Short term results of three modalities of periodontal treatment.

Short term data were obtained from 74 patients who recieved comprehensive periodontal treatment using a split mouth approach to test three variables; subgingival curettage, pocket elimination surgery, and modified Widman flap procedure. The patients initially had an average interproximal loss of attachment of 3.2 mm and an average interproximal pocket depth of 3.9 mm. Evaluation of the data indicate that after 4 to 6 weeks: 1. All three surgical procedures reduce pocket depths. In order of effectiveness they are: pocket elimination surgery, modified Widman flap, and subgingival curettage. 2. Pocket elimination surgery reduces pockets more than subgingival curettage on the buccal, lingual and interproximal, and more than the modified Widman flap on the lingual. The modified Widman flap procedure reduces pockets more interproximally than subgingival curettage. 3. Subgingival curettage results in a gain of attachment interproximally, and on the lingual side, while the modified Widman flap resulted in a gain of attachment interproximally only. 4 Pocket elimination surgery resulted in a loss of attachment buccally. 5 Subgingival curettage results in a more favorable postoperative attachment level on all surfaces than did pocket elimination surgery.     

α-l-Fucosidase activity in human saliva and dental plaque

α-l-Fucosidase activities were determined using p-nitrophenyl-α-l-fucoside (p-NPF) and de-sialized porcine submandibular glycoprotein (DS-PSG) as substrates. Dental plaque and whole saliva possessed enzyme activity against both substrates. Parotid and submaxillary-sublingual saliva exhibited the activity on p-NPF, but did not on DS-PSG.     

Sealant effectiveness for children receiving a combination of preventive methods in a fluoridated community: two-year results.

A series of preventive methods in combination have been used to reduce dental caries in children including dental health education, prophylaxes, pit and fissure sealants, topical application of fluoride and restorative care. Prophylaxes, sealant, and fluoride procedures are repeated every six months. Two-year results show reductions of occlusal caries increments of 74.3% for first graders and 77.1% for sixth graders. Sealant loss, as defined in this study, varied from 33% to 90% with the highest loss occurring in the newly erupted permanent molars during the first six months of the project. These high sealant loss rates are thought to be related to the age of the population which was designed to include children at the ages of peak eruption of permanent molar teeth (ages six and twelve). These teeth were often only minimally erupted and maintaining the dry field required for sealant retention was extremely difficult. However, in spite of these high rates of sealant loss, caries reduction on occlusal surfaces was highly significant in comparision to that of children who did not receive sealants.     

Painless swelling proved to be a central giant cell granuloma

A 32-year-old female patient was referred to an oral and maxillofacial surgeon with an asymptomatic swelling in the left mandibular premolar region. After extraction of these premolars and enucleation of the lesion histopathological examination confirmed the presence of a giant cell granuloma. This is a benign lesion and enucleation generally results in a permanent cure and is only recurrent in a few cases. Approximately 1 year after treatment, the patient was still free of recurrence and together with a prosthodontist, the appropriate rehabilitation of the resulting defect will be sought.     

Clinical assessment of peri-implant tissues in patients with varying severity of chronic periodontitis

Purpose: This retrospective study assessed the health of peri-implant tissues in patients with varying severity of chronic periodontitis.
Materials and Methods: Sixty-one subjects aged 44 to 70 years (median age 58 years) were recruited. Based on severity of periodontitis, 31 subjects were classified as having severe generalized chronic periodontitis, and the remaining 30 subjects had mild or no periodontitis. Social and medical histories were obtained from each patient. A comprehensive periodontal examination included: plaque index, gingival index, bleeding index, probing depth, clinical attachment level, and radiographic bone loss. Data were analyzed using Fisher's exact and chi-square tests for categorical variables, and t -test for continuous variables.
Results: There was a statistically significant greater loss of attachment ( p  < .05) around implants in the group with severe periodontitis compared to the no/mild periodontitis group.
Conclusion: Because of the greater loss of clinical attachment around implants placed in patients with generalized severe chronic periodontitis, close monitoring of these patients is suggested to prevent both development of peri-implantitis and recurrence of periodontal infection.     

Outcome of primary root canal treatment: systematic review of the literature -- Part 2. Influence of clinical factors.

AIMS: (i) To carry out meta-analyses to quantify the influence of the clinical factors on the efficacy of primary root canal treatment and (ii) to identify the best treatment protocol based on the current evidence. METHODOLOGY: The evidence for the effect of each clinical factor on the success rate (SR) of primary root canal treatment was gathered in three different ways: (i) intuitive synthesis of reported findings from individual studies; (ii) weighted pooled SR by each factor under investigation was estimated using random-effect meta-analysis; (iii) weighted effect of the factor under investigation on SR were estimated and expressed as odds ratio for the dichotomous outcomes (success or failure) using fixed- and random-effects meta-analysis. Statistical heterogeneity amongst the studies was assessed by Cochran's (Q) test. Potential sources of statistical heterogeneity were investigated by exploring clinical heterogeneity using meta-regression models which included study characteristics in the regression models. RESULTS: Out of the clinical factors investigated, pre-operative pulpal and periapical status were most frequently investigated, whilst the intra-operative factors were poorly studied in the 63 studies. Four factors were found to have a significant effect on the primary root canal treatment outcome, although the data heterogeneity was substantial, some of which could be explained by some of the study characteristics. CONCLUSIONS: Four conditions (pre-operative absence of periapical radiolucency, root filling with no voids, root filling extending to 2 mm within the radiographic apex and satisfactory coronal restoration) were found to improve the outcome of primary root canal treatment significantly. Root canal treatment should therefore aim at achieving and maintaining access to apical anatomy during chemo-mechanical debridement, obturating the canal with densely compacted material to the apical terminus without extrusion into the apical tissues and preventing re-infection with a good quality coronal restoration.