Comparative Evaluation of Autologous Platelet‐Rich Fibrin and Platelet‐Rich Plasma in the Treatment of 3‐Wall Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial

Background: The topical use of platelet concentrates is recent, and its efficiency remains controversial. The present study aims to explore the clinical and radiographic effectiveness of autologous platelet‐rich fibrin (PRF) and platelet‐rich plasma (PRP) in the treatment of intrabony defects in patients with chronic periodontitis. Methods: Ninety intrabony defects were treated with either autologous PRF with open‐flap debridement or autologous PRP with open‐flap debridement or open‐flap debridement alone. Clinical and radiologic parameters, such as probing depth (PD), clinical attachment level (CAL), intrabony defect depth, and percentage defect fill, were recorded at baseline and 9 months postoperatively. Results: Mean PD reduction and CAL gain were greater in PRF (3.77 ± 1.19 and 3.17 ± 1.29 mm) and PRP (3.77 ± 1.07 and 2.93 ± 1.08 mm) groups than the control group (2.97 ± 0.93 and 2.83 ± 0.91 mm). Furthermore, significantly greater percentage of mean bone fill was found in the PRF (55.41% ± 11.39%) and PRP (56.85% ± 14.01%) groups compared with the control (1.56% ± 15.12%) group. Conclusions: Within the limit of the present study, there was similar PD reduction, CAL gain, and bone fill at sites treated with PRF or PRP with conventional open‐flap debridement. Because PRF is less time consuming and less technique sensitive, it may seem a better treatment option than PRP. However, long‐term, multicenter randomized, controlled clinical trials will be required to know their clinical and radiographic effects on bone regeneration.     

Treatment of 3-wall intrabony defects in patients with chronic periodontitis with autologous platelet-rich fibrin: a randomized controlled clinical trial

Background: Platelet‐rich fibrin (PRF) is considered a second‐generation platelet concentrate that is widely used in osseous regeneration. The present study aims to explore the clinical and radiographic effectiveness of autologous PRF in the treatment of intrabony defects in patients with chronic periodontitis. Methods: Fifty‐six intrabony defects were treated with either autologous PRF with open‐flap debridement or open‐flap debridement alone. Clinical parameters such as the probing depth (PD) and periodontal attachment level (PAL) were recorded at baseline and 9 months postoperatively. The defect fill at baseline and 9 months was calculated on standardized radiographs by using image‐analysis software. Results: The mean PD reduction was greater in the test group (4.55 ± 1.87 mm) than in the control group (3.21 ± 1.64 mm), whereas the mean PAL gain was also greater in the test group (3.31 ± 1.76) compared to the control group (2.77 ± 1.44 mm). Furthermore, a significantly greater percentage of mean bone fill was found in the test group (48.26% ± 5.72%) compared to the control group (1.80% ± 1.56%). Conclusions: Within the limits of the present study, there was greater PD reduction, PAL gain, and bone fill at sites treated with PRF with conventional open‐flap debridement compared to conventional open‐flap debridement alone. However, a long‐term, multicentered randomized controlled clinical trial is required to know the clinical and radiographic effects of PRF on bone regeneration.     

Platelet rich fibrin combined with decalcified freeze-dried bone allograft for the treatment of human intrabony periodontal defects: a randomized split mouth clinical trail

Objective. Polypeptide growth factors of platelet rich fibrin (PRF) have the potential to regenerate periodontal tissues. Osteoinductive property of demineralized freeze-dried bone allograft (DFDBA) has been successfully utilized in periodontal regeneration. The aim of the present randomized, split mouth, clinical trial was to determine the additive effects of PRF with a DFDBA in the treatment of human intrabony periodontal defects. Materials and methods. Sixty interproximal infrabony defects in 30 healthy, non-smoker patients diagnosed with chronic periodontitis were randomly assigned to PRF/DFDBA group or the DFDBA/saline. Clinical [pocket depth (PD), clinical attachment level (CAL) and gingival recession (REC)] and radiographic (bone fill, defect resolution and alveolar crest resorption) measurements were made at baseline and at a 12-month evaluation. Results. Compared with baseline, 12-month results indicated that both treatment modalities resulted in significant changes in all clinical and radiographic parameters. However, the PRP/DFDBA group exhibited statistically significantly greater changes compared with the DFDBA/saline group in PD (4.15 ± 0.84 vs 3.60 ± 0.51 mm), CAL (3.73 ± 0.74 vs 2.61 ± 0.68 mm), REC (0.47 ± 0.56 vs 1.00 ± 0.61 mm), bone fill (3.50 ± 0.67 vs 2.49 ± 0.64 mm) and defect resolution (3.73 ± 0.63 vs 2.75 ± 0.57 mm). Conclusion. Observations indicate that a combination of PRF and DFDBA is more effective than DFDBA with saline for the treatment of infrabony periodontal defects.     

Clinical evaluation of anorganic bovine-derived hydroxyapatite matrix/cell-binding peptide (P-15) in the treatment of human infrabony defects

The purpose of the present study was to compare the clinical outcomes of infrabony periodontal defects following treatment with an anorganic bovine-derived hydroxyapatite matrix/cell-binding peptide (ABM/P-15) flow to open flap debridement. Twenty-six patients, each displaying one infrabony defect with probing depth >/=6 mm and vertical radiographic bone loss >/=3 mm participated in the present study. Patients were allocated randomly to be treated with ABM/P-15 flow (test group) or open flap debridement (control group). At baseline and at 12 months after surgery, the following clinical parameters were recorded by a blinded examiner: plaque index, gingival index, probing depth (PD), clinical attachment level (CAL), and gingival recession. Both treatments resulted in significant improvements between baseline and 12 months, in terms of PD reduction and CAL gain (p < 0.001). At 12 months following therapy, the test group showed a reduction in mean PD from 7.8 +/- 1.6 mm to 3.5 +/- 1.0 mm and a change in mean CAL from 8.5 +/- 2.1 mm to 4.6 +/- 1.2 mm, whereas in the control group the mean PD decreased from 7.5 +/- 0.8 mm to 4.9 +/- 0.7 mm and mean CAL from 8.2 +/- 1.2 mm to 6.4 +/- 1.4 mm. The test group demonstrated significantly greater PD reductions (p = 0.002) and CAL gains (p = 0.001) compared to the control group. In conclusion, treatment of infrabony periodontal defects with ABM/P-15 flow significantly improved clinical outcomes compared to open flap debridement.     

Torus mandibularis bone chips combined with platelet rich plasma gel for treatment of intrabony osseous defects: clinical and radiographic evaluation

The use of platelet rich plasma (PRP) gel in combination with torus mandibularis offers a potentially useful treatment for periodontal osseous defects. Whether this combination enhances the outcome of periodontal regenerative therapy is not known. This study compared the effectiveness of torus mandibularis bone chips alone and when combined with autogenous PRP gel in treating periodontal osseous defects. 24 sites from 12 patients were selected using a split mouth design and determined by a double-blind, randomized, controlled clinical trial. Both sites received a full-thickness mucoperiosteal flap; one intrabony defect was filled with torus mandibularis bone chips alone and the other with torus mandibularis bone chips mixed with PRP gel. There was a 57% gain in the clinical attachment level and 60% reduction in the probing depth for torus mandibularis alone compared to 72% and 68% for sites treated with torus mandibularis and PRP gel (p ≤ 0.01). There was a statistically significant difference in the bone dentistry and the marginal bone loss at sites with PRP gel compared to those without gel (p ≤ 0.01). The use of mandibular tori as autogenous bone graft combined with PRP gel showed a significant improvement in the clinical outcome of periodontal therapy than mandibular tori alone.     

Non invasive and surgical measurement of length of soft tissue from the tip of interdental papilla to the alveolar crest

BackgroundVarious methods, including clinical and radiographic techniques, can be used to assess periodontal regeneration in interproximal areas. The goal of the present study was to compare the papilla length relative to the alveolar bone crest measured by clinical, intrasurgical, and radiographic techniques.Materials and methodsThe study sample included 250 interproximal papillae in 68 patients with generalized chronic periodontitis. The papilla length from the alveolar bone crest was measured clinically (as the actual papilla length, APL), intrasurgically (as the bone probing length, BPL), and radiographically (as the radiographic bone length, RBL). Measurements were standardized by using acrylic resin stents, XCP rinn, a paralleling technique, and/or a radiographic grid.ResultsThe mean (± standard deviation) for RBL was 4.9 ± 0.8 mm, BPL was 5.1 ± 0.6 mm, and APL was 5.1 ± 0.6 mm. Correlations between RBL and APL and between BPL and APL were 0.918 and 0.943, respectively (both P < 0.01).ConclusionsIf the clinical recordings are appropriately standardized, then noninvasive radiographic methods can be used to evaluate the papilla length with good accuracy.     

Elevation of white blood cells and platelet counts in patients having chronic periodontitis

Background and aimMany risk factors that might contribute to the pathogenesis of atherosclerosis have been proposed, including chronic inflammation and infection. Furthermore, systemic inflammatory responses to periodontal bacteria have been suggested as a pathogenetic link between periodontal disease and atherosclerosis. The purpose of this study was to estimate the white blood cell (WBC) and platelet counts in chronic periodontitis patients.Materials and methodsFifty patients with chronic periodontitis and 50 patients with healthy periodontium were included in this study. Oral hygiene status, pocket probing depth (PPD) and clinical attachment level (CAL) were measured. During clinical evaluation, venous blood samples were taken to analyze the WBC and platelet counts. Statistical analysis was utilized to compare differences across groups.ResultsPeriodontitis patients demonstrated a significantly higher WBC count (7.22 ± 1.42 × 10⁹ cells/L) than that of control patients (5.64 ± 1.56 × 10⁹ cells/L; P < 0.001). The platelet count of patients with chronic periodontitis (290.73 ± 56.56 × 10⁹ cells/L) was also significantly higher compared to the healthy group (223.37 ± 50.27 × 10⁹ cells/L; P < 0.001).ConclusionLevels of WBCs and platelets are elevated in periodontitis patients compared to healthy controls.     

Autologous platelet-rich fibrin in the treatment of mandibular degree II furcation defects: a randomized clinical trial

Background: Platelet‐rich fibrin (PRF), an intimate assembly of cytokines, glycan chains, and structural glycoproteins enmeshed within a slowly polymerized fibrin network, has the potential to accelerate soft and hard tissue healing. This double‐masked randomized study is designed to evaluate the effectiveness of autologous PRF in the treatment of mandibular degree II furcation defects compared with open flap debridement (OFD). Methods: Using a split‐mouth design, 18 patients with 36 mandibular degree II furcation defects were randomly allotted and treated either with autologous PRF and OFD or OFD. Plaque index, sulcus bleeding index, probing depth, relative vertical and horizontal clinical attachment level, gingival marginal level, and radiographic bone defect were recorded at baseline and 9 months postoperatively. Comparison between indices between the test and control groups was performed using the paired t test except for plaque index and sulcus bleeding index data, which used the χ² test. Results: All clinical and radiographic parameters showed statistically significant improvement at the sites treated with PRF and OFD compared to those with OFD alone. Conclusion: Within the limitation of this study, significant improvement with autologous PRF implies its role as a regenerative material in the treatment of furcation defects.     

Clinical evaluation of submerged and non-submerged implants for posterior single-tooth replacements: a randomized split-mouth clinical trial

The aim of this study was to evaluate clinical and radiographic results of submerged and non-submerged implants for posterior single-tooth replacements and to assess patient-based outcomes. Twenty patients were included in the study. A split-mouth design was used; implants inserted using a submerged technique were compared to those inserted with a non-submerged technique. Implants were restored with metal–ceramic crowns after 3 months. Reconstructions were examined at baseline, 6, 12, and 24 months. Standardized radiographs were made. Radiographic crestal bone level changes were calculated, as well as soft tissue parameters, including pocket probing depth, bleeding on probing, plaque index, and gingival index. Results were analyzed by two-way repeated measures of variance (ANOVA). To evaluate patient-based outcomes, patients were asked to complete a questionnaire at the 6-month follow-up; the Wilcoxon paired signed rank test was used to compare scores. The data of 18 patients were reviewed. During 24 months, non-submerged implants (0.57 ± 0.21 mm) showed significantly lower bone loss than submerged implants (0.68 ± 0.22 mm) (P < 0.01). Patient satisfaction with non-submerged implants (median 87.5) was significantly higher than with submerged implants (median 81.5) (P < 0.01). Non-submerged implants showed comparable clinical results to submerged implants and resulted in higher patient satisfaction due to decreased surgical intervention.     

Platelet‐Rich Fibrin Combined With 1.2% Atorvastatin for Treatment of Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial

Background: Platelet‐rich fibrin (PRF), a second‐generation platelet concentrate, and atorvastatin (ATV), a potent member of the statin group, are known to promote tissue regeneration. The current study is designed to evaluate combined efficacy of PRF and 1.2% ATV gel with open flap debridement (OFD) in treatment of intrabony defects (IBDs) in individuals with chronic periodontitis (CP). Methods: Ninety‐six individuals with single defects were categorized into three groups: 1) OFD with PRF; 2) OFD with PRF + 1.2% ATV; and 3) OFD alone. Clinical parameters: 1) site‐specific plaque index; 2) modified sulcus bleeding index; 3) probing depth (PD); 4) relative clinical attachment level (rCAL); and 5) gingival marginal level were recorded at baseline before surgery and 9 months postoperatively. Percentage radiographic IBD depth reduction was evaluated at baseline and 9 months. Results: PRF + 1.2% ATV and PRF alone showed significantly greater PD reduction and rCAL gain compared with OFD alone at 9 months. Furthermore, PRF + 1.2% ATV showed a similar percentage radiographic defect depth reduction (50.96% ± 4.88%) compared with PRF alone (47.91% ± 4.79%), and a greater reduction compared with OFD alone (5.54% ± 1.71%) at 9 months. Conclusions: PRF + 1.2% ATV showed similar improvements in clinical parameters with a greater percentage radiographic defect depth reduction compared with PRF alone in treatment of IBDs in individuals with CP. Thus, 1.2% ATV failed to augment the regenerative potential of PRF alone in periodontal IBDs.     

Clinical evaluation of guided tissue regeneration in the treatment of maxillary class II molar furcation invasions

This investigation assessed and compared the clinical efficacy of combined open flap debridement/occlusive membrane therapy versus open flap debridement therapy alone, in the treatment of maxillary periodontal furcation defects. Seventeen patients presenting with advanced adult periodontitis, including at least one pair of Class II maxillary furcal defects, comprised the study group. Following completion of a hygienic phase of treatment, measurements were made with calibrated periodontal probes to determine soft tissue recession, probing pocket depths, and attachment levels. Each pair of furcation defects was surgically exposed and hard tissue measurements obtained. Defects were treated with either open flap debridement and a polytetrafluoroethylene periodontal membrane or open flap debridement alone. Membranes were removed at 4 to 6 weeks. Six months postsurgery, soft tissue measurements were repeated and all sites were surgically re-entered to obtain hard tissue measurements. No statistically significant differences were found in recession, probing depth reductions, clinical attachment gains, or resorption of alveolar crest height between test and control groups. Results for these parameters were inconsistent and unpredictable. Statistically significant improvements were found, however, in horizontal open probing attachment (HOPA) and vertical open probing attachment (VOPA) between experimental and control sites. The GTR procedure as used in this study likely has limited application as a therapeutic modality for Class II furcations of maxillary molars. Modifications or improvements in the procedure may result in more predictable healing of these lesions.     

Early and late studies of EMD use in periodontal intrabony defects

Background and Objective: The clinical efficacy of EMDs for the treatment of periodontal infrabony defects has been reported. However, recent publications have questioned the validity of results from early findings. Hence, the purpose of this study was to compare the results obtained from early and late studies when EMD was used as an adjunct in treating human intrabony defects during flap surgery. The aim of this meta‐analysis was to evaluate the validity of results published from early studies compared with those published from later studies. Material and Methods: PubMed and MEDLINE searches were performed. The evaluation period was 1997–2010 and it was divided into two groups of equal periods of time: early studies (1997–2003) and late studies (2004–2010). The clinical parameters assessed were clinical attachment level (CAL), probing pocket depth and bone gain (BG; measured as a percentage or in mm). Results: No statistically significant difference was found between the results obtained from early studies (1997–2003) and late studies (2004–2010) with regards to CAL gain, probing pocket depth reduction and BG. Nonetheless, both study periods showed a benefit for using EMD to treat periodontal infrabony defects when compared with the groups without EMD during open flap surgery. Conclusions: The results obtained from this study failed to show any potential differences between the results published from early studies and late studies with regards to the clinical effectiveness of EMD in treating periodontal infrabony defects.     

Guided tissue regeneration in the treatment of infrabony defects on maxillary premolars

The present study evaluated clinically and radiographically the short-term results of the healing of infrabony defects at maxillary premolars treated according to guided tissue regeneration (GTR). 9 patients with bilateral presence of infrabony defects with or without furcation involvements at maxillary premolars were selected. At baseline assessments of plaque and gingival indices, bleeding, probing pocket depth and attachment level, and furcation measurements were recorded. Conventional radiographs were obtained in a way that assured a reproducible projection geometry. One premolar was randomly treated with GTR and the contralateral with open debridement. Clinical and radiographic examinations were performed again 6 months postoperatively. The bone tissue changes were assessed by means of conventional radiographs and subtraction images. Sites treated by both procedures demonstrated an improvement of gingival conditions and a reduction of pocket depths. A statistically significant attachment gain was obtained for the test (mean 1.2 mm), but not for the control sites (mean 0.6 mm). The differences, though, were not significant between the test and control sites. Limited improvement in furcation closure was recorded. The radiographic examination demonstrated loss of bone tissue in four sites treated with GTR. The findings suggest that the regeneration of the periodontal soft and bone tissues was not significantly enhanced with the GTR therapy.     

Early implant placement and peri-implant augmentation with a porcine-derived acellular dermal matrix and synthetic bone in the aesthetic area: a 2-year follow-up prospective cohort study

The aim of this study was to evaluate the 2-year follow-up results of early implant placement with simultaneous peri-implant augmentation using an acellular dermal matrix (ADM) and a synthetic bone substitute in the aesthetic zone. Twenty subjects were enrolled in this study, they were either males (eight) or females (12), with a mean age of 47.8 ± 4.45 years and each patient was treated with one implant. Simultaneous contour augmentation with guided bone regeneration was performed using synthetic bone particles (maxresorb®) and an ADM (mucoderm®). Keratinized mucosa width (KMW) and gingival thickness (GT) were assessed at baseline, 1, 3, 6, 12 and 24 months. Marginal bone loss, probing pocket depth, bleeding on probing and plaque index were also recorded. GT and KMW increased between baseline and 1 month, slightly decreased between 1 month and 12 months (P < 0.001) and remained stable between 12 and 24 months (P < 0.001). After 2 years, mean marginal bone loss level was 0.51 ± 0.63 mm, with no probing pocket depth values >5 mm and no concomitant signs of inflammation registered. Pink aesthetic score was 8.3. Combining an ADM and guided bone regeneration with early implant placement revealed a significant increase of 1.9 mm for GT and 1.6 mm for KMW after 2 years, showing good patient satisfaction regarding the aesthetic outcomes of soft tissues and prosthetic crown.     

Platelet‐Rich Fibrin Combined With a Porous Hydroxyapatite Graft for the Treatment of 3‐Wall Intrabony Defects in Chronic Periodontitis: A Randomized Controlled Clinical Trial

Background: Porous hydroxyapatite (HA) bone grafting material has been used to fill periodontal intrabony defects (IBDs), resulting in clinically acceptable responses. Platelet‐rich fibrin (PRF) is a leukocyte and platelet preparation that concentrates various polypeptide growth factors and, therefore, has the potential for use as regenerative treatment for periodontal defects. The present study aims to explore the clinical and radiographic effectiveness of autologous PRF versus PRF + HA in treatment of IBDs in patients with chronic periodontitis. Methods: Ninety IBDs were treated with autologous PRF with open‐flap debridement (OFD), PRF + HA with OFD, or OFD (controls) alone. Clinical and radiologic parameters, including probing depth (PD), clinical attachment level (CAL), IBD depth, and percentage defect fill were recorded at baseline and 9 months postoperatively. Results: Mean PD reduction was greater in PRF (3.90 ± 1.09 mm) and PRF + HA (4.27 ± 0.98 mm) groups than the control group (2.97 ± 0.93 mm), and mean CAL gain was greater in PRF (3.03 ± 1.16 mm) and PRF + HA (3.67 ± 1.03 mm) compared to controls (2.67 ± 1.09 mm). Furthermore, significantly greater percentage of mean bone fill was found in the PRF (56.46% ± 9.26%) and PRF + HA (63.39% ± 16.52%) groups compared to controls (15.96% ± 13.91%). Conclusions: Treatment of IBD with PRF results in significant improvements of clinical parameters compared to baseline. When added to PRF, HA increases the regenerative effects observed with PRF in the treatment of 3‐wall IBDs.     

Efficacy of a bioactive alloplast, in the treatment of human periodontal osseous defects-a clinical study

Presently, bone replacement grafts are one of the modalities of therapy for which there is histologic evidence of regeneration coronal to the base of the previous osseous defect. Bioactive glasses are used extensively in medicine and dentistry. This study evaluated the additional efficacy of a bioactive alloplast, Perioglas, in comparison with open flap debridement only. 8 systemically healthy volunteers were chosen, each having 2 collateral sites with ≥6 mm clinical probing depth and radiographic evidence of an intrabony defect. Randomly, one defect was treated with open flap debridement plus bioactive glass (test) and the other with open flap debridement alone (control). At baseline, 3, 6, 9 months measurements were recorded which included plaque index, gingival index, pocket probing depth, clinical attachment level, and increase in gingival recession. Standardized radiographs were used to measure defect fill and alveolar crest resorption. The data were subjected to statistical analysis. Both treatments showed no significant differences between the two groups at any point of time. However, radiographically, bioactive glass group showing significant improvement in bone fill over the sites treated with open flap debridement alone. The alloplastic bone graft material, PerioGlas, demonstrated clinical advantages beyond that achieved by debridement alone.     

Demineralized freeze-dried bone allograft and platelet-rich plasma vs platelet-rich plasma alone in infrabony defects: a clinical and radiographic evaluation

The objective of this work is to compare the clinical and radiographic outcomes of demineralized freeze-dried bone allograft (DFDBA)/platelet-rich plasma (PRP) combination with PRP alone for the treatment of infrabony defects 18 months after surgery and to examine the influence of radiographic defect angle on the clinical and radiographic outcomes. Twenty-eight infrabony defects were treated with DFDBA/PRP combination or PRP alone. Clinical parameters and radiographic measurements were compared at baseline and 18 months. Interquartile range was performed to classify the defect angles. Mann-Whitney, Wilcoxon test, and Pearson correlation were used to analyze the data. The DFDBA/PRP combination exhibited more favorable gains in both clinical and radiographic parameters than PRP alone group (p < 0.05). A correlation existed between defect angle, defect depth, and clinical/radiographic outcomes for the defects treated with DFDBA/PRP. The narrow defects presented more favorable clinical attachment level values (CAL) gain, probing pocket depth (PPD) reduction and defect resolution than wide defects in the combination group (p < 0.05). The influence of baseline defect angle was not significant in the PRP-alone group (p > 0.05). The results indicate that DFDBA/PRP combination is more effective than PRP alone for the treatment of infrabony defects, and the amount of CAL gain, PPD reduction, and bone fill increases when the infrabony defect is narrow and deep before DFDBA/PRP combination treatment.     

A 5-year follow-up of 16 patients treated with coralline calcium carbonate (Biocoral™) bone replacement grafts in infrabony defects*

Abstract. A resorbable coralline calcium carbonate graft material (BIOCORAL^TM) (CalCarb) was evaluated as a bone replacement graft in human periodontal osseous defects. Following initial preparation and re-evaluation, flap surgery was carried out. Bone defects were curetted and root surfaces subjected to mechanical debridement and conditioning with tetracycline paste. The bone defects were grafted with CalCarb, and the host flaps replaced or slightly coronally positioned. Weekly, then monthly deplaquing was performed until surgical reentry at 6–12 months. Patients were then followed on approximate 3 month recalls for ≥5 years. Significant clinical changes included improvement in mean vertical clinical probing attachment level from 5.7 mm at surgery to 4.2 mm at re-entry to 4.0 mm at 5 years, decrease in mean probing pocket depth from 6.1 mm at surgery to 3.0 mm at re-entry to 3.3 mm at 5 years, and mean gingival recession from +0.4 mm at surgery to 1,0 mm at re-entry to 0.7 mm at 5 years (all at least p<0.05 from surgery to re-entry and surgery to 5 years, N.S. from reentry to 5 years via ANO-VA) These favorable long-term results with CalCarb suggest that CalCarb may have a beneficial effect in the long-term clinical management of infrabony defects.     

Microbiological and clinical assessment of the abutment and non-abutment teeth of partial removable denture wearers

ObjectiveThe aim of this study was assessing the changes in both clinical and microbiological parameters of healthy individuals after rehabilitation with removable partial denture (RPD).Design11 women received unilateral or bilateral free-end saddle RPD in the mandibular arch. Clinical and microbiological parameters of abutment, non-abutment, and antagonist teeth were assessed at baseline (RPD installation) and after 7, 30, 90, and 180 days of function. The Checkerboard DNA–DNA hybridization technique was used to identify and quantify up to 43 different microbial species from subgingival biofilm samples. Probing depth, gingival recession, and bleeding on probing were also investigated over time.ResultsThe total and individual microbial genome counts were shown significantly increased after 180 days with no significant differences between abutment, non-abutment, or antagonist teeth. Streptococcus spp., Aggregatibacter actinomycetemcomitans, and other species associated to periodontitis (Peptostreptococcus anaerobius, Prevotella nigrescens, and Tannerella forsythia), as well as opportunistic Candida spp., were recovered in moderate counts. Abutment teeth presented higher values of gingival recession when compared with non-abutment or antagonist teeth, irrespectively time of sampling (p < 0.05). No significant differences were found between groups regarding bleeding on probing or probing depth over time.ConclusionsOverall, the microbial counts significantly increased after 6 months of denture loading for both abutment and non-abutment teeth with no significant differences regarding the microbial profile over time. Bleeding on probing and probing depth showed no significant difference between groups over time whereas gingival recession increased in the abutment teeth.     

Short-term periodontal and microbiological changes following orthognathic surgery

ObjectiveAim of the present study was to evaluate the influence of orthognathic surgery on the development of periodontal and microbiological changes.Materials and methodsFifteen consecutively treated patients with a mean age of 24.9 ± 7.7 years receiving orthognathic surgery were included in the present study. Plaque index (PI) and concentrations of 11 periodonto-pathogenic bacteria were recorded one day prior to surgery (t₀) and one week (t₁) and six weeks (t₂) post-surgery. In addition, a complete periodontal examination including pocket probing depth (PPD), gingival recession (GR), clinical attachment level (CAL), bleeding on probing (BOP) and width of keratinized gingiva (WKG) was conducted at t₀ and t₂. For statistical analysis, general linear model and paired t-test were applied.ResultsA significant increase of PI (t₀–t₁, p = 0.037) was followed by a significant decrease (t₁–t₂, p = 0.017). Apart from Eikenella corrodens (p = 0.036), no significant microbiological changes were recorded. PPD significantly increased on oral sites (p = 0.045) and GR especially on buccal sites (p = 0.001). In the incision area the development of GR was significantly higher on the test (buccal) than on the control sites (oral). Both gingival biotypes were affected by GR.ConclusionsOrthognathic surgery causes statistically significant changes of periodontal parameters, but these changes do not necessarily impair the aesthetic appearance of the gingival margin.