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Biomedical subjects

Micha Peled

Publications and source records attributed to Micha Peled.

At least 19 recordsLinked to original sources
PubMed2006

Etodolac versus dexamethasone effect in reduction of postoperative symptoms following surgical endodontic treatment: a double-blind study.

OBJECTIVE: The purpose of this prospective study was to analyze the effect of etodolac versus dexamethasone in reducing postoperative pain in patients who had surgical endodontic treatment using a strict protocol. STUDY DESIGN: The study consisted of 90 patients (38 males and 52 females) referred for surgical endodontic treatment. All procedures were performed using a microsurgical technique with a strict protocol. Patients were randomly premedicated with placebo or with one of both protocols: either a single dose of oral dexamethasone, 8 mg, preoperatively and 2 single doses, 4 mg, 1 and 2 days postoperatively, or a single dose of etodolac, 600 mg, and 2 single doses, 600 mg, 1 and 2 days postoperatively. Pain was recorded at 8, 24, and 48 hours, as well as 7 days postoperatively, on a 1-10 scale. The influence of different variables on postoperative sequelae was analyzed. RESULTS: On a 1-10 scale, the mean values of pain report recorded were 3.8 +/- 2.9 (8 hours postoperatively), 2.93 +/- 2.4 (24 hours), 2.31 +/- 2.2 (48 hours), and 1.4 +/- 0.9 (7 days postoperatively). One day postoperatively, 41.8% of the patients reported no or very mild pain (score 1 or 2), whereas after 7 days, 87.9% reported no or very mild pain (score 1 or 2). Both etodolac and dexamethasone had a significant effect of reducing postoperative pain in patients who had surgical endodontic procedure compared with placebo (P < or = .001). CONCLUSION: Postoperative pain following endodontic surgical treatment is not uncommon. Etodolac as well as dexamethasone might serve as a pain relief measure for postoperative pain in these patients.

Adolescent↗
PubMed2006

The clinical significance of sinus membrane perforation during augmentation of the maxillary sinus.

PURPOSE: Augmentation of the maxillary sinus floor is a well-documented technique and is generally accepted as a pure implantology procedure to facilitate placement of dental implants in the posterior atrophic maxilla. The objective of this report was to evaluate the significance of the sinus membrane perforations on the incidence, complications, and success rate of this procedure. PATIENTS AND METHODS: Patients who received sinus floor augmentation and simultaneous placement of dental implant were included in this study. Subgroup I consisted of patients who had their sinus membrane perforated and repaired during the procedure with resorbable membrane. Subgroup II consisted of patients whose Schneiderian membrane was not perforated during the procedure. The patients were followed between 1 to 4 years after augmentation. RESULTS: All perforations were classified as class II or III. The success rate of the implants in the perforation group was 94.4%, and that for the nonperforation group was 93.9%. The difference between the 2 study groups was statistically not significant. A significant statistical correlation was found between the residual ridge height and the membrane perforation (P < .01). CONCLUSIONS: Mainly due to technical difficulties, maxillary sinus membrane perforation occurs more frequently with a small height of residual alveolar bone. In this study, no statistical difference was observed in the success rate of the immediate implants placed with sinus bone grafting in patients whose membrane was perforated versus those patients in whom an intact membrane was maintained.

Alveolar Ridge Augmentation↗
PubMed2006

Comparison of clinical, radiographic and immunological parameters of teeth and different dental implant platforms.

A comparison between host response in teeth and dental implants was not made. Likewise, the association between host response and periodontal parameters has never been explored. The purpose of this study was to compare periodontal health around natural teeth and dental implants with different restorative platforms. Twenty-seven partially edentulous patients with dental implants, either external hex butt joint (n=28) or tapered Morse (n=45), were included in this study. Implants were in function for 1-6 years (mean 2.9). Plaque index (PI), gingival index (GI), probing depth (PD); and clinical attachment level (CAL), were recorded at final examination; alveolar bone loss (ABL) was measured at baseline and final examination using panoramic radiographs. Gingival crevicular fluid samples were obtained from the Ramfjord index teeth and all implants and assayed using enzyme-linked immunosorbent assay for prostaglandin E(2) (PGE(2)), interleukin-1 (IL-1) and tumour necrosis factor alpha (TNFalpha). Differences between teeth and implants and between the two implant platforms were compared using Student's t-test. Correlations between cytokines, ABL and clinical parameters were analyzed using Pearson's co-efficient test. PI and GI were significantly higher in teeth than dental implants (1.2+/-0.5 vs. 0.8+/-0.5, P=0.0018; 1.2+/-0.3 vs. 1.1+/-0.3, P=0.048). Conversely, PD was deeper in implants (2.66+/-0.6 vs. 3.66+/-0.9, P=0.001). GI and PD around teeth and implants were positively associated (R=0.561, P=0.0023; R=0.39, P=0.0452). Greater ABL was observed around dental implants (1.62+/-2.2 mm) compared with teeth (0.49+/-0.3 mm). A positive correlation was found between both IL-1 (R=0.73, P=0.0064; R=0.52, P=0.0081) and TNFalpha (R=0.64, P=0.0246; R=0.46, P=0.091) and ABL in teeth and implants. Both implant platforms were similar clinically and radiographically; however, TNFalpha (2.49+/-0.3 vs. 4.79+/-0.5, P=0.004) and IL-1 (24.52+/-7.3 vs. 45.41+/-9.9, P=0.095) were higher for the non-submerged implants. In conclusion, IL-1 and TNFalpha are sensitive markers of ABL around teeth and implants. The two dental implant platforms showed a similar clinical and radiographic response; however, the greater host response in the non-submerged implants might suggest future bone loss.

Aged↗
PubMed2006

Physician and emergency medical technicians' knowledge and experience regarding dental trauma.

The purpose of the present study was to evaluate the knowledge of physicians and emergency medical technicians (EMT) regarding primary treatment for dental trauma and to assess the experience they have in treating dental injuries. The study population consisted of 70 military physicians and EMT during their military service. A questionnaire was distributed relating to demographic data, such as age, gender, position, and type of military service, as well as the following issues: past experience in treating or witnessing dental trauma, former education regarding diagnosis and treatment of dental trauma, assessment of knowledge regarding dental trauma, etc. Of all participants, only 4 (5.9%), all physicians, received education regarding dental trauma. Nevertheless, 42 (61.8%) reported they witnessed such an injury during their military service. Dental injuries were first seen by the EMT in 41.2% of the cases, by the physician in 25%, and by a dentist in only 7.3%. Overall, 58 (85.3%) of the physicians and EMT stated that it was important to educate the primary health care providers regarding diagnosis and treatment of dental trauma. Special emphasis should be given to providing primary caregivers with the relevant education to improve their knowledge and ability of dealing with diagnosis and treatment of dental trauma.

Clinical Competence↗
PubMed2006

Pregnancy tumor occurring twice in the same individual: report of a case and hormone receptors study.

A case of 2 pregnancy tumors in the same individual and at the same site within 2 years, during 2 consecutive pregnancies, despite complete eradication of the first lesion, is described. A 27-year-old woman at 32 weeks gestation was referred for gingival swelling. Gingival enlargement was pronounced on her maxillary right side, and a hemangioma was present on the lip adjacent to this mass. Despite preventive periodontal treatment the lesion continued to grow, interfering with speech and mastication, and became painful; it was therefore removed surgically. Sixteen months later, during a subsequent pregnancy, the woman returned at 20 weeks gestation for treatment of a recurrent lesion at the same site, and the lesion was excised. The roles of female sex hormones, multiplicity of vascularity, and local irritants in the development of pregnancy tumors are examined.

Adult↗
PubMed2006

In vitro antibacterial efficacy of a new chlorhexidine slow-release device.

OBJECTIVE: The aim of this study was to evaluate and compare the antibacterial effect of chlorhexidine and calcium hydroxide slow-release devices on oral bacteria. METHOD AND MATERIALS: The agar diffusion test was used to evaluate the antibacterial effect of the slow-release devices Activ Point (chlorhexidine; Roeko) and Calcium Hydroxide Plus Point (Roeko) on 8 anaerobic and 2 facultative oral bacterial strains, as well as 2 bacterial cultures randomly sampled from necrotic root canals and incubated in anaerobic and aerobic broth for 48 hours. The efficiency of the medicaments against the various strains was evaluated using a nonparametric test (Friedman type) and a second nonparametric test (Wilcoxon's signed rank test). RESULTS: Activ Point produced significantly larger inhibition zones (P < .001) than the calcium hydroxide slow-release device around all tested bacterial strains. CONCLUSION: The chlorhexidine slow-release device (Activ Point) exhibited significant antibacterial activity in the agar diffusion test and merits study as an intracanal medicament.

Actinomyces↗
PubMed2005

Metachronous ameloblastomas in the maxilla and mandible: report of a case.

Ameloblastoma is a locally aggressive tumour of odontogenic origin, with an unknown aetiology. Metachronous ameloblastoma in the maxilla and the mandible is rare. In this report, a case of a 63 year-old man is described with a solid ameloblastoma in the posterior part of the upper jaw. After surgical treatment, the patient returned 8 years later with a similar lesion in the anterior lower jaw. Both ameloblastomas were of the solid type but differed in their histological patterns. No evidence of recurrence was found in either of the surgical sites for the last 4 years.

Ameloblastoma↗
PubMed2005

The use of free fibular flap for functional mandibular reconstruction.

PURPOSE: The purpose of this investigation is to document our experience using the free vascularized fibular flap for comprehensive reconstruction of discontinuity defects in the mandible, after combined resections of malignant and aggressive odontogenic tumors, with special emphasis on functional aspect of the reconstruction process. MATERIALS AND METHODS: The study group consisted of consecutive patients treated for reconstruction of discontinuity defects of the mandible, using the fibular vascularized free flap, between 1997-2002. All procedures were performed in the same hospital and by the same surgical team. RESULTS: A total of 13 patients (9 males, 4 females) were treated in our department in a period of 6 years for reconstruction of discontinuity mandibular defects using the free fibula vascularized flap. Wound healing disturbances at the donor site occurred in 4 cases. Two flaps were lost, 1 because of total failure in a patient who was heavily irradiated because of osteosarcoma, the other because of resorption of the bone tissue transfer in a case of total avulsion of the mandible caused by a fall from height. CONCLUSION: Fibula free vascularized flap is a safe and reliable method for comprehensive functional and esthetic mandibular defect reconstruction. Our protocol has a significant impact on preserving the patients quality of life.

Adolescent↗
PubMed2005

Congenitally missing teeth in the Israeli cleft population.

OBJECTIVE: The purpose of the study was to determine the prevalence of congenitally missing teeth in a group of Israeli children with various types of clefts. DESIGN: Prevalence of congenitally missing teeth was determined for 179 children with cleft lip, cleft lip and alveolar ridge, cleft lip and palate, and cleft palate. Subgroupings were assessed according to patient sex, origin, cleft type, tooth type, and the side of hypodontia. The diagnosis of congenitally missing teeth (CMT) was based on initial and follow-up panoramic roentgenograms. In case of doubt, occlusal or periapical roentgenograms as well as clinical dental photographs were also used. SETTING: Data collection was conducted at the Rambam Medical Center, Orthodontic and Craniofacial Unit, Haifa, Israel. RESULTS: In the total cleft group, 67.6% of the patients presented with hypodontia, totaling 246 missing teeth. A statistically significant difference was found in the distribution of patients with CMT of Jewish and minority origin according to sex. Cleft lip and palate was the most frequently affected group in which 195 teeth were missing. The most frequently missing tooth among the cleft population was the maxillary incisor. The order of frequency of the other missing teeth was the same as in the normal population. Hypodontia and malformations of permanent teeth were most common on the cleft side. CONCLUSION: The frequency of CMT in the Israeli cleft population studied was higher than in the intact population. This confirms findings in other populations worldwide.

Adolescent↗
PubMed2005

Treatment of osseous cleft palate defects: a preliminary evaluation of novel treatment modalities.

OBJECTIVE: To compare the use of autogenous iliac bone graft (ABG) alone with nonresorbable expanded polytetrafluoroethylene Gore-Tex TR membrane (GTM) and with ABG plus resorbable Resolut XT membrane barriers for the secondary closure of alveolar cleft defects. STUDY DESIGN: Fifteen patients aged 9 to 17 years with unilateral cleft palate were included in this study. All patients had primary closure of the soft tissues at infancy. Presurgical orthodontics and scaling preceded the surgery. The patients were randomized to one of three surgical treatment groups: (1) ABG, (2) GTM, or (3) autogenous bone plus resorbable membrane (ABM). Periapical radiographs were taken pretreatment and 2 to 6 years later and were used to measure changes in size (linear and area) of the osseous defect. RESULTS: Significant decreases were observed in mean initial defect width (9.8 to 6.7 mm; p = .0263), mean initial defect height (20.7 to 15.1 mm), and overall mean defect size (223.6 to 143.9 mm2). Greater improvement in mean defect width was observed for the ABM group (6.42 mm) compared with the ABG (1.22 mm) and GTM (1.38 mm) groups. The reduction in overall mean defect size was significantly greater in the ABM group (177 mm2) compared with the GTM (20.51 mm2) and ABG (41.69 mm2) groups. CONCLUSION: Guided bone regeneration was found potentially useful for the treatment of osseous cleft palate defects. The combined approach yielded significantly greater defect fill. If further substantiated in larger independent studies, the adjunctive use of barrier membranes could improve the management of secondary closure of cleft palate defects.

Absorbable Implants↗
PubMed2005

Severe pregnancy complication (preeclampsia) is associated with greater periodontal destruction.

BACKGROUND: Preeclampsia is a pregnancy-specific disease which is one of the leading causes of maternal and fetal morbidity and mortality. The etiology of preeclampsia remains elusive. The underlying pathology may be related to a generalized intravascular hyperinflammatory state. Since the placental histopathologic lesions of acute atherosis, seen in preeclampsia, bear resemblance to those seen in atherosclerosis, and recent evidence links atherosclerosis with chronic infection, we decided to investigate a possible link between preeclampsia and chronic periodontal infection. METHODS: Thirty primigravidas, 15 suffering from preeclampsia, had full mouth periodontal examinations. Gingival crevicular fluid samples were taken for laboratory immunological assessment. Similar examination and sampling were performed in 15 age- and maternal status-matched controls. RESULTS: Significantly higher periodontal probing depth and clinical attachment level scores were found in the preeclamptic group compared with controls (2.98 versus 2.11 and 3.33 versus 2.30, respectively). Plaque index, gingival index, and mean gingival overgrowth scores were very similar in both groups. Furthermore, prostaglandin E2 (PGE2), tumor necrosis factor (TNF)-alpha, and interleukin (IL)-1beta levels were all significantly higher in the preeclamptic group (247.4 ngr/sample versus 89.1 ngr/sample, 8.03 pgr/sample versus 4.03 pgr/sample, and 175.7 pgr/sample versus 62.2 pgr/sample, respectively). CONCLUSION: The above results suggest a possible association between periodontal inflammation and preeclampsia.

Dinoprostone↗
PubMed2005

Amine fluoride/stannous fluoride and chlorhexidine mouthwashes as adjuncts to single-stage dental implants: a comparative study.

BACKGROUND: The growing popularity of non-submerged dental implants in recent years requires a greater emphasis on microbial plaque control. Chlorhexidine (CHX), the most commonly used mouthwash in implant surgery, is sometimes associated with tooth staining and alteration in taste perception. Amine fluoride/stannous fluoride (AmF/SnF2) mouthwash has been shown to have anti-infective properties; however, it has not been tested as an adjunct anti-infective means in non-submerged dental implants. The purpose of this trial was to compare AmF/SnF2 and CHX mouthwashes as adjuncts to single-stage dental implants. METHODS: Thirty-three patients aged 34 to 79 (mean 54.30 +/- 8.69 SD) requiring dental implants were accepted into the study. Following comprehensive periodontal therapy patients received one to three non-submerged dental implants (maxilla: 17; mandible: 45; anterior: 3, posterior: 59). After surgery patients were given analgesics and antibiotics as well as 2,400 ml of coded mouthwash bottles previously randomized between the two above mentioned formulations. Clinical and radiographic parameters were recorded at baseline and 3 and 12 months post-surgery. RESULTS: Twelve-month survival rates were 100% and 92.9% for the AmF/SnF2 and CHX groups, respectively. Compliance was slightly higher in the AmF/SnF2 group (84.35% +/- 3.39% versus 78.15% +/- 4.59% SE) but statistically similar. There was no statistically significant difference between the AmF/SnF2 and CHX groups in staining index at 3 months (1.519 +/- 0.22 versus 1.457 +/- 0.24 SE) and patient subjective evaluation of the mouthwashes. Radiographic bone loss was 0.79 +/- 0.23 and 1 +/- 0.13 SE at 3 months and 1.06 +/- 0.13 and 1.27 +/- 0.25 at 12 months for the CHX and AmF/SnF2 groups, respectively; the difference was statistically insignificant (P = 0.388 and 0.504, respectively). CONCLUSION: Both CHX and AmF/SnF2 mouthwashes can be used post-surgically after one-stage implant surgery.

Adult↗
PubMed2004

Comparing the effects of V-Y advancement versus simple closure on upper lip aesthetics after Le Fort I advancement.

PURPOSE: The aim of this study was to compare upper lip movement and its dimensional changes after maxillary advancement via Le Fort I osteotomy, using V-Y advancement versus simple continuous closure. The study investigates dimensional changes in the superior and inferior portions of the upper lip, as well as changes in lip length, resulting from the procedure. PATIENTS AND METHODS: The study group consisted of 35 patients who had undergone 1-piece Le Fort I osteotomy for maxillary advancement of 3 to 6 mm with less than 3 mm of vertical changes. Fixation was performed by rigid monocortical plating. Closure of soft tissue was achieved using V-Y advancement in 17 patients and simple continuous suturing in 18 patients. Lateral cephalometric radiographs were taken and measured preoperatively and then 6 months after surgery. RESULTS: The magnitude of upper lip movement was 88.89% of the maxillary advancement in the simple continuous suturing group and 90.77% in the V-Y advancement group. The superior portion of the upper lip thickened by 2.08 mm and 2.35 mm in the 2 groups, respectively. The inferior portion of the upper lip thickened by -1.94 mm and -1.14 mm, respectively. The upper lip shortened by 0.79 mm in the simple continuous suturing group and lengthened by 1.10 mm in the V-Y advancement group. CONCLUSIONS: Upper lip movement and dimensional changes differ when simple continuous suturing and V-Y advancement closure are used.

Adolescent↗
PubMed2004

Enhancement of bone formation by bone morphogenetic protein-2 during alveolar distraction: an experimental study in sheep.

BACKGROUND: The purpose of this study was to perform alveolar ridge augmentation by distraction osteogenesis (DO) and to enhance bone regeneration through the use of recombinant human bone morphogenetic protein-2 (rhBMP-2), followed by implant placement. METHODS: Alveolar segmental osteotomy was performed in the mandible of 10 sheep followed by placement of 1.5 mm alveolar distraction devices. The study group was injected on the fifth day of distraction with a single dose of 10 microg rhBMP-2. Only distraction was performed in the control group. RESULTS: A mean alveolar augmentation of 12 mm was achieved. After 12 weeks of consolidation, the distraction devices were removed and biopsies were taken for histological and immunohistochemical characterization and morphometry of the newly formed bone. Titanium threaded cylindrical implants were then placed in the newly augmented bone. Radiological evaluation showed lifting of the transport segment and integration of the implants within both the transport segment and the regenerated bone. The histological study demonstrated that the association of DO and BMP resulted in increased trabecular bone size and volume (32.2%+/-0.95% versus 18.6%+/-0.71%; P <1 x 10(-17) after 24 days of lengthening and 63.8%+/-1.89% versus 42.5%+/-1.33%; P<1 x 10(-15) after 12 weeks of consolidation) and increased numbers of proliferating cell nuclear antigen stained cells (0.7+/-0.04 versus 0.47+/-0.04; P<1 x 10(-10)) compared with the DO only group. CONCLUSIONS: Alveolar distraction augments atrophic alveolar ridge and creates new bone that permits implant placement. rhBMP-2 enhances bone quality and may shorten the consolidation period of distraction allowing for earlier implant placement.

Alveolar Bone Loss↗
PubMed2004

The effect of menstrual cycle on periodontal health.

BACKGROUND: Fluctuation in estrogen/progesterone levels has been shown to affect the periodontium. The effects of pregnancy, prepuberty, and oral contraceptives on gingival health has been studied extensively, with gingival scores reported to be higher, in most instances, than in controls. Fluctuation in steroid sex hormone is also noticeable through women's menstrual cycle. Many women report an increase in gingival inflammation and discomfort associated with their menstrual cycle, most commonly around the menses period. However, this well-known phenomenon has never been studied. The purpose of this longitudinal, prospective study was to compare the periodontal status of premenopausal women at different times during their menstrual cycle. METHODS: Eighteen premenopausal women, enrolled in our maintenance program, were recruited. Clinical examination was performed before the recall visit at three different time points in their menstrual cycle: ovulation (OV), premenstruation (PM), and menstruation (M). Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were examined around the Ramfjord index teeth. Analysis of variance, with Scheffe modification, was used to determine differences between the menstrual time points. RESULTS: Several women in this study reported appreciable oral symptoms just before or during menses. Mean PI (0.85 +/- 0.06) was almost identical at all time points. Despite this, GI was significantly higher (P = 0.0245) in OV (0.54 +/- 0.07) and in PM (0.5 +/- 0.08) than in M (0.38 +/- 0.07). Mean patient's PD (2.22 +/- 0.08 mm) and CAL (2.92 +/- 0.15 mm) was not significantly different between examinations. CONCLUSIONS: We observed changes in gingival scores during the menstrual cycles of periodontally healthy women. These changes need to be addressed when analyzing data from epidemiological and treatment studies in premenopausal women.

Adult↗