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Ciardo A, Rampf S, Kim TS. Vital root resection with radicular retrograde partial pulpotomy in furcation-involved maxillary molars in patients with periodontitis: Technique description and case series considering clinical and economic aspects. Int Endod J 2024; 57:617-628. [PMID: 38306111 DOI: 10.1111/iej.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 02/03/2024]
Abstract
AIM Conventional root resection in periodontally compromised furcation-involved maxillary molars requires preceding endodontic treatment and is therefore associated with loss of tooth vitality, higher invasiveness, treatment time and costs, and the risk of endodontic complications. Vital root resection (VRR) could overcome these disadvantages while establishing stable periodontal and endodontic conditions. This case series aimed to introduce the concept of one-stage VRR with radicular retrograde partial pulpotomy (VRRretro). SUMMARY Seven vital maxillary molars with residual probing pocket depths (PPD) ≥ 6 mm and furcation ≥ class 2 of five patients with stage III/IV periodontitis were treated with VRRretro using mineral trioxide aggregate. Teeth with residual through-and-through furcations were additionally tunnelled. Follow-up up to 2.5 years postoperatively during supportive periodontal care included full periodontal status, percussion and thermal sensitivity testing. Periapical radiographs were obtained to rule out possible periradicular radiolucencies. All seven treated molars were in-situ at an average of 26.84 ± 5.37 months postoperatively and were clinically and radiographically inconspicuous independent of tooth position, the resected root, the need for tunnelling and the restorative status. The mean PPD on the seven treated molars was 4.02 ± 0.85 mm (6-10 mm) preoperatively and 2.62 ± 0.42 mm (3-4 mm) at the last follow-up. Clinical attachment level and bleeding on probing could also be decreased. The teeth showed no mobility over time and furcations class 2 were reduced to class 1 while the tunnelled furcations were accessible with interdental brushes. All molars reacted negatively to percussion and positively to thermal sensitivity testing. KEY LEARNING POINTS In carefully selected cases considering patient- and tooth-related factors, VRRretro could be a promising treatment option to establish stable periodontal and endodontic conditions in furcation-involved maxillary molars while preserving tooth vitality.
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Affiliation(s)
- Antonio Ciardo
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Sarah Rampf
- Section of Endodontology and Dental Traumatology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg Faculty of Medicine, Heidelberg University, Heidelberg, Germany
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Sykara M, Ntovas P, Markou N, Madianos P, Vassilopoulos S. Individualized digitally designed surgical template for guided soft tissue surgery in cases with severe gingival enlargement: A clinical application in hereditary gingival fibromatosis. Int J Comput Dent 2024; 27:99-107. [PMID: 38530272 DOI: 10.3290/j.ijcd.b5004083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
AIM The purpose of this study was to present the use of computer-assisted periodontal surgery utilizing a novel surgical guide for cases with severe gingival enlargement through a clinical application in a patient with hereditary gingival fibromatosis. MATERIALS AND METHODS The treatment plan included nonsurgical periodontal therapy, surgical periodontal treatment, and regular periodontal maintenance before the initiation of orthodontic treatment. Due to the increased soft tissue thickness, a surgical guide with a novel design was fabricated to facilitate the periodontal surgery since most of the patient's teeth were malpositioned and underexposed due to fibromatosis. For this purpose, the patient's intraoral scan was merged with a CBCT image in order to plan surgical excisions based on the anatomy of the teeth and the bone contour. RESULTS The customized surgical guide facilitated the gingivectomy by controlling not only the shape of the initial incisions but also their orientation toward the level of the cementoenamel junction, improving the efficiency of the clinical time compared with freehand surgery and assisting in the verification of the final soft tissue shape, based on the treatment plan. CONCLUSION Digital technology through the superimposition of multiple data sets can assist in the diagnosis and multidisciplinary management of cases with gingival fibromatosis. The proposed design of the surgical guide can facilitate soft tissue surgery based on the digital treatment plan, leading to more predictable management of the soft tissue, especially in patients with severe gingival enlargement, as in cases with hereditary gingival fibromatosis or drug-induced gingival overgrowth.
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Bartha V, Grünfeld D, Kopunic A, Klein C, Wolff D, Ratka-Krüger P, Woelber JP, Meller C. Increased safety in periodontal surgery: Doppler ultrasound for detection of relevant palatal blood vessels-A proof-of-concept and cross-sectional study. J Clin Periodontol 2024. [PMID: 38508585 DOI: 10.1111/jcpe.13972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/30/2024] [Accepted: 02/26/2024] [Indexed: 03/22/2024]
Abstract
AIM To evaluate the suitability of a Doppler ultrasound probe in detecting the greater palatine artery or its greater branches non-invasively. MATERIALS AND METHODS The palatal mucosa of 108 participants (median age 34 years, 51 female) was systematically divided into transversal sectors, each aligning with the positions of the upper molars (M), premolars (P) and canine teeth (C), aiming to facilitate precise and consistent localization of the detected palatal blood vessel across different patients. Blood flow of the palatal blood vessels, presumably, was located by scanning the palatal vault bilaterally using an 8-MHz ultrasound probe linked to a transducer. The distance to the corresponding tooth was measured using a millimetre-scale periodontal probe. RESULTS Within the regions of M2 to P1, the ultrasound transducer gave a delimitable acoustic pulse signal in 80%-98% of all measurements. The measured median distances between the determined position of the artery and the corresponding teeth ranged from 13 to 15 mm, with smaller distances in the anterior region. In several sectors, the distance was significantly higher for men (C: p = .048; P1: p = .041, M1: p < .01; M2: p = .034). CONCLUSIONS Use of the Doppler ultrasound transducer might be a promising approach to non-invasively detect relevant palatine blood vessels preoperatively. It, therefore, might have the potential to reduce the risk of accidental injury during palatal surgery.
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Affiliation(s)
- Valentin Bartha
- Department for Conservative Dentistry, School of Dental Medicine, University Heidelberg, Heidelberg, Germany
- Department for Conservative Dentistry, School of Dental Medicine, Eberhard-Karls University, Tübingen, Germany
| | - Dan Grünfeld
- Department for Conservative Dentistry, School of Dental Medicine, Eberhard-Karls University, Tübingen, Germany
- Private Practice, Dublin, Ireland
| | - Aleksandra Kopunic
- Department for Conservative Dentistry, School of Dental Medicine, Eberhard-Karls University, Tübingen, Germany
| | - Christian Klein
- Department for Conservative Dentistry, School of Dental Medicine, Eberhard-Karls University, Tübingen, Germany
- HealthCare Center Meller Zahngesundheit Schlauzahn MVZ GmbH, Waiblingen, Germany
| | - Diana Wolff
- Department for Conservative Dentistry, School of Dental Medicine, University Heidelberg, Heidelberg, Germany
| | - Petra Ratka-Krüger
- Department for Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johan Peter Woelber
- Clinic of Operative Dentistry, Periodontology, and Pediatric Dentistry, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Christian Meller
- Department for Conservative Dentistry, School of Dental Medicine, Eberhard-Karls University, Tübingen, Germany
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Bagde HS, Alam MK, Almohammed YEM, Almaqawid SMM, Ganji KK, Sghaireen MG. Comparing the Clinical and Radiographic Outcomes of Two Different Surgical Approaches for Treating Infrabony Defects in Chronic Periodontitis Patients. J Pharm Bioallied Sci 2024; 16:S567-S569. [PMID: 38595586 PMCID: PMC11001047 DOI: 10.4103/jpbs.jpbs_866_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 09/14/2023] [Accepted: 09/23/2023] [Indexed: 04/11/2024] Open
Abstract
Background Chronic periodontitis is a prevalent oral health issue, affecting a substantial portion of the population. Infrabony defects, characterized by bone loss around teeth, are a hallmark of this condition and require surgical intervention to prevent further damage and tooth loss. Two commonly used surgical approaches are open flap debridement (OFD) and guided tissue regeneration (GTR). Materials and Methods This prospective cohort study included 60 patients with chronic periodontitis and infrabony defects. Patients were randomly assigned to either the OFD or GTR group. Clinical parameters, including probing depth (PD) and clinical attachment level (CAL), were recorded at baseline and at 6-month and 12-month follow-up appointments. Radiographic assessments were conducted using periapical radiographs. The primary outcome measures were changes in PD and CAL, while secondary outcomes included radiographic evidence of bone regeneration. Results At the 6-month follow-up, the OFD group demonstrated an average reduction in PD of 2.4 mm (SD = 0.8) and an increase in CAL of 1.6 mm (SD = 0.5). In contrast, the GTR group showed a reduction in PD of 2.1 mm (SD = 0.7) and an increase in CAL of 1.9 mm (SD = 0.6). These differences were not statistically significant (P > 0.05). Radiographic analysis indicated a mean bone fill of 1.2 mm (SD = 0.4) in the OFD group and 1.4 mm (SD = 0.3) in the GTR group at 12 months, with no significant difference observed between the two groups (P > 0.05). Conclusion In this study, both OFD and GTR approaches demonstrated comparable clinical and radiographic outcomes in the treatment of infrabony defects in chronic periodontitis patients.
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Affiliation(s)
- Hiroj S. Bagde
- Department of Periodontology, CDCRI, Rajnandgaon, Chhattisgarh, India
| | - Mohammad K. Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
- Department of Dental Research Cell, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
| | | | | | - Kiran K. Ganji
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Mohammed G. Sghaireen
- Department of Prosthetic Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
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Betha H, Rajmohan M, Subhada B, Thakkar R, Ranjith Surya B, Shetty A, Tiwari R. Assessment of Postoperative Edema in Different Bone Graft Cases in Vertical Defects in Periodontal Surgery: An Original Research. J Pharm Bioallied Sci 2024; 16:S258-S260. [PMID: 38595343 PMCID: PMC11000930 DOI: 10.4103/jpbs.jpbs_484_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/23/2023] [Accepted: 09/17/2023] [Indexed: 04/11/2024] Open
Abstract
Background To replace missing periodontal tissues in vertical defects during periodontal surgery, bone graft materials are frequently used. A frequent occurrence that can affect healing outcomes is postoperative edema. The purpose of this study was to evaluate postoperative edema in various vertical bone graft defects following periodontal surgery. Materials and Methods 50 participants were split into two groups for a prospective study: Group A received xenografts, whereas Group B received synthetic grafts. Up to 14 days after surgery, baseline and routine postoperative edema measurements were made. Edema levels in each group were compared using statistical analysis. Results At all postoperative time points, Group A showed substantially more edema than Group B (P < 0.05). Furthermore, edema persisted longer in Group A than it did in Group B. Conclusion In conclusion, the substance of the bone graft used in vertical defects during periodontal surgery affects postoperative edema. Compared to synthetic grafts, xenografts caused swelling to last longer and at higher levels. To maximize healing results, clinicians should take these findings into account when choosing graft materials.
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Affiliation(s)
- Hymasree Betha
- Periodontist, CLOVE Dental, Visakhapatnam, Andhra Pradesh, India
| | - M. Rajmohan
- Department of Dental Surgery, KAPV Government Medical College and Hospital, Trichy, Tamil Nadu, India
| | - B. Subhada
- Department of Periodontics, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India
| | - Radhika Thakkar
- Eastman Institute for Oral Health, University of Rochester, New York, United States
| | - Bezgam Ranjith Surya
- Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Athma Shetty
- Department of Prosthodontics and Crown and Bridge, AB Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Mangalore, Karnataka, India
| | - Rahul Tiwari
- Oral and Maxillofacial Surgeon, CLOVE Dental, Visakhapatnam, Andhra Pradesh, India
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Nair V, Vasoya NS, Vakharia DH, Mansuri SN, Sutariya P, Dhamelia G, Patel HH. Evaluating the Long-Term Outcomes of Periodontal Surgery vs. Non-Surgical Treatment in Aggressive Periodontitis. J Pharm Bioallied Sci 2024; 16:S761-S763. [PMID: 38595569 PMCID: PMC11001040 DOI: 10.4103/jpbs.jpbs_999_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 04/11/2024] Open
Abstract
Background Aggressive periodontitis is a severe form of periodontal disease characterized by rapid tissue destruction and tooth loss. The optimal treatment approach for managing this condition remains a topic of debate. Materials and Methods A retrospective cohort study was conducted, involving patients diagnosed with aggressive periodontitis who received either surgical or non-surgical treatment between 2010 and 2020. Clinical and radiographic data were collected at baseline and regular intervals over a 5-year follow-up period. Surgical interventions included flap surgery, guided tissue regeneration, and bone grafting, while non-surgical treatments comprised scaling and root planning with or without adjunctive antibiotics. The primary outcomes assessed included changes in probing depth, clinical attachment level, tooth loss, and patient-reported quality of life measures. Results A total of 120 patients were included in the study, with 60 patients in each treatment group. The surgical group demonstrated significantly greater reductions in probing depth and gains in clinical attachment level compared to the non-surgical group (P < 0.05). Tooth loss was significantly lower in the surgical group over the 5 years (P < 0.01). Patient-reported outcomes also favored the surgical group, with improved oral health-related quality of life. However, the surgical group had a higher incidence of postoperative complications. Conclusion This study suggests that periodontal surgery yields superior long-term outcomes in the management of aggressive periodontitis compared to non-surgical treatment.
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Affiliation(s)
- Vineet Nair
- Department of Periodontia, Dr. R Ahmed Dental College and Hospital, Kolkata, West Bengal, India
| | - Nuti S. Vasoya
- Department of Dentistry, AMC Dental College, Khokhra, Ahmedabad, Gujarat, India
| | - Dhriti H. Vakharia
- Department of Dentistry, AMC Dental College, Khokhra, Ahmedabad, Gujarat, India
| | | | - Prachi Sutariya
- Department of Dentistry, AMC Dental College, Khokhra, Ahmedabad, Gujarat, India
| | - Greacy Dhamelia
- Department of Dentistry, AMC Dental College, Khokhra, Ahmedabad, Gujarat, India
| | - Heli H. Patel
- Department of Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
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Hamadeh W, Alhabashneh R, Abdelhafez R, Khader Y. Management of interdental papillary defects using subperiosteal hyaluronic acid injection overlay technique: a prospective longitudinal clinical study. Quintessence Int 2024; 0:0. [PMID: 38289001 DOI: 10.3290/j.qi.b4920305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Currently, there is no established treatment protocol to treat Interdental papillary loss. This research aimed to evaluate the outcomes of interdental papillary reconstruction using minimally invasive surgery, with injectable hyaluronic acid (HA) gel. MATERIALS AND METHODS Seventeen patients were included, each with five sites of class 1 papillary recession; (forty sites in the upper jaw and forty-five sites in the lower jaw). Subperiosteal tunneling was performed through a horizontal incision made apical to the base of the papilla without penetrating it. The free gingival sulcus was sealed by 000 retraction cord. After that a total of 0.2-0.6 mL HA was injected gradually. The incision was sutured with polyglycolic sutures. Treated sites underwent clinical and digital evaluation at three follow up time points (1 month, 3 months and 6 months). RESULTS The interdental papillary defect height in the upper jaw sites significantly reduced by 60%, 66%, and 42% at 1 month, 3 and 6 months, respectively. Also, in lower jaw sites, the reduction was of about 54%, 55%, and 40% at the same follow up time points. Regarding interdental papillary defect surface area in the upper jaw the reduction was about 65%, 71%, and 45% at 1 month, 3 and 6 months. In the lower jaw, a reduction of about 60%, 64%, and 48% was noticed at the same time points. Regarding patients' pain level score, during the day of surgery, sixteen patients reported pain, the average pain score out of 10 was 3.94, and eleven patients (64.7%) needed to take analgesics. The pain generally subsided in the following days. Also, at the day of the treatment twelve out of the seventeen patients (70.6%) reported mild difficulty in speaking and eating. No complication, hypersensitivity or allergy was noted in any patient. CONCLUSION Subperiosteal tunneling with HA injection demonstrates clinical improvements in papilla height and papillary recession surface area reduction after 3 months of follow-up with reduction in improvement after 6 months.
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Abu Alfar TM, Alaida WS, Hammudah HA, Mohamado LL, Gaw RR, Al-Salamah L, Alasmari BA, Alotaibi RM, Almutairi MA. Exploring the Potential of Phytogenic Materials for Bone Regeneration: A Narrative Review of Current Advances and Future Directions. Cureus 2023; 15:e48175. [PMID: 38046714 PMCID: PMC10693310 DOI: 10.7759/cureus.48175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
In dentistry, bone regeneration in areas following tooth loss, the removal of a tumor or cyst, and craniofacial surgery can be accomplished by using bone grafts. Many biocompatible materials have been employed for bone regeneration in dentistry; however, all these bone graft materials come with various drawbacks. Therefore, there is a growing demand for natural, cost-effective, and biocompatible plant-based bone grafts. This review explores the emerging field of phytogenic elements in bone restoration and their specific applications in dentistry. The review focuses on key phytogenic compounds, such as algae-based and plant-based bone substitutes, delineating their roles in bone regeneration in dental bone defects. It also highlights the existing challenges associated with phytogenic grafts, such as limited bioavailability and high-dose toxicity. This calls for increased research into compatible, affordable carriers and a broader spectrum of studies to determine the most effective phytogenic solutions in dental regenerative medicine.
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Meshram M, Durge K, Shirbhate U. An Overview of Oral Pyogenic Granuloma and Its Management: A Case Report. Cureus 2023; 15:e48305. [PMID: 38058325 PMCID: PMC10697180 DOI: 10.7759/cureus.48305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/05/2023] [Indexed: 12/08/2023] Open
Abstract
An inflammatory hyperplasia known as a pyogenic granuloma (PG) appears as a nodular growth on the oral mucosa. The most frequent place is the gingiva, followed by the buccal mucosa, tongue, and lips. Histologically, the surface epithelium may be hyperkeratotic, have ulceration foci, or be intact. It lies on the dense connective tissue that contains a sizable amount of fully developed collagen. Most of the pregnancies result in PG of the gingiva; for this reason, the phrases "Pregnancy Tumor" and "Granuloma Gravidarum" are frequently used. It typically occurs during the second and third months of pregnancy and tends to bleed, making it challenging to masticate. Estrogen increases the vascular endothelial growth factor (VEGF) synthesis in macrophages, which is associated with PG development during pregnancy. This case describes a surgically treated case of PG in a middle-aged female with a conventional scalpel technique, giving functional and esthetic outcomes in a patient.
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Affiliation(s)
- Mrunal Meshram
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Khushboo Durge
- Department of Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Unnati Shirbhate
- Department of Periodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Clem D, Heard R, McGuire M, Scheyer ET, Richardson C, Toback G, Gunsolley JC, Geurs N. A comparison of Er,Cr:YSGG laser to minimally invasive surgical technique in the treatment of intrabony defects: Twelve-month results of a multicenter, randomized, controlled study. J Periodontol 2023. [PMID: 37846761 DOI: 10.1002/jper.23-0286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND The purpose of this publication is to report on the 12-month clinical and radiographic results comparing the surgical use of the Er,Cr:YSGG laser (ERL) and minimally invasive surgical technique (MIST) for the treatment of intrabony defects in subjects with generalized periodontitis stage III, grade B. METHODS Fifty-three adult subjects (29 females and 24 males; 19-73 years) with 79 intrabony defects were randomized following scaling and root planing (SRP) to receive ERL monotherapy (n = 27) or MIST (n = 26). Fifty subjects completed the study. Recession (REC), probing depth (PD), clinical attachment level (CAL), treatment time, and standardized radiographs were assessed and compared for each treatment group. Clinical measurements were recorded at baseline, 4-6 weeks following SRP, and 6 and 12 months following surgical therapy. Radiographic results were compared to baseline at 6 and 12 months following surgical therapy. RESULTS The following primary and secondary outcome variables were non-inferior with the following margins: CAL with a non-inferiority margin of 0.7 mm (p = 0.05), PD with a non-inferiority margin of 0.7 mm (p = 0.05), and REC with a non-inferiority margin of 0.4 mm (p = 0.05). Standardized radiographs suggest similar bone fill of 1.14 ± 1.73 mm for MIST and 1.12 ± 1.52 mm for ERL. CONCLUSIONS This is the first multicenter, randomized, masked, and controlled study demonstrating the ERL is not inferior to MIST at 12 months in terms of clinical outcomes and similar to MIST in terms of radiographic bone fill for the surgical treatment of intrabony defects.
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Affiliation(s)
- Donald Clem
- Private Practice, Fullerton, CA, USA
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
| | - Rick Heard
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, Victoria, TX, USA
| | - Michael McGuire
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, Houston, TX, USA
| | - E Todd Scheyer
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, Houston, TX, USA
| | - Chris Richardson
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, Richmond, VA, USA
- Department of Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA, USA
| | - Gregory Toback
- The McGuire Institute, a Private Practice-Based Clinical Research Network, Houston, TX, USA
- Private Practice, New London, CT, USA
- Department of Periodontics, University of Connecticut School of Dental Medicine, Farmington, CT, USA
| | - John C Gunsolley
- Department of Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA, USA
| | - Nico Geurs
- Department of Periodontology, University of Alabama at Birmingham School of Dentistry, Birmingham, AL, USA
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Aoki A, Mizutani K, Mikami R, Ohsugi Y, Kobayashi H, Akizuki T, Taniguchi Y, Takeuchi Y, Katagiri S, Sasaki Y, Komaki M, Meinzer W, Izumi Y, Iwata T. Er:YAG laser-assisted comprehensive periodontal pocket therapy for residual periodontal pocket treatment: A randomized controlled clinical trial. J Periodontol 2023; 94:1187-1199. [PMID: 37015852 DOI: 10.1002/jper.22-0552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/27/2023] [Accepted: 03/27/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND This study evaluated the effectiveness of a novel pocket therapy (Er:YAG laser-assisted comprehensive periodontal pocket therapy [Er-LCPT]) for residual pocket treatment, compared with conventional mechanical treatment alone, in a randomized controlled clinical trial. METHODS Two sites in 18 patients having residual periodontal pockets of ≥5 mm depth, extant following initial active therapy, or during supportive therapy, were randomized into two groups in a split mouth design: the control group received scaling and root planing (SRP) by curette, and the test group received Er-LCPT using curette and laser. With Er-LCPT, after root debridement, inflamed connective tissue on the inner gingival surface and on the bone surface/within extant bone defects was thoroughly debrided. Furthermore, removal of proximate oral epithelium and coagulation of the blood clot in the pocket entrance were performed with laser. Clinical parameters were evaluated, before and after treatment, through 12 months. RESULTS Both groups showed significant improvements in clinical parameters. With Er-LCPT, pocket debridement was thoroughly and safely performed, without any adverse side effects and complications, and favorable healing was observed in most of the cases. At 12 months, Er-LCPT demonstrated significantly higher probing pocket depth reduction (2.78 mm vs. 1.89 mm on average; p = 0.012, Wilcoxon signed-rank test), clinical attachment gain (1.67 mm vs. 1.06 mm; p = 0.004) as primary outcomes, and reduced BOP value (0.89 vs. 0.56; p = 0.031), compared with SRP alone. CONCLUSION The results of this study indicate that Er-LCPT is more effective for residual pocket treatment, compared with SRP alone.
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Affiliation(s)
- Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Risako Mikami
- Department of Lifetime Oral Health Care Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroaki Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tatsuya Akizuki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Taniguchi Dental Clinic, Sapporo, Japan
| | - Yasuo Takeuchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoshiyuki Sasaki
- Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Motohiro Komaki
- Department of Periodontology, Kanagawa Dental University (KDU), Yokosuka, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Oral Care Periodontics Center, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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12
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Satpute AV, Chaturvedi SS, Kashyap L, Soni R, Ghosh S, Bhatnagar T. Liver Clot after Periodontal Surgery: A Rare Case Report. J Pharm Bioallied Sci 2023; 15:S1332-S1334. [PMID: 37694041 PMCID: PMC10485469 DOI: 10.4103/jpbs.jpbs_94_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/04/2023] [Accepted: 02/06/2023] [Indexed: 09/12/2023] Open
Abstract
Due to the primary closure of the fragile tissues, large postoperative drainage is unexpected following a periodontal medical procedure. This case study elaborately illustrates the formation of a "liver coagulation" or "currant jam clot" following a periodontal fold surgical operation. Contamination, internal damage, and the presence of foreign particles such as bone splinters or bits of dental restorative dressing can all increase the risk of an incident happening.
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Affiliation(s)
- Aishwarya Virendra Satpute
- Department of Periodontology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Shailendra Singh Chaturvedi
- Department of Periodontology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Laxmikant Kashyap
- Department of Periodontology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Ravindra Soni
- Department of Periodontology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Sanghamitra Ghosh
- Department of Periodontology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Tarun Bhatnagar
- Department of Periodontology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
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13
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Jafari H, Latifi SA, Bayani M. Evaluation of the effectiveness of Lactuca Sativa syrup in controlling pain after periodontal flap surgery: a split-mouth, randomized, double-blind placebo-controlled trial. J Complement Integr Med 2023; 20:457-463. [PMID: 35796290 DOI: 10.1515/jcim-2021-0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Effective pain control after oral surgeries including periodontal flap surgery is one of the biggest problems in the periodontology field. The use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) to reduce pain after periodontal flap surgery is common, but these have some adverse side effects such as impaired platelet function and causing digestive problems. Today, the tendency to use omedicinal plants is more than synthetic drugs due to their safety. Therefore, we designed a split-mouth randomized controlled clinical trial to evaluate the effects of Lactuca Sativa (L. Sativa) syrup as an adjunct therapy in reducing pain after periodontal flap surgery. METHODS This split-mouth, randomized, double-blind, placebo-controlled trial was performed on 26 subjects. Patients were assigned for two surgery. Primary surgery was performed on the right maxilla and after 30 days, secondary surgery was performed on the left maxilla. In primary surgery, patients consumed L. Sativa syrup (3 times a day for 72 h) and in secondary surgery, patients consumed placebo syrup (3 times a day for 72 h). Pain intensity was measured at 6, 12, 24, 48, and 72 h after a periodontal flap surgery in both surgeries using the Visual Analogue Scale (VAS). All patients received their routine drugs, including analgesics. The number of analgesics used after surgery was recorded. Statistical analysis of t-test was used to compare the results of the two surgery. RESULTS The results showed that the mean pain based on VAS score at 6, 12, 24, 48 and 72 h after primary periodontal flap surgery was significantly reduced compared to the secondary periodontal flap surgery (p<0.001). The results also showed that the use of analgesics after 72 h of surgery was significantly reduced in the primary periodontal flap surgery compared to the secondary periodontal flap surgery (p<0.001). CONCLUSIONS According to the results of this study, L.Sativa syrup can be effective as adjuvant therapy in reducing pain after periodontal flap surgery.
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Affiliation(s)
- Hadi Jafari
- Periodontics Department, Faculty of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | - Seyed Amirhossein Latifi
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Mojtaba Bayani
- Periodontics Department, Faculty of Dentistry, Arak University of Medical Sciences, Arak, Iran
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14
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Madi M, Smith S, Alshehri S, Zakaria O, Almas K. Influence of Smoking on Periodontal and Implant Therapy: A Narrative Review. Int J Environ Res Public Health 2023; 20:5368. [PMID: 37047982 PMCID: PMC10094532 DOI: 10.3390/ijerph20075368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/15/2023] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND smoking is considered the most modifiable risk factor for periodontal disease. OBJECTIVE the aim of this narrative review is to emphasize the effect of smoking on periodontal and implant therapy. METHODS The authors reviewed the literature reporting the clinical outcomes of smoking on periodontal surgical and nonsurgical treatment. The impact of smoking on implant therapy and sinus lifting procedures were also reviewed. RESULTS Periodontal and implant therapy outcomes are adversely affected by smoking. Smokers respond less favorably to periodontal therapy and periodontal flap procedures as compared to nonsmokers. Clinical outcomes for smokers are 50-75% worse than for nonsmokers. Studies reveal that smokers experience a significantly lower reduction in pocket depth compared to nonsmokers as well as less bone growth after treating infra-bony defects with guided tissue regeneration. The relative risk of implant failure is significantly higher in patients who smoke 20 cigarettes or more per day compared to nonsmokers. Additionally, smoking has also been shown to increase postoperative wound dehiscence and infection rates following sinus floor elevation. Longitudinal studies on smoke cessation have shown a reduction in bone loss and probing depths for periodontitis patients after cessation compared to those who smoke. CONCLUSION Smoking cessation can reduce probing depths and improve clinical attachment after nonsurgical periodontal therapy. There is insufficient evidence regarding the effect of smoking on peri-implantitis, as well as the loss of implants in the long-term.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Steph Smith
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Sami Alshehri
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Khalid Almas
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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15
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Krajewski A, Perussolo J, Gkranias N, Donos N. Influence of periodontal surgery on the subgingival microbiome-A systematic review and meta-analysis. J Periodontal Res 2023; 58:308-324. [PMID: 36597817 DOI: 10.1111/jre.13092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/10/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis was to evaluate the effect of periodontal surgery on the subgingival microbiome. BACKGROUND Periodontitis is a chronic inflammation of the tooth supporting tissues caused by the dysbiosis of the subgingival biofilm. It is managed through different non-surgical and surgical treatment modalities. Recent EFP S3 guidelines recommended performing periodontal surgery as part of Step 3 periodontitis treatment after Step 1 and Step 2 periodontal therapy, with the aim to achieve pocket closure of persisting sites. Changes in the sub-gingival microbiome may explain the treatment outcomes observed at different time points. Various microbiological detection techniques for disease-associated pathogens have been evolved over time and have been described in the literature. However, the impact of different types of periodontal surgery on the subgingival microbiome remains unclear. METHODS A systematic literature search was conducted in Medline, Embase, LILACS and Cochrane Library supplemented by manual search (23DEC2019, updated 21APR2022). RESULTS From an initial search of 3046 studies, 28 were included according to our specific inclusion criteria. Seven microbiological detection techniques were used to analyse disease-associated species in subgingival plaque samples: optical microscope, culture, polymerase chain reaction (PCR), checkerboard, enzymatic reactions, immunofluorescence and 16S gene sequencing. The included studies exhibited differences in various aspects of their methodologies such as subgingival plaque sample collection or treatment modalities. Clinical data showed a significant decrease in probing pocket depths (PPD) and clinical attachment loss (CAL) after periodontal surgery. Microbiological findings were overall heterogeneous. Meta-analysis was performed on a sub-cohort of studies all using checkerboard as a microbiological detection technique. Random effect models for Treponema denticola (T. denticola), Porphyromonas gingivalis (P. gingivalis) and Tannerella forsythia (T. forsythia) did not show a significant effect on mean counts 3 months after periodontal surgery. Notably, Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) showed a significant increase 3 months after periodontal surgery. 16S gene sequencing was used in one included study and reported a decrease in disease-associated species with an increase in health-associated species after periodontal surgery at 3 and 6 months. CONCLUSION This systematic review has shown that the effect of periodontal surgery on the changes in subgingival microbiome is heterogeneous and may not always be associated with a decrease in disease-associated species. The variability could be attributed to the microbiological techniques employed for the analysis. Therefore, there is a need for well-designed and adequately powered studies to understand how periodontal surgery influences the subgingival microbiome and how the individual's microbiome affects treatment outcomes after periodontal surgery.
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Affiliation(s)
- Anna Krajewski
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jeniffer Perussolo
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nikolaos Gkranias
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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16
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Palma LF, Joia C, Chambrone L. Effects of ozone therapy on periodontal and peri-implant surgical wound healing: a systematic review. Quintessence Int 2023; 54:100-110. [PMID: 36437805 DOI: 10.3290/j.qi.b3512007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of the use of adjuvant ozone therapy in the healing process of wounds resulting from periodontal and peri-implant surgical procedures by answering the following focused question: "Can adjuvant ozone therapy improve wound healing outcomes related to periodontal and peri-implant surgical procedures?". METHOD AND MATERIALS MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched, without language restriction, for peer-reviewed articles published until 23 March 2022, in addition to manual search. Only controlled clinical trials (randomized or not) were considered. The risk of bias was evaluated by the Cochrane risk-of-bias tool for RCTs - version 1 (RoB1). Data were pooled into evidence tables and a descriptive summary was presented. RESULTS Of the 107 potentially eligible records, only seven studies were included. Four addressed free/deepithelialized gingival grafts with a palatal donor area, two evaluated implant sites, and one comprised gingivectomy and gingivoplasty. A total of 225 patients were evaluated in the included studies, considering control and test groups (ozone and other adjuvant therapies for comparison). Ozone therapy had a positive effect on outcomes directly or indirectly related to periodontal/peri-implant surgical wound healing. Furthermore, it could also increase the stability of immediately loaded single implants installed in the posterior mandible. CONCLUSION In general, ozone therapy seems to both accelerate the healing processes of periodontal/peri-implant wounds and increase the secondary stability of dental implants; however, considering the limited evidence available and the risk of bias in the included studies (none classified as low risk), a definitive conclusion cannot be drawn. (Quintessence Int 2023;54: 100-110; doi: 10.3290/j.qi.b3512007).
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Raj SC, Pradhan SS, Mahapatra A, Katti N, Mohanty D, Rath R, Patnaik K, Agrawal P. Histomorphometric Analysis of Residual Alveolar Ridge Preserved using Collagen Cell Occlusive Membrane Alone and Along with Demineralized Bone Matrix Following Tooth Extraction: A Randomized Control Trial. Contemp Clin Dent 2022; 13:375-382. [PMID: 36686994 PMCID: PMC9855258 DOI: 10.4103/ccd.ccd_347_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/19/2021] [Accepted: 12/26/2021] [Indexed: 11/09/2022] Open
Abstract
Context The changes in the volume and dimensions of the alveolar bone after tooth extraction often lead to challenges in prosthetic rehabilitation of the same necessitating ridge preservation procedures (RPP). Aim The aim of this randomized clinical trial was to evaluate and compare the dimensional and histomorphometric changes of the sites preserved using the collagen membrane with and without demineralized bone matrix (DMBM). Settings and Design Interventional, parallel-design, double blinded, randomized controlled trail. Materials and Methods A randomized controlled trial was designed with 45 participants having at least 2 teeth indicated for were enrolled in this study. The sites were randomly assigned to the control group (RPP using collagen membrane) and the test group (RPP using collagen membrane with DMBM). The clinical parameters assessed were alveolar bone width and alveolar bone height. Histomorphometric analysis was carried out on tissue trephined from the preserved sites to evaluate the percentage of bone and connective tissue (CT %) formed 8 months postRPP. Statistical Analysis Used Shapiro - Wilk test and paired and unpaired t-test. Results Horizontal resorption was significantly less in the test group (7.375 ± 1.64). Histomorphometry of these sites revealed a complete absence of residual graft particles, presence of trabecular bone, and a more mineralized matrix (63.256%) as compared to the control sites (46.833%). Conclusions The use of DMBM along with the collagen membrane for RPP yielded better results both clinically and histomorphometically.
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Affiliation(s)
- Subash Chandra Raj
- Department of Periodontics, S. C. B Dental College and Hospital, Cuttack, Odisha, India
| | - Shiba Shankar Pradhan
- Department of Periodontics, S. C. B Dental College and Hospital, Cuttack, Odisha, India
| | - Annuroopa Mahapatra
- Department of Periodontics, S. C. B Dental College and Hospital, Cuttack, Odisha, India
| | - Neelima Katti
- Department of Periodontics, S. C. B Dental College and Hospital, Cuttack, Odisha, India
| | - Devapratim Mohanty
- Department of Periodontics, S. C. B Dental College and Hospital, Cuttack, Odisha, India
| | - Rachna Rath
- Department of Oral Pathology, S. C. B Dental College and Hospital, Cuttack, Odisha, India
| | - Kaushik Patnaik
- Department of Periodontics, S. C. B Dental College and Hospital, Cuttack, Odisha, India
| | - Poonam Agrawal
- Department of Periodontics, S. C. B Dental College and Hospital, Cuttack, Odisha, India
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Kim HR, Son K, Son YT, Kim YG, Lee KB, Lee SC, Suh JY, Lee JM. A Comparative Immunohistochemical Study of Wound Healing after Dental Diode Laser Treatment in the Rat Oral Mucosa. Bioengineering (Basel) 2022; 9:bioengineering9090466. [PMID: 36135012 PMCID: PMC9495772 DOI: 10.3390/bioengineering9090466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/05/2022] [Accepted: 09/10/2022] [Indexed: 11/18/2022] Open
Abstract
This study aimed to examine the differences in healing patterns using two types of diode laser devices (laser A and laser B) and a steel scalpel for periodontal surgery through histological and immunohistochemical methods. Twenty 12-week-old male rats were assigned to three groups (3, 7, and 14 days). Square-shaped erosion wounds (2 × 2 mm2 diameter) were created on the hard palate of each rat. Two wounds were created using Laser A and a steel scalpel (Bard-Parker No. 15) on the right palate and using Laser B and a steel scalpel on the left side. Rats were sacrificed after 3, 7, and 14 days. Tissues were collected with a margin of 1 mm from the border of the erosional wound of the maxillary hard palate. Histological and immunohistochemical analyses were performed on the tissue samples after 3, 7, and 14 days. The tissue healing pattern and expression of inducible nitric oxide synthase (iNOS) and cluster of differentiation (CD) were observed under a light microscope. Statistical analysis was conducted using the Kruskal−Wallis H test for comparison among the groups (α = 0.05). In comparison to the wounds made with the scalpel, wounds treated with lasers A and B showed delayed healing patterns. There was no significant difference between the two laser treatment groups (p > 0.05). The expression of iNOS and CD68 was not significantly different among the three groups after 3 and 7 days (p > 0.05). On day 14, the groups treated with the dental diode lasers showed higher expression than the group treated with the steel scalpel, but no significant difference was observed (p > 0.05). Laser-induced wounds tended to heal slower than surgical wounds performed using a steel scalpel, but histological and immunohistochemical results showed no significant difference between the dental diode laser and scalpel groups.
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Affiliation(s)
- Hye Rin Kim
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Keunbada Son
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Korea
| | - Young-Tak Son
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Korea
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu 41940, Korea
| | - Yong-Gun Kim
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Kyu-Bok Lee
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Korea
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
- Correspondence: (K.-B.L.); (J.M.L.); Tel.: +82-53-660-7674 (K.-B.L.); +82-053-600-7522 (J.M.L.)
| | - Seung Cheol Lee
- Department of Pathology, Andong General Hospital, Andong-si 36743, Korea
| | - Jo-Young Suh
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
| | - Jae Mok Lee
- Department of Periodontology, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
- Correspondence: (K.-B.L.); (J.M.L.); Tel.: +82-53-660-7674 (K.-B.L.); +82-053-600-7522 (J.M.L.)
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Ozcan Bulut S, Ilhan D, Karabulut E, Caglayan F, Keceli HG. Efficacy of platelet-rich fibrin and connective tissue graft in papilla reconstruction. J ESTHET RESTOR DENT 2022; 34:1096-1104. [PMID: 35731089 DOI: 10.1111/jerd.12937] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate efficacy of platelet-rich fibrin (PRF) or connective tissue graft (CTG) in papilla reconstruction (PR) with the semilunar incision (SI) technique. MATERIALS AND METHODS The analysis consisted of 55 sites (27 CTG and 28 PRF) from 20 patients who underwent PR with either PRF or CTG placed in the maxillary anterior region with SI technique. Baseline (BL) and follow-up (T1 , first month, T3 , third month, T6 , sixth month) clinical data including periodontal evaluations (gingival index (GI), plaque index (PI), pocket depth (PD), keratinized tissue width (KTW), gingival recession), papilla-associated recordings (alveolar crest-interdental contact point [AC-IC], alveolar crest-papilla tip [AC-PT], papilla tip-interdental contact point [PT-IC], papilla height loss [PHL], interdental tissue stroke [ITS] and papilla presence index [PPI]) and patient satisfaction were analyzed. RESULTS CTG provided better PR outcomes. GI, PI, and PD showed a slight increase at T1 and then, turned to their BL levels. The other periodontal parameters showed significant improvement after both treatment modalities. No inter-group difference was found except for KTW, which was in favor of CTG. CONCLUSION Based on the results, CTG is recommended over PRF in PR treatment due to its superior outcomes with less recurrence risk. CLINICAL SIGNIFICANCE Connective tissue graft provides superior results than platelet-rich fibrin in papilla reconstruction with the semilunar incision technique.
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Affiliation(s)
- Selcen Ozcan Bulut
- Periodontology Department, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - Dilek Ilhan
- Periodontology Department, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - Erdem Karabulut
- Biostatistics Department, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Feriha Caglayan
- Periodontology Department, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - H Gencay Keceli
- Periodontology Department, Hacettepe University Faculty of Dentistry, Ankara, Turkey
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Abullais SS, AlOsman SS, AlQahtani SM, Khan AA, Nahid R, Basheer SA, Jameel AS. Effect of Common Mouthwashes on Mechanical Properties of Suture Materials Used in Dental Surgeries: A Laboratory Experiment. Polymers (Basel) 2022; 14:polym14122439. [PMID: 35746015 PMCID: PMC9227470 DOI: 10.3390/polym14122439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/25/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Sutures play a pivotal role in promoting healing in any surgical procedure. However, the versatile nature of the oral environment entails additional properties in the suture materials to assure uneventful healing. A surgeon needs to understand these delicate intricacies in the immediate postoperative phase and needs some kind of algorithm in the selection of sutures that suits the different surgical scenarios. Therefore, a study was designed to observe the effect of four different types of mouthwash, viz. Avohex, Aloedent, Parodontax and Betadine, on the mechanical properties of Vicryl (polyglactin 910), PTFE (polytetrafluoroethylene), Prolene (polypropylene) and Mersilk. Methods: A total of 288 suture samples were divided in four equal groups (72 = each group) and used for the experiments. Tensile load, tensile strength as well as percentage elongation of the suture materials were evaluated in the various stated media at 3rd, 7th, 10th and 14th days, which were compared with the controls. The results were analyzed statistically and inferences were drawn. Results: Mersilk in (Avohex, Parodontax and Betadine) solutions showed a statistically significant decrease in tensile load over time. All the sutures had the highest tensile strength in Parodontax and had the lowest in Betadine solution. Vicryl and PTFE presented significant percentage elongation over time as compared to Prolene and Mersilk. Conclusion: The author has given certain recommendations but also states that there is no standard rule for the use of a particular suture material in all clinical situations. However, the selection of the suture material should be based on the type of surgery and preferences of the surgeon.
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Affiliation(s)
- Shahabe Saquib Abullais
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Shaker Saleh AlOsman
- Inters, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (S.S.A.); (S.M.A.)
| | - Sultan Mansoor AlQahtani
- Inters, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (S.S.A.); (S.M.A.)
| | - Abdul Ahad Khan
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
- Correspondence: ; Tel.: +96-658-3576764
| | - Rakhshinda Nahid
- Department of Periodontology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India;
| | - Sulphi Abdul Basheer
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Ahmad Saib Jameel
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
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Loukas G, Kosho MXF, Paraskevas S, Loos BG. Post-Operative Bleeding Complications in a Periodontitis Patient Testing Positive for COVID-19. Dent J (Basel) 2022; 10:110. [PMID: 35735652 DOI: 10.3390/dj10060110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/21/2022] [Accepted: 05/30/2022] [Indexed: 02/01/2023] Open
Abstract
Recent scientific evidence states that a subset of COVID-19 patients may have a risk of increased bleeding tendency. This case report presents a healthy 38-year-old woman with generalized stage III, grade C periodontitis with an abnormal post-operative blood clot formation who tested positive for COVID-19 after a standard periodontal surgery. Previously, two periodontal surgeries proceeded without any complications and were considered standard. On day one after the third periodontal surgery the patient had no complaints. On day two the patient reported excess bleeding in the oral cavity from the operated area simultaneously with fever and loss of taste. On day three the patient was seen in our clinic; general malaise symptoms and bleeding tendency had started to decline and the patient received a COVID-19 PCR test. At day four the test resulted positive, and she reported no further complaints of intraoral bleeding. Six months later the taste of the patient was still distorted. For this patient with free medical anamnesis, we suggest that the patient had increased plasma levels of tissue plasminogen activator during the crucial postoperative period due to an acute COVID-19 infection. This led to increased plasmin levels with a hyper-fibrinolytic state as a consequence.
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Jaikumar S, Srinivasan L, Kennedy Babu SPK, Gandhimadhi D, Margabandhu M. Laser-Assisted Frenectomy Followed by Post-Operative Tongue Exercises in Ankyloglossia: A Report of Two Cases. Cureus 2022; 14:e23274. [PMID: 35449662 PMCID: PMC9012555 DOI: 10.7759/cureus.23274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/05/2022] Open
Abstract
Ankyloglossia, commonly known as tongue-tie, is a developmental abnormality that may interfere in speech and articulation of lingual and sibilant sounds, due to the abnormal lingual frenal attachment. Lingual frenectomy severs the tie, however in adolescents and young adults, kinesthetic awareness, that is, the senses of position and movement of the tongue, needs to be increased. In such a scenario, tongue exercises lend a helping hand. Here, we discuss the benefits of this combined treatment modality in two cases diagnosed with ankyloglossia.
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Affiliation(s)
- Sowmiya Jaikumar
- Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, IND
| | | | - S P K Kennedy Babu
- Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, IND
| | - D Gandhimadhi
- Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, IND
| | - Manoj Margabandhu
- Department of Periodontology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, IND
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23
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Fernandes GVDO, Santos NBM, Siqueira RACD, Wang HL, Blanco-Carrion J, Fernandes JCH. Autologous Platelet Concentrate of 2 nd and 3 rd generations efficacy in the surgical treatment of gingival recession: an overview of systematic reviews. J Indian Soc Periodontol 2021; 25:463-479. [PMID: 34898911 PMCID: PMC8603797 DOI: 10.4103/jisp.jisp_515_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 03/21/2021] [Accepted: 07/21/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Autologous platelet concentrate (APC)/platelet-rich fibrin (PRF) of second and third generations has increased use in periodontics to optimize wound healing. Few systematic reviews (SRs) have reported improved clinical outcomes, while other studies reported significantly better results for the connective tissue graft (CTG). There is still unclear clinical evidence about APC/PRF use to treat gingival recession (GR) defects. Then, the purpose of this SR was to evaluate the use of APC/PRF membranes (2nd and 3rd generations) in root coverage (RC) procedures and assess its efficacy as a substitute biomaterial. MATERIALS AND METHODS An electronic search was conducted in PubMed, Cochrane Central, Web of Science, Google Scholar, BookSC databases, and gray literature. The search strategy, without date restriction up to April 2020, included keywords as "platelet-rich fibrin," "autologous platelet concentrates," "blood," "systematic review," "periodontics," "surgery," "tissue," "gingiva," "gingival recession," "connective tissue," "graft," and "root coverage." The methodological quality was evaluated through the AMSTAR2, and a population, index test, comparator, outcome strategy was used to assess specific clinical parameters such as recession depth, clinical attachment levels, and RC outcomes. RESULTS Nine SRs were included. Only three articles described the technique of APC/PRF production. Three studies reported unfavorable outcomes using APC, while six reported favorable results and postoperative discomfort reduction. Articles included in this SRs that provided information about APC/PRF membranes (n = 13) showed no significant difference between APC/PRF and the control group for the parameters analyzed. CONCLUSIONS This implies that APC/PRF may be considered a feasible substitute biomaterial for treating GR defects, although the CTG still provides superior outcomes. Further long-term and controlled studies are needed to verify this finding.
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Affiliation(s)
- Gustavo Vicentis De Oliveira Fernandes
- Faculty of Dental Medicine at Universidade Católica Portuguesa, Ann Arbor, Michigan, USA,
- Center for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, Viseu, Portugal
- Department of Periodontics and Oral Medicine at the University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | | | | | - How-Lay Wang
- Department of Periodontics and Oral Medicine at the University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Juan Blanco-Carrion
- Department of Stomatology, Santiago de Compostela University, Santiago De Compostela, Spain
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Lee IK, Choi HS, Jeong SH, Lee JT. Evaluating Change of Marginal Bone Height with Cone-Beam Computed Tomography Following Surgical Treatment with Guided Tissue Regeneration (Bone Grafting) or Access Flap Alone: A Retrospective Study. Medicina (Kaunas) 2021; 57:medicina57090869. [PMID: 34577792 PMCID: PMC8472387 DOI: 10.3390/medicina57090869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/21/2021] [Accepted: 08/21/2021] [Indexed: 11/25/2022]
Abstract
Background and Objectives: This study aimed to evaluate the change of bone height following treatment of human intrabony defects with guided tissue regeneration (GTR) with bone grafting or access flap alone by cone-beam computed tomography (CBCT) scan. Materials and methods: This study was conducted as a retrospective longitudinal study. In this study, a total of 2281 teeth sites were included: the GTR group had 1210 sites, and the Flap group had 1071 sites. In the GTR group, demineralized freeze-dried bone (DFDBA) particles in combination with resorbable collagen membrane were used. No regenerative material was applied to the Flap group. CBCT images were taken twice at baseline and at least 2.5 months postoperatively. Bone heights were measured using software on CBCT images. Results: The bony change between the GTR and Flap groups was significantly different (p = 0.00001). Both males and females in the GTR group had smaller bone loss than in the Flap group. In age groups, significant differences of bony height between the GTR and Flap groups were observed in the subgroups consisting of those 29–45 and 46–53 years old. The non-smoking subjects in the GTR group had higher bone heights than those in the Flap group. In the absence of systemic disease and medicine, bone formation was higher in the GTR group than in the Flap group. In terms of oral position, the #14–17, #34–37, and #44–47 subgroups of the GTR group showed higher levels of bone heights than those of the Flap group. Conclusions. The results of this study indicated that the GTR procedure offers the additional benefit of higher bone heights than the Flap procedure does.
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Affiliation(s)
- In-Kyung Lee
- Department of Periodontics, Jukjeon Dental Hospital, College of Dentistry, Dankook University, Yongin 16890, Korea; (I.-K.L.); (H.-S.C.)
| | - Hyun-Seok Choi
- Department of Periodontics, Jukjeon Dental Hospital, College of Dentistry, Dankook University, Yongin 16890, Korea; (I.-K.L.); (H.-S.C.)
| | - Sang-Heon Jeong
- Department of Radiology, Jukjeon Dental Hospital, College of Dentistry, Dankook University, Yongin 16890, Korea;
| | - Jung-Tae Lee
- Department of Periodontics, One-Stop Specialty Center, Seoul National University, Dental Hospital, Seoul 05698, Korea
- Correspondence: ; Tel.: +82-2-2072-0054; Fax: +82-2-2072-3018
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Gulameabasse S, Gindraux F, Catros S, Fricain JC, Fenelon M. Chorion and amnion/chorion membranes in oral and periodontal surgery: A systematic review. J Biomed Mater Res B Appl Biomater 2021; 109:1216-1229. [PMID: 33354857 DOI: 10.1002/jbm.b.34783] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/13/2020] [Accepted: 12/08/2020] [Indexed: 12/20/2022]
Abstract
The aim of this study was to perform a systematic review on the clinical applications where chorion membrane (CM) and amnion/chorion membrane (ACM) were used for oral tissue regeneration procedures. Selection of articles was carried out by two evaluators in Pubmed and Scopus databases, and Outcomes (PICO) method was used to select the relevant articles. Clinical studies reporting the use of CM or ACM for oral soft and hard tissue regeneration were included. The research involved 21 studies conducted on 375 human patients. Seven clinical applications of CM and ACM in oral and periodontal surgery were identified: gingival recession treatment, intrabony and furcation defect treatment, alveolar ridge preservation, keratinized gum width augmentation around dental implants, maxillary sinus membrane repair, and large bone defect reconstruction. CM and ACM were compared to negative controls (conventional surgeries without membrane) or to the following materials: collagen membranes, dense polytetrafluoroethylene membranes, platelet-rich fibrin membranes, amnion membranes, and to a bone substitute. Several studies support the use of CM and ACM as an efficient alternative to current techniques for periodontal and oral soft tissue regeneration procedures. However, further studies are necessary to increase the level of evidence and especially to demonstrate their role for bone regeneration.
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Affiliation(s)
- Sarah Gulameabasse
- Département de chirurgie orale, UFR d'Odontologie, Université de Bordeaux, 46 rue Léo-Saignat, Bordeaux, France
| | - Florelle Gindraux
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, Besançon, France
- Service de Chirurgie Orthopédique, Traumatologique et Plastique, CHU Besançon, Besançon, France
| | - Sylvain Catros
- Département de chirurgie orale, UFR d'Odontologie, Université de Bordeaux, 46 rue Léo-Saignat, Bordeaux, France
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
| | - Jean-Christophe Fricain
- Département de chirurgie orale, UFR d'Odontologie, Université de Bordeaux, 46 rue Léo-Saignat, Bordeaux, France
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
| | - Mathilde Fenelon
- Département de chirurgie orale, UFR d'Odontologie, Université de Bordeaux, 46 rue Léo-Saignat, Bordeaux, France
- Univ. Bordeaux, INSERM, BIOTIS, U1026, Bordeaux, France
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De Ry SP, Roccuzzo A, Lang NP, Sculean A, Salvi GE. Long-term clinical outcomes of periodontal regeneration with Enamel Matrix Derivative (EMD): a retrospective cohort study with a mean follow-up of 10 years. J Periodontol 2021; 93:548-559. [PMID: 34258767 PMCID: PMC9373923 DOI: 10.1002/jper.21-0347] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/10/2021] [Accepted: 07/10/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Despite the large body of evidence on the efficacy of Enamel Matrix Derivative (EMD) in the treatment of periodontal intrabony defects, few studies reported long-term data (≥ 10-year). METHODS Periodontal patients treated with regenerative surgery with EMD between 1999 and 2012 were invited to participate in a clinical examination. The following clinical parameters were recorded and compared at baseline (T0), 6 months after surgery (T1) and after at least 8 years of follow-up (T2): probing depth (PD), gingival recession (GR), clinical attachment level (CAL), plaque and bleeding scores. The primary outcome variable was CAL change. RESULTS Forty-one patients with 75 treated teeth were available for analysis. Out of these, 68 (tooth survival rate: 90.7%) reached the latest follow-up with a mean observation period of 10.3 years (range: 8.0-21.3). The most frequent reason for tooth loss was recurrence of periodontal disease. Tooth survival curves showed a statistically significant difference between smokers and non-smokers (p = 0.028). Mean CAL changed from 8.43 ± 1.86 (T0) to 6.47 ± 1.70 (T1) (p<0.001) and to 5.91 ± 1.83 (T2) (p<0.001). At T1, a CAL gain of ≥3 mm was measured in 35% of the defects while at T2 it was detected in 51% of cases. CONCLUSIONS Within their limitations, the present results have shown that in intrabony defects, the clinical improvements obtained following regenerative surgery with EMD can be maintained on a mean period of 10 years. Smoking status and maxillary molars were correlated with an increased risk for tooth and CAL loss, respectively. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Siro P De Ry
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Couto SR, Luan X, Rossmann JA, Stenberg WV, Yen K, Atwi S, Svoboda KK. An in vivo comparison of wound healing characteristics of two commercial acellular dermal matrices. Clin Exp Dent Res 2021; 7:679-691. [PMID: 33939337 PMCID: PMC8543485 DOI: 10.1002/cre2.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 01/09/2021] [Accepted: 01/29/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives Many acellular dermal matrices (ADMs) are available for use in periodontal surgical procedures. However, few studies exist evaluating their in vivo healing properties. The objectives of this study were to compare the wound healing and remodeling of two ADMs used for gingival augmentation procedures in the rat model. Materials and methods This was a nonrandomized controlled split‐mouth study. Envelope flaps were surgically created in the maxillary quadrants of 24 Sprague Dawley rats. Each received either (a) AlloDerm Regenerative Tissue Matrix, or (b) OrACELL. Gingival tissue from one mandibular quadrant served as the untreated control. Six male and six female rats were treated for 7 or 21 days. Biopsies were processed for histologic analysis (H&E, Picro‐sirius red, Verhoeff's solution) or RNA analysis (RT‐PCR) to analyze the expression of type I collagen (Col1a1), fibronectin (Fn‐1) and VEGF‐A (Vegf‐A). Results There was a greater density of fibroblasts in OrACELL compared to AlloDerm at both timepoints. There was a greater density of elastin present in AlloDerm compared to OrACELL at 7 days but no differences at 21 days. There were no differences between test groups in the percentage of birefringent collagen or in the expression of Vegf‐A or Fn‐1. At 7 days, there were significantly more fibroblasts for males in the OrACELL group compared to females. At 21 days, there was a significantly greater expression of Col1a1 for males in the OrACELL group compared to females. Conclusions Early wound healing and remodeling of OrACELL appeared to occur more rapidly than AlloDerm and was accelerated in male rats. Whether these results have clinical implications for soft tissue grafting procedures in humans remains to be determined.
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Affiliation(s)
- Sophie R Couto
- Department of Periodontics, Texas A&M University, College of Dentistry, Dallas, Texas, USA
| | - Xianghong Luan
- Department of Periodontics, Texas A&M University, College of Dentistry, Dallas, Texas, USA
| | - Jeffrey A Rossmann
- Department of Periodontics, Texas A&M University, College of Dentistry, Dallas, Texas, USA
| | - William V Stenberg
- Department of Biomedical Sciences, Texas A&M University, College of Dentistry, Dallas, Texas, USA
| | - Karen Yen
- Texas A&M University, College of Dentistry, Dallas, Texas, USA
| | - Sarah Atwi
- Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
| | - Kathy K Svoboda
- Department of Biomedical Sciences, Texas A&M University, College of Dentistry, Dallas, Texas, USA
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Milutinovic J, Popovska M, Rusevska B, Nacevski M, Anastasovski S, Ivanоvska-Stojanoska M. Evaluation of PRF Efficiency in the Treatment of Infrabony Defects. ACTA ACUST UNITED AC 2020; 41:79-86. [PMID: 32573474 DOI: 10.2478/prilozi-2020-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The present study aimed to investigate the effectiveness of PRF in the treatment of infrabony defects in patients with chronic periodontitis by evaluating the clinical outcome through periodontal depth, clinical attachment level at the baseline, 6 and 9 months post operatively. MATERIAL AND METHODS Sixty infrabony defects with probing depth ≥ 5 mm were treated. The inclusion criterion was the necessity for surgical bilateral maxillary treatment. By using split-mouth study design, each patient had one side treated with conventional flap surgery and the other side with conventional flap surgery and PRF. Clinical parameters, such as probing depth (PD) and clinical attachment lost (CAL), were recorded in both groups at baseline, 6 and 9 months post operatively. RESULTS Positive effects for all clinical and radiographic parameters were evident in the group with PRF. Mean PD reduction demonstrated statistically significant greater results in the test group (4.00±1.07 mm) compared to the control one (4.83±0.99 mm), p = 0.003 after 9 months postoperatively. After 9 months, there were better results in the test group compared to the control group for CAL (5.60±1.61 mm, 6.20±1.58 mm), but statistically not significant. CONCLUSION Additional use of PRF in the conventional surgical treatment of infrabony defects demonstrated better parameters than the open flap debridement alone.
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29
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Shaikh MS, Husain S, Lone MA, Lone MA, Akhlaq H, Zafar MS. Clinical effectiveness of anorganic bovine-derived hydroxyapatite matrix/cell-binding peptide grafts for regeneration of periodontal defects: a systematic review and meta-analysis. Regen Med 2020; 15:2379-2395. [PMID: 33356535 DOI: 10.2217/rme-2020-0113] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Aim: To ascertain clinical effectiveness of anorganic bovine-derived hydroxyapatite matrix/cell-binding peptide (ABM/P-15) for regeneration of periodontal defects. Materials & methods: Electronic databases (National Library of Medicine [Medline by PubMed], Cochrane Library [Wiley], CINAHL [EBSCO] and Medline [EBSCO]) were systematically searched up to December 2019. Randomized controlled clinical trials comparing ABM/P-15 grafts to conventional surgery for intrabony and gingival recession defects were included and evaluated intrabony defects including clinical attachment level (CAL), probing depth and gingival recession. Results: A significant gain in CAL (1.37 mm), and reduction in probing depth (1.22 mm) were shown by ABM/P-15 grafts than open flap debridement (p < 0.00001). The subgroup analysis also showed better results for ABM/P-15 grafts in CAL gain for intrabony defects. For furcation and gingival recession defects, no significant difference was seen. Conclusion: The adjunct use of ABM/P-15 grafts in conventional periodontal surgery is useful for periodontal regeneration of intrabony defects.
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Affiliation(s)
- Muhammad S Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Shehriar Husain
- Department of Dental Materials Science, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Mohid A Lone
- Department of Oral Pathology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Muneeb A Lone
- Department of Prosthodontics, Dow University of Health Sciences, Karachi, 74200, Pakistan
| | - Humera Akhlaq
- Department of Oral Pathology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Muhammad S Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madina Al Munawwarra, 41311, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, 44000, Pakistan
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Merijohn GK, Chambrone L, Brodsky AI, Xenoudi P. Mandibular Anterior Lingual Recession: Keratinized Tissue Grafting and Minimally Invasive Harvesting. Clin Adv Periodontics 2020; 11:201-207. [PMID: 33067880 DOI: 10.1002/cap.10132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 08/31/2020] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The mandibular anterior lingual (MAL) keratinized tissue (KT) band is often insufficient in dimension: <2 mm height of which <1 mm is attached gingiva (AG). Its gingival phenotype is commonly characterized as thin (<1 mm) gingival thickness (GT) and having inadequate (<1 mm) AG width. When surgical treatment is indicated, prevention of significant apical displacement of the gingival margin and improvement of long-term gingival stability are enhanced by KT increase and phenotype modification in order to establish thick GT and adequate AG. The aim of this case report is to describe a bilaminar surgical approach, the modified coronally advanced flap (mCAF) and connective tissue graft with retained KT band (mCAF + CTGkt). It is an outcomes-driven surgical approach for KT increase and phenotype modification in order to predictably establish thick GT and adequate AG. The mCAF + CTGkt procedure is minimally invasive, predictable, well-tolerated and addresses both the unique features of MAL anatomy and normal oral functioning movement during the postoperative healing phase. CASE PRESENTATION A 48-year old female presented with chief complaint of MAL progressive gingival recession (GR). Attachment loss of 3-4 mm and lack of both KT and AG were documented. Primary treatment outcomes objectives were GR cessation, establish KT, increase GT and AG. A secondary outcome was decreasing GR. CONCLUSION The mCAF + CTGkt procedure resulted in KT increase, phenotype modification to establish thick GT and adequate AG, and decreased GR. It addressed unique features of MAL anatomy. Postoperative healing outcomes were not negatively impacted by normal oral functioning.
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Affiliation(s)
- George K Merijohn
- Department of Periodontology, University of Washington, Seattle, WA.,Division of Periodontology, University of California San Francisco, San Francisco, CA
| | - Leandro Chambrone
- School of Dentistry, Ibirapuera University (Unib), Sao Paulo, Brazil.,Unit of Basic Oral Investigation (UIBO), School of Dentistry, Universidad El Bosque, Bogota, Colombia.,Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Caparica, Almada, Portugal
| | | | - Pinelopi Xenoudi
- Division of Periodontology, University of California San Francisco, San Francisco, CA.,College of Dental Medicine, California Northstate University, Sacramento, CA
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Mauland EK, Preus HR, Aass AM. Comparison of commercially available 0.2% chlorhexidine mouthwash with and without anti-discoloration system: A blinded, crossover clinical trial. J Clin Periodontol 2020; 47:1522-1527. [PMID: 33020951 DOI: 10.1111/jcpe.13382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/31/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
AIM To evaluate clinical performance and side effects of two commercially available 0.2% chlorhexidine mouthwashes after periodontal surgery, one with (test) and one without (control) an anti-discoloration system. MATERIALS AND METHODS This single-centre, crossover clinical trial included 38 patients undergoing two sessions of periodontal flap surgery. The participants used two different 0.2% chlorhexidine products, one with and one without an anti-discoloration system, in the 14-day post-operative periods. Plaque, gingival inflammation, tooth staining, side effects and patient preference were evaluated. RESULTS The control mouthwash (without an anti-discolouring system) produced significantly lower plaque (p = 0.02) and gingival index (p = 0.01) compared to the test mouthwash. The test mouthwash produced significantly less staining in the gingival (p = 0.002) and approximal areas (p = 0.0004), but no difference was detected in the buccal area of the teeth. The patients did not show preference for any of the mouthwashes. CONCLUSION Chlorhexidine mouthwash without an anti-discoloration system resulted in significantly lowered plaque and gingival index compared to chlorhexidine mouthwash with an anti-discoloration following periodontal surgery. No difference in patient preference was found despite less side effects produced by the chlorhexidine mouthwash with the anti-discoloration system.
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Affiliation(s)
- Erik Klepsland Mauland
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hans R Preus
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Anne Merete Aass
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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González-Martín O, Carbajo G, Rodrigo M, Montero E, Sanz M. One- versus two-stage crown lengthening surgical procedure for aesthetic restorative purposes: A randomized controlled trial. J Clin Periodontol 2020; 47:1511-1521. [PMID: 32997836 DOI: 10.1111/jcpe.13375] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/11/2020] [Accepted: 09/22/2020] [Indexed: 12/18/2022]
Abstract
AIM This randomized controlled trial aimed to assess the efficacy of a two-stage crown lengthening intervention (SCL) in the aesthetic zone compared with a one-stage crown lengthening procedure (CCL). MATERIALS AND METHODS Thirty subjects were randomly assigned to either SCL (n = 15) or CCL (n = 15) groups. SCL consisted of full-thickness flaps followed by bone recontouring and gingivectomy 4 months postoperatively, if required. In CCL, osseous recontouring after submarginal incisions was performed, followed by flap repositioning. Records were obtained at baseline, 4 months (only in SCL), 6 months and 12 months. Primary outcome was the precision in achieving a pre-determined gingival margin position. Other outcomes considered were changes in the gingival margin position and keratinized tissue width (KTW) at 12 months, and patient-reported outcomes (PROMs). RESULTS Surgical precision was comparable between groups (0.2 ± 0.4 mm in the CCL group and -0.2 ± 0.5 mm in the SCL group). Four patients in the SCL group (27.7%) did not require a second-stage surgery. KTW was significantly higher in the SCL group (6.3 ± 1.4 mm versus 5.0 ± 1.4 mm, p = 0.017). SCL resulted in a lower impact on quality of life when compared to the CCL group. CONCLUSIONS Both approaches were highly accurate obtaining the desired crown length. SCL was associated with a lower reduction in KTW and more favourable oral health-related quality of life (OHIP-14).
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Affiliation(s)
- Oscar González-Martín
- Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,Private Specialist Practice, Madrid, Spain
| | - Georgina Carbajo
- Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,Private Specialist Practice, Madrid, Spain
| | - Marta Rodrigo
- Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,Private Specialist Practice, Madrid, Spain
| | - Eduardo Montero
- Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,Private Specialist Practice, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Mariano Sanz
- Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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Beaudette JR, Fritz PC, Sullivan PJ, Piccini A, Ward WE. Patients undergoing periodontal procedures commonly use dietary supplements: A consideration in the design of intervention trials. Clin Exp Dent Res 2020; 7:123-128. [PMID: 32954684 PMCID: PMC7853901 DOI: 10.1002/cre2.328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 02/02/2023] Open
Abstract
Objective Diet and dietary supplement use are associated with periodontal health while a cause and effect relationship is less clear. Although associations with specific nutrients and supplements suggest a potential benefit to healing of periodontal tissues after periodontal procedures, this study determined if patients undergoing periodontal surgery currently take dietary supplements to gage whether patients may accept use of such supplements as a potential intervention. Materials and methods Patients who were undergoing implant placement or soft tissue graft surgery completed a questionnaire indicating any dietary supplements they consumed. Patient demographics, such as age, sex, and smoking status, were gathered from patients' charting records. Results Data on dietary supplement usage were collected from 221 patients. More than half (64.7%) the population surveyed reported using one or more dietary supplements. The most commonly used dietary supplements were vitamin D (31%), multivitamin (28%), and B‐complex (17.2%). Females were more likely to be taking calcium, vitamin B12, and magnesium than males. Adults, aged 51 years and older, were more likely to be taking dietary supplements than their younger counterparts. They were also more likely to be taking four or more supplements than those under the age of 50 years. There was no association between supplement use and sex, but when the number of different supplements being used was assessed, females were more likely than males to be taking four or more different supplements. Conclusions The majority of the study population is already taking dietary supplements as part of their routine. Based on this study, future studies to determine if supplement usage, potentially at levels higher than current levels of intake, can be used to maintain or promote periodontal health seem highly feasible.
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Affiliation(s)
- Jennifer R Beaudette
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada.,Center for Bone and Muscle Health, Brock University, St. Catharines, Ontario, Canada
| | - Peter C Fritz
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada.,Periodontal Wellness & Implant Surgery, Fonthill, Ontario, Canada.,Center for Bone and Muscle Health, Brock University, St. Catharines, Ontario, Canada
| | - Philip J Sullivan
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Assunta Piccini
- Periodontal Wellness & Implant Surgery, Fonthill, Ontario, Canada
| | - Wendy E Ward
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada.,Center for Bone and Muscle Health, Brock University, St. Catharines, Ontario, Canada
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Ferreira CL, de Fátima Pedroso J, da Silva Lima VC, de Souza Ramos TC, Melo Filho AB, Neves Jardini MA. Treatment of Grade III furcation involvement in upper molars: Case Series with 2-16-year follow-up. J Indian Soc Periodontol 2020; 24:387-391. [PMID: 32831515 PMCID: PMC7418549 DOI: 10.4103/jisp.jisp_251_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/16/2019] [Accepted: 09/01/2019] [Indexed: 12/03/2022] Open
Abstract
Frequently, the clinicians are addressed to decide between the preservation of Grade III furcation molar and the implant replacement, due to the increased access among the population to this therapy over the years and high success rate of the osseointegrated implants. This case series presents clinical and radiographic data collected from 10 patients who underwent 13 root amputations for the treatment of degree Grade III furcation in maxillary molars with follow-up until 16 years. The results showed improvements in probing depth, bleeding on probing, and radiographic aspects. The follow-up time indicates that root amputation is an effective long-term treatment solution, especially when the patient's local, systemic, or financial conditions make it difficult or impossible to implant placement.
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Affiliation(s)
- Camila Lopes Ferreira
- Department of Oral Biopathology Program, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Juliana de Fátima Pedroso
- Department of Oral Biopathology Program, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Victória Clara da Silva Lima
- Department of Oral Biopathology Program, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Tatiane Caroline de Souza Ramos
- Department of Oral Biopathology Program, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Antonio Braulino Melo Filho
- Department of Social and Pediatric Dentistry, Division of Integrated Clinic, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Maria Aparecida Neves Jardini
- Department of Diagnosis and Surgery, Division of Periodontology, College of Dentistry-ICT, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
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Polak D, Wilensky A, Antonoglou GN, Shapira L, Goldstein M, Martin C. The efficacy of pocket elimination/reduction compared to access flap surgery: A systematic review and meta-analysis. J Clin Periodontol 2020; 47 Suppl 22:303-319. [PMID: 31912516 DOI: 10.1111/jcpe.13246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/17/2019] [Accepted: 12/17/2019] [Indexed: 01/22/2023]
Abstract
AIM To assess the efficacy and adverse effects of resective surgery compared to access flap in patients with periodontitis. METHODS Randomized controlled trials with a follow-up ≥6 months were identified in ten databases. Screening, data extraction, and quality assessment were conducted by two reviewers. The primary outcome was probing pocket depth, and the main secondary outcome was clinical attachment level. Data on adverse events were collected. Meta-analysis was used to synthesize the findings of trials. RESULTS A total of 880 publications were identified. Fourteen publications from nine clinical trials met the inclusion criteria and were included for analysis. Meta-analysis was carried out using all available results. The results indicated superior pocket depth reduction following resective surgery compared to access flap after 6-12 months of follow-up (weighted mean difference 0.47 mm; confidence interval 0.7-0.24; p = .010). After 36-60 months of follow-up, no differences were found between the two treatments in pocket depth and attachment level. The prevalence of adverse effects was not different between the groups. Post-operative recession tended to be more severe for the resective approaches. CONCLUSION Resective surgical approach was superior to access flap in reducing pocket depth 6-12 months post-surgery, while no differences between the two modalities were found at 36-60 months of follow-up.
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Affiliation(s)
- David Polak
- Faculty of Dental Medicine (Periodontology), The Hebrew University - Hadassah, Jerusalem, Israel
| | - Asaf Wilensky
- Faculty of Dental Medicine (Periodontology), The Hebrew University - Hadassah, Jerusalem, Israel
| | | | - Lior Shapira
- Faculty of Dental Medicine (Periodontology), The Hebrew University - Hadassah, Jerusalem, Israel
| | - Moshe Goldstein
- Faculty of Dental Medicine (Periodontology), The Hebrew University - Hadassah, Jerusalem, Israel
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Kashani H, Vora MV, Kuraji R, Brody H, Kapila YL. Rebuilding the Interproximal Papilla: Description of "Tube" Technique and Two Case Reports. Clin Adv Periodontics 2020; 11:17-21. [PMID: 32472968 DOI: 10.1002/cap.10109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 04/19/2020] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Papilla reconstruction relies on similar principles as those applied to soft tissue grafting for recession defects; however, it is uniquely challenging from a surgical perspective because of the small size and lack of a blood supply. Several techniques have been used to reconstruct lost papilla; however, there are no prescribed techniques for this specific application. CASE PRESENTATION This report describes a novel technique, herein called, the "tube technique" for treating interproximal recession and reconstructing the interproximal papilla, and documents two cases using the tube technique. An increase in attachment levels was observed in Case 1 (5 mm) and in Case 2 (4 mm) after using this surgical technique for papilla reconstruction. CONCLUSION The tube grafting technique requires technical precision. Although when executed carefully, it results in predictable reconstruction of the interproximal papilla. Use of the tube technique helps mitigate issues associated with inadequate flap thickness, blood supply, and flap retraction.
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Affiliation(s)
- Hooshang Kashani
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA
| | - Manali V Vora
- Center for Tobacco Control, Research and Education, University of California, San Francisco, San Francisco, CA
| | - Ryutaro Kuraji
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA.,Department of Life Science Dentistry, The Nippon Dental University, Tokyo, Japan.,Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Hanna Brody
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA
| | - Yvonne L Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA
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Theodoridis C, Violesti A, Nikiforidou M, Menexes GC, Vouros ID. Short-Term Impact of Non-Surgical and Surgical Periodontal Therapy on Oral Health-Related Quality of Life in a Greek Population-A Prospective Cohort Study. Dent J (Basel) 2020; 8:E54. [PMID: 32466149 DOI: 10.3390/dj8020054] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/01/2020] [Accepted: 05/20/2020] [Indexed: 11/17/2022] Open
Abstract
While periodontitis deteriorates patients’ quality of life, non-surgical periodontal treatment seems to offer an improvement. The purpose of the present study was to evaluate the impact of non-surgical and surgical periodontal treatment on the oral health-related quality of life (OHRQoL) utilizing patient-centered assessments and surrogate clinical measurements in Greek adults. Eighty-three individuals with chronic periodontitis were enrolled in the study. Assessment of OHRQoL with the use of the Oral Health Impact Profile (OHIP-14) questionnaire in conjunction with clinical measurements of pocket probing depth (PPD), plaque index (PI) and bleeding on probing (BOP) were performed at baseline (t0), after non-surgical therapy (t1) and after periodontal surgery (t2). A statistically significant reduction of OHIP-14 score was recorded at t1 and t2 examination compared to baseline (p < 0.001) and a statistically significant improvement in all clinical parameter at all time points was recorded (p < 0.05). No correlation between the clinical parameters and the total score of OHIP-14 was recorded at any time point. Non-surgical periodontal treatment seemed to improve OHRQoL in terms of OHIP-14 scores, whilst supplementary surgical periodontal therapy did not offer any additional benefit. No correlation was found between patients’ perception of quality of life expressed by OHIP-14 score and the surrogate clinical parameters.
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Cieplik F, Ihlenfeld I, Hiller KA, Pummer A, Schmalz G, Buchalla W, Christgau M. Tooth survival and clinical outcomes up to 26 years after guided tissue regeneration therapy in deep intra-bony defects: Follow-up investigation of three randomized clinical trials. J Clin Periodontol 2020; 47:863-874. [PMID: 32390170 DOI: 10.1111/jcpe.13302] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/21/2020] [Accepted: 05/02/2020] [Indexed: 12/24/2022]
Abstract
AIM To investigate tooth survival and clinical long-term outcomes up to 26 years following guided tissue regeneration (GTR) therapy in deep intra-bony defects. METHODS Patients from three prospective clinical split-mouth studies, which investigated the outcomes of GTR therapy, were re-evaluated 21-26 years after surgery independent of the membrane type used, and tooth survival was assessed according to several site-specific and patient-related factors. RESULTS About 50 patients contributing 102 defects were available for this long-term follow-up. After up to 26 years (median 23.3 years), 52.9% of the teeth were still in situ. The median survival of the extracted teeth was 13.8 years. Patients with diabetes mellitus and/or smoking history lost significantly more teeth in the long term. Compared to the 1-year situation, there was no new median CAL loss after up to 26 years in the teeth which were still in situ. CONCLUSIONS Within the limitations of this study, our data show that more than 50% of the initially seriously diseased teeth were still in situ up to 26 years following GTR therapy despite an overall limited adherence to SPT. In the majority of these teeth, the CAL gain 1 year after GTR could be maintained over this long period.
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Affiliation(s)
- Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Insa Ihlenfeld
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Andreas Pummer
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany.,Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Michael Christgau
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany.,Private Practice, Düsseldorf, Germany
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Rinne CA, Dagassan-Berndt DC, Connert T, Müller-Gerbl M, Weiger R, Walter C. Impact of CBCT image quality on the confidence of furcation measurements. J Clin Periodontol 2020; 47:816-824. [PMID: 32324295 DOI: 10.1111/jcpe.13298] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/27/2020] [Accepted: 04/19/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND To investigate the impact of scanning parameter in cone-beam computed tomography (CBCT) images on accuracy and confidence with measurements of furcation involvement (FI) in maxillary molars. MATERIAL AND METHODS Six half cadaver heads with present maxillary molars (n = 10) were available. CBCT scans with the fixed-parameter field of view (4 × 4 cm, 12 × 17 cm) amperage and voltage (4 mA, 90 kV) and with varying scan modes (SM), that is images/scan (IS), voxel sizes (VZ) and rotation (R), were performed using one CBCT apparatus. The images were analysed by two calibrated investigators. Horizontal FI's were measured in mm or a "through and through" destruction (FI degree III) was recorded. Each rater scored the FI measurements performed in each scan as "confident" or as "not confident". Data were statistically analysed using chi-square tests. RESULTS The agreement between CBCT FI measurements and intra-surgical FI measurements varied according to SM (SM HiSp 180°, 0.08: kappa 0.538, CI; 95%: 0.362-0.714; SM Std. 360°, 0.25: kappa 0.698, CI; 95%: 0.534-0.861). The number of measurements scored as "confident" varied according to SM (SM Std. 360°, 0.08:52 out of 60 measurements; SM Std. 360°, 0.25:16 out of 60 measurements; p < .001). CONCLUSIONS SM of CBCT significantly affect the confidence with FI measurements in maxillary molars.
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Affiliation(s)
- Carin Aime Rinne
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Basel, Switzerland
| | - Dorothea C Dagassan-Berndt
- Department of Oral Surgery, Oral Radiology and Oral Medicine University Center of Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Basel, Switzerland
| | | | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Basel, Switzerland
| | - Clemens Walter
- Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Basel, Switzerland
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Meitner S, Papadimitriou D, Kotsailidi EA, Habibzadeh M, Chochlidakis K, Ercoli C, Caton J, Tsigarida A. An alternative approach for vestibular extension using temporary coverage of epithelialized palatal grafts. Quintessence Int 2020; 51:286-292. [PMID: 32080683 DOI: 10.3290/j.qi.a44141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
An alternative approach was used to increase the buccal vestibular depth of two edentulous patients, using free epithelialized palatal grafts. Two edentulous patients presented with shallow vestibules and inadequate keratinized tissue width in the mandibular anterior region. These sites were treated with vestibuloplasty followed by placement of an epithelialized palatal graft. In order to minimize graft movement and possible mechanical trauma to the area, the graft was covered with the buccal flap during the initial stages of healing. The patients maintained an increase in the vestibular depth as well as the keratinized tissue width at 14 months and 5 years postoperatively. Successful outcomes in terms of increase in vestibular depth can be achieved with the use of epithelialized palatal graft that is covered during the initial stage of healing. The dental practitioner fabricating the complete denture should be aware of the advantages offered by this alternative surgical technique.
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41
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Bebel A, Rochette J. Guided Tissue Regeneration Therapy With Bone Augmentation in a Lingual, Infrabony Osseous Defect of a Mandibular Canine. J Vet Dent 2020; 36:266-276. [PMID: 32066323 DOI: 10.1177/0898756420905125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This case report describes the use of canine demineralized freeze-dried membrane allograft and cancellous bone graft material to treat an infrabony osseous defect along the lingual aspect of a left mandibular canine in a 10-year-old miniature dachshund. Postoperative examination 6 and 12 months postoperatively showed osseous integration at the infrabony defect and improvement in periodontal probing measurements.
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Affiliation(s)
| | - Judy Rochette
- West Coast Veterinary Dental Services, Vancouver, British Columbia, Canada
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42
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Atchuta A, Gooty JR, Guntakandla VR, Palakuru SK, Durvasula S, Palaparthy R. Clinical and radiographic evaluation of platelet-rich fibrin as an adjunct to bone grafting demineralized freeze-dried bone allograft in intrabony defects. J Indian Soc Periodontol 2020; 24:60-66. [PMID: 31983847 PMCID: PMC6961455 DOI: 10.4103/jisp.jisp_99_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 08/29/2019] [Accepted: 09/02/2019] [Indexed: 11/18/2022] Open
Abstract
Background: Several bone graft materials are popularized in the treatment of intrabony defects. Demineralized freeze-dried bone allograft (DFDBA) is widely used in the treatment of intrabony defects. Platelet-rich fibrin (PRF) is autologous blood preparation which helps in wound healing and regeneration. Hence, this study focuses on evaluation of PRF, DFDBA, and their combination in the regeneration of intrabony defects. Materials and Methods: A total of 39 sites with intrabony defects were randomly assigned into three groups: (Group I - Open flap debridement, Group II - DFDBA alone, and Group III- DFDBA + PRF). Parameters such as probing pocket depth (PPD), relative attachment level (RAL), and radiographic bone fill were measured at baseline, 3 months, and 6 months. Intragroup comparison at various study intervals was made using one-way ANOVA test. Intergroup comparison was made using Tukey's multiple post hoc test. Results: Reduction in the PPD and greater difference in RAL was observed over the study period in all the three groups with greater reduction in DFDBA + PRF group. Reduction in the radiographic defect depths was observed over the study period in all the three groups with the greatest reduction of 38.99% in the DFDBA + PRF group. However, no statistically significant difference was reported by DFDBA versus DFDBA + PRF group. Conclusion: Combination of DFDBA and PRF improved the clinical and radiographic parameters compared to PRF and DFDBA alone. PRF was combined with DFDBA to produce a synergistic effect for treating intrabony defects in chronic periodontitis patients.
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Affiliation(s)
- Abhinav Atchuta
- Department of Periodontics, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
| | - Jagadish Reddy Gooty
- Department of Periodontics, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
| | | | - Sunil Kumar Palakuru
- Department of Periodontics, CKS Teja Institute of Dental Sciences, Tirupati, Andhra Pradesh, India
| | - Satyanarayana Durvasula
- Department of Periodontics, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
| | - Rajababu Palaparthy
- Department of Periodontics, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
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Verardi S, Lombardi T, Stacchi C. Clinical and Radiographic Evaluation of Nanohydroxyapatite Powder in Combination with Polylactic Acid/Polyglycolic Acid Copolymer as Bone Replacement Graft in the Surgical Treatment of Intrabony Periodontal Defects: A Retrospective Case Series Study. Materials (Basel) 2020; 13:E269. [PMID: 31936143 DOI: 10.3390/ma13020269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/22/2019] [Accepted: 01/06/2020] [Indexed: 01/25/2023]
Abstract
The aim of this retrospective case series was to evaluate the clinical efficacy of nanohydroxyapatite powder (NHA) in combination with polylactic acid/polyglycolic acid copolymer (PLGA) as a bone replacement graft in the surgical treatment of intrabony periodontal defects. Medical charts were screened following inclusion and exclusion criteria. Periodontal parameters and periapical radiographs taken before surgery and at 12-month follow-up were collected. Intra-group comparisons were performed using a two-tailed Wilcoxon signed-rank test. Twenty-five patients (13 males, 12 females, mean age 55.1 ± 10.5 years) were included in the final analysis. Mean probing depth (PD) and clinical attachment level (CAL) at baseline were 8.32 ± 1.41 mm and 9.96 ± 1.69 mm, respectively. Twelve months after surgery, mean PD was 4.04 ± 0.84 mm and CAL was 6.24 ± 1.71 mm. Both PD and CAL variations gave statistically significant results (p < 0.00001). The mean radiographic defect depth was 5.54 ± 1.55 mm and 1.48 ± 1.38 mm at baseline and at 12-month follow-up, respectively (p < 0.0001). This case series, with the limitations inherent in the study design, showed that the combination of NHA and PLGA, used as bone replacement graft in intrabony periodontal defects, may give significant improvements of periodontal parameters at 12-month follow-up.
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Maldonado-Alfandari K, Chong CH. Pinwheel Pedicle Flap Technique for Increasing Keratinized Tissue at Stage 2 Implant Surgery. Clin Adv Periodontics 2019; 10:60-63. [PMID: 31855315 DOI: 10.1002/cap.10088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 06/19/2019] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The goal of stage 2 implant surgery is to uncover implants while maintaining or augmenting the peri-implant keratinized tissue. Although the absolute requirement for keratinized tissue around natural teeth can be debated, implants appear to have consistently improved postoperative clinical parameters and health when there is an adequate keratinized peri-implant tissue. CASE PRESENTATION This article presents a new technique to optimize the keratinized tissue around implants during stage 2 surgery. Although there are many treatment options that can be considered at the time of surgery, the technique presented here has the advantage of increasing the keratinized tissue circumferentially around the implant without using a second donor site. The technique, called the "pinwheel," is presented in two cases with the same clinical presentation. Two mandibular overdenture patients with ≤3 mm of keratinized tissue over implant sites, stage 2 surgery was performed using the "pinwheel technique" to increase the keratinized tissue on the facial and lingual surfaces. CONCLUSION The use of the pinwheel technique to augment keratinized tissue around implants is effective and is a viable treatment option during stage 2 implant surgery.
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Chandra RV, Bhavana N. Palatal pyogenic granuloma: An unusual complication following mucogingival surgery for alveolar socket preservation. J Indian Soc Periodontol 2019; 23:580-583. [PMID: 31849406 PMCID: PMC6906912 DOI: 10.4103/jisp.jisp_603_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We report a case of palatal pyogenic granuloma following mucogingival surgery for alveolar socket preservation. A 24-year-old systemically healthy female underwent a pediculated palatal pedicle graft procedure to achieve soft tissue augmentation over a grafted maxillary anterior extraction site. After 1 month, a 15 mm × 20 mm exophytic growth extending from the palatal donor site to distance of 3–4 mm from the extraction socket was observed. After obtaining the subject's consent, local anesthesia was administered and the growth was excised from the base. On histopathological examination, the findings suggestive of pyogenic granuloma were seen. Palatal pyogenic granuloma occurs rarely and the authors were unable to find the reports of pyogenic granuloma originating in the vicinity of a surgical wound after a pediculated connective tissue mucogingival procedure. Healing plays a vital role in mucogingival procedures, and thus, it is very important to know about the complications affecting this important cascade of events. Failing to consider potential sources of irritation or trauma at the surgical site may lead to considerable morbidity even in sites that may heal without any untoward complications.
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Affiliation(s)
- Rampalli Viswa Chandra
- Department of Periodontics, SVS Institute of Dental Sciences, Yedira Post, Mahabubnagar, Telangana, India
| | - Nama Bhavana
- Department of Periodontics, SVS Institute of Dental Sciences, Yedira Post, Mahabubnagar, Telangana, India
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Abstract
A perforation in the furcation area is a potential risk factor for extension of pulpal inflammation into the periodontium and formation of advanced furcation defect with severe loss of clinical attachment and interradicular bone. Furthermore, the management of such furcal perforation is difficult due to poor accessibility, visibility, and regenerative potential. The development of such advanced furcation defects further compromises the prognosis of the treatment as they preclude effective plaque control and maintenance by the patient. Therefore, the management of advanced furcation defects remains an enigmatic and challenging task for the clinician. This case report describes a minimally invasive approach for the treatment of a furcal perforation by a conservative tunnel preparation. The present case report aims to highlight the importance of surgical tunnel preparation as an alternative to conventional flap procedure to repair furcal perforation with advanced furcation defects.
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Affiliation(s)
- Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Askari M, Yazdani R. Comparison of two desensitizing agents for decreasing dentin hypersensitivity following periodontal surgeries: a randomized clinical trial. Quintessence Int 2019; 50:320-329. [PMID: 30887965 DOI: 10.3290/j.qi.a42096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Dentin hypersensitivity (DH) is a common problem with multifactorial etiology. It is characterized by a short, sharp pain due to exposed dentin usually at the cervical margin. This randomized clinical trial aimed to evaluate the efficacy of two desensitizing agents for reduction of dentin hypersensitivity (DH) following periodontal surgeries. METHOD AND MATERIALS This study evaluated 96 patients who had one or two teeth with DH (120 teeth). The teeth were randomly allocated into four groups for treatment with 10% ethanolic extract of propolis (group 1), 30% ethanolic extract of propolis (group 2), Single Bond Universal dentin bonding agent (group 3), and distilled water as placebo (group 4). The degree of DH was determined according to the patients' response to tactile and air blast stimuli using a visual analog scale (VAS). The level of pain was also recorded before treatment and at 1, 7, 14, 21, 60 and 90 days after the treatment. RESULTS All interventions (groups 1 to 3) were significantly effective in decreasing DH, and 10% and 30% ethanolic extracts of propolis were equally effective. The dentin bonding agent was completely effective at all time points. All three interventions (groups 1 to 3) effectively decreased DH at 60 and 90 days. CONCLUSIONS This clinical trial showed all interventions were more effective than the placebo in decreasing DH. The tested propolis extracts were equally effective irrespective of their concentration. Application of Single Bond Universal had a fast relieving effect on DH. Propolis extracts and dentin bonding agent were equally effective in relieving DH in the long term. CLINICAL RELEVANCE DH following periodontal surgery causes patient discomfort and hinders everyday activities. Propolis is a natural desensitizing agent with antimicrobial and anti-inflammatory properties, healing effects, and cariostatic activity. It also stimulates reparative dentin formation. Flavonoids and cinnamic acid derivatives are the main biologically active components in the composition of propolis. According to the results of this study, application of propolis is recommended for patients with mild or moderate pain. Dentin bonding agent could be a better choice when immediate effect is needed.
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Oh SL, Joshi S. Single-Flap Approach in Periodontal Regeneration for Intraosseous Defects: Case Series. Clin Adv Periodontics 2019; 10:69-74. [PMID: 31612636 DOI: 10.1002/cap.10082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/18/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION A single-flap approach (SFA) is the elevation of a periodontal flap to access the defect only from one side. Several studies have reported that the SFA is at least as clinically effective as the elevation of a flap at both buccal and palatal/lingual aspects. However, studies regarding the SFA have reported only 6 to 10 months follow-up clinical outcomes. The purpose of this case series was to investigate the outcomes of the SFA for periodontal regeneration with a collagen membrane and bone grafts in regard to linear bone defect fill and clinical parameters such as gingival recession (GR), pocket depth (PD), and clinical attachment level (CAL) for the 15-month follow-up. CASE SERIES Based on the deepest pocket depth site, the flap retraction side for each case, either buccal or palatal/lingual, was determined. After retraction of a one-side full thickness flap, complete removal of granulation tissue and thorough scaling and root planing were performed. Demineralized ground cortical bone grafts were gently packed into the defect areas and an absorbable collagen membrane was placed over the grafts in 13 cases from 11 patients. CONCLUSION This case series demonstrated that the SFA for periodontal regeneration with a collagen membrane and bone grafts resulted in decreased PD with minimum GR, gain in CAL, and bone fill at defect sites for the 15-month follow-up.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD
| | - Shashank Joshi
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD
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Moreno Rodríguez JA. Peripheral Giant Cell Granuloma Associated With Periodontal Intrabony Defect. Clin Adv Periodontics 2019; 9:142-146. [PMID: 31490044 DOI: 10.1002/cap.10061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/15/2018] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The peripheral giant cell granuloma (PGCG) is associated with periodontal bony lesions in several situations and excision results in a soft papilla defect and an intrabony defect without soft tissue protection. CASE PRESENTATION A PGCG associated with loss of periodontal support is described. Following the lesion excision, a specific flap design outlining a surgical papilla in the adjacent area was proposed. The aim of this flap design was to obtain an optimal condition for periodontal regeneration, to treat the lesion excision associated with soft tissue defect, and to avoid a second surgical area. Complete periodontal defect resolution without soft tissue contraction or lesion recurrence was obtained at 2-year follow-up. CONCLUSION Early diagnosis and treatment are essential to prevent greater loss of periodontal attachment.
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Alassadi M, Qazi M, Ravidà A, Siqueira R, Garaicoa-Pazmiño C, Wang HL. Outcomes of root resection therapy up to 16.8 years: A retrospective study in an academic setting. J Periodontol 2019; 91:493-500. [PMID: 31397897 DOI: 10.1002/jper.19-0033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/06/2019] [Accepted: 05/13/2019] [Indexed: 12/28/2022]
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.
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Affiliation(s)
- Madi Alassadi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Musa Qazi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Andrea Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Rafael Siqueira
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Carlos Garaicoa-Pazmiño
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
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