Journal of Advanced Periodontology and Implant Dentistry
Volume:12 Issue: 2, Dec 2020

Background :

The present study aimed to assess the clinical and radiographic effect of strontium ranelate and metal-substituted hydroxyapatite as bone graft materials on treating chronic periodontitis among diabetes mellitus patients

Methods:

 A randomized split-mouth study was conducted on 20 sites in 10 controlled type II diabetic patients suffering from chronic periodontitis After phase I therapy, the sites were randomly allocated by a computer-generated table into two groups Group 1: A mucoperiosteal flap was elevated in 10 sites, followed by the placement of strontium ranelate mixed with Gengigel Group 2: A mucoperiosteal flap was elevated in 10 opposite sites, followed by the placement of metal-substituted hydroxyapatite mixed with Gengigel Clinical parameters were assessed at baseline and 3- and 6-month intervals Cone-beam computed tomography (CBCT) was used at baseline and after six months to assess bone gain

Results :

The two treatment modalities resulted in a statistically significant reduction in clinical parameters at the 3- and 6-month intervals compared to the mean baseline value Intergroup comparison showed a significant reduction in probing pocket depth and clinical attachment loss in group 1 compared to group 2 Comparison of the two sides by CBCT showed a significant increase in the alveolar bone height in the SR group than the metal-substituted hydroxyapatite group

Conclusion:

 Clinical and radiographic results showed a significant improvement in the two groups and provided evidence that strontium ranelate is promising in treating periodontal diseases

Background:

Evaluation of salivary biomarkers is a non-invasive, convenient, and economical method for diagnosing many diseases Evidence shows that salivary biomarkers and periodontal disease might be correlated This study was conducted to evaluate phase I periodontal therapy’s effect on salivary concentrations of calcium, phosphorous, and alkaline phosphatase (ALP).

Methods:

In this descriptive, analytical study, 16 patients were selected from those referred to the Department of Oral Medicine, Faculty of Dentistry, Isfahan University of Medical Sciences, using convenience sampling Salivary samples were collected using the drooling method The salivary concentrations of calcium, phosphorous, and ALP were measured immediately after saliva collection, before the first phase of periodontal therapy and one month later, using a colorimetric assay The data were analyzed with SPSS using paired t-test P<005 was considered statistically significant.

Results:

 The salivary concentrations of calcium, phosphorous, and ALP were 668, 2057, and 4831 mg/dL, respectively, before and 715, 2251, and 4037 mg/dL, respectively, after phase I periodontal therapy There were no significant differences between the salivary levels of calcium, phosphorous, and ALP before and after phase I periodontal therapy (P>005).

Conclusion:

This study revealed that the salivary concentrations of calcium, phosphorous, and ALP remained relatively unchanged after phase I periodontal therapy.

Background:

This study aimed to develop a classification for the sagittal root positioning (SRP) of mandibular anterior teeth in terms of their anterior buccal bone for use before placing immediate implants.

Methods:

A retrospective review of CBCT images was conducted on 150 patients (75 males and 75 females; mean age: 47.5 years) who met the inclusion criteria. The root position of the tooth samples was classified as buccal, middle, or lingual types according to their respective sagittal position and subtypes a, b, c, or d, according to the morphology of their osseous housing.

Results:

The frequencies of the root positions of each classified group of the sample teeth were as follows: 14% buccal type, 77% middle type, and 8% lingual type; 18.0% subtype a, 4.33% subtype b, 75.55% subtype c, and 2.11% subtype d. As a complementary procedure for data collection, the sagittal position of the apex was classified into Class I (buccally angulated apex: 4.6%), Class II (apex with no angulation: 78.2%), Class III (lingually angulated apex: 0.7%) and Class IV (exposed root: 16.3%). In addition, the results of the examination of the buccal undercut showed that in 1.6%, 32.0%, and 66.3% of the sample teeth, the undercut was located coronally, medially, and apically, respectively.

Conclusion:

Considering these results, the newly proposed SRP classification system can be used to study the mandibular anterior buccal bone morphology as a diagnostic tool for immediate implant treatment.

Background:

 Periodontal disease is a chronic polymicrobial infectious condition Non-surgical treatments, including scaling and root planing (SRP) with or without adjunctive treatments, are among the recommended treatment options for this condition This study investigated the effect of probiotic supplementation in the form of mouthwash with SRP on periodontal indices in patients with stage III grade A generalized periodontitis.

Methods :

Thirty-six patients were randomly assigned to two groups (n=18) and received SRP treatment along with a placebo in one group and probiotic supplementation in the other After SRP, the test group used daily probiotics for 20 days The control group subjects were treated only with SRP and placebo mouthwash Periodontal indices were determined at three time intervals: at baseline and after one and three months The data were analyzed using SPSS 17 P<005 was considered statistically significantd.

Results:

 There were significant differences in BOP levels in both the test and control groups between different intervals, with no significant difference between the groups The significance of changes in the CAL and PI indices were similar to those in BOP There were significant differences in PD levels between the groups after one and three months using the mouthwash There were also significant differences between the PD values at different intervals in both groups.

Conclusion:

This study’s results showed that probiotic supplementation as a mouthwash, along with SRP, had a positive effect on periodontal indices in patients with stage III and grade A generalized periodontitis.

Background:

 Preventive dentistry, including supportive periodontal therapy (SPT), is one of the most critical areas of attention. Despite SPT’s importance in the long-term success of periodontal treatment, the patients’ adherence to it is weak. The present study aimed to evaluate of periodontal disease’s recurrence rate and its related factors in periodontal patients without regular follow-up.

Methods:

A cross-sectional study was set in a specialized periodontics clinic in Tehran, Iran. Patients with periodontitis who completed periodontal therapy during 2005–2014 and did not adhere to the maintenance phase were evaluated. The periodontal history of the patients was updated. The previous diagnoses of patients according to their previous periodontal charts were revised by AAP 2015 criteria. Then, periodontal parameters were assessed, and current periodontal status was evaluated. Statistical analyses consisted of Fisher’s exact test, t-test, Man-Whitney test, and Kruskal-Wallis test. Spearman’s correlation coefficient was used to assess the relationship between factors and variables.

Results:

 Fifty patients were evaluated, including 29 males and 21 females. There was a significant relationship between the initial diagnosis and recurrence rate of periodontitis (P=0.017). There was also a significant relationship between the recurrence of periodontitis and the years elapsed since the initial treatment (P=0.027, r = 0.353). Smoking significantly affected tooth loss (P=0.001).

Conclusion:

 Patients with severe periodontitis need more attention to participate in supportive periodontal care. The patients must be aware of the disadvantages of neglecting this phase and be reminded of regular follow-up.

Background:

Periodontal regeneration is an essential goal of periodontal therapy. Acellular dermal matrix (ADM) has been recommended as an alternative to autogenous grafts. However, since it is devoid of cells and vasculature, there are concerns regarding the biological behavior of cells on ADM. This study aimed to assess the effects of two commonly used ADMs on biological behavior, i.e., attachment and proliferation, of human gingival fibroblasts (HGFs).

Methods:

This in vitro, experimental study was conducted on explanted and cultured HGFs. ADM types 1 and 2 (n=26; measuring 10×15 mm) were rinsed with saline solution, adapted to the bottom of 52 wells, exposed to HGFs with a cell density of 16,000 cells/mL, and incubated at 37°C for 12, 24, and 84 hours and seven days. Cell attachment was assessed 12 hours after incubation using 4›,6-diamidino-2-phenylindole (DAPI) and methyl-thiazol-diphenyl-tetrazolium (MTT) assay under a fluorescence microscope. Cell viability was assessed at 24 and 84 hours and one week using the MTT assay. Cells were then platinum-coated, and their morphology was evaluated under a scanning electron microscope (SEM). Data were analyzed using ANOVA.

Results:

 HGFs were evaluated in 60 samples in three groups (n=20). Cell attachment was the same in the three groups, as shown by the MTT assay and DAPI test (P=0.6). Cell viability at one week was 3.73±0.02, 2.88±0.29, and 2.13±0.24 in the control, ADM 1, and ADM 2 groups, respectively. The difference was statistically significant (P=0.01).

Conclusion:

Both scaffolds were the same in terms of attachment of HGFs. However, ADM 1 was superior to ADM2 in terms of cell viability and morphology at one week. It was concluded that the quality of acellular dermal scaffolds could significantly influence cellular behaviors and tissue maturation.

Gingival recession defined as the apical migration of the gingival margin leads to the exposure of root surface. This in turn may lead to compromised esthetics, dentine hypersensitivity and attachment loss. Severe gingival recession is typically managed surgically. However, achieving complete root coverage in cases of severe gingival recession, especially in the mandibular canine region is quite challenging. Different surgical techniques have been described in the literature to manage this condition. Tunnelling technique is one such technique which has shown promising results. Use of connective tissue graft with tunnelling technique has demonstrated favorable results in cases with mild to moderate gingival recession. Here we report a case where connective tissue graft was used in conjunction with tunnelling technique to achieve complete root coverage despite severe gingival recession and unfavorable prognosis.

Reactive lesions of soft tissue are common oral lesions that are usually non-neoplastic growths without pain; however, they can interfere with oral hygiene and plaque control, and if present in the anterior segment, they can cause esthetics problems. In this case, there was a reactive lesion at the gingiva of the left maxillary central incisor area. The particular consideration about this case was the recurrence of a peripheral ossifying fibroma as a pyogenic granuloma, indicating the association between reactive gingival lesions. The history of several recurrences due to incomplete removal shows the importance of complete excision for preventing recurrence. Therefore, the lesion was completely excised, and the mucogingival defect was successfully augmented with periodontal plastic surgery.