Tooth loss assessment during periodontal maintenance in erratic versus complete compliance in a periodontal private practice in Shiraz, Iran: a 10-year retrospective study

BACKGROUND

Several studies have demonstrated the efficacy of periodontal maintenance (PM), but there are conflicting data regarding tooth loss following patient compliance.

METHOD

Seventy-two periodontal patients (52 women, 20 men), 86% of whom had been diagnosed with chronic moderate to severe periodontitis, were included in this retrospective study. Clinical variables such as tooth loss, bleeding on probing (BOP), plaque index and probing depth were collected from patients after 10 years of PM. The periodontal status of regular compliers (RCs) and erratic compliers (ECs) were compared in a private practice.

RESULTS

The statistical analysis showed that clinical variables were not significant between RCs and ECs except for BOP (p = 0.038). During PM, 24 teeth (a mean of 1.5 teeth per participant) were lost in the RC group, and 80 teeth (a mean of 1.43 teeth per participant) were lost in the EC group. Molars were the most frequently lost teeth and canines the least. In general, those patients with less BOP lost fewer teeth (p = 0.002) and attended more recall visits (p = 0.001).

CONCLUSIONS

In the present sample, RCs and ECs did not show significant differences in rates of tooth loss. However, a significant difference between RCs and ECs in regard to BOP was observed at the final examination (p = 0.038). There was also a strong relationship between BOP and recall visits: the patients with less BOP attended more recall visits (p = 0.001).

Evaluation of scaling and root planing effect in generalized chronic periodontitis by fractal and multifractal analysis

BACKGROUND AND OBJECTIVE

Fractal and multifractal analysis are useful additional non-invasive methods for quantitative description of complex morphological features. However, the quantitative and qualitative assessment of morphologic changes within human gingival cells and tissues are still unexplored. The aim of this work is to assess the structural gingival changes in patients with generalized chronic periodontitis (GCP), before and after scaling and root planing (SRP) by using fractal and multifractal analysis.

MATERIAL AND METHODS

Twelve adults with untreated chronic periodontitis were treated only by SRP. At baseline and after SRP, gingivomucosal biopsies were collected for histopathological examination. Fractal and multifractal analysis of digital images of the granular, spinous and basal and conjunctive layers structure, using the standard box-counting method was performed. The fractal dimension was determined for cell membrane, nuclear membrane of cell and nucleolus membrane of cell.

RESULTS

In GCP a higher fractal dimension corresponds to a higher geometric complexity of cells contour, as its values increase when the contour irregularities increase. The generalized fractal dimensions were determined for the conjunctive layer structure of patients with GCP and patients with GCP and SRP. The fractal and multifractal analysis of gingival biopsies confirmed earlier findings that SRP reduces gingival injury in patients with GCP.

CONCLUSION

It has been shown that fractal and multifractal analysis of tissue images as a non-invasive technique could be used to measure contrasting morphologic changes within human gingival cells and tissues and can provide detailed information for investigation of healthy and diseased gingival mucosa from patients with GCP.

Immediate post-application effect of professional prophylaxis with 8% arginine-calcium carbonate desensitizing paste on hypersensitive teeth. A practitioner-based clinical trial

PURPOSE

This practitioner-based clinical trial compared the pain reduction achieved by professional prophylaxis with 8% arginine calcium carbonate (CaCO3) desensitizing paste versus 5% potassium nitrate (KNO3) toothpaste on adult patients with tooth hypersensitivity.

METHODS

All dentists in Hong Kong were invited to join the study. Each participating dentist identified six adult patients with hypersensitive teeth after scaling in the clinic. For each patient, the most hypersensitive tooth was selected. Each hypersensitive tooth was isolated and tested with a blast of compressed cold air delivered from a three-in-one syringe. The patient was then asked to indicate a sensitivity score (SS) from 0 to 10. Three patients received professional prophylaxis with 8% arginine CaCO3 desensitizing paste (Group 1), and the other three received prophylaxis with desensitizing toothpaste containing 5% KNO3 and 1,450 ppm fluoride (Group 2). The teeth were tested for a second time with compressed cold air, and the patients were asked to report the SS again. A non-parametric test was used to analyze the results following a normality test of the SS.

RESULTS

A total of 303 patients were recruited by 65 participating dentists. The mean age of the patients was 40.1, and 59% were female. The median pre-treatment SS of Groups 1 and 2 were both 7, whereas the post-treatment SS were 3 and 4, respectively (P < 0.001). The median percentage reductions in sensitivity scores of Groups 1 and 2 were 57.14% and 38.75%, respectively (P < 0.001).

Unexpected soft tissue changes in response to root coverage using an acellular dermal matrix allograft: 12–year follow up

A woman undergoing orthodontic treatment presented with recession and reduced keratinized gingiva on teeth 31 and 41. The patient declined creation of a donor site for conventional autogenous connective soft tissue grafting and opted for an acellular dermal matrix soft tissue substitute for root coverage. Orthodontic treatment followed, and the patient returned for orthognatic surgery after 12 years. Long-term follow up revealed that root coverage remained stable over time and creeping attachment on both teeth was observed. Unexpectedly, an increase in the width of keratinized gingiva was observed. No adverse effects of orthodontic treatment carried out after grafting were observed.

Mandibular incisor extractions in orthodontics: pitfalls and triumphs: a report of three cases

Mandibular incisor extraction therapy has been used as a treatment option since the early 1900s to relieve tooth size-arch length discrepancies in the anterior segment of the mandible. The advantages of this therapy include potential reduction in treatment time, possibility of achieving better long-term stability in the mandibular anterior segment since inter canine width is not increased and maintenance of the soft-tissue profile because retraction of the mandibular incisors is less compared with mandibular premolar extractions These advantages are counterbalanced, however, by some potential disadvantages. The most significant of these is the possibility of the space reopening in the long term, an occlusal result less than ideal because of a significant tooth-mass reduction in the anterior mandibular region, development of an open gingival embrasure and the need for permanent or long term retention. We present three cases with three different indications for mandibular incisor extraction where the patient was benefited despite this atypical extraction pattern.

Comparative evaluation of root surface morphology after planing and root conditioning with tetracycline hydrochloride--an in vitro SEM study

BACKGROUND AND OBJECTIVES

Tetracycline hydrochloride has been shown to produce changes on periodontally involved root surfaces that can potentially enhance periodontal regeneration. This in vitro study was carried out to compare the root surface changes after scaling and root planing alone, and scaling and root planing followed by application of 100 mg/ml tetracycline hydrochloride under the Scanning Electron Microscope.

MATERIALS AND METHOD

Fifteen periodontally compromised freshly extracted single-rooted teeth were thoroughly cleaned. The teeth were then sectioned into thirty blocks and divided into two groups. Group I (control) consisted of teeth which received scaling and and root planing alone and Group II received scaling and root planing followed by application of 100 mg/ml tetracycline hydrochloride under the Scanning Electron Microscope.

RESULTS

Tetracycline hydrochloride solution showed statistically highly significant removal of smear layer at 100 mg/ml solution (p < 0.001) and enlargement of dentinal tubule diameter (1.46 microm).

CONCLUSION

It can be concluded that tetracycline hydrochloride at concentration 100 mg/ml effectively removes the smear layer and enlarges the dentinal tubules.

Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study

AIM

The aim of this randomized placebo-controlled clinical trial was to evaluate the effects of Lactobacillus reuteri-containing probiotic lozenges as an adjunct to scaling and root planing (SRP).

MATERIAL AND METHODS

Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks.

RESULTS

At week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction (p < 0.05) and attachment gain (p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group.

CONCLUSIONS

The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.

Influence of nicotine and cotinine impregnation on the first step of periodontal regeneration: clot stabilization

This study analyzes the clot stabilization on root surfaces of teeth impregnated with cotinine and nicotine and the influence of the scaling in the adhesion of blood components, observing the influence of new exposition to nicotine and/or cotinine after scaling. Fifteen human teeth extracted due to periodontal disease of non-smokers patients were selected and manually scaled. Four dentin blocks were obtained from each tooth (n = 60). Samples received blood application or reimpregnation with nicotine and/or cotinine, depending on the groups. Group 1: PBS immersion + root scaling + blood; group 2: nicotine + root scaling + blood; group 3: nicotine + root scaling + nicotine reapplication + blood; group 4: cotinine + root scaling + blood; group 5: cotinine + root scaling + cotinine reapplication+ blood; group 6: nicotine and cotinine + root scaling + nicotine and cotinine + blood. Samples were kept in 2 ml of each substance for 24 hours. Each group received a blood drop and was analyzed by SEM. The higher amount of blood components was present in teeth exposed to cotinine and the groups submitted to scaling and blood application in comparison with groups that received reapplication of toxic substances after scaling. The greater toxic effect on root dentin surface was after the exposure to nicotine and cotinine. Results suggest that periodontal healing may be delayed in smokers due to the direct inhibition of clot stabilization on the root surface when nicotine and cotinine are present concomitantly.

The use of controlled release locally delivered 10% doxycycline hyclate gel as an adjunct to scaling and root planing in the treatment of chronic periodontitis: clinical and microbiological results

BACKGROUND

Local delivery of antimicrobial agents provides higher concentration of the drug in the periodontal site for longer periods than systemically delivered methods. In the present study an attempt is made to know the efficacy of controlled local drug delivery of doxycycline as an adjunctive treatment in the management of chronic periodontitis.

MATERIALS AND METHODS

A total of 12 patients, diagnosed as Chronic Periodontitis in the age of 25 to 55 years, were selected of both the sexes in this study. They were divided into Experimental group consisted of 30 sites who received complete scaling and root planing (SRP) followed by placement of Atridox gel and control group consisted of 30 sites who received only SRP. Clinical parameters were recorded at, baseline, days 30, 90 and 180. Parameters were plaque index, gingival index, gingival bleeding index and microbial analysis, probing pocket depth and Clinical attachment level (CAL). The microbiological analysis was done at baseline visit and at 90th day. Probing pocket depth and CAL were recorded only on day 0 and 180th day.

RESULTS

In 180 days study, both the groups exhibited a significant improvement in periodontal status. Significant gain in attachment level was observed in both the group. Between both the groups the clinical parameters in the experimental groups exhibited better results as compared to the control group. Both the groups exhibited significant reduction in the number of spirochetes.

CONCLUSION

Combination therapy of SRP and 10% DH gel demonstrated better results at all levels suggesting that this therapy can play a significant role as an adjunct to SRP in the management of chronic periodontitis.

Compare the effcacy of two commercially available mouthrinses in reducing viable bacterial count in dental aerosol produced during ultrasonic scaling when used as a preprocedural rinse

AIM

To evaluate and compare the effcacy of preprocedural mouthrinses (chlorhexidine digluconate and tea tree oil) in reducing microbial content of aerosol product during ultrasonic scaling procedures by viable bacterial count.

SETTINGS AND DESIGN

It was a randomized single blind, placebo-controlled parallel group study.

MATERIALS AND METHODS

Sixty subjects were randomly assigned to rinse 10 ml of any one of the mouthrinses (chlorhexidine digluconate or tea tree oil or distilled water). Ultrasonic scaling was done for a period of 10 minutes in presence of trypticase soy agar plates placed at standardized distance. Plates were then sent for microbiological evaluation for the aerosol produced.

RESULTS

This study showed that all the antiseptic mouthwashes signifcantly reduced the bacterial colony forming units (CFUs) in aerosol samples. Chlorhexidine rinses were found to be superior to tea tree when used preprocedurally in reducing aerolized bacteria.

CONCLUSION

This study advocates preprocedural dural rinsing with an effective antimicrobial mouthrinse during any dental treatment which generates aerosols, reduces the risk of cross-contamination with infectious agents in the dental operatory.

CLINICAL SIGNIFICANCE

The aerolization of oral microbes occurring during dental procedures can potentially result in cross-contamination in the dental operatory and transmission of infectious agents to both dental professionals and patient. It is reasonable to assume therefore, that any stratagem for reducing the viable bacterial content of these aerosols could lower the risk of cross-contamination.

A randomized controlled clinical trial evaluating the effectiveness of an external mandibular support device during dental care for patients with temporomandibular disorders

This study tested a jaw support device for patients receiving dental care while suffering from temporomandibular joint pain. This crossover randomized trial used 31 subjects with jaw pain. Subjects underwent 2 consecutive dental scaling sessions of 30 minutes each. For each subject, the device was used for 1 of the sessions. Subjects completed questionnaires regarding jaw pain and jaw fatigue before and after each session. Multivariate analyses were performed to assess the device's effectiveness in preventing the aggravation of pain and fatigue during dental treatment. Statistically significant differences were found for jaw pain (P = 0.001), and fatigue (P = 0.04), indicating the effectiveness of the device. Based on the results, supporting the mandible of patients with temporomandibular disorders during dental treatments may prevent further pain.

Use of high-magnification loupes or surgical operating microscope when performing prophylaxes, scaling or root planing procedures

The use of high-level magnification (6-8x loupes magnification, or higher degrees of magnification provided by the surgical operating microscope), combined with head-mounted, coaxial lighting, may improve the ability of a dentist or dental hygienist to perform prophylaxis or scaling and root planing procedures, compared to the performance of these tasks using unaided vision or entry-level (2.5x) magnification, combined with overhead operatory lighting. A magnified view of the supragingival contours of a tooth surface facilitates visualizing the dimensions and curvature of the unseen sub-gingival tooth surfaces, which facilitates detection and removal of calculus that is located on these subgingival surfaces. Improved calculus removal ability may lead to better periodontal disease outcomes.

One stage, full-mouth, ultrasonic debridement in the treatment of severe chronic periodontitis in smokers: a preliminary, blind and randomized clinical trial

OBJECTIVE

The aim of this clinical trial was to assess the performance of a full-mouth ultrasonic debridement protocol in the treatment of severe chronic periodontitis in comparison with scaling and root planing in a quadrant-wise procedure in smokers.

MATERIALS AND METHODS

The trial consisted of 30 participants presenting with periodontitis divided into 3 groups: Group FMUD - full-mouth ultrasonic debridement, i.e., one session of 45 minutes of ultrasonic instrumentation for smokers (n = 10), Group SRP- scaling and root planing performed in a quadrant-wise manner for smokers (n = 10), and Group Control - SRP for nonsmokers (n = 10), treated following the same protocol as the SRP group. The parameters evaluated were: plaque/bleeding on probing indices, probing pocket depth, relative recession, and relative probing attachment level at baseline, 45, 90 and 180 days after therapy.

RESULTS

Full-mouth ultrasonic debridement and scaling and root planing resulted in comparable gain of attachment 6 months after therapy. Both groups exhibited probing pocket depth reduction at all experimental periods as compared to baseline. Smokers, however, had less probing pocket depth reduction and relative probing attachment level gain compared to non-smokers, despite the mechanical protocol used (p < 0.05). Moreover, at 180 days, nonsmokers presented with fewer sites requiring re-treatment (probing pocket depth > 5 mm and bleeding on probing) than smokers (p < 0.05).

CONCLUSIONS

Full-mouth ultrasonic debridement and scaling and root planing result in comparable clinical outcomes for the treatment of smokers with severe chronic periodontitis. Despite the non-surgical technique used, smokers had a less favorable clinical response than non-smokers.

A pilot study comparing the outcome of scaling/root planing with and without Perioscope™ technology

PURPOSE

The purpose of this study was to determine if the use of a periodontal endoscope improves periodontal outcomes of scaling/root planing when compared to scaling/root planing alone.

METHODS

Thirty subjects with moderate periodontitis were recruited from the University of Minnesota School of Dentistry. Of these, 26 completed the study. A randomized split mouth design was used to evaluate periodontal outcomes at 6 to 8 weeks and 3 month intervals after sites within 2 quadrants of each subject were scaled and root planed with or without the use of the Perioscope™. Paired t-tests were used to test whether there were within-patient differences in improvement between Perioscope™ and non-Perioscope™ sites as measured by periodontal measurements (probing depth, clinical attachment level) and indices of gingival inflammation, including bleeding on probing (BOP) and gingival inflammation (GI). P-values less than 0.05 were declared to be statistically significant.

RESULTS

Less BOP and GI were found in the Perioscope™ sites at visit 1 and visit 2. Reduction in pocket depth and clinical attachment loss was achieved for all sites but probing depth and clinical attachment level changes were found to be unrelated to the use of the Perioscope™. Mean probing depth (SD) was reduced from 5.29 mm (0.4) to 3.55 mm (0.8) in the Perioscope™ sites and 5.39 mm (0.5) to 3.83 mm (1.2) in non-Perioscope™ sites from baseline measurements to visit 2.

CONCLUSION

The adjunctive use of the periodontal endoscope improved periodontal outcomes with respect to gingival inflammation and bleeding upon probing. The adjunctive use of the Perioscope™ was not found to be superior to traditional scaling and root planing with regard to pocket depth reduction and clinical attachment loss.

A clinico-biochemical evaluation of the role of a herbal (Ayurvedic) immunomodulator in chronic periodontal disease: a pilot study

BACKGROUND

Host modulation is fast gaining popularity as a preferred therapeutic modality for periodontal disease. Recent research in the medical field into herbal immunomodulators such as Septilin® has spurred an interest in evaluating its efficacy in periodontitis for the first time.

AIM

The aim of the study was to assess the immunomodulatory effects of the herbal immunomodulator Septilin® (Himalaya Drug Company, Bangalore, India) when used as an adjunct to scaling and root planing in chronic periodontal disease.

METHODS

Forty systemically healthy patients aged between 25 and 55 years of age and with chronic periodontitis were randomly divided into two groups. The test group was administered Septilin® tablets for two weeks following scaling and root planing whereas the control group was treated by scaling and root planing alone. Changes in gingival index (GI), gingival bleeding index (GBI), serum C-reactive protein (CRP) levels and salivary tumour necrosis factor-alpha (TNF-α) levels were assessed at day 0, at two weeks, and at three and six months.

RESULTS

The GI and GBI showed a statistically significant reduction at two weeks, three months and six months (P<0.001) in both groups. Salivary TNF-α level reduction was significant in the test group only (P<0.001). No significant change was found in serum CRP levels in both groups (P>0.05).

CONCLUSION

In this pilot evaluation, Septilin® was found to be a safe and effective immunomodulator as an adjunct to routine periodontal therapy. Further long-term studies to test Septilin® on larger sections of the population are recommended.

A randomized controlled clinical trial on the clinical and microbiological efficacy of systemic satranidazole in the treatment of chronic periodontitis

OBJECTIVE

The present clinical trial was designed to investigate the effectiveness of systemic satranidazole (SZ) as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis.

METHODS

Sixty-six subjects presenting with at least twelve teeth with probing depth (PD) > or = 4 mm were selected. Thirty-three subjects were randomly assigned to full-mouth SRP + placebo (Group 1) and 33 subjects were assigned to full-mouth SRP + SZ (Group 2). The clinical outcomes evaluated were plaque index (PI), gingival index (GI), clinical attachment level (CAL) and PD at baseline, 1 month, 3 months and 6 months. Also, microbial analysis of dental plaque using polymerase chain reaction was done at baseline, 3 and 6 months to estimate the number of sites harboring periodontopathogens.

RESULTS

Sixty subjects were evaluated up to 6 months. At 6 months, Group 2 showed greater mean reduction (3.84 +/- 1.31 mm) in PD as compared to Group 1 (1.42 +/- 1.01 mm; p < 0.05) and there was a greater mean CAL gain (3.22 +/- 1.01 mm) in Group 2 as compared to Group 1 (1.15 +/- 1.49 mm; p < 0.05). These subjects also showed significant reductions in the number of certain periodontopathogens, such as Tannerella forsythia, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans.

CONCLUSION

The systemic use of SZ, when used as an adjunct to non-surgical periodontal therapy in subjects with periodontitis, achieves significantly better clinical and microbiological results than scaling and root planing alone.

Predictors of quantitative microbiological analysis of spatter and aerosolization during scaling

The aim of this study is to analyze the infection risk through spatter and aerosolization during scaling and to create a prediction model of the total number of hemolytic bacteria.

MATERIAL AND METHODS

Air samples were collected prior to patient's arrival and spatter and aerosol samples were collected during scaling procedure in 80 patients of 4 different dental clinics. The dentists calculated DI, CI, DMFT. Only patients with CI > = 1 were included. The bacteriological results (CFU/m3) were correlated with clinical indicators. Patients were divided into 2 groups: one that rinse with sterile water and the other with chlohexidine mouth rinse 0.1%.

RESULTS AND CONCLUSIONS

Medium size effect positive correlations were found between the number of decayed teeth and the total number of bacteria and the total number of hemolytic bacteria that grew on plate attached to the dentist's mask. The mean number of bacteria and the mean number of hemolytic bacteria that grew on plate attached to the dentist's mask were significantly lower in the group that rinse with chlorhexidine 0.1%, when compared to the group that rinsed with sterile water. When controlling for the total number of bacteria and the total number of hemolytic bacteria from air sampling, the total number of hemolytic bacteria that grew on the plate attached to the dentist's mask can be predicted by CI, group membership and DMFT score.

Treatment of periodontitis as a manifestation of neutropenia with or without systemic antibiotics: a systematic review

The purposes of this paper were to systematically review the clinical presentations and management of periodontitis patients with neutropenia and present a patient with severe autoimmune neutropenia. Twenty-four case reports describing a total of 33 patients were identified. The reported signs and symptoms occurred in either a generalized or localized pattern. Improvements in periodontal condition were observed in 86% of patients who were administered adjuvant systemic antibiotics compared to 47% of patients who were not given supplemental therapy. Granulocyte-colony stimulating factor was administered to 67% of the neutropenic patients, and both improvement and progression of the hematological condition were monitored. Scaling and root planing, in combination with systemic antibiotics to supplement therapy for the underlying disease, have been successful in most cases.

Chronic inflammatory gingival enlargement associated with orthodontic therapy--a case report

Gingival enlargement, also synonymous with the terms gingival hyperplasia or hypertrophy, is defined as an abnormal overgrowth of gingival tissues. A case of a 19-year-old male presenting with maxillary and mandibular chronic inflammatory gingival enlargement associated with prolonged orthodontic therapy is reported here. Surgical therapy was carried out to provide a good aesthetic outcome. No recurrence was reported at the end of 1 year. The importance of patient motivation and compliance during and after therapy as a critical factor in the success of treatment has also been highlighted through this case report.

Response of molars and non-molars to a strict supragingival control in periodontal patients

The posterior position in the arches is one of the factors that underlies the poor prognosis of molar teeth (M). It is speculated that M do not benefit from the oral hygiene routine as well as non-molars (NM) do. This study evaluated the response of M and NM to supragingival control during a 6-month period in 25 smokers (S) and 25 never-smokers (NS) with moderate-to-severe periodontitis. One calibrated examiner assessed visible plaque (VPI) and gingival bleeding (GBI) indexes, periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) at days 0 (baseline), 30 and 180. At baseline, M showed significantly higher mean values of VPI (p = 0.017) and PPD (p < 0.001) compared with NM; CAL was also greater in M (p < 0.001) and was affected by smoking (p = 0.007). The reductions obtained for periodontal indicators at day 180 showed similar responses between M and NM. For CAL, M (NS 0.57 ± 0.50; S 0.67 ± 0.64) and NM (NS 0.38 ± 0.23; S 0.50 ± 0.33) reached an almost significant difference (p = 0.05). Smoking did not influence the response to treatment. Multilevel analysis revealed that, only for PDD reductions, the interaction between sites, teeth and patient was significant (p < 0.001). It was concluded that M benefit from an adequate regimen of supragingival biofilm control; therefore, supragingival condition should be considered in the prognosis of molar teeth.

[The impact of ultrasonic dental hygiene procedures on the bonding strength of restorations]

Ultrasonic calculus scaling has become a common oral hygiene procedure in patients with composite restorations, dental veneers, orthodontic brackets. The aim of the study was to evaluate in vitro the influence of the EMS-ultrasonic system scaling on the flowable composite bond strength to the tooth enamel, dentine, and e-max ceramic. The samples were divided into three groups: 1 group (composite bonded to enamel), 2 group (composite bonded to dentine), 3 group (composite bonded to e-max ceramic). The bonded samples were loaded to failure in the universal testing machine. The shear bond strength was calculated in newtons (N). T (Student's)-test was used to evaluate the data. Significantly lower bond strengths were observed with the ultrasonic treated samples in each groups. The EMS-ultrasonic system scaling significantly decreases the flowable composite bond strength to the tooth enamel, dentine, and e-max ceramic.

Activity of platelet activating factor acetylhydrolase following phase I periodontal therapy

OBJECTIVE

Elevated levels of platelet activating factor (PAF), a potent inflammatory mediator in periodontal disease and decreased PAF levels following periodontal surgical therapy have been previously detected in gingival tissues and gingival crevicular fluid (GCF). Platelet activating factor acetylhydrolase (PAF-AH) is a calcium-independent phospholipase A2 that catalyses the hydrolysis of PAF, thereby inactivating this mediator The hypothesis, a relationship between activity of PAF-AH and healing following periodontal therapy, was tested by detecting activity of PAF-AH in GCF samples collected from sites that had undergone phase I periodontal therapy with generalized chronic periodontitis.

METHODS

Twenty patients with generalized chronic periodontitis were divided into two groups (n = 10): group 1 with probing pocket depth (PPD) 4-5 mm and group 2 with PPD > or = 6-8 mm. Clinical parameters were recorded and GCF was sampled before phase I periodontal therapy and at the 2nd, 7th, 14th, 21st and 28th day follow-up evaluation visits. Activity of PAF-AH in GCF was analysed by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Probing pocket depth at the 21st and 28th day in group 1, and PPD at the 14th, 21st and 28th day in group 2 were significantly decreased when compared to the baseline values (p < 0.001). Activity of PAF-AH (micromol/ml) was significantly decreased at the 7th, 14th, 21st and 28th day following phase I periodontal therapy in both groups 1 and 2 compared to the baseline values (p < 0.05).

CONCLUSION

Platelet activating factor acetylhydrolase is detectable in GCF by ELISA and showed a continuous decrease following phase I periodontal therapy. Changes in the PAF-AH activity would be a progressive marker of periodontal healing to evaluate the success of periodontal therapies.

Effectiveness of root planing with diode laser curettage for the treatment of periodontitis

This study investigated the effectiveness of scaling/root planing using closed approach, closed approach with laser-curettage, closed approach with laser-curettage/laser-sealing, and an open approach (papilla reflection/flap closure) in treating moderate-advanced chronic periodontitis. All treatments resulted in a reduction in probing depth and bleeding upon probing. The closed approach therapies: SRP, laser-curettage/SRP, and laser-curettage/SRP/laser-sealing resulted in less gingival recession than the open approach (papilla reflection/flap closure). If esthetics are a concern, laser-curettage is a viable option.