This study was designed to determine if the following two variables influence the predictability of the presence of the interproximal papilla between single implant supported crown adjacent to a natural tooth: a) the vertical measurement from the crest of bone on the natural tooth to the contact point, and b) the horizontal measurement from the platform of the implant to the adjacent tooth root. Retrospective data from a multi-private practice based research network (PBRN) and from a graduate teaching institution were analyzed specific to the maxillary anterior aesthetic zones. 116 patients who had 139 dental implants restored for at least 6 months, with mesial and/or distal sites (N= 253) were included in the analysis. Assessments of the implant position based on osseous crestal topography were conducted using standardized radiographs which were digitized and interpreted with “Access” software. The gingival papilla morphology was assessed using the Jemt Papillary Index from calibrated digital clinical photographs. Contrary to previously published data, our results indicate that the presence of interproximal papillae is independent of the vertical and horizontal measurements investigated.

This study was designed to determine if the following two variables influence the predictability of the presence of the interproximal papilla between single implant supported crown adjacent to a natural tooth: a) the vertical measurement from the crest of bone on the natural tooth to the contact point, and b) the horizontal measurement from the platform of the implant to the adjacent tooth root. Retrospective data from a multi-private practice based research network (PBRN) and from a graduate teaching institution were analyzed specific to the maxillary anterior aesthetic zones. 116 patients who had 139 dental implants restored for at least 6 months, with mesial and/or distal sites (N= 253) were included in the analysis. Assessments of the implant position based on osseous crestal topography were conducted using standardized radiographs which were digitized and interpreted with “Access” software. The gingival papilla morphology was assessed using the Jemt Papillary Index from calibrated digital clinical photographs. Contrary to previously published data, our results indicate that the presence of interproximal papillae is independent of the vertical and horizontal measurements investigated.

The clinical implications of a diseased papilla at endoscopic retrograde cholangiopancreatography (ERCP) are ambiguous. Is the diseased appearance caused by inflammation or tumor? Is there stenosis? Could papillary disease be the consequence of pathology elsewhere in the biliary–pancreatic tract? What should be the next step? Of 17 patients with a “diseased papilla” among 284 consecutive patients who underwent ERCP for customary indications, 10 had papillitis [inflamed papilla] confirmed. The two major associations of papillitis were common bile duct stones (50%) and biliary or pancreatic surgery (40%). Cholestatic jaundice (60%) and pain (50%) were the major presenting symptoms of papillitis. Six patients had tumor with progressive jaundice (83%). Visually and cholangiographically, it may be difficult to distinguish papillitis from tumor. These concepts will be helpful in the evaluation and management of patients who have a “diseased papilla”. Do they sound like wild tales?

No description available.

Made available in DSpace on 2014-06-11T19:31:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2004-02-27Bitstream added on 2014-06-13T19:41:03Z : No. of bitstreams: 1 santos_das_dr_jabo.pdf: 2572223 bytes, checksum: aea5701db88f8bf27923f6c9ed630f4e (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Este estudo utilizou 15 fêmeas bufalinas, provenientes de abatedouros frigoríficos dos estados do Maranhão, São Paulo e Paraná para estudo morfológico, macroscópico, microscópico e morfométrico das papilas mamárias. O material para estudo macroscópico foi pesado, medido e fotografado, e os resultados do peso papilar foram de: cranial direita (PCD) 20, 95g; caudal direita (PCaD) 21,49g; cranial esquerda (PCE) 23,52g e para caudal esquerda (PCaE) 21,35g. Os valores médios para comprimento do ducto papilar, número de pregas e comprimento da cisterna papilar foram de: 0,67cm; 5,5 e 2,17cm para PCD; 0,62cm; 6,0 e 2,26cm para PCaD; 0,71cm; 6,0 e 2,26cm para PCE e 0,74cm; 5,7 e 2,57cm para PCaE, respectivamente. A análise de correlação de Pearson indicou não existir relação entre o peso corpóreo e o peso glandular. Fragmentos das regiões proximal, média e distal foram colhidos e fixados em solução aquosa de formol 10%, cortados com 10, 20 e 40mm e corados em Azan, Picrocírus F3BA e Weigert-Van Gieson, para a análise mesoscópica. Cortes com 5mm corados em HE, tricrômico de Masson foram utilizados para a análise histológica e morfométrica. A estrutura histológica da papila mamária em búfalas mostrou-se similar aquela dos bovinos, a camada muscular é formada por fibras em duas disposições, a interna circular e a externa longitudinal, e com epitélio cúbico biestratificado em quase toda a sua extensão. Na porção média da papila a camada mais desenvolvida é a muscular com 22,90mm de espessura, a qual possui grande quantidade de tecido conjuntivo denso (7,10 mm). / Fifteen Murrah female buffaloes, proceeding from abattoirs of Maranhão, São Paulo and Paraná states, were used in this study and submitted for morphologic, macroscopic, microscopic and morphometric analysis of the mammary papilla. The material for macroscopic study was weighed, measured and photographed, the results for papillary weight had been: cranial right (PCD) 20.95g; caudal right (PCaD) 21.49g; left cranial (PCE) 23.52g and for left caudal (PCaE) 21.35g. The average values for the papillary duct length, number of folds and length of the papillary cistern had been respectively for PCD: 0.67cm, 5.5, 2.17cm; PCaD: 0.62cm, 6.0, 2.26cm; PCE: 0.71cm, 6.0, 2.26cm and PcaE: 0.74cm, 5.7, 2.57cm. The analysis of de Pearson correlation coefficient test between corporeal weight and the glandular weight indicated not relation existence. Proximal, meddle and distal tissue samples had been collected and fixed in 10% formol watery solution and cut with 10-20-40mm and stained in Azan, Picrosirus F3BA and Weigert-Van Gieson, for the mesoscopic analysis. Cuts of 5mm and had stained in HE and Masson's trichrome were submitted to the morphologic and morphometric analysis. Buffalo's' mammary papilla structure revealed to be similar to the described for bovines, the muscular layer was composed by two bundles of smooth muscle fibers, the external circular layer and the longitudinal external one. The mucosa was bi-stratified cuboidal ephitelia in almost all its extension. The papilla meddle portion muscular layer was 22.90mm of thickness which contained large amount of connective tissue (7.10mm).

The original study design called for twenty patients. Fourteen patients with 13 implants have thus far been recruited for a prospective proof of principle study to assess the effect of addition of Platelet Rich Fibrin (PRF) on interproximal papillary height (I.P.H.) at the restorative line angles when used during the second stage uncovering procedure for dental implants. The secondary objective of this study was to assess the effect on the height of the direct interproximal tissue thickness (I.T.T.) at 6 weeks following uncovering. Implants placed 3 or more months prior at Boston University School of Dental Medicine Periodontics Department were scheduled to be uncovered by the principal investigator. Second stage uncovering was performed with a conventional mid-crestal incision to place standard healing abutments. PRF membrane(s) were inserted around the implants before flap closure in an attempt to augment or thicken the interproximal papillary area. The I.P.H. was measured at the four line angles of each abutment at the highest aspect of the interproximal tissue immediately following the uncovering procedure and at 2, 4 & 6 week intervals. I.T.T. was also measured prior to surgical exposure and at 6 weeks following the uncovering procedure. Results: The use of PRF membranes around dental implants did not significantly improve I.P.H. However, a positive correlation was observed between the use of P.R.F and I.T.T. Further studies are warranted to assess the effect of PRF on the peri-implant papillary tissue.

A ausência ou perda da papila interdental cria deficiência estética, problemas fonéticos, impactação alimentar e gera muita expectativa ao paciente. Até o momento, o tratamento da ausência ou perda da papila interdental tem sido mal sucedido e não há estudos que indiquem que a regeneração da papila é um resultado previsível. O objetivo deste estudo foi avaliar a efetividade da injeção de gel de ácido hialurônico de origem não animal na redução ou eliminação da deficiência de papila entre dentes naturais comparativamente ao tratamento por meio de enxerto de tecido conjuntivo subepitelial. Foram avaliados neste estudo 20 sítios de 6 pacientes de ambos os sexos, com idade variável de 29 a 62 anos, apresentando deficiência de papila entre dentes naturais, na região anterior superior, em pelo menos dois dentes. Os 20 sítios tratados foram aleatoriamente divididos em dois grupos, de acordo com o tratamento para correção da deficiência de papila por meio de enxerto de tecido conjuntivo subepitelial (grupo controle) ou por meio de injeção de gel de ácido hialurônico (grupo teste). Um examinador único, calibrado, avaliou a distância da ponta da papila ao ponto de contato com auxílio de sonda periodontal milimetrada antes e aos 1, 3 e 6 meses após o tratamento. Além disso, foram investigados, nos sítios tratados, as medidas de profundidade de sondagem, nível de inserção, índice de sangramento do sulco, índice de placa, distância do ponto de contato à crista óssea alveolar, distância da ponta da papila à crista óssea alveolar e largura da papila. Os resultados demonstraram que aos 6 meses de pósoperatório o percentual de mudança na altura da papila foi maior no grupo teste (14,94% ± 21,35%) do que no grupo controle (-1,39% ± 31,46%), entretanto sem diferenças significantes entre os grupos (p> 0.05). Não houve variação estatisticamente significante na largura da papila antes e aos 4 meses após o tratamento nos grupos teste (p= 0.09) e controle (p= 0.16), assim como não houve variação significativa na distância entre a ponta da papila e a crista óssea alveolar. Houve melhora significativa do Índice de Estética Rosa (IER) observado aos 6 meses de acompanhamento em comparação com a condição inicial no grupo teste (p= 0.0078; Wilcoxon), enquanto que não houve mudança significativa no IER observado no grupo controle aos 6 meses de acompanhamento (p= 0.35). Os resultados obtidos permitiram concluir que o tratamento da deficiência de papila por meio de injeção de gel de ácido hialurônico promove melhora da deficiência de papila, similar aos resultados obtidos com o tratamento por meio de enxerto de tecido conjuntivo subepitelial, porém com melhora estética significativa relacionada especialmente às características de cor e textura do tecido relativamente aos tecidos moles adjacentes. / The absence or loss of interdental papilla creates an esthetic deficiency, phonetic problems and food impaction and generates a lot of expectation for the patient. Until now, the treatment for absence or loss of interdental papilla is unsuccessful e and there are no researches that show that the papilla regeneration is a predictable outcome. The aim of this study was to evaluate the effectivity of a non-animal originated hyaluronic acid injection in the reduction or elimination of papilla deficiency between natural teeth in comparison to a sub epithelial connective tissue graft treatment. The analysis was made on 20 sites in 6 patients, both genders, 29 - 62 years, showing deficiency in the papilla between natural teeth in the upper anterior region in at least two teeth. The 20 sites treated were randomly divided into two groups, according to the treatment by subepithelial connective tissue graft (control group) or by hyaluronic acid injection (test group). A single calibrated examiner evaluated the distance between the tip of the papilla to the contact point using a graduated periodontal probe before the treatment and 1, 3 and 6 months after it. Besides, it were investigated probing pocket depth, clinical attachment level, gingival bleeding index, plaque index, distance from papilla to alveolar crest, distance from contact point to alveolar crest and width of the papilla. The results showed that 6 months after the procedure, the percentage of change in the papilla level was higher in the test group (14,94% ± 21,35%) than in the control group (-1,39% ± 31,46%), though not statistically significant (p>0.05). There was no significant difference variation in the width of the papilla before and 4 months after the treatment in test group (p=0.09) and control group (p=0.16), and there was no significant difference variation in the distance between the tip of the papilla and the alveolar bone crest. There was significant improvement of the Pink Esthetic Score (PES) after 6 months in comparison to the initial condition in test group (p=0.0078; Wilcoxon), while there was no significant difference in the PES in control group 6 months after treatment (p=0.35). The results allow to conclude that the treatment for of the papilla deficiency using hyaluronic acid injection promotes improvement, similar to the results of the sub epithelial connective tissue graft treatment, but with significant esthetic improvement related specially to the color and texture characteristics of the adjacent soft tissues.

Losing interdental gingival tissue can lead to a phenomemon known as black triangles. The absence of the interdental papilla (the so called 'black triangle disease') can cause patients problems with appearance, phonetics and with the impaction of food. The gingival soft tissues form the framework and the architecture of the dentition and, in the maxillary anterior region of the mouth, play an important role in dental aesthetics. If there is any change to the shape and/or symmetry of the gingivae through developmental, pathologic or iatrogenic factors, there can be a significant and detrimental change in the appearance and balance of the natural dentition and any prosthetic tooth replacement. In this clinical research study, we find that the radiographic measurement of the distance of the contact point to the crest of the bone is a valid and reliable tool to use. This method also adds strength to predicting black triangles as the results are similar to earlier studies and the numbers used in this study was nearly twice as much.

Molecular and behavioural characterisation of ovine dermal papilla cells performed in this study indicate they synthesise a highly specialised extracellular matrix (ECM). This is conserved between different species and distinguishes papilla cells from dermal fibroblasts with which they have a common origin. The composition of the dermal papilla ECM is temporally and spatially regulated during wool follicle development. It was shown that the ECM associated with dermal papilla cells in foetal sheep skin becomes specialised in regard to chondroitin sulphate synthesis prior to the appearance of follicle primordia. Chrondroitin sulphate and fibronectin were present in the ECM of dermal papilla cells throughout follicle development and during fibre production. Cellular differentiation antigen 44 was present in the ECM od papilla cells exclusively during the formation of dermal papilla, while laminin was present in the dermal papilla ECM of fibre producing follicles only. Co-operation between chondroitin sulphate, fibronectin, and CD44 in regulating the agrregative and proliferative behaviour of papilla cells was demonstrated in culture. Finally, the inhibition of proteoglycan synthesis in newborn mouse skin was found to disrupt the growth of existing follicles and the generation of new ones. Together these findings demonstrate that chondroitin sulphate is intimately associated with the earliest interactions between epithelial and mesenchymal cells during the formation of follicle primordia. It is likely that the interactions specifically involve fibronectin and CD44, and possibly other ECM molecules which have he effect of regulating the behaviour of papilla cells / Doctor of Philosophy (PhD)

Thesis (M.Sc.) (Honours) -- University of Western Sydney, Hawkesbury, 2001. / A thesis submitted in fulfilment of the requirements for the degree of Masters of Science (Honours) in the Centre for Advance [sic.] Food Research, University of Western Sydney, Hawkesbury Campus, July 2001. Bibliography : leaves 98-110.