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Biomedical subjects

Ofer Moses

Publications and source records attributed to Ofer Moses.

12 recordsLinked to original sources
PubMed2006

Comparative study of two root coverage procedures: a 24-month follow-up multicenter study.

BACKGROUND: Treatment alternatives to cover exposed root surfaces include free grafts, pedicle flaps, and barrier membranes. This 24-month follow-up study clinically evaluated the long-term effect of a coronally advanced flap procedure with the additional use of enamel matrix derivative (EMD) to treat gingival recession versus the subpedicle connective tissue graft (CTG) procedure. METHODS: Miller Class I or II buccal recession-type defects in the anterior teeth or premolars in 65 patients (28 in EMD and 37 in CTG groups) were treated in several centers. At baseline and 12 and 24 months post-treatment, vertical recession defect (VRD), height of keratinized tissue (HKT), and probing depth (PD) were recorded, and the percentage of root coverage (PRC) of the original defect was calculated. Student t test, analysis of variance, and analysis of covariance were used for statistical analyses. RESULTS: At 12- and 24-month evaluations, PRC was 73.2% (SD=15.58%) and 76.9% (SD=16.77%) in the EMD group and 86.8% (SD=12.48%) and 84.3% (SD=13.32%) in the CTG group, respectively (P<0.001). Differences between groups were statistically significant (P=0.002). Baseline HKT was 1.07 mm (SD=0.66 mm) in the EMD group and 1.65 mm (SD=0.92 mm) in the CTG group. At 12 and 24 months, values were 1.75 mm (SD=0.59 mm) and 2.25 mm (SD=0.52 mm) in the EMD group and 4.24 mm (SD=0.89 mm) and 4.05 mm (SD=0.94 mm) in the CTG group, respectively. Differences in HKT were statistically significant within (EMD: P<0.001; CTG: P=0.017) and between (P<0.001) groups. CONCLUSIONS: Both treatments proved clinically successful. CTG treatment showed a higher percentage of root coverage and HKT increase. EMD is a valuable, long-term effective treatment alternative to achieve root coverage together with an increase in HKT.

Adolescent↗
PubMed2006

Effect of enamel matrix protein derivative on healing of surgical supra-infrabony periodontal defects in the rat molar: a histomorphometric study.

BACKGROUND: Enamel matrix protein derivative (EMD) has proven to enhance periodontal regeneration in human and animal studies. The present histomorphometric study evaluated healing of combined supra-infrabony periodontal defects with EMD. METHODS: The study comprised two groups of 10 Wistar rats each, 7 to 8 months old. Bony defects were created on the mesial aspect of the mesial root of the first maxillary molar. The root surface was planed and 24% EDTA gel applied for 2 minutes and then rinsed with water. In the study group, EMD was applied, and in the control group, only propylene glycol alginate was applied. Animals were sacrificed 12 weeks after surgery, and block sections were removed, demineralized, and embedded in paraffin. For histomorphometric analysis, three sections from the central area of the defect were selected. Root, surgical defect, epithelial attachment, sulcus, supracrestal connective tissue, ankylosis, and the length and area of new cementum and new bone were measured. RESULTS: No statistically significant differences between the two groups were found for root and defect measures. The remaining parameters were calculated as a percentage of the defect. In the study group, smaller gingival recession (P = 0.05), deeper gingival sulcus (P = 0.05), and shorter junctional epithelium (P = 0.01) were found. New cementum was observed in the study group only (P = 0.02). Ankylosis was six times larger in the control group but not statistically significant. New bone formation was similar in both groups. CONCLUSION: Enamel matrix protein derivative enhanced periodontal healing in this model by reducing gingival recession and junctional epithelium along the root surface and enhancing the formation of new cementum.

Alveolar Process↗
PubMed2006

Interaction of chlorhexidine with smooth and rough types of titanium surfaces.

BACKGROUND: Chlorhexidine (CHX) digluconate exerts plaque inhibitory efficacy in the natural dentition environment due to a superior degree of persistence at the tooth surface. The purpose of the present study was to assess the interaction of CHX with titanium surfaces to estimate its antiplaque potential in the peri-implant environment. METHODS: Saliva-coated machined smooth (S) and sand-blasted acid-etched rough (R) titanium disks were soaked in either 0.1% or 0.2% CHX solution. After 24 hours, CHX amounts that were adsorbed, washed out, and desorbed from the titanium surfaces were determined spectrophotometrically at 230 nm. The antibacterial activity of CHX-treated titanium disks was assessed by measuring bacterial inhibition zones on Streptococcus mutans lawns. RESULTS: Titanium disks adsorbed 3% to 8% of the available CHX, which was significantly higher with 0.2% CHX (P<0.001) than with 0.1% CHX and two-fold higher on the R titanium disks compared to S titanium surface (P<0.001). After rinsing with water, 2.2% of the adsorbed CHX was washed out. Over 24 hours, S- and R-type disks released 1.1% and 0.6% of the adsorbed agent, respectively. Larger bacterial inhibition zones were obtained with 0.2% CHX and in R disks compared to S disks. CONCLUSIONS: CHX displayed persistence at the titanium surface. The adsorption level and bacterial growth inhibition were affected by CHX concentration and titanium surface characteristics, with higher levels of adsorption and antibacterial activity with 0.2% CHX and rough titanium surface. The slow CHX release rate suggests persistence of this agent at the titanium-pellicle surface, which can provide a long-term antiplaque effect.

Adsorption↗
PubMed2005

Healing of dehiscence-type defects in implants placed together with different barrier membranes: a comparative clinical study.

OBJECTIVE: Premature exposure of membranes used in guided bone regeneration (GBR) results in decreased bone formation. The effect of an expanded polytetrafluoroethylene (e-PTFE) and two collagen membrane on bone healing of buccal dehiscence defects around implants in cases with and without premature membrane exposure was clinically evaluated. METHODS: Three groups were established: Group OS (Ossix, n=73 implants, 41 patients), Group BG (Bio-Gide, n=53 implants, 28 patients) and Group GT (e-PTFE, Gore-Tex, n=34 implants, 17 patients). Defect height and width were measured at the time of implant placement and at second stage surgery. Surface area was calculated as half ellipses. When several implants were placed simultaneously, a mean of their defect width and height was calculated. RESULTS: Mean percentage reduction of defect area (92.2+/-13.78% Group OS, 94.6+/-6.69% Group BG, and 97.3+/-4.91% Group GT) and height (81.6+/-23.19%, 85.4+/-12.26%, and 93.4+/-9.39% respectively) did not show statistically significant differences between groups. Differences between groups were not statistically significant for all parameters when cases without spontaneous membrane exposure were compared. However, differences were significant when spontaneous membrane exposure occurred. Mean percentage reduction of defect area among cases where membrane exposure occurred was 91.5+/-10.86% Group OS, 71.5+/-8.61% Group BG, and 73.7+/-13.97% Group GT. Mean percentage reduction of defect height among cases with membrane exposure was 76.4+/-18.28%, 53.4+/-9.86%, and 49.4+/-11.05%, respectively. CONCLUSIONS: Premature exposure of membranes and subsequent and consequent exposure of implants results in impaired bone healing. Certain barrier membranes, as used in group OS, are apparently capable of supporting gingival healing even when prematurely exposed that could be advantageous in GBR procedures.

Analysis of Variance↗
PubMed2005

Guided periodontal regeneration using bilayered collagen membranes and bovine bone mineral in fenestration defects in the canine.

This study was performed to evaluate the effect of deproteinized bovine porous bone mineral (BBM) and BBM-collagen (BBMC) used alone or in combination with a bilayer collagen membrane in guided periodontal regeneration. In 12 dogs, contralateral surgical circular fenestration defects 5 mm in diameter were produced at the midbuccal aspect of the alveolar bone in 24 maxillary canines. Bone, periodontal ligament, and cementum were completely removed. Experimental sites were filled with BBM or BBMC. Bilayered collagen membranes covered half the experimental sites (BBM+M and BBMC+M), and the other half were left uncovered. Control sites remained empty; half were covered with collagen membranes (cont+M) and the underlying space spontaneously filled with blood, and half were left uncovered (cont). Three months postsurgery, undecalcified sections were prepared. Measurements were made using a caliper on a projection microscope, and the surface area of new bone and BBM particles within the healed surgical defect was evaluated using the point-counting method. In the experimental defects, new cementum covered 31% to 67% of the exposed dentin, with a significant difference between defects covered with membranes and defects that were not covered (P < .05). New cementum in the control (unfilled) defects also differed significantly between covered and uncovered defects. New bone growth presented a pattern similar to the cementum. There was no statistical difference between defects treated with BBM and BBMC, within both covered and uncovered groups. There was less connective tissue in the covered defects than in the uncovered defects (P < .05). The defects were filled with new bone, new connective tissue/bone marrow, and bovine bone particles. New bone area fraction was 23.4% to 25.2% in defects filled with BBMC and BBM, respectively (P = NS). Bone fraction area in membrane-covered defects ranged from 34.4% to 36.8% in experimental defects (P = NS). All membrane-treated defects showed higher values for bone area fraction in comparison to the uncovered control defects. Particle area fraction ranged between 17.4% and 26.2%, with only BBMC and BBM+M defects showing a statistically significant difference (P < .05). Defects filled with submembranous blood clot exhibited significantly more new cementum and bone regeneration than experimental defects filled with BBM or BBMC. Treatment of defects with BBM or BBMC showed similar influences on bone and cementum regeneration in fenestration periodontal defects. The presence or absence of bilayered collagen membranes was the predominant factor influencing bone and cementum regeneration.

Absorbable Implants↗
PubMed2004

A multicenter comparative study of two root coverage procedures: coronally advanced flap with addition of enamel matrix proteins and subpedicle connective tissue graft.

BACKGROUND: Free grafts, pedicle flaps, and barrier membranes have been used to cover exposed root surfaces. The aim of the present study was to evaluate the clinical efficacy of a coronally advanced flap procedure with the additional use of enamel matrix protein derivative (EMD) to treat gingival recession and to compare it to the subpedicle connective tissue graft procedure (CTG). METHODS: The study was conducted in six different periodontal clinics. Miller Class I or II buccal recession type defects in the anterior or premolar teeth were treated in 70 consecutive patients, 30 with EMD and 40 with CTG. At baseline and 6 and 12 months post-surgical treatment, vertical recession defect, defined as the distance from cemento-enamel junction to gingival margin; width of keratinized tissue; and probing depth were recorded and the percentage of coverage of the original defect was calculated. Statistical analyses consisted of t-test, analysis of variance, and analysis of covariance. RESULTS: At 6 months, percent of root coverage was 77.4% +/- 11.92% in EMD and 84.1% +/- 11.97% in CTG (statistically significant at P = 0.024). At 12 months, percent of root coverage in EMD was 71.7% +/- 16.14% and 87.0% +/- 12.22% in CTG; again, differences between groups were statistically significant (P < 0.001). Differences between the 6- and 12-month vertical recession defect and percent of root coverage recordings within each group were also statistically significant. CONCLUSIONS: The connective tissue graft procedure was superior to the coronally positioned flap with the addition of enamel matrix proteins derivative in percentage of coverage and increase in width of keratinized tissue. The EMD procedure is a predictable treatment for root coverage that is relatively easy to perform and presents low patient morbidity, and is appropriate especially where a substantial increase in the width of keratinized tissue is not of prime importance.

Adolescent↗
PubMed2004

Tetracycline impregnation delays collagen membrane degradation in vivo.

BACKGROUND: Guided tissue and bone regeneration using bioabsorbable collagen membranes is a common practice. Collagen promotes progenitor cell adhesion, chemotaxis, homeostasis, and physiologic degradation with low immunogenicity, which makes it an ideal material for barrier preparation. Collagen membranes have to maintain integrity for a proper time, thus ensuring successful cell exclusion. Early collagen membrane degradation is detrimental for the success of regenerative procedures. This in vivo study was conducted to evaluate the effect of soaking collagen membranes in different tetracycline hydrochloride (TCN) concentration solutions on its degradation. METHODS: Five mm disks of collagen membrane were soaked in either 100 mg/ml TCN (group 100) or 50 mg/ml TCN (group 50); a group of non-treated disks served as controls. All disks were labeled with aminohexanoyl-biotin-N-hydroxy-succinimide ester (biotin) and implanted in rat calvaria bone. Block sections were taken after 3 weeks and histological slides stained with horseradish peroxidase (HRP) to detect remnants of biotinylated collagen. Staining intensity was analyzed by image-analysis software taking quadruplicate measurements of a 500 microm2 area each. Data were analyzed using analysis of variance (ANOVA) with repeated measures and paired t test with Bonferroni correction. RESULTS: Staining intensity of membranes in group 100 was > 5-fold higher than the control while group 50 exhibited > 11-fold higher intensity than the control and > 2.5-fold higher than the 100. All of these differences were statistically significant (P < 0.001). CONCLUSION: Soaking collagen membranes in 50 mg/ml TCN solution is a useful, practical, and simple tool to slow membrane degradation.

Absorbable Implants↗
PubMed2003

Scanning electron microscope evaluation of two methods of resharpening periodontal curets: a comparative study.

BACKGROUND: Effective root planing demands sharp cutting edges on dental curets. However, after several strokes, they become dull and must be resharpened frequently. The purpose of this study was to evaluate by scanning electron microscopy (SEM) the quality of the cutting edge of periodontal curets resharpened by 2 different methods. METHODS: Forty new detachable Gracey curets were used in this study. After similar blunting, all instruments were resharpened either with 10 strokes using an Arkansas fine-grit sharpening stone (AR), or with 7 strokes using a high-grit and -density aluminum oxide stone (CH). The cutting edges of each instrument were examined using SEM at 1 mm and 2 mm from the tip before and after the resharpening procedure. Bevel measurement and the amount of functional and non-functional wire edges (WE) on the cutting edge were evaluated. Data were statistically analyzed using analysis of variance (ANOVA) with repeated measures, 2-way ANOVA, and Fisher's exact test. RESULTS: After blunting and resharpening, differences in bevel between groups were statistically non-significant. Generally, after resharpening, there were significantly more functional and non-functional WE in the AR group than in the CH group. There were significantly more instruments with a complete absence of WE in the CH group. CONCLUSIONS: The CH stone resulted in a smoother and better cutting edge than the AR stone. The procedure was easy to perform and required fewer strokes of the curet on the stone.

Aluminum Oxide↗
PubMed2002

Healing of marginal defects at implants placed in fresh extraction sockets or after 4-6 weeks of healing. A comparative study.

The purpose of this study was to evaluate the clinical healing of buccal marginal defects around implants placed in fresh extraction sockets or after several weeks together with barrier membranes and bone graft. Two implant placement protocols were compared: delayed-immediate sites primarily closed by a rotated (full thickness) palatal flap (RPF) at the time of tooth extraction and implantation after 4-6 weeks (Group 1, 24 patients, n = 31 implants) and immediate procedures (into fresh extraction sockets) primarily closed by a rotated split palatal flap (RSPF) (Group 2, 19 patients, n = 23 implants). One or two proximal maxillary implants were simultaneously placed. Height and width of the marginal defect were measured at the time of implant placement and after 6-8 months, at second stage surgery. For Groups 1 and 2, the mean percentage of the reduced defect height was 91.2% (+/- 9.12) and 77.4% (+/- 16.92), respectively, and the mean percentage area of the reduced defect was 97.2% (+/- 3.85) and 90.2% (+/- 9.15), respectively. Differences between groups were statistically significant. Groups were subdivided according to number of implants placed (one or two). Spontaneous implant cover screw exposure was seen only in Group 2. There was an association between the number of implants simultaneously placed and the occurrence of spontaneous exposure. The mean percentage reduction of the defect height and area was significantly smaller where there was spontaneous exposure. Significant differences were found for mean percentage reduction of the defect height and area only between the two implant subgroups within each group.

Alveolar Ridge Augmentation↗
PubMed2002

Root coverage of advanced gingival recession: a comparative study between acellular dermal matrix allograft and subepithelial connective tissue grafts.

BACKGROUND: Acellular dermal matrix allograft (ADMA) has successfully been applied as a substitute for free connective tissue grafts (CTG) in various periodontal procedures, including root coverage. The purpose of this study was to clinically compare the efficiency of ADMA and CTG in the treatment of gingival recessions > or = 4 mm. METHODS: Seven patients with bilateral recession lesions participated. Fourteen teeth presenting gingival recessions > or = 4 mm were randomly treated with ADMA or CTG covered by coronally advanced flaps. Recession, probing depth, and width of keratinized tissue were measured preoperatively and 12 months postoperatively. Changes in these clinical parameters were calculated within and compared between groups and analyzed statistically. RESULTS: Baseline recession, probing depth, and keratinized tissue width were similar for both groups. At 12 months, root coverage gain was 4.57 mm (89.1%) versus 4.29 mm (88.7%) (P = NS), and keratinized tissue gain was 0.86 mm (36%) versus 2.14 mm (107%) (P < 0.05) for ADMA and CTG, respectively. Probing depth remained unchanged (0.22 mm/0 mm), with no difference between the groups. CONCLUSIONS: Recession defects may be covered using ADMA or CTG, with no practical difference. However, CTG results in significantly greater gain of keratinized gingiva.

Adult↗
PubMed2002

Rotated palatal flap. A surgical approach to increase keratinized tissue width in maxillary implant uncovering: technique and clinical evaluation.

Although keratinized mucosa is not indispensible for the maintenance of periimplant tissue health if oral hygiene is adequate, its presence is generally advocated. The establishment of an adequate zone of gingiva that is firmly attached to the underlying periosteum and bone is important for the overall long-term success of implant-supported oral rehabilitation. The purpose of this study was to describe and evaluate a surgical approach for maxillary implant uncovering that augments the buccal periimplant keratinized tissue while avoiding a large zone of exposed implant-supporting bone by using a rotated palatal flap. The study comprised 40 implants that were uncovered in 13 patients using a combination of full-thickness buccally repositioned and rotated palatal flaps. Within each patient, the mean preoperative width of keratinized mucosa was 0.19 mm (SD 0.316), and the mean postoperative width was 3.45 mm (SD 0.489). The difference between post- and preoperative widths was 3.26 mm (SD 0.498), which was statistically significant according to a paired t test (P < .0001). The main advantages of this technique are simplicity and predictability, and it consistently provides a wider zone of keratinized gingiva in the buccal aspect of the future maxillary implant-supported restoration.

Dental Abutments↗