Andrea Ravidà

University of Michigan–Ann Arbor

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Hom‐Lay Wang

University of Michigan–Ann Arbor

Muhammad H. A. Saleh

University of Michigan–Ann Arbor

Shayan Barootchi

University of Michigan–Ann Arbor

Lorenzo Tavelli

Harvard University

Giuseppe Troiano

University of Foggia

Mustafa Tattan

University of Iowa

Musa Qazi

University of Pittsburgh

Matthew Galli

University of Michigan–Ann Arbor

István Urbán

Loma Linda University

Henry Greenwell

University of Louisville

Cooperative Institutions

University of Michigan–Ann Arbor

University of Milan

Universidad de Granada

Istituti di Ricovero e Cura a Carattere Scientifico

University of Pittsburgh

Lithuanian University of Health Sciences

John Wiley & Sons (United States)

University of Iowa

University of Foggia

University of Chieti-Pescara

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Periodontitis stage and grade modifies the benefit of regular supportive periodontal care in terms of need for retreatment and mean cumulative cost

Journal Of Clinical Periodontology (2023)

Muhammad H. A. Saleh Ann M. Decker Andrea Ravidà Hom‐Lay Wang Maurizio S. Tonetti

Abstract Aim This study aimed to characterize the periodontal breakdown during supportive periodontal care (SPC) and to quantify the corresponding cost‐effectiveness of periodontal therapy. Materials and Methods Data were obtained from charts of patients who received active periodontal therapy (APT) with a minimum follow‐up of ≥10 years. Analysis was done to identify factors associated with the incidence of additional sub‐gingival instrumentation (SGI) and/or surgery (SUR) during SPC and mean cumulative cost of recurrence was calculated. All relevant data were collected. Results In all, 442 patients were included. Over the follow‐up period, 62% of Stage I and II patients and 72% of Stage III and IV patients required further treatment following the APT; 56.5% of SGI patients and 78.6% of SUR patients received a second intervention. SUR patients received more SUR during the follow‐up period ( p = .035). Stage III and IV patients received more SUR during SPC than Stage I and II patients ( p = .001). Grade C patients received more SUR during the follow‐up period ( p < .05). During the 5‐year period preceding retreatment, the mean SPC visits were lower for patients who did not require retreatment ( p < .001). Risk factors such as regularity of maintenance, smoking and diabetes were related to a higher chance of receiving SUR during the follow‐up period ( p < .05). The mean cumulative costs indicated less recurrence cost for compliers in Stage III and IV or Grade B and C but not for those in Stage I and II or Grade A. Conclusions The risk of relapse in the maintenance population may be correlated with higher stage and grade, patient compliance, modifiable risk factors and the nature of the treatment provided during APT. The total cost of treatment of recurrences was lower for compliers in Stage III/IV and Grade B/C compared with erratic compliers with the same severity and risk.

Cumulative incidence

Cumulative dose

Periodontal surgery

Clinical attachment loss

10.1111/jcpe.13909

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Citations (5)

Regeneration of Chronic Alveolar Vertical Defects Using a Micro Dosage of rhBMP‐2. An Experimental In Vivo Study

Carolina Digital Repository (University of North Carolina at Chapel Hill) (2024)

István Urbán Sándor Farkasdi Dieter D. Bosshardt Maurício G. Araújo Andrea Ravidà

10.17615/ezkq-5v49

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Citations (0)

Outcomes of root resection therapy up to 16.8 years: A retrospective study in an academic setting

Journal of Periodontology (2019)

Madi Alassadi Musa Qazi Andrea Ravidà Rafael Siqueira Carlos Garaicoa‐Pazmiño

Abstract Background Root resection has been considered a viable treatment option for molars with furcation defects. However, need of a multidisciplinary approach could potentially deem this procedure less successful. The aim of the present article was to determine survival rates of root resection procedure and reasons for failure in an academic setting. Methods Patient‐related demographic data, medical history information, and relevant data pertaining to the root‐resected teeth performed from January 1990 to September 2017 were reviewed through electronic and paper chart. Survival rates were analyzed using Kaplan‐Meier estimate. Association between the reasons for failure and independent variables was established by a Pearson Chi‐squared and Kruskal‐Wallis test. Results A total of 85 patients with an average follow‐up of 5 ± 4.3 years (range: 1 to 16.8 years) were included in the present article. A total of 47 molar teeth treated with root resection remained as part of the dentition (55.3%) and 38 (44.7%) failed. The mean survival time with the Kaplan‐Mayer analysis was 109.9 months (9.1 years). Fracture (39.5%), caries (26.3%), and periodontal disease (23.7%) were the most common causes for failure. Interestingly, the majority of failures occurred in the first 4 years after therapy (n = 31; 81.5% of all failures). Conclusions Root resection therapy remains a treatment solution for molars with furcation defects. In an academic setting, >50% of teeth remained functional after 9 years of root resection therapy.

Medical record

Endodontic therapy

10.1002/jper.19-0033

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Citations (14)

Comparison between Subepithelial Connective Tissue Graft and De-epithelialized Gingival Graft: A systematic review and a meta-analysis.

PubMed (2019)

Lorenzo Tavelli Andrea Ravidà Guo‐Hao Lin Del Amo Fs Mustafa Tattan

Sup-epithelial connective tissue graft (SCTG) and de-epithelialized gingival graft (DGG) approaches have been investigated with a focus on post-operative morbidity but not from a clinical outcome standpoint. The aim of this systematic review was to systematically investigate the literature for coronally advanced flaps (CAFs) combined with SCTG or DGG.Electronic and hand searches were performed to identified randomized controlled trials (RCTs) investigating the treatment of gingival recession (GRs) using CAF, with at least a 1-year of follow-up. The primary outcome was the mean root coverage (mRC), while the secondary outcomes included recession reduction (Rec Red), keratinized tissue (KT) gain, probing depth (PD) change, and clinical attachment level (CAL) gain.Ten RCTs with a total of 408 gingival recessions were included. The meta-analysis demonstrated that CAF + DGG is associated with superior mRC, Rec Red, KT gain, PD reduction and CAL gain. The mRC for SCTG and DGG at 1-year was 89.3% and 94.0% respectively, while the mean difference of the other clinical parameters between the two approaches was within 1 mm in favor of the DGG group.Limited evidence is available when comparing the two techniques, however the usage of DGG may be considered as the preferred technique of choice for autologous CTG harvesting when incorporated with a CAF.

Gingival recession

Source

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Agreement among international periodontal experts using the 2017 World Workshop classification of periodontitis

Journal of Periodontology (2021)

Andrea Ravidà Sunčica Travan Muhammad H. A. Saleh Henry Greenwell Panos N. Papapanou

A new periodontitis classification was recently introduced involving multidimensional staging and grading. The aim of the study was to assess if individuals well-trained in periodontics consistently used the new classification for patients with severe periodontitis. The secondary goal was to identify "gray zones" related to classifications.Participants (raters) individually classified 10 pre-selected severe periodontitis cases using the 2017 World Workshop classification. An internet case-based study was conducted after inviting members from American Academy of Periodontology and European Federation of Periodontology. Gold-standard diagnoses were determined by five experts who developed the new periodontitis classification. Inter-reliability agreement among raters was assessed using Fleiss Kappa index with the jackknife method for linearly weighted kappa calculations. McNemar test was used to determine symmetry between raters and gold-standard panel.A total of 103 raters participated and classified nine clinical cases. Fleiss Kappa values showed moderate inter-examiner consistency among raters for stage (K value: 0.49; 95% CI, 0.19 to 0.79), grade (K value: 0.50; 95% CI, 0.30 to 0.70) and extent (K value: 0.51; 95% CI, 0.23 to 0.77). When analyzed as composite (stage, grade, extent) a moderate inter-reliability was present among raters, k = 0.479 (K value: 0.47; 95% CI, 0.442 to 0.515). Agreement between raters and gold-standard panel was staging 76.6%; grading 82%; and extent 84.8%. In six of nine cases 77% to 99% of raters consistently agreed with gold-standard panel, and the other three cases had gray zone factors that reduced rater consistency.Clinicians trained in the 2017 World Workshop periodontitis classification demonstrated moderate concordance in classifying nine severe periodontitis cases, and in six of nine cases raters consistently agreed with the gold-standard panel.

Kappa

Cohen's kappa

Gold standard (test)

Grading (engineering)

Inter-Rater Reliability

McNemar's test

10.1002/jper.20-0825

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Citations (23)

Patient‐reported outcomes of palatal donor site healing using four different wound dressing modalities following free epithelialized mucosal grafts: A four‐arm randomized controlled clinical trial

Journal of Periodontology (2022)

Hussein Basma Muhammad H. A. Saleh Ramzi V. Abou‐Arraj Matthew Imbrogno Andrea Ravidà

The aim of this study was to compare the effects of four different commonly used wound dressings in improving patient reported outcomes (PROMS) after free epithelialized mucosal grafts (FEGs) harvesting.Following 72 FEGs harvesting from 72 patients, patients were assigned into four groups.collagen plug + sutures (CPS); test: collagen plug with cyano-acrylate (CPC), platelet rich fibrin (PRF) + sutures, or palatal stent only (PS). Patients were observed for 14 days, with evaluation of pain level utilizing the visual analog scale, number of analgesics consumed, need for additional analgesics, amount of swelling, amount of bleeding, activity tolerance, and willingness for retreatment.Compared to the control group all test groups indicated significant lower pain perception (P < 0.0001), lower analgesic consumption (P < 0.0001), and higher willingness for retreatment (P < 0.0001), while no statistically significant differences among test groups were observed. There were no statistically significant differences in amount of day-by-day swelling, bleeding, and activity tolerance among four groups. Compared to other groups, the PS had the lowest overall pain scores (over the 14-day period). Palatal thickness, graft length, graft width, and graft thickness did not appear to affect patient morbidity (P > 0.05).All interventions significantly decreased pain perception compared to a hemostatic collagen sponge alone over the palatal donor site after FEG surgery. In the first few days after surgery, the use of a palatal stent seemed to be associated with less overall pain, pain pills consumed, and higher willingness of doing the same procedure again.

Pain Perception

10.1002/jper.22-0172

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Citations (22)

Simultaneous Alveolar Ridge Augmentation and Periodontal Regenerative Therapy Leveraging Recombinant Human Platelet-Derived Growth Factor-BB (rhPDGF-BB): A Case Report

The International Journal of Periodontics & Restorative Dentistry (2022)

István Urbán Mustafa Tattan Andrea Ravidà Muhammad H. A. Saleh Lorenzo Tavelli

Severe alveolar ridge deficiencies in concomitance with periodontal attachment loss can represent a serious clinical challenge in the context of implant therapy. The present case report describes the management of a complex defect in the esthetic zone via ridge augmentation and periodontal regenerative therapy using a biologic material. A systemically healthy 55-year-old man diagnosed with peri-implantitis around an implant in the maxillary left central incisor position and with severe bone loss on the mesial aspect of the maxillary left lateral incisor underwent several surgical interventions to achieve simultaneous vertical ridge augmentation and periodontal regeneration. These interventions included implant removal, bone augmentation using a composite bone graft (autogenous bone + xenograft particles), and a bioactive protein (recombinant human platelet-derived growth factor), soft tissue augmentation using connective tissue grafts, and peri-implant keratinized mucosa width augmentation via a labial gingival graft strip and a xenogeneic collagen matrix. Substantial gains in vertical bone and clinical attachment were achieved, which allowed for delayed implant placement and subsequent completion of tooth replacement therapy with an implant-supported prosthesis. The present case report demonstrates how simultaneous vertical ridge augmentation and periodontal regeneration can be achieved to manage a challenging clinical situation. Key factors to consider in this type of scenario are proximal bone level, tooth mobility, surgical flap design and management, biomaterial selection, and proper treatment sequencing.

Alveolar ridge

Maxillary lateral incisor

10.11607/prd.6055

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Citations (9)

Maiorchino cheese: physicochemical, hygienic and safety characteristics

Italian Journal of Food Safety (2015)

F. Conte Andrea Ravidà Alessandro Mandanici Vincenzo Ferrantelli Michele Chetta

This study assessed the physical, chemical, and microbiological characteristics of traditional Maiorchino cheese (Italy) made from raw ewe's milk or from a mixture with goat's milk. Cheese samples from the same batch were analyzed after 20 days and 6, 8, 12, 17 and 24 months of ripening. A decrease in moisture level lead to progressive total solids concentration (fat, total nitrogen, total solids and chloride) during ripening. Aw values decreased from 0.97 (day 20) to 0.85 (month 24), while pH increased from 4.99 to 5.41 (6 months) followed a by reduction until 4.85 (month 24). In samples analysed 20 days after cheesemaking, aerobic mesophilic count was 1.8•107 CFU/g, Enterobacteriaceae were 2.7•106 CFU/g, Staphylococcus spp. were 1.8•104 CFU/g, and yeasts 4.5•105 CFU/g. Sulphite reducing bacteria were not found. Lactic bacteria count at 30°C (LAB30) and 42°C (LAB42) was about 108 CFU/g (day 20); LAB30 reduced until month 8; LAB 42 reduced until month 12; both were not detectable at months 17 and 24. Cheese-making process does not consider commercial starter cultures and LAB group is heterogeneous because of its natural microflora. Yeasts were considered as typical microflora of Maiorchino. Volatile compounds were examined at 6, 12 and 24 months of ripening; 54 components were identified. Statistical analysis showed that the seasoning period of 12 months was the best for Maiorchino flavour attributes. The characterisation of Maiorchino traditional cheese may be considered as significant for this old traditional product, with the aim of obtaining the PDO certification.

Mesophile

Starter

Seasoning

Water activity

Cheesemaking

Total Viable Count

Cheese ripening

Aerobic bacteria

Food microbiology

10.4081/ijfs.2015.4532

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Citations (5)

Influence of suturing technique on marginal flap stability following coronally advanced flap: a cadaver study

Clinical Oral Investigations (2018)

Lorenzo Tavelli Shayan Barootchi Andrea Ravidà Fernando Suárez Giulio Rasperini

10.1007/s00784-018-2597-5

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Citations (16)

Comparison of three different types of implant‐supported fixed dental prostheses: A long‐term retrospective study of clinical outcomes and cost‐effectiveness

Clinical Oral Implants Research (2019)

Andrea Ravidà Mustafa Tattan Houssam Askar Shayan Barootchi Lorenzo Tavelli

Abstract Objective To study the performance of 2–3 posterior bone‐level dental implants constructed with either three non‐splinted crowns (NSC), three splinted crowns (SC), or a 3‐unit implant‐supported bridge over two implants (ISB). Material and methods Patients treated with three metal‐ceramic NSC, SC, or an ISB were included in the present retrospective study. Implant survival and success rate as well as all biological and technical complications were collected. The cost associated with each of the treatment options was evaluated in the comparative analysis. Results One hundred and forty‐five patients (40 NSC, 52 SC, and 53 in the ISB) receiving 382 bone‐level implants (120 NSC, 106 ISB, and 156 SC) were included (mean follow‐up of 76.2 months). Lack of success was observed in 33.8% of the total patient sample, being lower in the ISB group. Implant survival rates were 92.5% in the NSC, 100% in the ISB, and 88.5% in the SC, with significant difference noted between the ISB and SC ( p = 0.01). Overall, 9.9% of the total implants were found to have peri‐implantitis (PI), with 16.7% in the SC, 7.5% in the NSC, and 2.8% in the ISB. Patients presenting prosthodontic complications were significantly higher in NSC (32.5%) than ISB (13.2%) and SC (15.4%). The total cost of the ISB group was significantly lower when compared to the NSC and SC groups ( p < 0.001). Conclusions An 3‐unit implant‐supported bridge restoring 2 implants seems to present the most ideal long‐term therapeutic solution, among the investigated approaches in this study, in rehabilitating a 3‐unit edentulous area.

Bridge (graph theory)

10.1111/clr.13415

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Citations (37)