Relative Clinical Attachment Level Research Articles

Comparison of the effectiveness of DFDBA and T-PRF in the regeneration of intra-bony defects- A randomized split-mouth study

ObjectivesThis research intended to compare and evaluate the effectiveness of titanium-prepared platelet-rich fibrin (T-PRF) over demineralized freeze-dried bone allograft (DFDBA) in treating intra-bony defects based on the clinical and radiographic criteria. MethodsThis is a prospective randomized controlled, single-blinded split-mouth study where 15 patients with 30 intrabony defects were included. Subjects were randomly divided into T-PRF and DFDBA groups respectively. Plaque index (PI), Gingival index (GI), Probing pocket depth (PPD), Relative- clinical attachment- level (R-CAL), Defect depth, Linear amount of bone fill, Percentage of bone fill, Defect angle were assessed at baseline, 3, 6, and 9 months. For intra- and inter-group comparisons, paired and unpaired t-tests were executed. P<0.05 was set as statistically significant. ResultsThere were statistically significant differences (P<0.05) in clinical and radiographic parameters in both T-PRF and DFDBA groups from baseline values to 9 months in intragroup comparisons. However, on intergroup comparison, no statistical significance was seen. ConclusionThe clinical parameters and radiographic outcomes showed marked improvement at 9 months with both T-PRF and DFDBA in the treatment of intrabony defects from baseline values. Clinical relevanceT-PRF has shown favorable results that are comparable to DFDBA for the treatment of intrabony periodontal defects.

Clinical and Radiographic Evaluation of Autologous Platelet-Rich Fibrin With or Without Demineralized Bone Matrix in the Treatment of Grade II Furcation Defects.

Introduction This study aims to differentiate the employment of demineralized bone matrix (DMBM; Osseograft, Advanced Biotech Products (P) Ltd, Chennai, India) and platelet-rich fibrin (PRF) alone to a composite graft consisting of both materials in the surgical actions toward the anomalies of the human periodontal furcation imperfection. Methods In a split-mouth study, 30 patients with mandibular molars affected by the furcation were allocated without conscious choice to test (PRF + DMBM, n = 30) or control (PRF, n = 30) categories. At the starting point, three months after surgery, and six months later, the following modifiable factors were evaluated: probing pocket depth (PPD), full-mouth plaque scores, full-mouth gingival scores, radiographic defect depth, relative vertical clinical attachment level (RVCAL), and relative horizontal clinical attachment level (RHCAL). Results Results at three and six months demonstrated substantial differences between baseline values for both treatment methods in clinical and X-ray imaging appraisal. Nonetheless, the PRF/DMBM group manifests statistically significantly soaring changes observed in comparison to the PRF group. Overall, the probing depth (PD) in the test site was significantly lower than that in the control site, showing a reduction of 68% (95% CI=41%, 95%, p<0.001). Conclusion Clinical indications significantly improved with PRF and DMBM combined instead of PRF alone. On radiographs, the test group also showed higher bone fill.

Evaluation of Bone Graft (Hydroxyapatite + Platelet-Rich Plasma) Alone and in Combination with Diode Laser in Management of Infrabony Defect.

The current study looked at how well bone graft (hydroxyapatite + platelet-rich plasma (PRP)) and a diode laser treated infrabony defects. Twenty patients with bilateral infrabony deficiency were treated in a split-moth evaluation with bone graft (hydroxyapatite + PRP) alone (group I) (control) and bone graft combined with a diode laser (group II) (test). Clinical and radiologic measures such as the relative clinical attachment level (RCAL), probing depth (PD), gingival index (GI), and plaque index (PI) were recorded at baseline, 3 months later, and 6 months later in all patients. At the 6-month follow-up, there was a decline in the plaque index, probing depth, gingival index, and relative clinical attachment level. When compared across groups, the intrabony pocket was significantly reduced with either the bone graft (hydroxyapatite + PRP) or in conjunction with the laser.

Treatment of mandibular Grade II furcation defects using demineralized freeze-dried bone allograft alone or in combination with guided tissue regeneration membrane – A randomized controlled clinical trial.

Background– Periodontal disease, if not interfered, will headway further with attachment loss involving the bifurcation or trifurcation of multirooted teeth. Furcation involved molar teeth respond less favorably to conventional periodontal therapy alone resulting into tooth loss. Combining osseous grafting with guided tissue regeneration membrane may enhance the response to treatment as compared to graft – only therapy by achieving mechanical stabilization and preventing micromovement of the bone graft material.&#x0D; &#x0D; Aim &amp; Objective – To compare the efficacy of demineralized freeze-dried bone allograft alone or in combination with guided tissue regeneration membrane in the treatment of mandibular Grade II furcation defects.&#x0D; &#x0D; Materials &amp; method - In this study a total number of 20 patients with 20 mandibular sites (buccal grade II furcation involvement) were evaluated. They were divided into two groups: Control group (bone graft only) and test group (bone graft + GTR). The clinical parameters assessed were vertical probing depth, horizontal probing depth and relative clinical attachment level.&#x0D; &#x0D; Results – In this study the statistical analyses comparing test and control sites at baseline revealed no significant differences between the two groups for any of the clinical parameters considered. At 6 month evaluation, significant difference was found between two groups regarding VPD, HPD and rCAL.&#x0D; &#x0D; Conclusion – It was concluded that there is a significant enhanced effect of using DFDBA bone graft in combination with GTR membrane over bone graft alone for the treatment of mandibular Grade II furcation defects.&#x0D;

A COMPARATIVE EVALUATION OF VESTIBULAR INCISION SUBPERIOSTEAL TUNNEL ACCESS (VISTA) VERSUS CORONALLY ADVANCED FLAP WITH COLLAGEN MEMBRANE FOR THE TREATMENT OF MILLERS CLASS I AND CLASS II GINGIVAL RECESSION: A CLINICAL STUDY

Background: Gingival recession is defined asThe displacement of soft tissue margin apical to CEJ with exposure of root surface. Factors such as abnormal tooth alignment in the arch, fenestration, dehiscence, faulty tooth brushing, periodontal diseases etc. are few of the causes of gingival recession. The aim of the present study was to compare the effectiveness of minimally invasive Vestibular Incision Subperiosteal Tunnel Access (VISTA) technique and coronally advanced flap using a bioresorbable collagen membrane in Millers Class I and II gingival recessions Material and Methods: 20 sites with Millers Class I or II gingival recession were recruited and allocated into 2 groups with 10 sites each. Test group: VISTA with bioresorbable collagen membrane control group: CAF with bioresorbable collagen membrane. Plaque Index (PI), Gingival Index (GI), relative Clinical attachment level (CAL) Pocket Probing Depth (PPD) Recession Height (RH) and width of keratinized gingiva (WKG) Recession Width (RW) were measured at baseline 3 months and 6 months. Results: A significant improvement was found in all the clinical parameters in the Test group from baseline to 3 months and 6 months Recession width reduction was significantly more in the Test group as compared to Control group. Conclusion: Both the groups, viz: VISTA with resorbable collagen membrane and CAF with resorbable collagen membrane were effective in the treatment of Millers Class I and II gingival recessions VISTA being minimally invasive can be used for covering recession defects.

Treatment of Gingival Recession Defects with Pouch and Tunnel Technique Using Connective Tissue Graft and Lyophilized Chorion Membrane in Smokers.

BACKGROUND The chorion membrane has been used for several decades as an allograft in tissue repair and various periodontal regenerative procedures. The present study, conducted at a single center in India, aimed to evaluate and compare the clinical outcomes of 26 gingival recession sites in chronic smokers treated using a pouch and tunnel technique with connective tissue graft (CTG) and lyophilized chorion membrane (LCM). MATERIAL AND METHODS The study included 22 smokers with 26 sites of recession defect, with Miller's class I and class II gingival recession, which were allotted into control and test groups. The control group (13 sites) was treated with CTG, and the test group (13 sites) was treated with LCM. Clinical parameters like recession depth, recession width, relative clinical attachment level (RCAL), relative gingival position, width of attached gingiva, and width of keratinized gingiva were recorded at baseline and 6 months postoperatively. Visual analogue scores for pain and wound-healing index scores were assessed in the first week after surgery. RESULTS All clinical parameters showed significant improvements from baseline to 6 months postoperatively in the control and test groups. Recession width, RCAL, width of attached gingiva, and width of keratinized gingiva demonstrated significant differences, whereas mean root coverage percentage and recession depth did not show any significant differences between the study groups at 6 months postoperatively. CONCLUSIONS This study supports the role of LCM allograft as a scaffold to promote soft tissue regeneration and has demonstrated a favorable role for its use in root coverage procedures in patients who smoke.

Intrabony defect management with a bone graft (hydroxyapatite and β-tricalcium phosphate) alone and in combination with a diode laser: A randomized control trial.

The current research was conducted to evaluate the use of a diode laser and a bone graft (hydroxyapatite [HA] + β-tricalcium phosphate [β-TCP]) in healing of intrabony defects. In this split-mouth evaluation, 40 patients with bilateral intrabony defects were treated with, Group I (control) - bone graft alone (HA + β-TCP) and Group II, (test) - bone graft with a diode laser. The clinical and radiologic parameters of all patients, such as plaque index (PI), probing depth (PD), gingival index (GI), gingival recession (GR), and relative clinical attachment level (RCAL) were recorded at baseline, after 3 months and after 6 months. Reductions in PI, PD, GI, GR, and RCAL were found after 6 months. Furthermore, significant differences were displayed in the intra-group comparison while those of the inter-group evaluation (P > 0.05) were insignificant. In both groups, considerable decrease in intrabony pockets was discovered; however, the inter-group comparison was insignificant in relation to GR and RCAL.

Comparative Evaluation of Metformin Gel and Chlorhexidine Gel as Adjunct to Scaling and Root Planning in the Treatment of Chronic Periodontitis: A Clinical Study

Introduction: Pyorrhoea is an inflammatory gum disease in which destruction of tooth supporting tissues that results ultimate tooth mobility and exfoliation. In local drug delivery (LDD), which includes the delivery of therapeutic agents like Irrigating systems, fibers, gels, strips, films, microparticles, nanoparticles and low dose antimicrobial agents via systemic and local route as an adjunct to mechanical therapy which has beneficial for periodontal therapy. Aim: To evaluate and compare the efficacy of subgingivally delivered 1% Metformin gel and Chlorhexidine gel as an adjunct to scaling and root planing in the management of patients with chronic periodontitis. Materials and Method: Twenty systemically healthy patients with the age group of 20-60 years irrespective of gender suffering from generalized chronic periodontitis were selected, in which fourty sites were randomized at split mouth level and divided into two groups: (Group A -SRP+1% Metformin gel and Group B - SRP+ 0.2% Chlorhexidine gel). Parameters such as, Plaque index (PI), Modified gingival index (MGI), Probing pocket depth (PPD), and Relative clinical attachment level (R-CAL) were measured at baseline and after 1 month and 3 months. The significance of difference within and between the groups was evaluated with paired and unpaired t-tests. Result: In our study, the mean Plaque index (PI), Modified gingival index (MGI), Probing pocket depth (PPD), and Relative clinical attachment level (R-CAL) showed a statistically significant difference from baseline to 1 month and 3 months (p≤0.05) in both Group A and Group B. But, Mean PPD reduction and mean R-CAL gain was found to be greater in Group-A than Group B at 1 month and 3 months. Conclusion: Both Metformin and 0.2% Chlorhexidine gel can be considered as effective as a LDD agent adjunct to scaling and root planning (SRP) in the management of chronic periodontitis. But, 1% Metformin gel was more effective as a LDD adjunct to SRP in curative of chronic periodontitis patient than Chlorhexidine gel (Cevitec gel).

Comparative Evaluation of Platelet Rich Fibrin Membrane vs. Collagen Membrane in Combination with Hydroxy-Apatite (HA) for the Treatment of Mandibular Molar Furcation Defects – A Randomized Clinical Control Trial

Aim: A clinical trial to compare the relative efficacy of hydroxyapatite in combination with either PRF (Platelet rich fibrin) or collagen membrane in treatment of grade II furcation defects of mandibular molars. Methodology: The sample consisted of 35 Grade II mandibular molar furcation defects planed for open flap debridement (OFD) (Group 1, n=12), Platelet-rich fibrin membrane + Hydroxyapatite (HA) with OFD (Group 2, n=12), and Collagen membrane (CM) + HA with OFD (Group 3, n=11). These were recorded at baseline and 9 months postoperatively for plaque index (PI), gingival index (GI), probing depth (PPD), relative vertical and relative horizontal clinical attachment levels (RVCAL and RHCAL), and intrabony defect depth (IBD). Results: PI and GI scores decreased significantly in all three groups at 9 months postoperatively as compared to baseline scores. After 9 months of follow up visits mean PD reduction was greater in Group 2 (3.66 ± 0.98 mm) and Group 3 (3.45 ± 1.5 mm) than Group 1 (2.08 ± 0.90 mm), and mean RVCAL and RHCAL gain were greater in Group 2 (3.25 ± 0.75 mm and 3.92 ± 0.29 mm, respectively) and Group 3 (3.09 ± 0.70 mm and 3.89 ± 0.54 mm) compared with Group 1 (1.33 ± 0.77 mm and 2.25 ± 0.62 mm). A significant reduction in IBD depth was found in Groups 2 (2.16*0.38 mm) and 3 (1.58*0.35 mm) than in Group 1 (0.70*0.15 mm). The differences in PI, GI, PPD, RVCAL, and RHCAL between Groups 2 and 3 at baseline and 9 months were not statistically significant. There was a statistically significant difference in the depth reduction of IBD between Groups 2 and 3 at nine months. Conclusion: Within the scope of this study, it can be stated that the use of HA in conjunction with PRF or CM in the treatment of grade II mandibular furcation abnormalities resulted in a considerable reduction in GI PI, PPD, RVCAL, RHCAL, and IBD depth on follow up visit at 9 months after surgery. However, the combination of HA with PRF membrane exhibited significant improvement in radiographic parameters in comparison to the combination of HA with Collagen membrane.

Low-level laser periodontal therapy in diabetic patients: a randomized controlled clinical trial - pilot study

Objectives We aimed to evaluate the effects of low-level laser therapy as an adjunct to non-surgical periodontal therapy in patients with periodontitis and compare the effect on periodontal healing in diabetes mellitus and non-diabetes mellitus patients. Methodology Ten patients with periodontitis stage II grade B were divided into two groups; Group 1 included 5 non-diabetes mellitus patients with periodontitis, and Group 2 included 5 type2 diabetes mellitus patients with periodontitis. A 13 mW low-level laser was used in a continuous wave and non-contact mode as an adjunct to scaling and root planning (SRP) in a split-mouth study design “OPTODAN” (Scientific Development and Production Center, Saratov, Russia). The clinical parameters; plaque and gingival index, probing depth, and relative clinical attachment level of the test and control sides of both groups were analyzed at baseline and 1-month post-therapy. Visual analogue scale was used to determine patient discomfort intraoperatively and after 1 week. Results Statistically, significant improvement was evident in the gingival index, probing depth, and relative clinical attachment level when comparing test and control sides in all patients 1-month post-therapy. There was improvement in gingival index amongst type 2 diabetes mellitus patients in the test group. However, non-diabetes mellitus patients demonstrated superior results especially in probing depth and relative clinical attachment level. Conclusion The use of low-level laser therapy as an adjunct in periodontal therapy showed overall improvement in gingival inflammation, probing depth, and clinical attachment level. In comparison to non-diabetes mellitus patients, type 2 diabetes mellitus patients demonstrated significant improvement in gingival inflammation with low-level laser therapy.

Platelet rich fibrin in combination with bioabsorbable guided tissue regeneration (GTR) membrane and GTR membrane alone using double lateral sliding bridge flap for treatment of multiple gingival recession defects in humans: A randomized controlled clinical trail.

Background:Marginal tissue recession is a frequent clinical scenario that creates substantial compromise in esthetic appearance of the patient. The current randomized, double-blind interventional trial aims to evaluate the effectiveness of the combination of “platelet rich fibrin (PRF)” membrane with bioresorbable guided tissue regeneration (GTR) membrane as compared to GTR membrane alone utilizing “double lateral sliding bridge flap (DLSBF) technique” for the management of simultaneous GR defects in human subjects.Materials and Methods:Twenty subjects were randomly allotted in two groups: Group 1 (test): 10 subjects treated with PRF + GTR membrane using DLSBF technique and Group 2 (control): 10 subjects treated with GTR membrane alone using DLSBF technique. Clinical measurements such as relative gingival marginal level, “relative clinical attachment level (R-CAL),” “probing pocket depth (PPD),” “gingival recession (GR),” and “width of keratinized gingiva (WKG) and gingival thickness (GT)” were evaluated at the initiation of the study and 6 months thereafter.Results:Two groups showed statistically significant differences with respect to probing depth reduction, CAL gain, and increase in WKG and GT. No significant result was observed with mean root coverage (RC) and complete RC for test (84.80% ± 19.53% and 54.99% ± 38.53%) and control group (75.69% ± 18.86% and 35.83% ± 39.29%), respectively.Conclusions:The combination of PRF membrane used along with GTR membrane provides no additional benefits over GTR membrane alone. However, the DLSBF technique convincingly shows simultaneous elimination of multiple problems associated with GR, shallow vestibule, hypersensitivity, and aberrant frenum pull in a single stage with meticulous performance.

Comparison of Laser-assisted and Conventional Flap Surgery with Hydroxyapatite Crystals in the Treatment of Intrabony Defects under Magnification- A Randomised Clinical Trial

Introduction: Achieving regeneration of the lost periodontal structures after surgical approach plays a major role. This healing can be interrupted due to the presence of invasive bacteria which is present in the periodontal tissues. Aim: To compare laser-assisted and conventional flap surgery using microsurgical instruments and under surgical operating microscope with hydroxyapatite graft in the treatment of intrabony defects. Materials and Methods: This prospective randomised split-mouth clinical study was conducted in Department of Periodontology at Vishnu Dental College, Bhimavaram, Andhra Pradesh, India, from June 2020 to December 2021. A total of 24 bilateral intrabony defects were selected for the study. Control sites (n=12) received the graft after conventional open flap debridement. In the test group (n=12), graft placement was done followed by laser irradiation with diode laser (980 nm, power: 3.0 W; frequency 2.5 KHz) for 30 seconds. The entire flap surgery procedure was performed under Surgical Operating Microscope (SOM). Clinical parameters such as plaque index, gingival index, probing depth, relative attachment level, were assessed at 3 months and 6 months. Healing index was assessed after 7 days of surgery. Radiographic parameters were assessed at baseline and 6 months using Cone Beam Computed Tomography (CBCT). Descriptive statistics, Independent samples t-test, repeated measures analysis of variance and Paired t-tests were used in data analysis. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0 software. Results: Intragroup comparison showed statistical significance in all clinical and radiographical parameters (p-value&lt;0.001). Intergroup comparison between the test and control group did not show any statistical significance in terms of plaque index, gingival index, relative Clinical attachment level, probing depth (p-value≥0.05). Intragroup comparison of the depth of defect was statistically significant in both test (p-value=0.011) and control groups (p-values=0.002). Intergroup comparison did not show any statistical significance in linear bone fill (p-value=0.1). Intergroup comparison did not show any statistical significance in defect angle (p-value=0.773). No statistical significance was obtained in percentage fill (p-value=0.074). Intergroup comparison did not show any statistical significance in the clinical and radiographical parameters. Conclusion: The additional laser irradiation at the test site did not exhibit any significant benefits in the bone regeneration. All the outcomes were similar in test and control group.

Root coverage with tunneling technique or modified advanced flap associated with acellular dermal matrix: results from 6 months randomized clinical trial.

This study compared two surgical techniques using acellular dermal matrix (ADM) for the treatment of multiple gingival recessions. Twenty patients, with bilateral RT1 gingival recessions, were selected. One side received a modified extended coronally advanced flap (MECAF), and the contralateral side a supra-periosteal flap (TUN). The evaluated parameters were probing depth (PD), relative clinical attachment level, gingival index, gingival recession height (GR), width of keratinized tissue, keratinized tissue thickness, and gingival recession area at baseline and 6 months postoperative. Pain was evaluated weekly, using a visual analog scale (VAS) during first month postoperative. Both groups were effective in reducing GR (ΔGR: MECAF 2.28 mm; TUN 1.93 mm), without significant differences. The % of root coverage was numerically superior favoring MECAF (MECAF 61.24%; TUN 56.07%), without significant differences between groups. VAS scale failed to provide differences between groups. Both treatment were effective in root coverage and might be valuable for the treatment of multiple gingival recessions. The use of vertical releasing incisions and a flap design including the papillae did not hamper root coverage. This study compared two techniques for use of ADM in large multiple gingival recessions. Within its limitations, both treatments successfully achieved root coverage and were able to reduce gingival recession. It is expected a partial root coverage when using these techniques in large gingival recessions. The study failed to provide significant differences between groups. The use of modified extended coronally advanced flap may be advisable for the treatment of multiple gingival recessions, specially involving large defects when using ADM, to avoid early matrix exposure.

Comparative evaluation of the efficacy of diode laser as an adjunct to modified Widman flap surgery for the treatment of chronic periodontitis: A randomized split-mouth clinical trial.

Background:Periodontitis is a chronic inflammatory disease that is mainly initiated by plaque biofilm which may require treatment using periodontal flap surgery. Recently, diode lasers have become popular in the field of periodontology owing to advantages such as antibacterial effect, promoting angiogenesis, and providing hemostasis. However, scientific data on application of diode laser in periodontal flap surgery and its benefits are limited. Hence, the aim of the study was to investigate the adjunctive effect of removal of remnant pocket epithelium by 980 nm diode laser and biostimulation in modified Widman flap (MWF) surgery for the treatment of chronic periodontitis.Materials and Methods:A total of 20 patients with generalized chronic periodontitis with pocket probing depth (PPD) ≥5mm post Phase I therapy were selected for this split-mouth study. MWF surgery was performed in Group 1, and in Group 2, MWF surgery with adjunctive diode laser de-epithelization and biostimulation was done. Clinical parameters including PPD, clinical attachment level, plaque index, and gingival index were recorded at baseline and 3 months following treatment, and postprocedural pain (Visual Analog Scale [VAS] score) was assessed 1-week posttreatment. In addition, colony-forming units/milliliter (CFU/ml) of anaerobic bacteria at baseline and 3 months were microbiologically examined.Results:MWF surgery along with diode laser led to a significant improvement in Group 2 compared to Group 1 in clinical parameters such as PPD, relative clinical attachment level, VAS score as well as microbial parameter CFU/ml after 3 months.Conclusion:Diode laser as an adjunct to MWF in chronic periodontitis can provide enhanced clinical attachment gain with little postoperative discomfort.

Functionally graded membrane: A novel approach in the treatment of gingival recession defects.

Background:Guided tissue regeneration has recently been advocated in re-constructing soft-tissue dimensions in recession defects. Advancement in nanotechnology has led to increased zest for approaches such as electrospinning of biologically active; nanofibrous functionally graded regenerative membranes for periodontal tissue engineering. A functionally graded membrane (FGM) had been tailored by incorporating chitosan and nano-hydroxyapatite over Amnion membrane and used in gingival recession defects.Study Design:It was single-blind, randomized controlled study. Split-mouth study was conducted in nine patients and 22 sites with recession defects were selected. Sites were divided into Group A (Amnion membrane with coronal advanced flap) and Group B (FGM with coronal advanced flap).Materials and Methods:Sites were assessed clinically by recording plaque index (PI), gingival index (GI), vertical recession defect depth (VRDD), relative clinical attachment level (CAL), and width of keratinized tissue at baseline, 3–6 months; and radiographically by recording linear bone growth by dentascan at baseline and 6 months.Result:Both groups showed statistically significant reduction in PI, GI and VRDD, and CAL and nonsignificant reduction in width of keratinized tissue at 3 and 6 months postoperatively. Group A showed statistically significant linear bone growth at 6 months. Group B also showed gain in linear bone growth at 6 months; however, result was statistically nonsignificant.Conclusion:FGM had shown favorable results by enhancing bone growth while preventing the gingival tissue downgrowth.

Clinical, radiographic, and patient-centered outcomes after use of enamel matrix proteins for the treatment of intrabony defects in patients with aggressive periodontitis: A 12-month multicenter clinical trial.

The aim of this study was to evaluate the clinical, radiographic and patient-centered results of enamel matrix derivative (EMD) therapy in intrabony defects in aggressive periodontitis (AgP) patients and compare them with those in chronic periodontitis (CP) patients. Sixty intrabony defects in AgP and CP patients associated with ≥ 6 mm residual probing pocket depth (PPD) were included and randomly assigned to one of three groups: AgP+CS (conservative surgery) (n = 20); AgP+CS/EMD (n = 20); CP+CS/EMD (n = 20). Clinical parameters were measured at baseline and after 6 and 12 months. Defect resolution (DR) and bone filling (BF) were used for radiographic analysis. The quality of life was recorded at baseline and 6 months using OHIP-14 and VAS scale in the early post-therapy period. PPD and relative clinical attachment level (rCAL) improved for all groups during follow-up (P ≤ 0.05), and AgP+CS/EMD presented a higher rCAL gain (2.4 ± 1.0 mm) when compared to AgP control patients (1.6 ± 1.6 mm, P ≤ 0.05) after 12 months. No difference was observed between AgP+CS/EMD and CP+CS/EMD groups (P > 0.05). No radiographic differences were observed among groups at any time point (P > 0.05). All the groups reported a positive impact on OHIP-14 total score, without differences among them. EMD therapy of intrabony defects promotes additional benefits in AgP patients, presenting a similar regeneration rate compared to CP patients, and has proven to be a viable therapy for the treatment of individuals with AgP.

COMPARATIVE STUDY OF BIOACTIVE GLASS AND FREEZE DRIED BONE ALLOGRAFT IN CLASS II FURCATION DEFECTS

Background: In periodontal therapy, furcation defects are one of the most therapeutically challenging periodontal therapies. Till now various treatment methods have been tried which have shown different success rates. The present study was undertaken to compare the efficacy of bioactive glass (alloplast) with Freeze dried bone allograft (FDBA) in the treatment of Class II furcation defects.&#x0D; Materials and Methods: Twenty patients were selected for the study which had bilateral Class II furcation defects in molars from which ten patients were male and ten patients sere female in the age group of 45-55 years. Various clinical measurements were recorded at three times i.e. at baseline, at one month and at six months post surgery which included the Turesky-Glimore-Glickman modification of the Quigley Hein plaque index, the Loe and silness gingival index, relative clinical attachment level vertical probing depth in the mid-furcation area, and horizontal probing depth in the furcation area. The statistical analysis was done using SPSS version 23.0.&#x0D; Results: In the relative clinical attachment levels, the mean gain in the test and control groups was 2.45 and 1.58 mm, respectively at the end of six months. In the horizontal probing depth values, the mean change in the bioactive glass graft and freeze dried bone allograft was 1.45 and 1.33 mm, respectively.&#x0D; Conclusion: From our study it was concluded that efficacy of Bioactive glass is much better as compared to Freeze dried bone allograft in the treatment of Class II furcation defects.&#x0D; Keywords: Bioactive glass, Freeze dried bone allograft, furcation defects

Comparative evaluation of efficacy of subepithelial connective tissue graft versus platelet-rich fibrin membrane in surgical reconstruction of interdental papillae using Han and Takie technique: A randomized controlled clinical trial.

Background:Platelet-rich fibrin (PRF) has emerged as one of the promising regenerative materials in the field of periodontics. Hence, this study evaluated the efficacy of subepithelial connective tissue graft (SCTG) and PRF in surgical reconstruction of interdental papillae using Han and Takei technique.Materials and Methods:A total of 20 sites with Class I and Class II interdental papilla defects were assigned to two groups (Group 1 – Han and Takie technique + SCTG and Group 2 – Han and Takie technique + PRF). Parameters such as papillary height (PH), distance from the contact point to the tip of papillae (CPTP), papilla presence index (PPI), pocket probing depth (PPD), relative clinical attachment level (RCAL), plaque index (PI), gingival index (GI), and distance from contact point to alveolar crest (CP-BC) were measured at baseline and after 3 months. The significance of difference within and between the groups was evaluated with paired and unpaired t-tests.Results:The mean PI, GI, PPD, RCAL, PPI, and CPTP distance decreased significantly, whereas the mean PH increased significantly in Group 1 as well as in Group 2. After 3 months, mean reduction in CPTP distance and mean gain in PH were statistically significant in Group 1 as compared to Group 2. However, there was no significant difference in mean CPBC distance between baseline and 3 months in Group 1 as well as in Group 2.Conclusion:Both the techniques were effective in the treatment of papillary recession defects; however, more significant clinical papillary enhancement was achieved after the surgical reconstruction with SCTG.

Clinical evaluation of mineral trioxide aggregate in the surgical management of degree I and degree II furcation defects

Background: Mineral trioxide aggregate (MTA) is known as a strong bioactive material which induces hard tissue formation. It does not get contaminated with tissue fluids or blood and has low cytotoxicity with good antibacterial effects. Objectives: This study aims to evaluate the clinical effectiveness of MTA in the surgical management of Degree I and Degree II furcation defects. Methods: Individuals were 15 patients exhibiting clinical and radiographic evidence of Degree I and Degree II furcation defects. The pocket probing depth, plaque index, gingival index, relative vertical clinical attachment level, relative horizontal clinical attachment level, and gingival recession level of subjects were recorded at baseline, 3 months, and 6 months. Data were analyzed at a significance level of P < 0.05 using paired t-test. Results: The purpose of this study was to maintain furcation involved teeth with the use of MTA. Regeneration of periodontal attachment apparatus by MTA was not the goal of the treatment technique used in this study. However, MTA application results improvement in the recorded clinical parameters. Conclusion: MTA is effective in obliterating the Degree I and Degree II furcation defects. There are no signs and symptoms of any adverse effect to this treatment.

Treatment of Gingival Recession Associated with Non-Carious Cervical Lesions Using Resin Modified Glass Ionomer Cement with Connective Tissue Graft a Randomized Controlled Clinical Trial

Introduction: Gingival recession (GR) is a common aesthetic problem associated with the cervical wear of the tooth structure and dentin hypersensitivity. Recently, periodontal-restorative approaches have been proposed for the management of GR associated with non-carious cervical lesions (NCCLs), which has proven effective. The present study aimed to evaluate this method. Methods: In total, 30 subjects with isolated Millers class I GR associated with NCCL in the maxillary canines and premolars were randomly assigned to group A (CTG) and group B (R+CTG). Clinical parameters, including the probing pocket depth (PPD), relative GR (RGR), keratinized tissue width (KTW), keratinized tissue thickness (KTT), relative clinical attachment level (CAL), cervical lesion height (CLH), and dentin hypersensitivity (DH), were recorded at baseline (BL) and after one and six months. In addition, maximum root coverage (MRC) was evaluated after six months. Results: In both groups, a statistically significant reduction was observed in the PPD, RGR, and CLH after six months (P=0.001). On the other hand, a significant increase was observed in the KTW, KTT, and CAL in both groups (P=0.001). Moreover, the visual analogue pain scores indicated a significant reduction in both groups, while the reduction was considered more significant in group B (P˂0.05) compared to group A. In groups A and B, 69.24% and 61.54% of the sites showed MRC, respectively. Conclusion: According to the results, both groups achieved comparable root coverage, while the presence of restoration led to a greater reduction in dentin hypersensitivity.