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Biomedical subjects

M C Alfano

Publications and source records attributed to M C Alfano.

At least 19 recordsLinked to original sources
PubMed2001

Professional and community efforts to prevent morbidity and mortality from oral cancer.

BACKGROUND: Oral and pharyngeal cancers cause significant morbidity and mortality, yet there has been little improvement in survival rates in the past 30 years. Because early diagnoses significantly increase survival rates, the authors summarize several approaches to educating and mobilizing the dental profession and the public about this problem. Clinicians are invited to initiate similar programs to catalyze change in their own communities. METHODS: The authors found that many approaches have been used to define the problem and initiate change. These include surveys, focus groups, development of consortia, media programs, flyers, leaflets, prescription pads, legislation and professional endorsements. RESULTS: In Maryland in 1996, only 20 percent of adults reported receiving an oral cancer examination, and most oral cancers were diagnosed at late stages by physicians, not dentists. Results of the public educational campaigns in the regions of New York/New Jersey and Maryland have not been formally evaluated, but there is a developing consensus that oral cancer diagnostic practices in the regions with active educational programs are increasing. CONCLUSIONS: Coalitions or partnerships among individuals and organizations from government, academia, private practice, industry, the general community and the media can affect awareness about oral cancer prevention and early detection on a regional basis. CLINICAL IMPLICATIONS: By increasing awareness of oral cancer among the dental profession and the public, earlier diagnosis of these cancers with consequent improved cure rates is likely. Providing oral cancer diagnostic services as a routine part of an oral examination also may motivate patients to visit the dentist at least once a year.

Adult↗
PubMed2001

Dental education: one dean's perspective.

A dean looks at dental education and the practicing profession from the perspective of three years in dental school administration and sixteen in industry. A significant challenge is to balance costs and standards in the face of well-meaning calls for benefits from those who are not charged with meeting costs. One issue of central importance for education is keeping the curriculum properly positioned in a dynamically evolving profession. The knowledge and skills needed to manage the practice pharmacopeia are used as an example of this problem. It is proposed that schools adopt a future orientation. Dental education must be valued within the higher educational community just as dentistry is valued for its contributions to society at large. Any drift toward proprietary interests must be resisted. This can best be accomplished through a partnership between education and organized dentistry where the lobbying power of the ADA is used to gain the resources education needs and where education, including research and patient care aspects of its mission, are enlisted in support of the practicing community.

Administrative Personnel↗
PubMed1997

5% amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers: I. Clinical demonstration of acceleration of healing and resolution of pain.

5% Amlexanox oral paste (Aphthasol) was studied in four vehicle-controlled, randomized, double-blind, parallel group, multicenter, clinical studies involving 1335 subjects who had 1 to 3 aphthous ulcers less than 48 hours old at enrollment. Subjects applied study pastes directly to ulcers four times a day until ulcers healed or for the duration of the study, whichever occurred first. Ulcer size was measured by the investigator and pain was evaluated by the subject; the primary determinant of efficacy was the percentage of subjects with complete healing of ulcers and complete resolution of ulcer pain. The vehicle had marginal beneficial effects as would be expected from a covering material, but statistical significance over no treatment was inconsistent. However, these studies, both individually and collectively, clearly demonstrated in a highly significant and consistent manner that in comparison to both Vehicle and No Treatment 5% Amlexanox oral paste accelerates the resolution of pain and healing of aphthous ulcers.

Administration, Topical↗
PubMed1997

5% amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers: II. Pharmacokinetics and demonstration of clinical safety.

The safety of 5% Amlexanox paste was demonstrated in the following clinical studies: vehicle-controlled safety and efficacy studies; dermal irritation and sensitization studies; single and multiple dose pharmacokinetic studies; and a 28-day in use safety study. Minimal adverse experiences were observed with the 991 subjects that were exposed to 5% Amlexanox paste. No significant irritation or sensitization was associated with 5% Amlexanox paste. Pharmacokinetic studies indicated that systemic levels of Amlexanox are most likely due to normal gastrointestinal absorption with only limited absorption directly through the ulcer. After a 100 mg dose of 5% Amlexanox paste the average maximum concentration of Amlexanox in the serum was 120 ng/ml, occurring 2.4 hours after application. The half-life for elimination of Amlexanox was 3.5 hours, and there was no evidence of accumulation with multiple applications. Overall, the data indicate that 5% Amlexanox paste (Aphthasol) is safe for the treatment of recurrent minor aphthous ulcers.

Administration, Topical↗
PubMed1996

The effect of ketoprofen creams on periodontal disease in rhesus monkeys.

Ketoprofen creams were evaluated for the treatment of periodontal disease in a placebo-controlled, double-blind study in the rhesus monkeys, Macaca mulatta. Two formulations containing ketoprofen (1%), with or without vitamin E, were evaluated against appropriate controls (8 monkeys per group). Two weeks prior to treatment, the animals received prophylaxis on only the left side of the mouth (spontaneous model). Selected teeth on the right side of the mouth were ligated (ligature model). The creams were administered to the gingiva once daily at a standard dose of 1.8 ml per monkey for 6 months. Clinical assessments were made 2 wk before initiation, at baseline and 1, 2, 3 and 6 months post-treatment. The clinical parameters included plaque formation, gingival redness, edema, bleeding on probing and Ramfjord Attachment Level measurements (RAL). Radiographs were taken at 2 wk before initiation, baseline and at 3 and 6 months post-treatment. Digital, subtraction radiography was used to measure vertical linear bone loss along the interproximal root surfaces of the left and right mandibular first molars. Gingival crevicular fluid (GCF) was collected for biochemical assays on PGE2, TxB2, LTB4, IL-1 beta and TNF alpha. There were no significant differences among groups with respect to gingival indices. Radiographic data demonstrated significant positive effects on bone activity in both groups treated with ketoprofen formulations with improvement over time in the ligature model (0.01 < or = p < or = 0.04). The placebo group exhibited bone loss of 1.96 +/- 0.48 and 1.40 +/- 0.56 mm per site at 3 and 6 months, respectively. The group treated with ketoprofen cream showed an apparent bone gain of 0.28 +/- 0.41 and 0.78 +/- 0.47 mm per site at 3 and 6 months, respectively. The group treated with ketoprofen cream containing vitamin E showed a mean bone loss of 0.41-0.48 mm per site at 3 months with improvement to an apparent bone gain of 0.31 +/- 0.44 mm per site at 6 months. The biochemical data demonstrated early and significant suppression of GCF-LTB4 by both ketoprofen formulations at 1 month, which preceded the significant suppression of GCF-PGE2 at 2 and 3 months in the ligature model (p < 0.003) and at 2 to 6 months in the spontaneous model (p < 0.02). We conclude that ketoprofen at 1% level in suitable topical vehicles can effectively inhibit GCF-LTB4 and GCF-PGE2 and positively alter alveolar bone activity in the ligature-induced model of periodontitis in the monkey.

Administration, Topical↗
PubMed1990

Sulfadiazines reduce gingivitis and plaque formation in beagle dogs.

The effect of zinc sulfadiazine (ZnSD) and silver sulfadiazine (AgSD) on reducing plaque formation and gingivitis was studied in 12 beagle dogs over a 14-week period. 12 beagle dogs were scaled, root planed and pumiced to bring them to a similar level of gingival health, prior to placing them on a diet of Purina Dog Chow softened with canned gravy and molasses to promote the build-up of plaque and the initiation of gingivitis. At the end of 8 weeks, the dogs were determined to have substantial bacterial plaque accumulation and apparent gingivitis. Thereafter, 4 dogs were treated 2 x daily with topical applications of 3% zinc sulfadiazine; 4 dogs were treated with 2% silver sulfadiazine while 4 dogs were treated with placebo gel serving as control over a 14-week treatment period. By week 2, the zinc and silver sulfadiazine dogs showed a significant decrease in gingival index which was maintained throughout the study. Additionally, by week 2, the % of sites with bleeding was also seen to decrease significantly in the experimental groups. The plaque index remained consistent in all 3 groups until week 6 when the 2 experimental groups indicated significant decrease in plaque accumulation as compared to controls. Probing depths were also seen to decrease significantly in the experimental groups after 10 weeks of therapy. The mean stain index was similar in all 3 groups of dogs throughout the study. Data indicate that both zinc and silver sulfadiazine inhibit plaque formation and reduce existing gingivitis in beagle dogs.

Administration, Topical↗
PubMed1990

Sulfadiazines prevent plaque formation and gingivitis in beagles.

The effect of zinc sulfadiazine (ZnSD) and silver sulfadiazine (AgSD) on developing plaque formation and gingivitis was studied in 12 beagle dogs over a 14-week period. Plaque and gingival indices were used to measure plaque formation and gingivitis. During a 2-wk baseline period each dog was brought to optimal gingival health with prophylaxis and tooth brushing. Thereafter, 4 dogs were treated twice daily with topical application of 3.0% zinc sulfadiazine; 4 dogs were treated with 2.0% silver sulfadiazine while 4 dogs treated with placebo gel served as controls over a 12-wk treatment period. At wk 2 of treatment, all three groups of dogs showed an increase in plaque build-up on their teeth from baseline. By wk 6, plaque accumulation on the teeth was significantly less in dogs treated with either ZnSD or AgSD compared to control dogs. At wk 2 of treatment, gingival inflammation was increased from baseline in all three groups. Thereafter, over the course of the 12-wk treatment period, gingival inflammation in the ZnSD and the AgSD treated dogs was significantly less than the placebo treated dogs. The data indicate that both ZnSD and AgSD inhibit developing plaque formation in beagles. This significant inhibition of plaque formation was accompanied by a significant reduction in gingival inflammation.

Administration, Topical↗
PubMed1979

The relationship between the mobility of human teeth and their supracrestal fiber support.

A method to study the relationship between the mobility of human teeth and their supracrestal fiber support was developed. The results of this study would indicate that: (1) The supracrestal fibers do not contribute significantly to the support of a normal premolar tooth. (2) As a human premolar tooth develops moderate to severe loss of osseous support, the relative contribution of the supracrestal fibers to the support of the tooth increases significantly.

Adolescent↗
PubMed1977

Preserved scleral allografts in periodontal defects in man. II. Histological evaluation.

1. The scleral grafts appeared to be well accepted as there were no signs of antigenicity or untoward reactions. 2. The gingival connective tissue, periodontal ligament and the periosteum were observed intertwined with sclera at the interface. 3. Sclera was invaded by host fibroblasts, capillaries, and appeared in some areas to be raplaced by a dense connective tissue. 4. Areas of cementogenesis could be observed in all specimens. 5. There were no signs of osteogenesis within the scleral grafts. 6. The alveolar crest appeared relatively nonreactive to sclera. 7. There were no signs of external root resorption or ankylosis. 8. Sclera may be able to be used to fill in osseous craters, other periodontal defects and as a scaffolding in conjunction with osseous grafts. This requires further investigation. 9. Sclera may possibly be used in areas where there was loss of gingival contour or need for ridge augmentation.

Alveolar Process↗