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Periodontal Surgery (periodontal + surgery)
Selected AbstractsSystemic antibiotics in periodontal therapyAUSTRALIAN DENTAL JOURNAL, Issue 2009LJA Heitz-Mayfield Abstract Periodontitis is a biofilm infection with a mixed microbial aetiology. Periodontitis is generally treated by non-surgical mechanical debridement and regular periodontal maintenance care. Periodontal surgery may be indicated for some patients to improve access to the root surface for mechanical debridement. A range of systemic antibiotics for treatment of periodontitis has been documented, with some studies showing superior clinical outcomes following adjunctive antibiotics while others do not. This has resulted in controversy as to the role of systemic antibiotics in the treatment of periodontal diseases. Recent systematic reviews have provided an evidence-based assessment of the possible benefits of adjunctive antibiotics in periodontal therapy. This review aims to provide an update on clinical issues of when and how to prescribe systemic antibiotics in periodontal therapy. [source] Multidisciplinary approach of complicated crown fractures of both superior central incisors: a case reportDENTAL TRAUMATOLOGY, Issue 4 2008Anca Silvia Vâlceanu Since the development of the adhesive dentistry, many case reports of crown fractures restored using adhesive reattachment techniques were published. Complex cases, in which more than one tooth are involved, with fractures differing from each other, require specific treatment of each fracture, taking different advantages of the different remaining tooth structures. This case report describes a patient with dissimilar crown fractures of both superior central incisors. After the endodontic treatment, the patient was treated using the combination of several techniques: periodontal surgery (crown lengthening with apically repositioned flap and osseous resective surgery), adhesive technique and cast restoration plus esthetic crown. The periodontal procedure re-created the biologic width and proved to be a reliable adjunctive procedure to the adhesive and the prosthetic techniques used. [source] Effect of gender on acute pain prediction and memory in periodontal surgeryEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 2 2000Ilana Eli Pain is a complex experience that is affected by factors such as gender, stress, anxiety and cognitions. The purpose of this study was to investigate the inter-relationship between gender and acute pain prediction and memory under periodontal surgery treatment. The study was conducted on 15 male and 22 female dental patients (mean age 34 yr, mean education level 14.7 yr), who were scheduled for periodontal surgery. Patients were evaluated during four consecutive appointments: at initial check-up, immediately pre-operatively, 1 wk post-operatively, and at 4 wk post-operative follow-up. Patients were requested to complete questionnaires concerning their anxiety at each appointment and to indicate their subjective evaluations concerning pain (on a visual analogue scale). Evaluations concerning expectation to experience pain during the planned surgery (pain prediction) were made at the first two appointments and evaluations of the experienced pain as remembered from the surgery (pain memory) were made at the last two appointments. Gender had a significant effect on pain prediction and pain memory. Men expected to experience more pain pre-operatively than women but remembered less pain post-operatively. It was concluded that cognitive pain perception in clinical situations differs between genders. [source] The temporal course of mucoperiosteal flap revascularization at guided bone regeneration-treated implant sites: a pilot studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2009Dan M. J. Milstein Abstract Aims: To investigate post-operative capillary density regeneration in healing mucoperiosteal flaps at guided bone regeneration-treated implant sites. Material and Methods: A non-invasive post-operative investigation was performed in 10 patients using orthogonal polarization spectral (OPS) imaging for assessment of capillary density during the course of mucoperiosteal flap wound healing for 6 weeks in patients receiving dental implants. Results: The greatest increase in capillary regeneration occurred in the early wound-healing phase, during weeks 1 and 2, and recovery to baseline was achieved between weeks 4 and 5. A comparison of adjacent OPS measurements indicated that differences between the time point immediately following administration of local anaesthesia and directly post-operatively ( p=0.002), between a directly post-operative time point and after 1 week (p=0.009), and between post-operative weeks 1 and 2 (p=0.036) were statistically significant. Conclusions: The early healing phase of mucoperiosteal flaps is characterized by rapid capillary regeneration. OPS imaging enabled the possibility to monitor and quantify the temporal development of mucoperiosteal flap revascularization following periodontal surgery. [source] Periodontal therapy alters gene expression of peripheral blood monocytesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2007Panos N. Papapanou Abstract Aims: We investigated the effects of periodontal therapy on gene expression of peripheral blood monocytes. Methods: Fifteen patients with periodontitis gave blood samples at four time points: 1 week before periodontal treatment (#1), at treatment initiation (baseline, #2), 6-week (#3) and 10-week post-baseline (#4). At baseline and 10 weeks, periodontal status was recorded and subgingival plaque samples were obtained. Periodontal therapy (periodontal surgery and extractions without adjunctive antibiotics) was completed within 6 weeks. At each time point, serum concentrations of 19 biomarkers were determined. Peripheral blood monocytes were purified, RNA was extracted, reverse-transcribed, labelled and hybridized with AffymetrixU133Plus2.0 chips. Expression profiles were analysed using linear random-effects models. Further analysis of gene ontology terms summarized the expression patterns into biologically relevant categories. Differential expression of selected genes was confirmed by real-time reverse transcriptase-polymerase chain reaction in a subset of patients. Results: Treatment resulted in a substantial improvement in clinical periodontal status and reduction in the levels of several periodontal pathogens. Expression profiling over time revealed more than 11,000 probe sets differentially expressed at a false discovery rate of <0.05. Approximately 1/3 of the patients showed substantial changes in expression in genes relevant to innate immunity, apoptosis and cell signalling. Conclusions: The data suggest that periodontal therapy may alter monocytic gene expression in a manner consistent with a systemic anti-inflammatory effect. [source] Tooth loss in well-maintained patients with chronic periodontitis during long-term supportive therapy in BrazilJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2006Luiz A. Chambrone Abstract Aim: The objective of this retrospective study was to assess the reasons for tooth loss in a sample of patients who underwent periodontal therapy and supportive periodontal therapy (SPT) in a Brazilian private periodontal practice. Material and Methods: A sample of 120 subjects who had been treated and maintained for 10 years or longer was selected from patients attending a periodontal practice. All patients followed a similar treatment: basic procedures, re-evaluation and periodontal surgery where indicated. Reasons for tooth loss were categorized as periodontal, caries, endodontal, root fractures and extraction of retained or partially erupted third molars. Results: Of the 2927 teeth present at the completion of active periodontal treatment, 53 (1.8%) were lost due to periodontal disease, 16 (0.5%) for root fracture, six (0.2%) to caries, five (0.2%) for endodontic reasons and 31 (1.0%) were lost to extraction of retained or partially erupted third molars. Logistic regression analysis was performed to investigate the association between five independent variables with tooth loss due to periodontitis. Only age (>60 years) and smoking were statistically significant (p<0.05). Conclusion: The findings of this survey were consistent with previous studies. Older subjects and smokers were more susceptible to periodontal tooth loss. In addition, patients with generalized chronic periodontitis were treated and maintained for long-term periods with low rates of tooth loss. [source] Microbial colonization patterns predict the outcomes of surgical treatment of intrabony defectsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2006Lisa Heitz-Mayfield Abstract Aim: To explore the impact of bacterial load and microbial colonization patterns on the clinical outcomes of periodontal surgery at deep intrabony defects. Materials and Methods: One hundred and twenty-two patients with advanced chronic periodontitis and at least one intrabony defect of >3 mm were recruited in 10 centres. Before recruitment, the infection control phase of periodontal therapy was completed. After surgical access and debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CAL), pocket probing depths (PPD), recession (REC), full-mouth plaque scores and full-mouth bleeding scores were assessed. Microbial colonization of the defect-associated pocket was assessed using a DNA,DNA checkerboard analysis. Results: Total bacterial load and counts of red complex bacteria were negatively associated with CAL gains 1 year following treatment. The probability of achieving above median CAL gains (>3 mm) was significantly decreased by higher total bacterial counts, higher red complex and T. forsythensis counts immediately before surgery. Conclusions: Presence of high bacterial load and specific periodontal pathogen complexes in deep periodontal pockets associated with intrabony defects had a significant negative impact on the 1 year outcome of surgical/regenerative treatment. [source] Clinical outcomes following treatment of human intrabony defects with GTR/bone replacement material or access flap aloneJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2004A multicenter randomized controlled clinical trial Abstract Aim: This prospective multicenter randomized controlled clinical trial was designed to compare the clinical outcomes of papilla preservation flap surgery with or without the application of a guided tissue regeneration (GTR)/bone replacement material. Materials and Methods: One hundred and twenty-four patients with advanced chronic periodontitis were recruited in 10 centers in seven countries. All patients had at least one intrabony defect of 3 mm. The surgical procedures included access for root instrumentation using either the simplified or the modified papilla preservation flap in order to obtain optimal tissue adaptation and primary closure. After debridement, the regenerative material was applied in the test subjects, and omitted in the controls. At baseline and 1 year following the interventions, clinical attachment levels (CALs), probing pocket depths (PPDs), recession, full-mouth plaque scores and full-mouth bleeding scores (FMBS) were assessed. Results: One year after treatment, the test defects gained 3.3±1.7 mm of CAL, while the control defects yielded a significantly lower CAL gain of 2.5±1.5 mm. Pocket reduction was also significantly higher in the test group (3.7±1.8 mm) when compared with the controls (3.2±1.5 mm). A multivariate analysis indicated that the treatment, the clinical centers, baseline PPD and baseline FMBS significantly influenced CAL gains. Odds ratios (ORs) of achieving above-median CAL gains were significantly improved by the test procedure (OR=2.6, 95% CI 1.2,5.4) and by starting with deeper PPD (OR=1.7, 1.3,2.2) but were decreased by receiving treatment at the worst-performing clinical center (OR=0.9, 0.76,0.99). Conclusions: The results of this trial indicated that regenerative periodontal surgery with a GTR/bone replacement material offers an additional benefit in terms of CAL gains, PPD reductions and predictability of outcomes with respect to papilla preservation flaps alone. [source] Polymer-assisted regeneration therapy with Atrisorb® barriers in human periodontal intrabony defectsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2004Lein-Tuan Hou Abstract Aim: This study compared clinical results of 40 periodontal osseous defects treated by two types of absorbable barrier materials. Material and Methods: Thirty patients (23 males and seven females) suffering from moderate to advanced periodontitis (with comparable osseous defects) were randomly assigned to receive either Atrisorb® barrier (n=22; group A) or Resolut XT® barrier (n=18; group B) therapy. Periodontal phase I treatment and oral hygiene instruction were performed before periodontal surgery. Papillary preservation, partial thickness flap, citric acid root conditioning, and decortication procedures were applied during the operation. Bone defects were filled with demineralized freeze-dried bone allograft and minocycline mixture (4:1 ratio). Postoperative care included 0.10% chlorhexidine rinse daily and antibiotic medication for 2 weeks. Clinical assessments including probing depth (PD), clinical attachment level (CAL), gingival recession (GR), plaque index (PlI), gingival index (GI), and radiographic examinations were taken at the baseline, preoperatively and at 3 and 6 months after regenerative surgery. Results: Six months following therapy, both Atrisorb® and Resolut XT® groups had achieved comparable clinical improvement in pocket reduction (3.9 versus 4.4 mm), attachment tissue gain (clinical attachment gain; 3.5 versus 3.6 mm), and reduction in the GI and in the PlI. Within-group comparisons showed significant attachment gain and pocket reduction between baseline data and those at both 3 and 6 months postoperatively (p<0.01). There were no statistically significant differences in any measured data between groups A and B. Conclusions: The results of this study indicate that a comparable and favorable regeneration of periodontal defects can be achieved with both Atrisorb® and Resolut XT® barriers. Further long-term study and histologic observations of tissue healing are needed to evaluate whether Atrisorb® is promising for clinical use. [source] Acellular dermal matrix allograft used to gain attached gingiva in a case of epidermolysis bullosaJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2003Eralp Buduneli Abstract Background: Epidermolysis bullosa (EB) is an acquired disease or inherited as either autosomal dominant or recessive with an incidence of 1/50,000. The prominent clinical characteristic of the disease is the development of bullae or vesicles in mucosa or skin in response to minor trauma. Aim: A female patient with a dystrophic type of EB had been put in a maintenance regimen after completion of the initial phase of periodontal therapy and followed for 7 years. The purpose of this report is to document acellular dermal matrix allograft application to increase the width of the attached gingiva in this patient experiencing difficulty in chewing and performing plaque control due to the dramatic loss of attached gingiva after 7 years of supportive periodontal therapy. Methods: Under local anaesthesia and antibiotic coverage, the acellular dermal matrix allograft was applied in the anterior region of the upper jaw in order to increase the width of attached gingiva, thereby improving patient comfort. Results: The healing was uneventful and a significant gain in attached gingiva dimensions was observed 9 months after the periodontal surgery. The procedure avoided a second surgical site, provided satisfactory results from an aesthetic point of view, and improved patient comfort. Conclusion: Acellular dermal matrix allograft may be regarded as an alternative in the treatment of EB cases to increase the width of attached gingiva and facilitate maintenance of the dentition. Zusammenfassung Hintergrund: Die Epidermolysis bullosa (EB) ist eine erworbene oder eine autosomal dominant oder rezessiv vererbte Krankheit mit einer Incidenz von 1:50,000. Die hervorstechenden klinischen Symptome dieser Erkrankung sind die Entwicklung von Blasen oder Vesikeln in der Mukosa oder in der Haut auf geringste Traumen. Ziel: Eine Frau mit dem dystrophischen Typ von EB wurde in der Erhaltungsphase seit 7 Jahren geführt, nachdem die initiale Phase der parodontalen Therapie beendet worden war. Der Zweck dieser Studie ist die Dokumentation der Applikation eines azellulären Hautmatrixtransplantats für die Verbreiterung der fest angewachsenen Gingiva bei dieser Patientin, die nach 7 Jahren der erhaltenden parodontalen Therapie Probleme beim Kauen und bei der Durchführung der Plaquekontrolle durch einen starken Verlust an fest angewachsener Gingiva hatte. Methoden: Unter lokaler Anästhesie und antibiotischer Abschirmung wurde das azelluläre Hautmatrixtransplantat in die anteriore Region des Oberkiefers appliziert, um die Breite der fest angewachsenen Gingiva zu vergrößern und so das Befinden der Patientin zu verbessern. Ergebnisse: Die Heilung war komplikationslos, und ein signifikanter Gewinn an fest angewachsener Gingiva 9 Monate nach der parodontalen Operation wurde beobachtet. Die Methode vermied eine zweite chirurgische Region, erbrachte zufriedenstellende Ergebnisse aus ästhetischer Sicht und verbesserte das Befinden der Patientin. Schlussfolgerung: Das azelluläre Hautmatrixtransplantat kann als eine Alternative in der Behandlung von EB betrachtet werden, um die Breite der fest angewachsenen Gingiva zu vergrößern und zur Möglichkeit der Erhaltung der Dentition beizutragen. Résumé La bullose épidermolysie (EB) est une maladie contractée ou héritée qui peut être aussi bien autosomale dominante que récessive avec une fréquence de 1/50,000. La caractéristique clinique importante de la maladie est le développement de bulles ou de vésicules au niveau de la muqueuse ou de la peau comme réponse à un traumatisme mineur. Une femme avec un type dystrophique de EB a été placée dans un régime de maintenance après la fin de la phase initiale du traitement parodontal et suivie durant sept années. Le but de ce rapport est de documenter le placement d'un allographe de la matrice dermique acellulaire visant à augmenter la largeur de la gencive attachée chez cette patiente qui avait des problèmes aux niveaux masticatoire et du contrôle de la plaque dentaire vu la perte dramatique de la gencive attachée après sept années de maintenance parodontale. Sous anesthésie locale et sous couverture antibiotique, l'allographe de la matrice dermique acellulaire a été placé dans la région antérieure de la mâchoire supérieure pour augmenter la largeur de la gencive attachée afin d'améliorer le confort de la patiente. La guérison s'est déroulée sans problème et un gain significatif de gencive attachée a été observé neuf mois après la chirurgie parodontale. Ce processus chirurgical élimine la nécessité d'avoir un site donneur, apporte des résultats satisfaisants du point de vue esthétique et améliore le confort du patient. L'allographe de la matrice dermique acellulaire peut donc être considéré comme une alternative dans le traitement des cas de EB afin d'augmenter la largeur de la gencive attachée et faciliter le maintien de la dentition. [source] Mutans streptococci in subgingival plaque of treated and untreated patients with periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2001W. A. Van Der Reijden Abstract Background: The etiology of root caries is thought to be identical to coronal caries, though root caries seem to be more complicated because of the higher susceptibility of exposed roots (dentin) by periodontal therapy to demineralization than intact enamel. This implies that mutans streptococci are the most likely pathogens in the development of root caries. Although it is known that both the numbers of mutans streptococci and the frequency of isolation in root caries lesions are negatively correlated with the distance from the gingival margin, the subgingival sulcus has not been considered a possible habitat for mutans streptococci. However, subgingival occurence of mutans streptococci in both untreated and treated periodontal patients has not been documented well in the literature. Objective: To investigate the presence and levels of mutans streptococci in the subgingival plaque of patients (n=154) in different stages of periodontal therapy. The subgingival sulcus may be a possible habitat for mutans streptococci. This localisation of mutans streptococci may be of importance in the development of root caries after periodontal surgery. Materials and methods: In this cross-sectional study, subgingival plaque samples from 154 consecutive adult periodontitis patients were tested for presence and levels of mutans streptococci and putative periodontal pathogens by anaerobic cultures. These patients were divided into 4 groups based on their stage of periodontal treatment: (1) untreated patients; (2) patients after initial periodontal therapy only; (3) patients in the maintenance phase who not underwent periodontal surgery; (4) patients after periodontal surgery. Results: The prevalence of mutans streptococci in the 4 study groups varied from 82% in untreated patients to 94% in maintenance patients. The mean proportion of mutans streptococci was 6.65% in maintenance patients versus 1.86% in untreated patients (p=0.005) and 2.51% in patients after scaling and root planing (p=0.041). Conclusions: The subgingival area is a microbial habitat for mutans streptococci that may be of importance in the development of root caries in periodontitis patients. Zusammenfassung Hintergrund: Es wird angenommen, dass die Ätiologie der Wurzelkaries und der Kronenkaries übereinstimmen, obwohl die Entstehung von Wurzelkaries komplizierter zu sein scheint wegen der erhöhten Empfindlichkeit entblößter Wurzeln (Dentin) für Demineralisation im Vergleich zu gesundem Schmelz. Das bedeutet, dass MS die wahrscheinlichsten Pathogene für die Entstehung der Wurzelkaries sind. Obwohl bekannt ist, dass die Zahl der MS und die Häufigkeit ihres Nachweises aus Wurzelkariesläsionen negativ mit dem Abstand vom Gingivarand korrelieren, wurde die subgingivale Region bisher nicht als möglicher Lebensraum für MS erwogen. Das subgingivale Vorkommen von MS bei behandelten und unbehandelten Parodontitispatienten ist in der Literatur nicht gut dokumentiert. Die subgingivale Region könnte ein möglicher Lebensraum für MS und diese Lokalisation bedeutsam für die Entstehung von Wurzelkaries nach parodontaler Therapie sein. Zielsetzung: Untersuchung des Vorkommens und der Menge von MS in der subgingivalen Plaque von Patienten zu unterschiedlichen Zeitpunkten parodontaler Therapie. Material und Methoden: In einer Querschnittsstudie wurden subgingivale Plaqueproben von 154 Patienten mit Erwachsenenparodontitis auf das Vorkommen und den Anteil von MS und putativer Parodontalpathogene in anaerober Kultur untersucht. Die Patienten wurden nach dem Stadium der parodontalen Therapie in 4 Gruppen unterteilt: (1) unbehandelte Patienten (n=51), (2) Patienten nach abgeschlossener Initialtherapie (Mundhygieneunterweisungen sowie Scaling und Wurzelglättung [SRP]) (n=41), (3) Patienten in der unterstützenden Parodontitistherapie (UPT), die nicht parodontalchirurgisch behandelt worden waren (n=48), und (4) Patienten nach Parodontalchirurgie (n=14). Ergebnisse: Die Prävalenz der MS variierte in den 4 Untersuchungsgruppen von 82% bei unbehandelten bis 94% bei UPT-Patienten. Der mittlere Anteil der MS an subgingivaler Plaque lag bei 6.65% (UPT) im Vergleich zu 1.86% (unbehandelte Parodontitis) (p=0.005) bzw. zu 2.51% (SRP) (p=0.041) und 2.18% nach Parodontalchirurgie (n.s.) Schlußfolgerungen: Die subgingivale Region ist ein Lebensraum für MS, die eine Bedeutung für die Pathogenese der Wurzelkaries bei Patienten mit Parodontitis haben könnte. Résumé L'étiologie des caries radiculaires semble étre identique à celle des caries coronaires bien que les caires radiculaires paraîssent plus compliquées vu la susceptibilité plus importante des racines exposées (dentine) par le traitement parodontal à la même déminéralisation que ne l'est l'émail intact. Ceci a comme conséquence que les Streptocoques mutans sont vraisemblabement les pathogènes les plus problables dans le dévelopment des caries radicularies. Bien qu'il soit connu que les nombres de Streptocoques mutans autant que la fréquence de l'isolation des lésions carieuses radiculaires soient en corrélation négative avec la distance depuis la gencive marginale, le sulcus gingival n'a pas été considéré comme habitat possible pour les Streptocoques mutans. Cependant, l'occurence sous-gingivale des Streptocoques mutans chez les patients avec parodontite traitée ou non n'a pas été suffisamment documentée dans la littérature. Le but de cette étude a été d'analyser la présence et les niveaux de Streptocoques mutans dans la plaque sous-gingivale de 154 patients à différentes étapes de leur traitement parodontale. Le sillon sous-gingival pourrait dont être un habitat possible pour les Streptocoques mutans. Cette localisation peut être importante dans le dévelopment des caries radiculaires après le traitement parodontal. Dans cette étude croisée des échantillons de plaque sous-gingivale ont été prélevés chez 154 patients adultes avec parodontite pour vérifier la présence et les niveaux de Streptocoques mutans et d'autres pathogènes parodontaux putatifs par culture anaérobie. Les patients étaient divisés en 4 groupes suivant le stade de leur traitement parodontal: non-traité, traitement initial seulement, phase de maintien mais sans chirurgie, et patient après chirurgie parodontale. La fréquence globale des Streptocoques mutans dans les 4 goupes variaient de 82% chez les patients non-traités à 94% chez ceux au stade de maintenance. La proportion moyenne de Streptocoques mutansétaient de 6.65% chez les patients en maintenance versus 1.86% chez les patients non-traités (p=0.005) et de 2.51% chez les patients après détartrage et surfaçage radiculaire (p=0.041). L'aire sous-gingivale est donc un habitat microbien pour les Streptocoques mutans qui pourraient être assez importants dans le développement des caries radiculaires chez les patients souffrant de parodontite. [source] Regenerative periodontal surgery in interproximal intrabony defects with biodegradable barriersJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2000Christof E. Dörfer Abstract Aim: The comparison of the effects of guided-tissue regeneration (GTR) using 2 different biodegradable barriers (polylactide acetyltributyl citrate; polydioxanon) in 3- and 2-wall intrabony defects. Method: The polydioxanon barrier is an experimental membrane for GTR therapy that consists of an continuous occlusive barrier that has a layer of slings on the side that is meant to face the mucoperiosteal flap. 15 patients provided 15 pairs of similar contralateral periodontal defects: 12 predominantly 2-wall and 18 predominantly 3-wall intrabony defects. Each defect was randomly assigned to treatment with either polylactide acetyltributyl citrate (control [c]) or polydioxanon (test [t]) devices. At baseline and 6 months after surgery, clinical measurements (PlI, GI, PPD, PAL-V) were performed. Results: Barrier exposure was commonly observed in both groups (control/test): 5/4 after 7 days, 9/11 after 14 days and 11/12 after 28 days postsurgically. 4 weeks after surgery, 77% of all barriers were exposed to some extent. However, both treatments revealed a significant GI reduction (p<0.05), PPD reduction [,4.63±1.85 mm (t), ,4.17±1.89 mm (c); p<0.001] and PAL-V gain [3.97±1.17 mm (t), 3.40 mm±1.40 (c); p<0.001] 6 months after surgery. Regarding GI and PPD reduction as well as PAL-V gain, there were neither statistically significant nor clinically relevant differences between test and control: similar clinical results were found 6 months after surgical treatment using both biodegradable barriers. Conclusions: Based on the results of the present study, the use of both biodegradable barriers in GTR therapy may be recommended. [source] A study of the prevalence and distribution of dentine sensitivity in a population of 17,58-year-old serving personnel on an RAF base in the MidlandsJOURNAL OF ORAL REHABILITATION, Issue 1 2002D. R. Clayton Previous studies have reported on dentine sensitivity (DS) prevalence in hospital and general practice populations. Results from these studies indicate that perception and prevalence of DS vary depending on the population. The study aimed to determine any major differences in the perception and prevalence of DS in subjects in a military training establishment. Questionnaires from 228 subjects [188 completed by males, 39 completed by females, with one person not indicating their gender of mean age 24·0 years (s.d. 7·16)] were collected and analysed using the Statistical Package for the Social Sciences (SPSS). Fifty percent of the subjects (n=114) claimed to have DS. Yet approximately 30% of the subjects (29·8%, n=68) perceived the condition as a slight problem and approximately 40% of the subjects (40·8%, n=93) claimed it was an occasional problem and approximately 50% (49·1%, n=112) did not seek treatment. Seventeen subjects (7·5%) used a desensitizing paste during periods of discomfort. No clear pattern emerged with regard to seasonal variation in DS although 5·7% (n=13) subjects considered DS to be more of a problem in winter. Only 7·9% (n=18) reported any previous periodontal surgery, consistent with previous studies (12·6 and 15·5%). Of those who received regular scaling (27·2%, n=62), only 23 (10·1%) reported any discomfort following treatment, which did not last ,5 days. The results indicate that self-reporting of DS was similar to previous reports, although it is of fundamental importance that such studies should be supplemented with a thorough clinical examination to determine more reliable prevalence data. [source] Comparison of dentine hypersensitivity in selected occidental and oriental populationsJOURNAL OF ORAL REHABILITATION, Issue 1 2001D. G. Gillam Epidemiological data on dentine hypersensitivity (DH) prevalence are limited. Few studies have compared prevalence between populations. The aim of this investigation, therefore, was to compare the perception and prevalence of DH in two distinct non-periodontal practice populations, one U.K. and one Korean. Completed questionnaires from 557 patients (230 males and 327 females, comprising 115 males and 162 females, mean age 41·7 years (s.d.=14·36), U.K. and 115 males and 165 females, mean age 29·7 years (s.d.=11·86), Korean) were collected. Analysis was by frequency distribution and cross-tabulation (Statistical Package for the Social Sciences (SPSS)). DH prevalence was similar and at levels comparable with those reported previously. Prevalence was higher in the third and fourth decades in both populations. Although there were no differences between U.K. or Korean males and U.K. or Korean females, there was a significant difference between gender reporting of DH, with more females complaining of DH than males (standard normal deviation (SND)=4·3, 95% confidence interval (CI)=0·1134,0·2736). DH appeared to be regarded by patients as not severe in most cases, so treatment was not generally sought. Of those who claimed to have sought treatment, a significant number had received restorative treatment. Of those patients, only 23·3% of U.K. and ,2% of Korean patients claimed to have used a desensitizing dentifrice. Pain from DH was reported as low grade (slight, occasional) occurring over 5 years in both populations. Cold appeared to be the most reported stimulus in the two populations. Less periodontal surgery had been undertaken in these two populations (12·6% U.K. and 7·1% Korean) compared with those referred to a teaching hospital periodontal department (34·5%). This compared favourably with previous findings in the general dental population (15·5%). Discomfort following hygiene therapy did not appear to last ,7 days in either population. The results indicated that there were no significant differences between U.K.- and Korean-based populations in their perception of DH, with the exception that more females complained of sensitivity than males in both groups. Overall, DH was not considered a major dental problem by most patients in either of the populations. [source] Enamel matrix proteins; old molecules for new applicationsORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 3 2009SP Lyngstadaas Structured Abstract Authors,,, Lyngstadaas SP, Wohlfahrt JC, Brookes SJ, Paine ML, Snead ML, Reseland JE Emdogain® (enamel matrix derivative, EMD) is well recognized in periodontology, where it is used as a local adjunct to periodontal surgery to stimulate regeneration of periodontal tissues lost to periodontal disease. The biological effect of EMD is through stimulation of local growth factor secretion and cytokine expression in the treated tissues, inducing a regenerative process that mimics odontogenesis. The major (>95%) component of EMD is Amelogenins (Amel). No other active components have so far been isolated from EMD, and several studies have shown that purified amelogenins can induce the same effect as the complete EMD. Amelogenins comprise a family of highly conserved extracellular matrix proteins derived from one gene. Amelogenin structure and function is evolutionary well conserved, suggesting a profound role in biomineralization and hard tissue formation. A special feature of amelogenins is that under physiological conditions the proteins self-assembles into nanospheres that constitute an extracellular matrix. In the body, this matrix is slowly digested by specific extracellular proteolytic enzymes (matrix metalloproteinase) in a controlled process, releasing bioactive peptides to the surrounding tissues for weeks after application. Based on clinical and experimental observations in periodontology indicating that amelogenins can have a significant positive influence on wound healing, bone formation and root resorption, several new applications for amelogenins have been suggested. New experiments now confirm that amelogenins have potential for being used also in the fields of endodontics, bone regeneration, implantology, traumatology, and wound care. [source] |