Use of platelet gel with connective tissue grafts for root coverage: a randomized-controlled trial

BACKGROUND

Platelet-rich plasma (PRP) was speculated to be a promoter of periodontal regeneration. There are only a few clinical comparative studies using PRP in the treatment of gingival recession.

AIM

The aim of the present study was to compare connective tissue graft (CTG)+PRP with CTG alone in the treatment of gingival recession.

MATERIAL AND METHODS

Forty patients with Miller I/II recessions were included. Each recession was randomly treated with either CTG+PRP or CTG. Clinical variables were recorded at baseline and at 6 weeks, 6 and 12 months. Root coverage (RC) and attachment gain (AG) were also calculated.

RESULTS

Probing depth, recession depth, clinical attachment level, keratinized tissue width and recession width (RW) were improved in both study groups. However, no difference was observed between groups, except RW. RW in the control group was statistically lower than the test group at all follow-up periods.

CONCLUSION

Treatment of recession with CTG or a CTG-PRP combination resulted in favourable clinical outcomes. However, no difference could be found between CTG and CTG+PRP. Whether much longer follow-up studies with higher statistical power may change these results remains questionable.

Clinical evaluation of platelet-rich plasma and bioactive glass in the treatment of intra-bony defects

BACKGROUND

There are limited numbers of studies focused on the using of platelet-rich plasma (PRP) combined with different types of bone substitutes in intra-bony defects.

AIM

The purpose of this study was to evaluate the effect of bioactive glass graft material (BG) with and without PRP on the clinical healing of intra-bony defects.

MATERIALS AND METHODS

Twenty-nine intra-bony defects were randomly treated with either PRP/BG or BG alone. Clinical parameters were recorded at baseline and repeated 9 months after surgery and surgical reentries were also performed.

RESULTS

The results showed that both treatment modalities were effective. Pocket depth reduction of 3.60 +/- 0.51 mm, clinical attachment gain of 3.3 +/- 1.77 mm and defect fill of 3.47 +/- 0.53 mm were noted in the PRP/BG group, with 3.29 +/- 1.68, 2.86 +/- 1.56 and 3.36 +/- 0.55 mm improvements, respectively, noted for the BG group. None of the differences between the two treatment modalities were statistically significant.

CONCLUSIONS

It is suggested that both PRP/BG combination and BG alone are effective in the treatment of intra-bony defects. The results also showed that using PRP with BG has no additional benefit in the reduction of pocket depth, clinical attachment gain and defect fill.

Cone beam CT evaluation of maxillary sinus septa prevalence, height, location and morphology in children and an adult population

OBJECTIVE

The purpose of this study was to determine the prevalence, height, location and morphology of maxillary sinus septa in dentate, partially dentate and edentulous adults as well as in mixed dentition children using cone beam computed tomography (CBCT) for maxillary sinus surgical interventions.

SUBJECTS AND METHODS

Five hundred and fifty-four sides in the CBCT scans of 272 patients (30 children and 242 adults) were retrospectively analyzed. The prevalence, location and morphology were assessed in axial, sagittal, cross-sectional and panoramic 3-dimensional images. The height of septa was measured with the angle between the direction of the septum and median palatine suture. The differences among age, localization and measurements were statistically analyzed.

RESULTS

The prevalence of maxillary sinus segments with septa was 58%. There were a total of 13 (3.2%) septa of completely edentulous (CE), 198 (53.9%) septa of edentate and 14 (3.8%) septa of the mixed dentition maxillary segments. The location of septa observed in all study groups demonstrated a greater prevalence (69.1%) in the middle region than in the anterior and posterior regions. No statistically significant differences were observed with regard to gender or age, for septum height (p > 0.05). However, maxillary sinus septa are higher in partially edentulous patients than edentate and CE ones (p < 0.05).

CONCLUSION

Septa of various heights and courses developed in all parts of the maxillary sinus, therefore to prevent possible complications during sinus surgery, extensive evaluation with an appropriate radiographic technique was indispensable.

An unusual cause of gingival recession: oral piercing

Wearing so-called jewelry in uncommon sites, termed as body piercing, is gaining increased popularity. There also seems to be a significant increase in oral piercing mainly in the lip and/or tongue. We report a case of multiple oral piercing sites and localized gingival recession as an adverse consequence. Furthermore, based on the medical characteristics of the case, we also emphasize the necessity and importance of professional dental/medical consultation before oral piercing.

Impact of the Distinct Sampling Area on Volumetric Features of Gingival Crevicular Fluid

BACKGROUND

Volumetric features of gingival crevicular fluid (GCF) are under the influence of many factors, including sampling variables. Standardizing such factors may enable a more precise methodology. Thus, analysis of the possible impact of the clinical periodontal status and the distinct location of sampling sites on fluid volume was performed.

METHODS

Clinical parameters were recorded, and fluid samples were obtained from 931 maxillary sites. The potential site-specific volumetric differences among healthy, gingivitis, and periodontitis sites; between multirooted or single-rooted teeth and mesio-buccal or disto-buccal sampling sites; and the correlations between volume and clinical measures were statistically analyzed.

RESULTS

Although volume increased in a disease-related pattern (healthy < gingivitis < periodontitis; P <0.05), the distribution range of volume was widespread, with prominent overlaps between the different clinical periodontal conditions. Multirooted teeth presented more fluid volume, and even mesio-buccal or disto-buccal sites exhibited some volumetric differences (P <0.05). Constant correlations between volume and clinical parameters could be observed only at gingivitis sites (P <0.05).

CONCLUSIONS

The spectrum of fluid volume is disease related in general. However, the wide range of volumetric distribution, the site-specific nature, and the clear impact of the distinct sampling site on volume are important volumetric features of this biologic fluid. Whenever possible, standardization of the extent of probing depth, degree of gingival inflammation, and distinct sampling area is likely to improve the reliability of GCF methodology.

Effect of systemically administered naproxen sodium on clinical parameters and myeloperoxidase and elastase-like activity levels in gingival crevicular fluid

BACKGROUND

The present study was conducted to determine the possible effect of naproxen sodium on clinical status and the enzymatic profile of gingival crevicular fluid (GCF) when given as adjunct to periodontal treatment.

METHODS

A total of 34 subjects with chronic periodontitis were selected and divided into two groups to receive either naproxen sodium or placebo. At baseline, GCF samples were obtained and probing depths (PD), gingival index (GI), plaque index (PI), and gingival bleeding index (GBI) scores were recorded. In the non-steroidal anti-inflammatory drug (NSAID) group, patients were treated with a protocol consisting of baseline periodontal treatment (scaling, root planing) and naproxen sodium (275 mg) administration daily for 6 weeks. In the placebo group, patients received the same treatment except placebo was given instead of naproxen sodium. At the end of the experimental period, clinical recordings and GCF sampling were repeated. Myeloperoxidase (MPO) and elastase-like enzyme activity (ELA) levels were determined in GCF samples by a spectrophotometric method. GCF enzymatic content was calculated both as total enzyme activity and enzyme concentration.

RESULTS

All of the clinical parameters, except mean GBI, were significantly lower in the experimental group (P <0.05). At baseline and at the end of the experimental period, there were no significant differences between the NSAID and placebo groups regarding GCF MPO and ELA levels in either mode of data presentation (P <0.05). However, in the NSAID group, mean ELA concentration (P = 0.002) and mean total ELA (P = 0.003) presented significant decreases with treatment. Also, with treatment, a general reduction in MPO levels was seen; however, this difference was not significant. Although constant and stable correlations between GCF enzyme levels and clinical parameters could not be found, positive and strong correlations were observed between total enzyme activity and enzyme concentrations.

CONCLUSION

Based on the positive clinical effect and the ELA profile of GCF, it can be suggested that NSAIDs given as an adjunct to baseline periodontal treatment could be beneficial in the outcome of treatment.

The Location and Incidence of Patent Accessory Pulpal Canals in Permanent Molars with Periodontal Lesion by Using Micro-Computed Tomography

Objective: In this study, the event of patent accessory pulpal canals situated in periodontal pockets has been resolved to utilize the micro-CT method. Methods: Fifty-seven extracted permanent human teeth were utilized to examine the commonness, location, and diameter of the patent accessory canals that are opening outside toward the periodontal pocket by utilizing micro-CT and high-resolution desktop. Results: Through 57 molars 6 (10.25%) were accessible with patent accessory, canals inside furcation area, of root, 49 (85%) were accessible with patent accessory canals inside the mesial and distal buccal root, and 28 (49.1%) were accessible with patent accessory, canals inside the palatal/lingual root. A measurably critical variety was found alongside the nearness of patent accessory trench in various roots and pocket depth at a similar region of the nearness waterway just as the nearness of these canals and connection misfortune in this region. Conclusions: Progression of periodontal pocket might be responsible for opening accessory canal and cause pulp pathosis, making successful periodontal therapy difficult.

National survey of oral health status of children and adults in Turkey

OBJECTIVES

To estimate the severity of dental caries and the periodontal status of children and adults in Turkey.

BASIC RESEARCH DESIGN

This cross-sectional study was undertaken between September 2004 and February 2005. The Turkish Statistics Institute (TSI) selected a representative sample using the proportional stratified sampling method. The selected ages/age groups were 5, 12, 15, 35-44 and 65-74. At the end of the study, 7,833 individuals had been reached. Dental students were calibrated and examinations were done according to World Health Organization (WHO) guidelines during home visits.

RESULTS

Only 30.2% of the 5-year-old group was caries-free, and the mean dmft was 3.7. Mean DMFT was 1.9 in 12- year-olds, 2.3 in 15-year-olds, 10.8 in 35-44-year-olds, and 25.8 in 65-74-year-olds. In both adolescents and adults, the prevalence of caries was higher among females than in males. In rural areas, the prevalence of caries was high among 5-year-olds, while DMFT was high in the elderly. The prevalence of dental caries was similar for 12- and 15-year-olds in urban and rural areas. Slightly less than half (48.0%) of 65-74 year-olds were edentulous. Healthy periodontal tissue was noted in 56.2% of fifteen-year-olds. In the 35-44 yr-old age group, calculus problems were high (62.6%), and 1.2% had attachment losses of 6 mm or greater. Rural subjects had more severe periodontal problems than their urban counterparts.

CONCLUSION

Community-based oral disease prevention programs are needed urgently for the promotion of oral health in Turkey.