Changes In Probing Depth Research Articles

A Comparative Study of Platelet-Rich Fibrin (PRF) and Titanium-Prepared Platelet-Rich Fibrin (T-PRF) in Management of Endo-Perio Lesion

ABSTRACT Introduction: Association between pulp and periodontal lesion is termed as endo-perio lesion. Treatment of intra-bony defect can be done by GTR. Methodology: The present study was conducted on 180 patients suffering from endo-perio lesion. They were divided into two groups namely the ones treated by PRF and the other one treated with T-PRF. Follow-up was taken at 3 and 6 months interval. The results thus obtained were analyzed statistically using SPSS version 21.0 (IBM. Chicago, USA) and unpaired t test. The level of implication was set less than 0.05. Results: Mean change in probing depth at period of 3 months in group 1 is 2-15 while after 6 months is 2.74. P value is 0.91 which is highly insignificant. Similarly relative attachment level at 3 months is 1.96 and at 6 months is 2.63. P value is 0.73. Conclusion: No statistically significant results were observed in term of baseline attachment measurements.

Assessment of Changes in the Outcome of Autogenous Tooth Grafts Over Time: A Clinical Study Evaluating Periodontal Healing in Bone Defects After Lower Third Molar Removal

BackgroundThe removal of impacted lower third molars (ILTM) is associated with bone defects in the distal area of second molars. Different methods have been described to minimize these defects. PurposeThe primary objective was to assess changes in probing depth (PD) over time (up to 36 months) between test (grafted) and control (ungrafted) groups; the graft was obtained from the extracted ILTM. Study design, setting, sampleThis split-mouth randomized clinical trial was conducted at the Postgraduate Course in Oral Surgery of the Faculty of Dentistry of the Complutense University of Madrid. Adult patients requiring bilateral ILTM extraction with adjacent second molars were recruited, excluding pregnant/lactating women, patients in treatment with nonsteroidal anti-inflammatory drugs and patients with periodontal diseases. Predictor/exposure/independent variableThe predictor variable was the graft technique. The bone defect after ILTM removal was treated with autogenous tooth graft (ATG) in the test group, leaving the control group ungrafted. Main outcome variablePD on the distobuccal, distomedial and distolingual surfaces was recorded in both groups and averaged at baseline (T0), 3 (T1), 6 (T2) and 36 months (T3) postoperatively. CovariatesSex, age, surgical time, ILTM situation and position between groups were assessed. AnalysesANOVA repeated measures for comparisons between groups and the Friedman test for comparisons within the groups over time were applied. Statistical significance was established with a confidence interval (CI) of 95% (p<0.05). ResultsThe sample comprised 22 patients (6 males, 16 females) with a mean age of 21.68±2.19 years; 44 ILTM extractions were performed. Statistically significant differences in PD average were found between groups (p<0.001, 95% CI) at 3 (1.63 ± 0.29), 6 (1.76 ± 0.3) and 36 months (1.74 ± 0.36). Reductions from T0 to T3 of 2.74±0.28 (p<0.001) and 0.54 ± 0.3 (p=0.43) were observed in test and control groups, respectively. Conclusions and relevanceATG placed on the distal surface of lower second molars and almost completely filling the extraction socket improved PD 3, 6 and 36 months after ILTM. Furthermore, no significant changes in PD were observed over time; no major complications occurred. ATG appears to be a viable alternative graft material for this procedure.

Effects and clinical application of cannabinoids for the treatment of periodontal disease: a systematic review

Introduction: cannabinoids have a wide range of biological effects and are currently used for therapeutic purposes in modern medicine. The objective was to determine the effects and clinical application of cannabinoids as a therapeutic alternative for periodontal disease. Methods: we conducted a systematic review following the Cochrane manual for systematic reviews' recommendations to address the following inquiries: 1) What is the impact of non-surgical therapy with cannabidiol compared to conventional non-surgical therapy on the level of insertion in patients with periodontal disease? 2) What are the potential biological and microbiological effects of cannabinoids in the treatment of periodontal disease? The primary outcome was changes in the periodontal attachment level (CAL) and secondary outcomes included changes in probing depth (PD), changes in bleeding on probing (BoP), report of adverse effects and microbiological and biological effects. Results: out of 59 potential studies, 26 were excluded in the initial screening, and 33 full-text studies underwent further review. Among these, 13 were excluded for not meeting the selection criteria, resulting in 20 studies included in the qualitative synthesis. Notably, only one highly biased human clinical study was identified. In vitro and animal studies demonstrated that cannabinoids possess bactericidal properties, anti-inflammatory potential, and modulating activity on periodontal bone resorption. Conclusions: the available scientific evidence is scarce to recommend the use of cannabis derivatives for the treatment of periodontal disease. Despite promising findings in preclinical studies indicating therapeutic potential, further investigation is required to assess its application in human subjects.

Uso de proteínas derivadas de la matriz del esmalte combinado con injerto óseo para el tratamiento de defectos intraóseos: Resumen estructurado de revisiones sistemáticas (revisión FRISBEE)

Introduction: The use of enamel matrix-derived proteins (EMD) has increased in recent years due to their tissue-inducing properties that support periodontal regeneration. This study is an overview of systematic reviews with FRISBEE methodology on the use of EMD alone or combined with autologous bone graft materials (BGM) in the treatment of intrabony defects. Materials and Methods: A systematic search in the Epistemonikos database was performed. RevMan 5.3 and GRADEpro were used for data analysis and presentation Results: Four systematic reviews and two clinical trials were identified. All studies analysed change in probing depth, clinical attachment level, gingival margin level and bone defect depth (all changes in favour of EMD+BGM groups: mean difference (MD): 0.37 mm more, MD: 0.7 mm more, MD: 0.3 mm less, MD: 0.75 more, respectively). Conclusions: Adding autologous bone graft to EMD to treat intrabony defects showed better results, but not a relevant clinical difference compared to the use of EMD alone. Keywords: Dental enamel proteins; Bone transplantation; Autologous transplantation; Alveolar bone loss; Periodontal diseases; Bone regeneration.

Evaluating the Long-Term Outcomes of Periodontal Surgery vs. Non-Surgical Treatment in Aggressive Periodontitis.

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. 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. 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. This study suggests that periodontal surgery yields superior long-term outcomes in the management of aggressive periodontitis compared to non-surgical treatment.

Influence of immediate postoperative gingival thickness and gingival margin position on the outcomes of root coverage therapy: A 6 months prospective case series study using 3D digital measuring methods.

To assess linear and volumetric changes following the treatment of gingival recessions (GRs) by means of a modified coronally advanced tunnel technique combined with acellular dermal matrix (MTUN + ADM). Patients presenting GR type 1 (RT1) GRs underwent root coverage surgery consisting of MTUN + ADM. Clinical measurements were made, and intraoral scans were obtained at baseline, postoperatively, and 6 weeks, 3 and 6 months after surgery, to evaluate changes in probing depth (PD), keratinized tissue width (KTW), recession depth (RD), recession area (RA), marginal gingival thickness (MGT), and mucosal volume (MV). The impact of patient-level and surgical-site variables upon percentage root coverage (% RC) and the likelihood of achieving complete root coverage (CRC) were explored. A total of 20 patients (n = 47 teeth) were treated. After 6 months, RD and RA decreased, while KTW, MGT, and MV increased. The mean % RC was 93% at 6 months and CRC was found on 72.3% of the sites at 6 months. The postoperative MGT changes at 1.5 and 3 mm were significantly correlated to % RC and CRC at 6 months. Each additional mm of postoperative gain of gingival thickness resulted in a 4-fold increase in the probability of achieving CRC. Additionally, gingival margin positioned ≥0.5 mm coronal to the cementoenamel junction immediately after surgery was a strong predictor of CRC. The MGT gain at 1.5 and 3 mm achieved in the immediate postoperative period is a significant predictor of CRC at 6 months when treating multiple GRs via MTUN + ADM. The Scientific rationale for the study relies on the lack of 3D digital measuring tools in the assessment of soft tissue healing dynamics after root coverage therapy. The principal findings of this study can be summarized as follows: tooth type, tooth position, and post-operative gingival margin position and gingival thickness and volume changes are predictors of CRC. Therefore, the practical implications are that the more thickness and more coronal advancement achieved immediately after root coverage surgery, the higher chance of achieving CRC.

Size dependence of second-harmonic scattering from nanoparticles: Disentangling surface and electrostatic contributions.

Polarimetric angle-resolved second-harmonic scattering (AR-SHS) is an all-optical tool enabling the study of unlabeled interfaces of nano-sized particles in an aqueous solution. As the second harmonic signal is modulated by interference between nonlinear contributions originating at the particle's surface and those originating in the bulk electrolyte solution due to the presence of a surface electrostatic field, the AR-SHS patterns give insight into the structure of the electrical double layer. The mathematical framework of AR-SHS has been previously established, in particular regarding changes in probing depth with ionic strength. However, other experimental factors may influence the AR-SHS patterns. Here, we calculate the size dependence of the surface and electrostatic geometric form factors for nonlinear scattering, together with their relative contribution to the AR-SHS patterns. We show that the electrostatic term is stronger in the forward scattering direction for smaller particle sizes, while the ratio of the electrostatic to surface terms decreases with increasing size. Besides this competing effect, the total AR-SHS signal intensity is also weighted by the particle's surface characteristics, given by the surface potential Φ0 and the second-order surface susceptibility χs,2 2. The weighting effect is experimentally demonstrated by comparing SiO2 particles of different sizes in NaCl and NaOH solutions of varying ionic strengths. For NaOH, the larger χs,2 2 values generated by deprotonation of surface silanol groups prevail over the electrostatic screening occurring at high ionic strengths; however, only for larger particle sizes. This study establishes a better connection between the AR-SHS patterns and surface properties and predicts trends for arbitrarily-sized particles.

Effectiveness of the use of platelet-rich fibrin associated with open flap debridement compared to open flap debridement alone for the treatment of periodontal intrabony defects: Overview of systematic reviews.

In the recent years, platelet-rich fibrin (PRF) has gained importance in regenerative medicine due to its attributed tissue-inducing properties. However, it is still unclear whether there are benefits from using PRF with open flap debridement (OFD) for the treatment of intrabony defects compared to OFD alone. For this reason, in this study, we performed an overview of systematic reviews with Friendly Summaries of the Body of Evidence using Epistemonikos methodology on the use of PRF with OFD compared to OFD alone for the treatment of intrabony defects. We performed a systematic search in the Epistemonikos database. We extracted data from the included systematic reviews and reanalyzed the data of primary studies and generated a summary of the findings table. We used Review Manager (RevMan) v5.3 software and GRADEpro software for data analysis and data presentation. Eighteen systematic reviews were included after full-text screening, which had 16 clinical trials. Results were reported by the mean difference (MD); the following outcomes were analyzed: change in intrabony defect depth (MD: 1.37 mm more), change in radiographic bone defect filling (MD: 37.26% more), change in probing depth (MD: 1.22 mm more), change in clinical attachment level (MD: 1.32 mm more), and change in gingival margin level (MD: 0.31 more). We concluded that applying PRF with OFD to treat an intrabony defect has some clinical advantages compared to OFD alone.

The performance of two-implant overdentures in the atrophic maxilla: a case series with 1-year follow-up

To assess the implant and prosthesis survival rates, the clinical, radiographical and patient-related outcome measures, and the masticatory performance of maxillary overdentures supported by two implants in patients with an atrophic maxilla. In this case series, 15 consecutive patients who were eligible for maxillary implant overdenture therapy, but who had insufficient bone volume to place at least four implants and were unwilling to be treated with reconstructive surgery were asked to participate. After giving consent, participants received two implants in the maxilla under local anaesthesia. After 3 months of osseointegration, a maxillary overdenture with palatal coverage and solitary attachments was fabricated. Implant and overdenture survival, marginal bone level change, clinical outcome measures, masticatory performance and patient-related outcomes were evaluated at baseline and 1 year after overdenture placement. Fourteen out of 15 participants completed the follow-up period of 12months. Implant and overdenture survival rate were 89.3% and 85.7%, respectively. Change in marginal bone level (-0.5 ± 0.7mm), change in probing depth (0.0 ± 1.0mm), and clinical outcomes were favourable. Masticatory performance and patient-related outcomes improved significantly compared to baseline. Complications were minimal. Within the limitations of this study, it can be concluded that patients with extreme resorption of the maxilla that are unwilling to be treated with reconstructive surgery, benefit from two-implant maxillary overdentures retained by solitary attachments in terms of improved masticatory functioning and denture satisfaction. However, they have relatively high risk of implant loss. UMCG Trial Register (RR201900060), registered 22 January 2019.

Efficacy of concentrated growth factor versus collagen membrane in reconstructive surgical therapy of peri-implantitis: 3-year results of a randomized clinical trial

ObjectivesTo compare the 3-year clinical and radiographic outcomes of two different reconstructive surgical management of peri-implantitis using a bone substitute in combination with either concentrated growth factor (CGF) or collagen membrane (CM).Material and methodsFifty-one patients who had at least one implant presenting peri-implantitis with an intrabony defect were filled with a xenogenic bone grafting material and covered either CGF or CM. Clinical and radiographic assessments were carried out at baseline and postoperative years 1 and 3. Three different composite outcomes were defined to evaluate treatment success at a 3-year follow-up. The effects of possible prognostic indicators on treatment success were identified by using multilevel regression analysis.ResultsThe changes in probing depth (PD) and radiographic vertical defect depth (VDD) between baseline and year 1 and baseline and year 3 presented significantly greater decreases for the CM group in comparison with the CGF group (p < 0.05). No significant differences between the two treatment modalities were demonstrated regarding treatment success outcomes. History of periodontitis, VDD at baseline, and the number of intrabony defect walls revealed significant impacts on treatment success (p = 0.033; OR = 3.50, p = 0.039; OR = 0.975, and p = 0.024; OR = 7.0 and p = 0.019;OR = 6.0, respectively).ConclusionsCM in combination with a bone substitute seems to have slightly better outcomes compared to the CGF membranes in reconstructive surgical therapy of peri-implantitis. The history of periodontitis, baseline VDD, and peri-implant bone defect configuration could be possible predictors influencing treatment success.Trial registrationClinicalTrials.gov NCT04769609.Clinical relevanceFor the reconstruction of peri-implant bone defects, using a bone substitute in combination with a collagen membrane may show more favorable outcomes.

Influence of vestibular depth on the outcomes of root coverage therapy: A prospective case series study.

The purpose of this study was to investigate the influence of vestibular depth (VD) on the outcomes of root coverage therapy. Patients presenting gingival recession defects (GRD) with a minimum depth of 2mm underwent root coverage therapy consisting of a coronally advanced flap plus a connective tissue graft (CAF+CTG). Clinical examinations were performed, and intraoral scans were obtained at baseline, 3 and 6 months after surgery to assess changes in probing depth (PD), keratinized tissue width (KTW), recession depth (RD), GRD area, marginal gingival thickness (MGT), and VD. The influence of VD on percentage of root coverage (%RC) and the likelihood of achieving complete root coverage (CRC) were explored. A total of 20 patients were enrolled, and 44 teeth were treated. RD decreased and MGT increased in all treated sites. At 6 months, mean %RC was 87.47±18.37 and CRC was observed in 61.4% of sites. Mean baseline VD was 7.33±2.67mm. Mean VD reduction from baseline to 6 months was 1.98±1.27mm. %RC and CRC were significantly correlated with baseline VD. Each additional 1mm of baseline VD implied a gain of 6.58% for %RC and increased 2.75 times the probability of achieving CRC. Narrow baseline KTW and mandibular arch location were associated with inferior treatment outcomes. Lower %RC and likelihood of achieving CRC can be expected after root coverage therapy via CAF+CTG in sites presenting a shallow vestibulum.

Do fluoroquinolone agents produce therapeutic benefits or harmful effects in patients with periodontitis? A systematic review and meta-analysis.

The adjunctive use of fluoroquinolone (FQ) agents in patients with periodontitis produces contradictory results. There has been no meta-analysis performed based on the evaluations of FQ use that would enable making appropriate clinical decisions. Our study aimed to evaluate, via a systematic review and metaanalysis conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, the clinical benefits, antimicrobial effects and safety profiles of the FQ agents administered to periodontitis patients under a conventional treatment regime. Relevant databases were searched for studies published up to May 2020, with the quality and risk of bias evaluations performed on the selected studies, and meta-analyses, funnel plots and heterogeneity tests carried out based on the obtained data. Any finding of p-value less than 0.05 was considered statistically significant. Quality and the risk of bias ranged from high to low. With acceptable heterogeneity and no reporting bias, the meta-analyses showed that local or systemic FQ use produced the following results: a reduced probing depth change (ΔPD) (p < 0.00001 at ≤3 months); reduced bleeding on probing (BOP) (p < 0.00001 at 3-6 months); reduced subgingival detection of Aggregatibacter actinomycetemcomitans for up to 12 months (p-values from <0.00001 to 0.001); and an insignificant number of adverse events (p ≥ 0.05) in patients subjected to a conventional therapy as compared to those subjected to an antibiotic-free therapy. Our study found evidence to show that FQ administration provides clinical benefits and ensures antibacterial effects in periodontitis patients subjected to a conventional therapy regime.

Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development.

Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development.

Comparative Evaluation of Connective Tissue Graft and Platelet Rich Fibrin for The Management of Gingival Recession: A Split Mouth Study in 40 Cases with Long Follow Up of 3 Years

Introduction: Periodontal problems have taken top priority for treatment in patients suffering from periodontal diseases including gingival recession. This study aimed to compare Connective Tissue Graft (CTG) along with Coronally Advanced Flap (CAF) versus Platelet Rich Fibrin (PRF) along with Coronally Advanced Flap (CAF) in 40 sites of miller’s class I and II recession sites over a period of 3 years. Materials and methods: 40 bilateral Miller's class I and class II gingival recession cases were selected for the study and divided into two groups. Group A was treated with PRF and CAF whereas Group B was treated with CTG and CAF. Following clinical parameters i.e., change in recession depth, change in probing depth, change in clinical attachment level, change in width of keratinized gingiva were assessed at baseline 3, 6 and 36-months post-surgery. Results: 1. Group A showed root coverage of 71.00% whereas in Group B it was 83.33%. Group B subjects showed clinically higher and statistically significant amount of root coverage as compared to Group A. 2. Group B was associated with better clinical outcomes in terms of keratinized tissue gain. Conclusion: Current study concludes that CTG along with CAF is a better option for root coverage procedure as compared to PRF along with CAF.

Effect of full sulcular versus papilla-sparing flap on periodontal parameters in periradicular surgeries: A systematic review and meta-analysis.

Background:Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival recession, papilla recession, changes in probing depth, and clinical attachment loss.Objective:The objective of this study was to compare the effect of full sulcular flap design versus papilla-sparing flap design on the periodontal parameters in periradicular surgeries.Materials and Methods:It was a systematic review and meta-analysis. Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane, and CINAHL Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and change in the papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, postoperative pain, bleeding, and discomfort. Random-effects model was employed for computation of effect size, and forest plots were made.Results:Out of the five articles that satisfied the inclusion criteria, three were randomized control trials and two were nonrandom trials. No significant differences were found in the gingival recession (P = 0.79), papilla height (P = 0.55), gingival bleeding, and plaque indices. Statistically significant differences in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004) were observed for the two flap designs in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004).Conclusions:The present systematic review and meta-analysis showed that probing depth and attachment loss are affected by the choice of flap design. On the other hand, gingival recession and papilla height are not influenced by the type of incision. However, finding of the present review may change if more studies on this topic will be included in the future. Therefore, more clinical trials with long-term follow-ups are needed.

Comparative Evaluation of Porcelain Fused to Metal (PFM) Material used for Fixed Partial Prosthesis Placed on Vital &amp; Non-vital Abutments on the Periodontal Status – A Two Year Retrospective Follow-up

Objective: Sound periodontal foundation of abutment teeth is essential for successful restorative therapy and also for long-term success of prosthodontic restorations. Porcelain fused to metal (PFM) has been a popular choice of novel esthetic material in fixed prosthodontics over the last few decades. The present study aimed to assess the long term effect and tissue responses of fixed partial prosthesis using PFM material on vital and non- vital abutments on the periodontal parameters both clinically and radiographically.&#x0D; Methodology: Following ethical committee approval, the study group comprised of 86 abutment teeth in 41 systemically healthy patients (24 males and 17 females) aged between 18 – 45 years who had received 3 unit fixed prosthesis made of PFM, having equigingival margins using vital and non-vital abutments. The following parameters were assessed at baseline, phase 1, 3 and 4 (1 year follow up) – CAL, Probing depth, Distance between CEJ/ cervical crown margin and alveolar crest of the abutment teeth (radiograph).&#x0D; Results: Statistical analysis carried out by SPSSV22 software revealed no significant changes in probing depth and CAL (p&gt;0.05) and significant changes in radiographic bone levels (p&lt;0.05) in vital abutments whereas significant changes in probing depth and CAL from baseline to the end of 2 years (p&lt;0.05) with no changes in radiographic parameters (p&gt;0.05) with non vital abutments. However, significant differences were observed between vital and non vital abutments with regard to probing depth at the end of 2years, CAL and radiographic bone levels at 6months, 1 year and 2 years (p&lt;0.05)&#x0D; Conclusion: The response of the periodontal tissues to the PFM material used on fixed prosthesis on both vital and non vital abutment teeth although favorable, were marginally better in vital abutments.

Influence of local anesthesia on the outcomes of non-surgical periodontal treatment.

BackgroundThere is limited evidence of the effects of local anesthesia (LA) on outcomes of non-surgical periodontal treatment (NSPT), in particular among the Chinese. This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes.MethodsData from periodontal examinations of 3980 patients were used. The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015. Descriptive analyses included changes in probing depth (PD) and the Mazza bleeding index (BI). Two-level (patient and tooth) logistic regression models and three-level (patient, tooth, and site) linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD ≥ 5 mm. Decreases in PD and BI at sites under LA using the initial PD were also compared.ResultsA significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia (NLA) group (0.98 vs. 0.54 mm, t = 24.12, P < 0.001). A significantly higher probability of decreases was found in the LA group in BI (percentages of teeth with BI > 1 and BI > 2) for all teeth (16.7% vs. 13.8%, t = 3.75, P < 0.001; 34.7% vs. 28.1%, t = 6.73, P < 0.001) and PD for teeth with PD ≥ 5 mm (32.3% vs. 17.3%, t = 28.48, P < 0.001). The difference in PD between the LA and NLA groups increased as the initial PD increased. The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD < 7 mm; however, it increased to 0.41 to 1.37 mm for sites with a baseline PD ≥ 7 mm.ConclusionsLA improved the decrease in PD after NSPT. Root debridement at sites with initial PD ≥ 7 mm should be performed under routine LA.

Treatment of periodontal pockets at the distal aspect of mandibular second molar after surgical removal of impacted third molar and application of L-PRF: a split-mouth randomized clinical trial.

Presence of clinical attachment loss on the distal aspect to the second molar may be associated with malposition of the third molar. The aim of this study was to evaluate the reduction of clinical attachment loss at the distal aspect of the second molar after third molar extraction and application of leukocyte- and platelet-rich fibrin (L-PRF). Eighteen subjects with a clinical attachment loss on the distal site to the second molar associated with impacted third molar in both sides of the jaw were recruited for the study. For each subject the teeth were randomly allocated in test and control groups. After surgical removal of the impacted third molar, the L-PRF was inserted in the fresh alveolar socket of test sites; in the control sites no graft was inserted after extraction. Full-mouth plaque score, full-mouth bleeding score, clinical attachment level (CAL), probing depth, and gingival recession were assessed at baseline and 6 months later. After 6 months, mean CAL change was 1.99 ± 1.18 mm in the test group and 1.15 ± 1.01 mm in the control group; probing depth change was 1.33 ± 0.87 mm in the test group and 0.50 ± 0.63 mm in the control group. Statistically significant differences (P < .05) were observed between groups in terms of CAL and probing depth changes. No differences were found in gingival recession changes. Within the limits of the present study, the sites treated by means of application of L-PRF after impacted third molar extraction showed better results in terms of CAL gain and probing depth reduction when compared with control sites.

INFUENCE OF TOOTH-IMPLANT SUPPORTED TELESCOPIC OVERDENTURES WITH CERVICAL CLEARANCE ON SUPPORTING STRUCTURES OF UNILATERAL DISTAL EXTENSION RIDGE

Aim: This study aimed to evaluate the influence of tooth -implant supported telescopic partial overdentures with cervical clearance on the supporting structures of unilateral distal extension removable partial dentures. Materials and methods: Twelve male partially edentulous patients exhibiting lower Kennedy class II (lost second premolar and molar teeth on one side) opposed by completely edentulous maxilla were selected. Single unilateral implant was placed in the edentulous first molar area of the distal extension ridge. Patients were rehabilitated by Maxillary complete dentures and mandibular tooth-implant retained telescopic partial overdentures. Patients were randomly divided by using closed envelope into two equal groups; according to the design of telescopic crown. Group I; patients received cervically relieved telescopic crowns, (cervical clearance), and Group II; patients received telescopic crowns with no relief between primary and secondary copings, (precise fit). Measuring probing depth, and radiographic changes in marginal bone height of the abutments, and crestal bone height of the residual ridge, were evaluated at 3, 6, 9 and 12 months after denture insertion.Results: Statistical analysis revealed a significant increase in the means of the measured abutments probing depth, change in alveolar bone height of the abutments, and crestal bone height of the residual ridge (mm) during the follow up time intervals in both group I (cervical clearance) and group II (precise fit). Abutments having telescopic crowns with precise fit showed significantly higher probing depth and change in alveolar bone height compared to those with cervical clearance. There was no statistically significant difference in the change in crestal bone height between the two studied groups at the end of the study period. Conclusions: Telescopic retainers with cervical clearance are recommended for unilateral partial dentures compared to those with precise fit as they have a lowest destructive effect on the change in probing depth and height of the marginal bone of the abutments. However, the change in the crestal bone height was not significantly affected by the design of the telescopic retainers.

Occlusal changes before and after orthodontic treatment in patients with aggressive periodontitis

To evaluate the efficacy of occlusal improvement in the labial fixed orthodontic treatment in aggressive periodontitis patients and to explore the relationship between occlusal improvement and inflammation control. Twenty-two aggressive periodontitis patients who underwent combined periodontal-orthodontic treatment were included in this study. The patient's photos were matched to the dental models and digital three dimentional models were acquired using 3Shape R700 laser scanner. The occlusal force distribution maps were generated in the OrthoAnalyzer software. The newly established occlusal force distribution score (OFDS) and proximal contact score (PCS) were used to evaluate the occlusal distribution changes before and after labial fixed orthodontic treatment for assessing the effectiveness of orthodontic treatment. The multi-level linear regression analysis was used to explore the relationship between the probing depth changes and OFDS or PCS changes to screen out the favorable orthodontic strategy for inflammation control, which would provide clinical strategy for combined periodontal-orthodontic treatment in aggressive periodontitis patients. At the patient level, OFDS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment (84.5±20.9 vs.105.3±22.6, P <0.001) and PCS was improved significantly after orthodontic treatment compared with the score before orthodontic treatment (68.9±9.1 vs. 83.7±6.3, P <0.001).At the tooth level, the OFDS was significantly increased in the maxillary anterior teeth (P <0.001) while the PCS of the anterior teeth in both maxillary and mandible arches were significantly increased significantly (P <0.01). No significant changes were found in other tooth positions. The multilevel linear regression model showed that no significant correlation was found between age and gender and probing depth decrease (P >0.05). The baseline probing depth,OFDS improvements and PCS improvements (P <0.001) were positively correlated with probing depth decrease. This study showed that the distribution of occlusal force was more reasonable and the proximal contacts were more ideal in aggressive periodontitis patients. Orthodontic treatment was effective in improving occlusal force distribution by the above two ways. Especially, the OFDS and PCS improvements were both positively correlated with probing depth decrease, indicating that in the combined periodontal-orthodontic treatment for aggressive periodontitis patients, occlusal force distribution and proximal contact should be improved in order to facilitate periodontal improvement.