Effect of synbiotics in the treatment of smokers and non-smokers with gingivitis: randomized controlled trial

BACKGROUND

To evaluate the efficacy of synbiotic tablets on the clinical and biochemical parameters of smokers and non-smokers with gingivitis.

METHODS

Eighty patients with gingivitis [40 smokers (+), 40 non-smokers (-)] were randomly assigned to test (T) or control (C) groups. Four groups were defined: T(+), T(-), C(+) and C(-). The subjects daily chewed a synbiotic or placebo tablet for 30 days. The gingival crevicular fluid levels of interleukin (IL)-6, IL-8 and IL-10 were determined as the primary outcome variables.

RESULTS

The clinical and biochemical parameters for all groups significantly reduced compared with the baseline (P < 0.05). While there were no significant differences between the groups for gingival index, the plaque index was significantly higher in both smoker groups than that in the T(-) group during the second month (P < 0.05). IL-8 levels in C(-) and IL-6 levels in both control groups were significantly higher than those in the T(+) group. The IL-10 levels in both control groups were significantly higher than those in the T(-) group during the second month (P < 0.05).

CONCLUSIONS

Adjunctive synbiotic tablets significantly reduce subclinical therapeutic outcomes for both smokers and non-smokers compared with placebo according to the biochemical parameters.

Effect of titanium-prepared platelet-rich fibrin treatment on the angiogenic biomarkers in gingival crevicular fluid in infrabony defects of patients with chronic periodontitis: A randomized controlled clinical trial

AIM

The aim of this double-blinded, randomized, controlled clinical study was to investigate the effect of titanium-prepared platelet-rich fibrin (T-PRF) treatment on the angiogenic biomarkers in gingival crevicular fluid (GCF) in infrabony defects of patients with chronic periodontitis.

MATERIALS AND METHODS

Twenty five systemically healthy participants who complied with inclusion criteria with periodontal infrabony defects were recruited. In each patient, the infrabony defect of one side of arch was designated as control group (allograft), whereas the infrabony defect on the contralateral side of same arch was designated as test group (allograft + T-PRF). The therapy methods (test or control) were randomly decided. GCF samples were collected at baseline (presurgery) and then the 3rd, 7th, 14th, and 30th days after surgery. Platelet-derived growth factor (PDGF)-BB, vascular endothelial growth factor (VEGF)-A, fibroblast growth factor (FGF)-2, anjiogenin (ANG), angiostatin (ANT) in the GCF samples were measured using human enzyme-linked immunosorbent assay kits.

RESULTS

In both groups, total amounts of PDGF-BB, VEGF-A, FGF-2, ANG, and ANT peaked in the GCF samples obtained at the early postoperative day (day 3) and decreased over time in the samples obtained at the 7th, 14th, and 30th days postsurgery. There were no significant differences between groups for the total amounts of PDGF-BB, VEGF-A, FGF-2, ANG, and ANT at all evaluation periods.

CONCLUSION

Application of T-PRF combined with allograft in infrabony defects of patients with chronic periodontitis had no significant effects on angiogenic biomarkers in GCF.

Comparison of applying particulate demineralized bone matrix (DBM), putty DBM and open flap debridement in periodontal horizontal bone defects. A 12-month longitudinal, multi-centre, triple-blind, split-mouth, randomized, controlled clinical study. Part 2 - evaluation of the interdental soft tissue

To date, there have been many studies clinically evaluating periodontal regenerative procedures by the help of routinely used hard and soft tissue parameters; however, these parameters are not capable of assessing interdental soft tissue located above the regenerative periodontal surgery area. The purpose of this study was to assess interproximal soft tissue changes following application of (i) particulate form demineralized bone matrix (DBM), (ii) putty form DBM and (ii) open flap debridement (OFD, control), using modified curtain technique in the treatment of interproximal suprabony (horizontal) defects located in anterior maxillary region, as previously reported. Twenty-five chronic periodontitis patients with 125 interproximal surgery sites (radiologically >or=4 mm horizontal bone defect) were also participate in this second stage of the triple-blind, split mouth, randomized, controlled clinical trial. Surgery sites were assessed by (i) plaque index (PI), (ii) gingival index (GI), (iii) the presence of interdental soft tissue clefts or craters and (iv) the loss of interdental papilla height by using papilla presence index (PPI), during the healing period. At the baseline and 3, 6, 9 and 12 months after the operations, these measurements were repeated. In all groups, there is a significant increase in the prevalence of soft tissue cleft and crater formation (P < 0.01), with increase in PI and GI scores at interdental soft tissue defect areas (P < 0.001), 3 months after the operations. There was also an increase in PPI scores after the operations in all treatment groups (P < 0.01). Three procedures affected the interproximal soft tissues similarly. There was no significant difference among groups in terms of all parameters (P > 0.05). Particulate DBM, putty DBM and OFD demostrated similar interproximal soft tissue changes especially increasing interproximal PI and GI scores in 3 months follow-up.

Comparison of applying particulate demineralized bone matrix (DBM), putty DBM and open flap debridement in periodontal horizontal bone defects. A 12-month longitudinal, multi-center, triple-blind, split-mouth, randomized, controlled clinical study. Part 1 - clinical and radiographic evaluation

Putty form graft materials may have additional favourable effects when compared with particulate ones in periodontal bone defects. The purpose of this study was to assess clinical and also radiographic changes following application of (i) putty form demineralized bone matrix (DBM), (ii) particulate form DBM and (iii) open flap debridement (control), using modified curtain suturing technique in the treatment of interproximal suprabony (horizontal) defects. Twenty-five chronic periodontitis patients with 125 sites (radiologically >or=4 mm horizontal bone defect) were selected to participate in this triple-blind, split mouth, randomized, controlled clinical trial. Putty and particulate form DBM grafts were placed at experimental sites. Clinical measurements included probing depth (PD), relative attachment level (RAL), gingival recession and bone probing depth (BPD) were made at baseline and repeated 12 months after the operations. Standardized digital radiographs were also taken to measure radiographic bone level (RBL) at baseline and 12 months later to be compared in a software. Probing depth reductions and RAL gains were significantly improved in all treatment groups (P < 0.001). No significant differences in soft tissue parameters were found among three groups (P > 0.05). Bone probing depth measurements indicated comparable significant bone gain in graft applied groups (P < 0.01) and a significant bone resorption in open flap debridement group (P < 0.01). Radiographic evaluation did not show any significant bone gain or resorption in all treatment groups (P > 0.05). The results of this study indicate that either putty or particulate DBM demonstrates similar enhancements in soft and hard tissue parameters. Applying putty or particulate form DBM results with slight bone formation when compared with open flap debridement in horizontal bone defects at 1-year post-operative examination according to BPD measurements.

Clinical management of ectodermal dysplasia with long term follow up: two case reports

The present study describes the characteristics and clinical management of two patients with ectodermal dysplasia with long term follow-up. Dental treatments depend on the severity of disorder, therefore, treatment varies according to the age, growth and development of the stomatognathic system of the patient. It is important that the patient and dentist understand continued monitoring for dental problems is necessary. This provides improved aesthetics, function and emotional development.

The effects of attachment factors on initial attachment of human periodontal ligament fibroblasts on different root surfaces: a light and scanning electron microscopic study

This study was aimed to test the effect of fibronectin (FN), vitronectin (VN) and a fibronectin analog (fibronectin-like engineered protein) on the attachment of periodontal ligament cells to mechanically-treated and mechanically non-treated periodontally involved and non-diseased root surfaces in vitro. Periodontal ligament fibroblasts were incubated with a total of 44 periodontally diseased and non-diseased root slices which had been treated in the following manner: 1) FN applied to mechanically-treated and non-treated root slices, 2) VN applied to mechanically-treated and non-treated root slices, 3) FN-like engineered protein applied to mechanically-treated and non-treated root slices, and 4) mechanically-treated and non-treated root slices. After the 1 hour incubation period in a humidified atmosphere of 95% air and 5% CO2 at 37 degrees C, the adherence of the fibroblasts was determined using light microscopy with an ocular grid system and orientation was evaluated by scanning electron microscopy. The results indicated that the number of attached cells to non-diseased cementum sites was significantly greater than the number of attached cells to diseased cementum sites for all of the groups (p < 0.05). Likewise, the number of attached cells to mechanically-treated diseased cementum sites was significantly greater than the number of attached cells to mechanically-non-treated diseased cementum sites (p < 0.05). Our findings suggest that these attachment factors cannot promote cell attachment to different cementum sites.

Evaluation of initial attachment of human gingival fibroblast cells to biodegradable membranes in vitro by light and scanning electron microscopy

Guided tissue regeneration procedures using resorbable membranes have become accepted therapy for treating periodontal defects. Resorbable collagen and synthetic polylactide and polyglycolide copolymer membranes have been found to support regeneration and preclude the need for surgical removal. This study was undertaken to assess and compare the initial attachment of human gingival fibroblast cells to four collagen-based membranes (fascia lata, fascia temporalis, dura mater, and Type I bovine collagen) and a synthetic polylactic acid-based membrane (resolut). Human gingival fibroblasts were grown from explants of normal tissue obtained during surgical reduction of retromolar tissues. Membrane specimens were placed in separate culture wells and incubated with fibroblasts for one hour. The number of adherent cells was evaluated by light microscopy using an ocular grid system and detailed examination was performed by scanning electron microscopy. The results of evaluation by light microscopy indicated that initial cell attachment was significantly less in the polylactic acid-based membrane group than in the collagen-based membrane groups (P < 0.01). However, no significant differences were found among the collagen membrane groups in terms of fibroblast attachment (P > 0.01). Scanning electron microscopy examination of fibroblasts cultured directly on barrier membranes indicated that the collagen-based membranes appeared to facilitate cell attachment, whereas the polylactic acid-based membrane exhibited a morphology that was not conducive to attachment of human gingival fibroblasts. Based on these limited in vitro results, it appears that collagen-based membranes offer greater potential than polylactic acid-based membranes for guided tissue regeneration at surgical sites.

[Guided tissue regeneration in degree III furcation involved teeth]

Present investigation was designed to evaluate the regenerative potential of the periodontal ligament tissue in degree III furcation defects. The upper 2. and 3. premolar teeth of 3 dogs were used. Periodontal breakdown was induced around the teeth by experimental periodontitis model. After the breakdown occurred, mucoperiostal flaps were elevated and granulation tissue removed. The roots were curretted and cementum of the periodontitis involved parts of the roots was removed. The resorbable material was trimmed to approximate size needed to cover the root surfaces. The material provisionally adapted to the both buccal and palatinal root surfaces and flaps were sutured. After 42 days of post operative period histological examination of experimental and control groups showed that chances of obtaining new connective tissue attachment may be enhanced in treatment of Cl III furcation defect by Guided Tissue Regeneration.

[Effects of citric acid and tetracycline HCL treatment on periodontal healing]

The aim of the present study was to examine if a new connective tissue attachment is established following citric acid and tetracycline HCI treatment of roots, surgically deprived of its attachment apparatus. The 2. and 3. premolars of three dogs were used. After elevation of mucoperiostal flaps alveolar bone was removed extending a level of 2/3 of the roots. Then, teeth were treated with %1 citric acid PH 1 and Tetracycline HCI (Aquas solution) for 3 minutes and 4 teeth were used as control. After the 21 days of healing period the groups were evaluated histopathologically. The results indicate that citric acid and tetracycline treatment increase the amount of new attachment, inhibit the down growth of the dento gingival epithelium, allowing more time for the repopulation of periodontal ligament cells on the root surfaces.