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Biomedical subjects

R Gilbert Triplett

Publications and source records attributed to R Gilbert Triplett.

10 recordsLinked to original sources
PubMed2006

Treatment of refractory facial pain diagnosed as atypical trigeminal neuralgia: a case report.

This case report describes an effective treatment protocol, the healing process, and the recovery of the patient to a pain-free status after more than 25 years of failed treatment for facial pain. Features of this case report include: 1. A procedure to produce a phenomenon useful as a pathognomonic sign of autonomic nervous system neuropathy, as a determination of the location of the origin of pain, and as a monitoring device for the effectiveness of treatment. 2. A digital pressure intervention procedure that appears effective as a treatment modality to relieve pain and to effect healing. 3. A method to improve posture of the body affecting the relationship of the maxilla to the mandible, the dental occlusion, and the etiology of facial pain. 4. A description of the nature and intensity of the different levels of the pain experienced in the face from the most severe state of pain to a no-pain condition. 5. A diagnosis using a diagnostic term that has developed since the initial diagnosis of atypical trigeminal neuralgia in this case.

Chronic Disease↗
PubMed2005

De novo bone induction by recombinant human bone morphogenetic protein-2 (rhBMP-2) in maxillary sinus floor augmentation.

PURPOSE: This phase II study was designed to evaluate 2 concentrations of recombinant human bone morphogenetic protein-2 (rhBMP-2) for safety and efficacy in inducing adequate bone for endosseous dental implant in patients requiring staged maxillary sinus floor augmentation. MATERIALS AND METHODS: Patients were treated with rhBMP-2 (via an absorbable collagen sponge [ACS]), at concentrations of 0.75 mg/mL (n = 18), 1.50 mg/mL (n = 17), or with bone graft (n = 13). Bone induction was assessed by alveolar ridge height, width, and density measurements from computed tomography scans obtained before and 4 months after treatment and 6 months post-functional loading of dental implants (density only). RESULTS: Mean increases in alveolar ridge height at 4 months after treatment were similar among the groups; 11.3 mm, 9.5 mm, and 10.2 mm, respectively, in the bone graft, 0.75 mg/mL, and 1.50 mg/mL rhBMP-2/ACS treatment groups. Mean increases in alveolar ridge width (buccal to lingual) at the crest of the ridge were statistically different among the treatment groups; 4.7 mm, 2.0 mm, and 2.0 mm, respectively, in the bone graft, 0.75 mg/mL, and 1.50 mg/mL treatment groups (P <or= .01 vs 0.75 mg/mL; P < .01 vs 1.50 mg/mL). At 4 months postoperative new bone density was statistically different among the treatment groups; 350 mg/cc, 84 mg/cc, and 134 mg/cc for the bone graft, 0.75 mg/mL, and 1.50 mg/mL rhBMP-2/ACS treatment groups, respectively (P = .003 vs 0.75 mg/mL, P = .0137 vs 1.50 mg/mL, P = .0188; 1.50 mg/mL vs 0.75 mg/mL). Core bone biopsies obtained at the time of dental implant placement confirmed normal bone formation. The proportion of patients who received dental implants that were functionally loaded and remained functional at 36 months post-functional loading was 62%, 67%, and 76% in the bone graft, 0.75 mg/mL, and 1.50 mg/mL rhBMP-2/ACS treatment groups, respectively. CONCLUSION: This study is the first randomized controlled trial demonstrating de novo organ tissue growth in humans from a recombinant human protein. rhBMP-2/ACS safely induced adequate bone for the placement and functional loading of endosseous dental implants in patients requiring staged maxillary sinus floor augmentation.

Alveolar Process↗
PubMed2004

Interactive imaging for implant planning, placement, and prosthesis construction.

PURPOSE: This review describes a new interactive imaging program that allows computed tomography (CT) images to be used to virtually place dental implants and construct a precise guide splint and final prosthesis for delivery at the time of implant placement. MATERIALS AND METHODS: Patients with edentulous arches were recruited to participate in a trial program to assess the feasibility of using CT images in a 3-dimensional image-based program (Oralim; Medicine NV, Belgium) for planning and placing dental implants. Patients meeting the criteria received a CT of the appropriate arch using a denture with radiopaque markers indexed to the opposing arch. Acquisition slices of 0.6 mm or less was required. The software allowed precise planning for implant placement after which the planned case was sent to a manufacturing facility for splint and prosthesis construction. RESULTS: The guide splint and final prosthesis were returned to the clinical site for implant placement. An implant map was provided for each patient showing the diameter and length of the implant and abutments to be used in each predetermined implant site. The surgery was accomplished without a flap, and the prosthesis was delivered immediately. Occlusion required only minor adjustments in all cases, and immediate function was accomplished. CONCLUSION: Interactive computer imaging can allow precise planning for implant position and the images can be used for guide splint and final prosthetic fabrication prior to surgery. This technology is powerful, easy to use, and is a significant advance in implant dentistry.

Computer-Aided Design↗
PubMed2004

Evaluation of ocular changes secondary to blowout fractures.

There has been extensive debate over the standard of care of orbital fractures. Entrapment, diplopia, and hypoglobus, with or without enophthalmos, are the most common clinical indications for surgical intervention. Evaluation of these injuries is often limited in the early postinjury period because of edema. In assessing the severity of the injury, the clinician often uses parameters such as changes in visual acuity, patient-reported diplopia, gross changes in globe position, and an evaluation of the extraocular muscles. Many of these parameters are only grossly assessed and therefore are not specifically documented and tracked. The decision to proceed with surgical intervention may be based only on these gross clinical findings. The purpose of this article is to present a reliable and repeatable method for evaluating the degree of diplopia and the globe position of the orbital trauma patient by describing the use of the double Maddox rod test (Wilson Ophthalmic, Mustang, OK) and Hertel exophthalmometer (Wilson Ophthalmic). These methods can provide sequential documentation of the progression of the injury and help better define the need for surgical intervention and to follow the postoperative course.

Diagnostic Techniques, Ophthalmological↗
PubMed2003

Implant materials, design, and surface topographies: their influence on osseointegration of dental implants.

The purpose of this review is to describe commonly used dental implants with reference to their material composition, design factors, and surface topographies. The review includes a discussion of the biological principle of osseointegration and how this process of bone-implant interaction is influenced by different implant materials, designs, and surface characteristics

Dental Implantation, Endosseous↗
PubMedDate not supplied

Bone reduction surgical guide for the Novum implant procedure: technical note.

The Novum System offers a unique opportunity to create a definitive, immediately loaded fixed prosthesis on the edentulous mandible for patients who meet specific presurgical criteria. Since this system is based on precisely placed implants and prefabricated bar structures, the surgical techniques are critical in obtaining a satisfactory result. It is especially important that the bone reduction required to create space for the implants and bar assembly be in the proper plane and deep enough to leave room for eventually setting and processing teeth. The surgical guide described here can be an important adjunct during bone reduction to assure proper spatial positioning of the preformed titanium bars. Mounted casts of the correct or corrected maxillary dentition and mandibular arch are required at the appropriate vertical dimension of occlusion. The mandibular cast is reduced in prescribed dimensions to allow the subsequent creation of a processed resin surgical guide for use during the initial stages of surgery. This guide, when used for bone reduction during surgery, eliminates the arbitrary removal of osseous structure and helps assure the plane of implant placement is appropriate for each patient. When used routinely, a significant complication of the Novum procedure can be minimized or eliminated completely. Setting of teeth and processing are subsequently simplified, especially in the posterior dimensions, with this guide technique.

Dental Arch↗
PubMedDate not supplied

Rescue procedure for the Brånemark Novum protocol.

The Brånemark Novum protocol for immediate functional loading of a mandibular fixed implant-supported prosthesis has been an effective alternative for selected patients. In the event of the loss of an implant, a rescue set that allows continuous use of the original fixed restoration while restoring tripod osseointegrated support at the implant level is available.

Dental Implantation, Endosseous↗
PubMedDate not supplied

Proximal tibia bone harvest: review of technique, complications, and use in maxillofacial surgery.

Autologous bone grafts for alveolar ridge augmentation are the gold standard for restoring atrophic residual ridges in preprosthetic surgery. Many indications, donor sites, and techniques have been reported. The purpose of this article is to review the anatomy, surgical technique, and potential complications associated with proximal tibia bone harvest. A consecutive series of 44 patients who underwent proximal tibia bone graft harvest between 2000 and 2003 was studied by retrospective chart review. Five major and 7 minor complications were observed; overall morbidity was low. A significant amount of corticocancellous bone may be harvested from the proximal tibia with minimal morbidity.

Adult↗
PubMedDate not supplied

Osseointegration of dental implants complexed with rhBMP-2: a comparative histomorphometric and radiographic evaluation.

PURPOSE: To evaluate the effect of rhBMP-2 on implant osseointegration using histomorphometric and radiographic imaging analyses and determine the diagnostic accuracy of periapical radiographs regarding clinical bone-implant contact levels. MATERIALS AND METHODS: Hollow-cylinder implants were filled with an absorbable collagen sponge soaked with recombinant human bone morphogenetic protein-2 (rhBMP-2) or left empty and implanted in the mandibles of dogs. Animals were followed for 2, 4, 8, or 12 weeks. At the end of each time interval, the animals were sacrificed and specimens were collected for histomorphometric and radiographic evaluation of the bone-implant contact levels. RESULTS: Both groups exhibited the same mean histologic bone-implant contact on the outer surface of the implant, except for the 4-week group. The radiographic evaluation of bone-implant contact overestimated the actual osseointegration levels by at least 30%, a significant amount. DISCUSSION: The osteoinductive and regenerative potential of rhBMP-2 is of clinical benefit in cases where bone augmentation is indicated and improved levels of osseointegration are expected. Radiographic evaluation has been the most widely employed technique in clinical practice for assessing bone levels around dental implants and comparing changes over time. However, there is a limit to the diagnostic accuracy of conventional radiographs when compared to the data obtained by histologic analysis. CONCLUSION: Application of rhBMP-2 within the confined boundaries of the hollow chamber of the implant had a limited effect on the osseointegration level along its outer surface, perhaps because of physically restricted diffusion. Radiographic evaluation resulted in the overestimation of bone-implant contact, and poor correlation with the histomorphometric data was found.

Animals↗