9 months were greater for the GBA group than for the GB group (2.92+/-1.78 versus 2.50+/-1.62 mm); however, these differences were not statistically significant. Seven of 12 furcations (58%) in the GBA group demonstrated >50% vertical defect fill at 9 months compared to 8 of 12 furcations (67%) in the GB group. There were no significant differences in mean open horizontal probing depth reduction between smokers and non-smokers in either the GBA or GB groups. Membrane exposure did not appear to affect regenerative healing in either the GBA or GB groups. CONCLUSIONS: The administration of postsurgical antibiotics did not produce statistically superior osseous healing of Class II furcation defects. This result may be attributable to membrane design which facilitates connective tissue ingrowth, thereby preventing bacterial downgrowth and contamination of the newly regenerated tissues.

Absorbable Implants↗

PubMed1993

Dentin pretreatment and caries inhibition by a fluoride-releasing resin.

The purpose of this study was to examine the effect that phosphoric acid etchant, used to remove the smear layer, may have on dentin demineralization inhibition. Fifteen molars had Class V preparations placed on the mesial and distal surfaces, the gingival seat being placed 1 mm below the cementoenamel junction. Randomly, one preparation of each tooth had etchant placed carefully on only enamel for 30 seconds. Etchant was placed on the gingival seat dentin of the remaining preparations, as well as the enamel for 30 seconds. A HEMA dentin primer containing maleic acid was placed and allowed to dry on the unetched dentin, then a Bis-GMA resin with tetrabutyl ammonium tetrafluoroborate was placed. Only the fluoridated resin was placed over the dentin that had been etched. All teeth were then restored with resin composite and subjected to an artificial caries challenge (pH 4.4) for 7 days. Sections 100 microns were obtained, photographed under polarized light microscopy and demineralized areas were digitized. Results demonstrated the mean area (mm2 +/- S.D.) demineralization 0.5 mm from the gingival margin to be: etched dentin (0.77 +/- 0.36); non-etched dentin (1.52 +/- 0.98). A t-test indicated that there was significantly less demineralization when the fluoridated resin came in direct contact with dentin that had the smear layer removed (P < 0.05).

Acid Etching, Dental↗