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Biomedical subjects

R Weltman

Publications and source records attributed to R Weltman.

11 recordsLinked to original sources
PubMed2000

Treatment of intraosseous defects with bioabsorbable barriers alone or in combination with decalcified freeze-dried bone allograft: a randomized clinical trial.

BACKGROUND: This study clinically compares the outcomes obtained from the use of a bioabsorbable barrier device in combination with demineralized freeze-dried bone allograft (DFDBA) to the results obtained from the barrier device used alone in the treatment of human intraosseous defects. METHODS: The study consisted of 30 patients with one intraosseous periodontal defect each. The trial included defects with loss of attachment of > or = 6 mm, with a radiographically detectable defect of at least 4 mm and with at least 2 remaining osseous walls. After the hygienic phase, at baseline, probing depth (PD), clinical attachment level (CAL), and recession (REC) were measured. During open flap debridement, the defects were randomly assigned to receive either a polylactic acid (PLA) barrier in combination with DFDBA (test) or a PLA barrier alone (control). Additionally, baseline osseous intrasurgical measurements of the periodontal defect were obtained to evaluate the amount of bone regeneration. PD, CAL, and REC were remeasured at 6 and 12 months postsurgery and osseous measurements repeated at 12 months during a re-entry procedure. RESULTS: Two-sample t-test comparisons of mean PD, CAL, and REC measurements (mm) between test (PLA+DFDBA) and control (PLA alone) groups at baseline, PLA+DFDBA: PD = 7.3, CAL = 8.1, REC = -0.7; PLA-alone: PD = 7.9, CAL = 8.4, REC = -0.5, were not statistically different (P>0.05). The following mean changes (delta) at 6 months for the test and the control groups were: decreased PD = 3.6 and 4.0 mm; gain CAL = 2.7 and 3.1 mm; and increased REC = -0.8 and -0.8 mm, respectively. At 12 months the changes for the test and control groups were: decreased PD = 3.3 and 4.1 mm; gain CAL = 2.3 and 3.2 mm; and increased REC = -0.8 and -1.0 mm, respectively. Two-sample t-test comparisons between PD, CAL, and REC changes yielded no significant differences between treatments (P > 0.05), except for the change in CAL at 12 months in favor of the control group, P = 0.008. Comparisons of osseous measurements resulted in no significant differences between groups at baseline and at 12 months (P > 0.05). The intrabony defect filled on the average 3.72 mm for the test and 4.85 mm for the control group. The experimental defects showed a 4.73 mm defect depth reduction, while the control defects reduced 5.35 mm. Re-entry measurements of osseous crest resorption were 1.1 mm for the test and 0.61 mm for the control. CONCLUSIONS: In the intraosseous defects treated in this study, the addition of DFDBA to the GTR procedure did not significantly enhance the clinical results obtained with the GTR procedure alone.

Absorbable Implants↗
PubMed2000

Citric acid demineralization and subepithelial connective tissue grafts.

BACKGROUND: The present study was designed to evaluate the effect, if any, of citric acid root demineralization in the outcome of subepithelial connective tissue grafts performed to cover localized gingival recessions. METHODS: Thirty-six patients participated, each providing one gingival recession; 19 received citric acid demineralization, while 17 did not. All were treated surgically with subepithelial connective tissue grafts and followed for 6 months. At baseline and 6 months, the following parameters were recorded: plaque index, gingival index, recession height, probing depth, recession width, and amount of keratinized tissue. Data were analyzed statistically to 1) evaluate the results achieved with each procedure individually over time and 2) compare the results obtained with the 2 procedures after 6 months. RESULTS: Results showed significant reductions in recession height after 6 months independently of whether citric acid was applied or not (2.79+/-0.79 versus 2.56+/-0.73). Similarly, recession width was significantly reduced (3.74+/-1.19 versus 3.50 +/-0.73), and the width of keratinized tissue was significantly increased (2.47+/-1.6 versus 2.3+/-1.2). No significant changes in probing depth were found (-0.16+/-0.06 versus -0.13+/-0.81). No significant differences were found when both techniques were compared in any one of the parameters analyzed (all P >0.30). CONCLUSIONS: It is concluded that: 1) the subepithelial connective tissue graft procedure provides a satisfactory solution in the treatment of localized gingival recessions, and 2) citric acid demineralization does not affect the clinical outcome of the surgical technique.

Adolescent↗
PubMed1998

Effects of expanded polytetrafluoroethylene and polylactic acid barriers on healthy sites.

The configuration of the barrier devices to treat interproximal defects by guided tissue regeneration (GTR) necessitates inclusion of healthy adjacent teeth to secure the barriers in place. The purpose of this study was to evaluate the effects of expanded polytetrafluoroethylene (ePTFE) and polylactic acid (PLA) barrier devices on probing depth (PD), clinical attachment level (CAL), and crestal bone height in healthy sites. The study included 30 patients who were in an earlier study which compared the effects of GTR utilizing an ePTFE or a PLA barrier in intrabony defects. Thirty defects were randomly assigned to receive either a PLA (test) or an ePTFE barrier (control) after open flap debridement. The sites in this investigation included those healthy sites in the immediately adjacent non-affected teeth covered by the barriers. CAL and PD were measured at baseline and 12 months. Intrasurgical crestal bone height was recorded at the time of barrier placement and at a 12-month re-entry. Two-sample t-test comparisons of PD and CAL measurements between barrier device covered sites at baseline (PD: ePTFE, 2.32+/-0.51; PLA, 2.59+/-0.74; CAL: ePTFE, 2.71+/-0.66; PLA, 2.59+/-0.65 mm), and at one year (PD: ePTFE, 2.14+/-0.37; PLA, 2.07+/-0.56; CAL: ePTFE, 3.14+/-1.05; PLA, 2.75+/-0.73 mm) were not statistically different (P > 0.05). Paired t-test was utilized to compare changes in PD, CAL, and crestal bone height from baseline to 12 months. A statistically significant reduction in PD was found in the PLA group (delta = -0.52, P = 0.01) while no significant change was found in the ePTFE group (delta = -0.18, P = 0.18). Change in CAL was statistically significant in the ePTFE group (delta = 0.43, P = 0.02) while no significant change was found in the PLA group (delta = 0.16, P = 0.39). Crestal bone height changes from baseline to 12 months were statistically different for both groups (ePTFE, delta = 0.8 mm, P = 0.001; PLA, delta = 0.6 mm, P = 0.001). These resorptive changes, when compared between treatment groups were not statistically different (P > 0.05). In conclusion, the placement of ePTFE or PLA barriers on healthy sites resulted in probing depth reductions and loss of attachment of 0.5 mm or less. Additionally, both groups exhibited less than 1.0 mm of crestal bone resorption.

Adult↗
PubMed1997

Assessment of guided tissue regeneration procedures in intrabony defects with bioabsorbable and non-resorbable barriers.

THE PURPOSE OF THIS STUDY was to assess periodontal regenerative techniques in intrabony defects utilizing a bioabsorbable, polylactic acid (PLA) barrier or the non-resorbable, expanded polytetrafluoroethylene (ePTFE) barrier. Thirty patients (26 to 64 years old) each with one radiographically evident intrabony periodontal lesion of probing depth > or = 6 mm participated in a 12-month controlled clinical trial. The subjects were randomly divided into two independent groups. The test group (n = 16) received a PLA barrier. The control group (n = 14) received an ePTFE barrier. Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and bone fill were recorded by a single calibrated examiner not involved with the surgical treatment prior to surgery, and at 6, 9, and 12 months postsurgery. The treatment results were statistically analyzed utilizing two sets of data. The "averaged-site" data set consisted of values computed from the averaging of measurements from all sites encompassing the defect. The second data set was comprised of only the deepest measurement of the defect. Statistical tests used to analyze these data sets included the t-test and paired t-test for parametric data and the Wilcoxon rank sum test and the Wilcoxon signed rank test for non-parametric data. Analyses with both the averaged-site data and deepest-site data resulted in significant improvements in PD reductions, CAL, and bone fill, after 12 months of healing with both the PLA and ePTFE barrier devices. Comparisons of healing response between treatments found no significant differences when the averaged-site data were analyzed. When only the deepest site of the defect was considered, the control group resulted in significantly more attachment gain (ePTFE, 3.36 mm; PLA, 1.75 mm; P < 0.02) and shallower probing depths (ePTFE, 3.29 mm; PLA, 4.69 mm; P < 0.01) than the test group. In intrabony defects, the use of PLA or ePTFE barriers in GTR procedures yielded comparable clinical results; however, in this study, data analysis using the deepest site of the defect found, after 12 months of healing, significantly more attachment gain and shallower probing depths with ePTFE.

Adult↗
PubMed1995

Guided tissue regeneration. A status report for the American Journal of Dentistry.

This report reviews clinical results which have been obtained with guided tissue regeneration (GTR) using non-resorbable and resorbable materials. The report highlights the clinical factors that affect and that should be considered in order to improve the predictability of the results obtained after GTR. The indications for GTR procedures are reviewed and the surgical technique is described. The importance of periodontal maintenance, and the significance of adjunctive therapies in GTR procedures are also discussed. Based upon the vast scientific information and clinical experience with GTR, it can be stated that with the use of either resorbable or non-resorbable materials a new attachment, determined both clinically and histologically, will be promoted providing that the principles of GTR are properly implemented.

Animals↗
PubMed1991

Power drills to fenestrate exposed bone to stimulate wound healing.

Power drills can be used to stimulate the formation of granulation tissue over exposed cortical bone. These tools allow for the rapid fenestration and selective abrasion of large areas of exposed bone; fenestration and abrasion create the multiple bleeding points essential for the production of granulation tissue. The granulation tissue thus produced is allowed to grow out through the holes to cover bone. This procedure can be performed in an outpatient setting, usually without the need for either local or general anesthesia; it is particularly useful for patients considered to be poor risks for general anesthesia. Healing by granulation tissue is a somewhat slow process, but it has a high success rate, causes few complications, and produces very good cosmetic results. Two cases illustrate the method of fenestration of exposed cranial bone to stimulate granulation tissue. Specific instructions describe the needed care of exposed bone.

Aged↗
PubMed1986

Importance of complete cutaneous examination for the detection of malignant melanoma.

With the rate of melanoma increasing 1,000% in the past 50 years, the early detection of the disease is becoming more important. Data from 2,239 persons seen at the Manhattan Melanoma/Skin Cancer Detection Screening Program were analyzed to determine if a complete cutaneous examination would significantly increase the chance of detecting melanoma. Thirteen of the fourteen melanomas detected were on anatomic sites normally covered by clothing. Patients having complete skin examinations were 6.4 times more likely to have a melanoma detected than those having partial examinations (p = 0.025). These findings reinforce the importance of complete skin examination for the early detection of malignant melanoma.

Basal Cell Carcinoma↗