Clinical And Radiographic Evaluation of periodontal Infrabony Defects Treated With chitosan In Periodontitis Patients

Chitosan is a naturally derived polymer that has been investigated for its uses as a biomaterial for drug delivery and anti-inflammatory. Recently, chitosan applications in bone regeneration has gained distinct interest. The aim of this study was to. evaluate clinically and radiographically the healing of the periodontal infra-bony defects using chitosan gel in periodontitis patients .Material & methods: Twenty periodontitis patients with bilateral infrabony defects having stage II and Stage III periodontitis were selected according to the criteria of AAP (2017) classification system of periodontal diseases and conditions. Using split mouth design, 20 defects were treated using chitosan gel; while contra-lateral defects were treated by flap only. A total of 40 periodontal infra-bony defects. were randomly assigned for treatment. The clinical parameters included clinical probing pocket depths and clinical attachment levels. Standardized periapical radiographs were recorded at baseline and 6 months after surgery. Results: The results were statistically analyzed and clinical and radiographic data. revealed a statistically significant difference between Chitosan and control sites in the parameters investigated with a significant bone fills versus baseline measurements (P \u3c 0.05).Conclusion: Chitosan gel showed promising benefit in the periodontal regeneration context among periodontitis patients

DIODE LASER TREATMENT OF ORTHODONTICALLY INDUCED GINGIVAL HYPERPLASIA. A RANDOMIZED CONTROLLED CLINICAL TRIAL

Gingival hyperplasia becomes a relatively frequent pathologic condition during orthodontic treatment. The aim of this study was to evaluate the effectiveness of diode laser gingivectomy as an adjunct to nonsurgical periodontal treatment in the management of gingival hyperplasia in orthodontic patients. Materials and Methods: Thirty eight orthodontic patients with gingival enlargement due to fixed appliances were divided randomly into two groups. The test group received diode laser (810-nm) gingivectomy as an adjunct to nonsurgical periodontal treatment. The control group received nonsurgical periodontal treatment only. For all patients, clinical periodontal parameters were assessed at baseline, 6weeks, and 12 weeks: Plaque Index, Gingival Index, bleeding on probing, probing pocket depth, and Gingival Overgrowth Index. Intra- and intergroup variations in the periodontal parameters were determined at time intervals versus baseline measurements. Results: Both groups showed statistically significant improvements in clinical periodontal parameters over the study period (P < .05). However, significant improvements in periodontal health were evident earlier in the test group as the extent of improvement in periodontal health compared to baseline was greater in the test group than in the control group for most of the clinical parameters. (P< .05)Conclusion: The adjunct use of diode laser gingivectomy combined with meticulous oral hygiene can produce quicker and greater improvement in gingival health, suggesting its beneficial use for orthodontic patients with gingival overgrowt

Evaluation of Amnion Chorion Membrane For Socket Preservation After The Extraction of Maxillary Single Rooted Teeth. (A randomized controlled clinical trial)

Abstract The aim of this study was to assess the efficiency of using dehydrated de-epithelialized amnion chorion membrane (ddACM) on socket preservation in the anterior region, clinically and radiographically. Materials and methods: 26 unrestorable maxillary anterior or single rooted premolars, with buccal fenestration, were selected. The socket was filled with allograft material and covered with ddACM for study group, and collagen membrane for the control group divided equally. Clinical parameters including gingival healing and tissue thickness was assessed. Volumetric bone change was measured 4 months later using a CBCT. Results: Study group showed clinical statistical significant results than the control group (P-value = 0.020, effect size = 0.574) along with a radiographic higher mean bone width measurement than control group after four months (P-value = 0.372, Effect size = 0.357). Conclusion: As compared to collagen membrane, intentionally exposed ACM is similarly successful in ridge preservation. Moreover, the use of ACM may help to reduce postoperative VAS ratings and may result in excellent bone quality available for implant placement. Key word: Collagen membrane, ddACM, FDBA, Socket Preservation. RESUME Le but de cette étude était d’évaluer l’efficacité de l’utilisation de la membrane chorion amnion désépithélialisée déshydratée (ddACM) sur la préservation de la cavité dans la région antérieure, cliniquement et radiographiquement. Matériaux et méthodes: 26 prémolaires maxillaires antérieures ou à racine unique non restaurables, avec fenestration buccale, ont été sélectionnées. La cavité a été remplie de matériau d’allogreffe et recouverte de ddACM pour le groupe d’étude, et la membrane de collagène pour le groupe témoin divisée également. Les paramètres cliniques, y compris la cicatrisation gingivale et l’épaisseur des tissus, ont été évalués. Le changement osseux volumétrique a été mesuré 4 mois plus tard à l’aide d’un CBCT. Résultats: Le groupe d’étude a montré des résultats statistiques cliniques significatifs que le groupe témoin (valeur P = 0,020, ampleur de l’effet = 0,574) ainsi qu’une mesure de la largeur osseuse moyenne radiographique plus élevée que le groupe témoin après quatre mois (valeur P = 0,372, ampleur de l’effet = 0,357). Conclusion: Par rapport à la membrane de collagène, l’ACM intentionnellement exposé est tout aussi efficace dans la préservation des crêtes. De plus, l’utilisation de MCA peut aider à réduire les cotes AVA postopératoires et peut entraîner une excellente qualité osseuse disponible pour la pose d’implants. Mot-clé: Membrane de collagène, ddACM, FDBA, Socket Preservation

COVID-19: WHAT ABOUT DENTISTS?

Coronavirus (COVID-19) has been associated with person-to-person transmission. This includes droplets inhalation, exposure to saliva, and contact with the oral or nasal mucosa. The World Health Organization (WHO) made it public that the novel coronavirus initiated an international public health emergency. COVID-19 cases are rising up until this day, as of End-April 2021, around 141 million confirmed cases and 3 million deaths were reported worldwide. Due to the characteristics of dental clinics, dental health care personnel are at a higher risk of getting exposed to the COVID-19 infection. Thus, there is an urgent need to improve the current implemented recommendations and strategies in order to prevent transmission of the disease. Despite the huge efforts made by the countries affected in an attempt to restrain this pandemic, there is still a daily flare-up of cases. Dental health personnel will come across patients with COVID-19, and thus will have to abide by strict infection control measures to prevent its spread. The aim of this article is to introduce a brief overview about the basic knowledge of COVID-19, its routes of transmission, as well as its clinical symptoms. Based on relevant research and guidelines, this study also provides recommendations for patients screening, management protocols, infection control as well as recommendations for dental health care personnel in different affected areas

Leukocytic Platelet Rich Fibrin (L-PRF) Versus Subepithelial Connective Tissue Graft (SCTG) Using Tunneling Technique in Treatment of Gingival Recession (Randomized Controlled Clinical Study)

Background: Gingival recession is a problem encountered daily in clinical practice, its etiology is often a multifactorial one. Surgical treatment is the only method to reverse this condition. Objective: to evaluate the effectiveness of leukocytic platelet rich fibrins (L-PRF) versus subepithelial connective tissue graft (SCTG) in the management of recession defects Miller’s class I or II (RT1) using the tunnel technique (TUN). Methods: 20 systemically healthy patients were allocated randomly to TUN with L-PRF (group A), and TUN with SCTG (group B). Probing depth, clinical attachment level, recession depth, width of keratinized tissue, gingival thickness, and recession esthetic score and wound healing index are clinical variables measured at baseline,14 days, 3 months, and 6 months postoperatively. Results: Significant improvement in mean CAL, and RD for both groups, and significant difference in GT and WKT for group B as well as higher RES. A significant difference was also recorded in group A for WHI. Conclusions: Both grafting modalities in combination with tunnel technique improved gingival phenotype switching. Although SCTG gives higher esthetic and functional results including better color matching, tissue contour and increased width of keratinized tissue, L-PRF has superior healing properties and can be used as an alternative to treat multiple gingival recession defects where the need of second surgical site is eliminated

Comparison Between Hyaluronic Acid and Chlorhexidine in the Treatment of Orthodontically Induced Gingival Enlargement.

Abstract Aim: The study aimed to assess and compare the effectiveness of chlorhexidine and hyaluronic acid when used as an adjuvant to professional mechanical plaque removal (PMPR) in the treatment of orthodontically induced gingival enlargement. Methods: The study conducted was a randomized controlled clinical trial involving 45 patients. The patients will be categorized into 3 groups; control group receiving conventional PMPR, study 1 group receiving PMPR and chlorhexidine (CHX), and study 2 group receiving PMPR and hyaluronic acid (HA). Probing depth (PD), Gingival overgrowth index (GOI), gingival bleeding index (GBI), and plaque index (PI), will be recorded at baseline, 1 month, 2 months, and 4 months’ post therapy. A bivariate analysis was conducted to evaluate the parameters in function of the three study groups, and to evaluate the changes in PD and GBI between baseline, month 1, month 2 and month 4 in the three study groups. Results: A significant reduction in probing depth and gingival bleeding was observed in the three groups (p 0.05). The change in PD, PI, GBI and GOI was more in Group 1 and Group 2 than in the control group. Hyaluronic acid demonstrated the same effect of chlorhexidine. Conclusion: HA is just as effective as CHX in treating gingival enlargement. Based on the acceptance of HA by patients generally and the negative effects of CHX, HA may be a potential alternative to CHX

Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial

The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing. Material and Methods. This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively. Results. Test and control sites were compared using paired t-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results. Conclusion. Piezosurgery technique improves quality of patient’s life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar

Azithromycin treatment of drug induced gingival hyperplasia in renal transplant patients

Objectives: was to evaluate and compare the efficacy of azithromycin therapy inreducing drug-induced gingival hyperplasia as an adjunctive therapy in renaltransplant patients (RTP) under cyclosporine (CsA) and those under tacrolimus(Tac) therapyMaterial & Methods: Seventy five kidney transplant recipients (48men, 27 women) diagnosed to have early to moderate gingival overgrowth withstable allograft function entered the study. These patients had been takingeither CsA or Tac for more than 6 months .The patients were randomized equallyinto three groups. Two groups had received 500-mg azithromycin for 5-days givenat baseline only. While the control group received placebo in addition to theoral hygiene program .The clinical periodontal parameters were assessed and includethe plaque index, bleeding on probing index, the gingival overgrowth index, andthe probing depth. They were evaluated at the baseline and at flow up time (1,3, 6 months)Results: At the baseline time all groups were similar in the clinical parameterswith no statistically significant difference (P>0.05). At follow up timeintervals all groups showed improvement over baseline measurements however bothgroups who received AZI showed more favorable results manifested by reductionof gingival bleeding and the depth of gingival sulcus .However, thisimprovement was more in the (CsA) group than the (Tac) group and the differencewas statistically significant (P≥ 0.05)Conclusions: Azithromycin is an effective therapeutic tool in the management ofdrug-induced gingival overgrowth as it is conservative, well tolerated, andrapidly effective with minimal side effects; especially in renal transplantpatients under cyclosporine therapy

Influence of Material Properties on Rate of Resorption of Two Bone Graft Materials after Sinus Lift Using Radiographic Assessment

. Purpose. The aim of this study was to investigate the influence of chemical and physical properties of two graft materials on the rate of resorption. Materials and Methods. Direct sinus graft procedure was performed on 22 patients intended for implant placement. Two types of graft materials were used (Bio-Oss and Cerabone) and after 8 months healing time the implants were inserted. Radiographic assessment was performed over the period of four years. Particle size, rate of calcium release, and size and type of crystal structure of each graft were evaluated. Results. The average particle size of Bio-Oss (1 mm) was much smaller compared to Cerabone (2.7 mm). The amount of calcium release due to dissolution of material in water was much higher for Bio-oss compared to Cerabone. X-ray image analysis revealed that Bio-Oss demonstrated significantly higher volumetric loss (33.4 ± 3.1%) of initial graft size compared to Cerabone (23.4 ± 3.6%). The greatest amount of vertical loss of graft material volume was observed after one year of surgery. Conclusion. The chemical and physical properties of bone graft material significantly influence resorption rate of bone graft materials used for sinus augmentation

Influence of Material Properties on Rate of Resorption of Two Bone Graft Materials after Sinus Lift Using Radiographic Assessment

Purpose. The aim of this study was to investigate the influence of chemical and physical properties of two graft materials on the rate of resorption. Materials and Methods. Direct sinus graft procedure was performed on 22 patients intended for implant placement. Two types of graft materials were used (Bio-Oss and Cerabone) and after 8 months healing time the implants were inserted. Radiographic assessment was performed over the period of four years. Particle size, rate of calcium release, and size and type of crystal structure of each graft were evaluated. Results. The average particle size of Bio-Oss (1 mm) was much smaller compared to Cerabone (2.7 mm). The amount of calcium release due to dissolution of material in water was much higher for Bio-oss compared to Cerabone. X-ray image analysis revealed that Bio-Oss demonstrated significantly higher volumetric loss (33.4 ± 3.1%) of initial graft size compared to Cerabone (23.4 ± 3.6%). The greatest amount of vertical loss of graft material volume was observed after one year of surgery. Conclusion. The chemical and physical properties of bone graft material significantly influence resorption rate of bone graft materials used for sinus augmentation