A prospective clinical trial on the influence of a triamcinolone/demeclocycline and a calcium hydroxide based temporary cement on pain perception

<p>Abstract</p> <p>Introduction</p> <p>The aim of this clinical trial was to compare the degree of short term post-operative irritation after application of a triamcinolone/demeclocycyline based or a calcium hydroxide based provisional cement.</p> <p>Methods</p> <p>A total of 109 patients (55 female and 54 male; mean age: 51 ± 14 years) with primary or secondary dentinal caries were randomly assigned to the two treatment groups of this biomedical clinical trial (phase III). Selection criteria were good systemic health and treated teeth, which were vital and showed no symptoms of pulpitis. Up to three teeth were prepared for indirect metallic restorations, and the provisional restorations were cemented with a triamcinolone/demeclocycyline (Ledermix) or a calcium hydroxide (Provicol) based material. The intensity of post-operative pain experienced was documented according to the VAS (4, 12, 20, 24, and 82 h) and compared to VAS baseline.</p> <p>Results</p> <p>A total of 159 teeth were treated (Ledermix: 83 teeth, Provicol: 76 teeth). The minor irritation of the teeth, experienced prior to treatment, was similar in both groups; however, 4 h after treatment this value was significantly higher in the Provicol group than in the Ledermix group (p < 0.005, t-test). After 12 h, the difference was no longer significant. The number of patients taking analgesics for post-treatment pain was higher in the Provicol group (n = 11/53) than in the Ledermix group (n = 3/56).</p> <p>Conclusions</p> <p>The patients had no long term post-operative pain experience in both groups. However, within the first hours after cementation the sensation of pain was considerably higher in the Provicol group than in the Ledermix group.</p

Photodynamic therapy has no adverse effects in vitro on human gingival fibroblasts and osteoblasts

Background: Invasion of periodontal pockets with persistent microorganisms and subsequent development of a biofilm are the main cause of periodontal infections. In severe cases, additional use of antibiotics to the standard therapy of scaling and root planing (SRP), is necessary, but the use of antibiotics may lead to resistance. As an alternative, the combination of SRP and adjunct photodynamic therapy (PDT) is applied in the treatment of periodontal infections to improve periodontal therapy. The aim of this study was to determine possible side effects of PDT on human gingival fibroblasts (GF) and human osteoblasts (OB). Methods: GF and OB were either untreated or treated with methylene blue (MB) only, with MB and subsequently irradiation with a soft laser (PDT) or irradiated with a soft laser only. All cells were analyzed for viability using the MTT test, migration capacity using Boyden chambers, and the scratch wound assay. Results: Viability and migration capacity of GF and OB were not affected by PDT (for GF: p = 0.48, for OB: p = 0.08 compared to control group) whereas soft laser irradiation only improved cell viability and migration and MB treatment only reduced cell viability and migration. After 72 hours of incubation of both GF and OB, the gaps were almost closed. Conclusions: In vitro, PDT did not affect viability and migration capacity of GF and OB whereas soft laser treatment only had a positive effect on GF and OB. Therefore, PDT seems to be a safe method in the treatment of periodontal infections without significant side effects

Efficacy of photodynamic therapy as adjunct treatment of chronic periodontitis: a systematic review and meta-analysis

Meta-analysis of treatment effects of antimicrobial photodynamic therapy (aPDT) adjunct to non-surgical scaling and root planing (SRP) in comparison to SRP alone on patients with chronic periodontitis. The meta-analysis was performed according to PRISMA statement and Cochrane Collaboration guidelines. Electronic search complemented by hand search assured a high yield of randomized controlled trials (RCTs) of aPDT as adjunct modality to SRP. Differences in probing depth (PD) and clinical attachment level (CAL) were calculated with 95% confidence intervals and pooled in a random effects model. Analysis for intra- and inter-study heterogeneity was provided by chi (2) and I (2) tests, and publication bias was checked by funnel plots. Pooled overall effects of 26 RCTs attested significant benefits of aPDT adjunct to SRP with respect to PD reduction (MD 0.37; 95% CI 0.12-0.53; P <0.0001) and CAL gain (MD 0.33; 95% CI 0.19-0.48; P <0.00001) after 3 and 6 months. Sensitivity analysis minimized heterogeneity of PD reduction (MD 0.21; 95% CI 0.13-0.30; P <0.00001) and CAL gain (MD 0.36; 95% CI 0.27-0.46). aPDT adjunct to SRP provides significant PD reduction and CAL gain in treatment of chronic periodontitis. This moderate effect was found after 3 and 6 months which is short from a clinical perspectiv

A survey of clearing techniques for 3D imaging of tissues with special reference to connective tissue

For 3-dimensional (3D) imaging of a tissue, 3 methodological steps are essential and their successful application depends on specific characteristics of the type of tissue. The steps are 1° clearing of the opaque tissue to render it transparent for microscopy, 2° fluorescence labeling of the tissues and 3° 3D imaging. In the past decades, new methodologies were introduced for the clearing steps with their specific advantages and disadvantages. Most clearing techniques have been applied to the central nervous system and other organs that contain relatively low amounts of connective tissue including extracellular matrix. However, tissues that contain large amounts of extracellular matrix such as dermis in skin or gingiva are difficult to clear. The present survey lists methodologies that are available for clearing of tissues for 3D imaging. We report here that the BABB method using a mixture of benzyl alcohol and benzyl benzoate and iDISCO using dibenzylether (DBE) are the most successful methods for clearing connective tissue-rich gingiva and dermis of skin for 3D histochemistry and imaging of fluorescence using light-sheet microscopy

Root coverage with connective tissue graft associated with coronally advanced flap or tunnel technique: a randomized, double-blind, mono-centre clinical trial

Aim: The aim of this randomized clinical trial was to compare the coronally advanced flap (CAF) with the modified microsurgical tunnel technique (MMTT) for treatment of Miller class I and II recessions. Material and Methods: Forty patients with 71 gingival recessions were recruited and randomly assigned to either CAF or to MMTT. In both groups, a connective tissue graft was applied. Clinical evaluations were performed after 3, 6, and 12 months. Impressions were taken and digitally scanned three-dimensionally to evaluate the quantitative soft tissue changes in the operative region. Patient satisfaction was measured with the root coverage aesthetic score (RES). Results: After a period of 12 months, significant differences were not found between the two groups. Root coverage was 98.3% for CAF and 97.2% for MMTT. The evaluation of the aesthetic outcome using RES showed good results in both groups. The RES score was in accordance with subjective patient satisfaction. There was no significant difference in the amount of volumetric changes. Conclusions: CAF and MMTT with the additional use of a graft are equally successful in covering gingival recessions of Miller class I and II, with high aesthetic results. All patients indicated their willingness for further periodontal surger

Additional file 1: of Efficacy of an aluminium triformate mouthrinse during the maintenance phase in periodontal patients: a pilot double blind randomized placebo-controlled clinical trial

Modified SBI and API (Lange, [16]). (DOCX 73 kb

Three-dimensional histochemistry and imaging of human gingiva

In the present study, 3D histochemistry and imaging methodology is described for human gingiva to analyze its vascular network. Fifteen human gingiva samples without signs of inflammation were cleared using a mixture of 2-parts benzyl benzoate and 1-part benzyl alcohol (BABB), after being immunofluorescently stained for CD31, marker of endothelial cells to visualize blood vessels in combination with fluorescent DNA dyes. Samples were imaged in 3D with the use of confocal microscopy and light-sheet microscopy and image processing. BABB clearing caused limited tissue shrinkage 13 +/- 7% as surface area and 24 +/- 1% as volume. Fluorescence remained intact in BABB-cleared gingiva samples and light-sheet microscopy was an excellent tool to image gingivae whereas confocal microscopy was not. Histochemistry on cryostat sections of gingiva samples after 3D imaging validated structures visualized in 3D. Three-dimensional images showed the vascular network in the stroma of gingiva with one capillary loop in each stromal papilla invading into the epithelium. The capillary loops were tortuous with structural irregularities that were not apparent in 2D images. It is concluded that 3D histochemistry and imaging methodology described here is a promising novel approach to study structural aspects of human gingiva in health and diseas