The evaluation of root surface modifications after different subgingival mechanical instrumentation techniques – an in vitro study

Objectives. The aim of this in vitro study was to observe through scanning electron microscopy (SEM) the surface morphology of root samples treated with different mechanical instrumentation methods and the additional application of a nanocolloidal silver-based antiseptic solution. Material and methods. Root samples were prepared from extracted molars and divided in four groups: group 1 of samples was instrumented with Gracey curette (7/8), group 2 of samples was instrumented with ultrasonic tip 1S, group 3 of samples was instrumented with ultrasonic tips 1S plus H4R/L, group 4 of samples was treated with ultrasonic tips 1S plus H4R/L and application of the silver-based antiseptic solution. All samples were then subjected to SEM examination. Outcomes. Group 1 of samples presented a smoother surface compared to the samples in the other groups. Group 2, 3 and 4 displayed superficial grooves parallel to the direction of action of the ultrasonic tip. In group 3 and 4, root planning with tip H4R/L did not ameliorate the smoothness of the surface. The smear layer was present, regardless the instrumentation method. In group 4, the additional application of the antiseptic solution did not influence the surface morphology or the amount of smear layer. Conclusions. Gracey curettes created a smoother radicular surface compared to ultrasonic tips. Smear layer was obvious on the radicular surfaces, no matter the instrumentation method. The application of the silver-based antiseptic solution had no additional impact on surface morphology

Adjunctive use of a nanocolloidal silver-based local antiseptic solution in the nonsurgical treatment of periodontitis: A split-mouth clinical study

Objectives. The aim of the present study was to evaluate the potential additional clinical benefit of a commercial nanocolloidal silver-based local antiseptic used as irrigation solution after subgingival mechanical instrumentation. Material and methods. Periodontitis patients were treated following the current guidelines. Two randomly assigned hemiarches of each patient received subgingival mechanical instrumentation plus irrigations with the commercial product (experimental group); the other two hemiarches received mechanical instrumentation plus saline irrigations (control group). A clinical periodontal examination at baseline moment and after 3 months was performed. The parameters considered for analysis were oral hygiene index (IHI), bleeding on probing score (BoP), periodontal pocket probing depth (PD), gingival recession (GR) and clinical attachment level (CAL). 72 sites were included in the analysis, the site with the highest PD/quadrant for each patient. Data were analyzed using GraphPad Prism version 8.0.1 (GraphPad Software Inc., La Jolla, CA, USA). p<0.05 was set as statistical significance level. Outcomes. Eighteen periodontitis patients were treated. All clinical parameters improved at re-evaluation, compared to baseline, both in experimental and control group. The differences were statistically significant in terms of IHI, BoP and PD reduction. At re-evaluation, there were no statistically significant differences between periodontal parameters registered in the experimental and control sites. Conclusions. The present study failed to prove an adjunctive clinical benefit of the antiseptic product in the nonsurgical treatment of periodontitis. These results support the gold standard role of subgingival mechanical instrumentation in the periodontitis’ therapeutic protocol

The RT-PCR additional value in detecting periodontal pathogens in periodontitis patients

Objectives. The aim of this study was to evaluate the prevalence of selected bacterial species from periodontal pockets samples in a group of young adult periodontitis patients and explore the additional value of the Real-Time Polymerase Chain Reaction (RT-PCR) assay. Material and Methods. Patients with periodontitis diagnosis and good general health were included in the study after a complete periodontal examination and following the inclusion/exclusion criteria. Samples from the deepest periodontal pockets were collected, and RT-PCR assay was performed in a private laboratory in order to identify eleven bacterial strains associated with periodontitis. The patient’s report provided the bacterial pathogen load quantified according to the detection threshold and classified as negative, weakly positive, positive, or intensely positive. Results. The RT-PCR assay detected periodontal pathogens, and their prevalence could be calculated based on the test report. The red complex bacteria were detected in all patients with the highest counts. Alongside the orange complex bacteria were also detected in periodontitis patients. A. actinomycetemcomitans remained undetected in our study. Conclusions. The RT-PCR technique proved to be a useful and easy approach for identifying and quantifying subgingival periodontal pathogens in periodontitis patients. RT-PCR testing may facilitate accurate diagnosis and prognosis as well as successful treatment

Alveolar ridge preservation following tooth extraction – basic concepts

After tooth extraction due different clinical situations, there are some physiological changes that include volumetric resorption of the bone, leading to changes in the dimensions and contours of the alveolar ridge that can negatively impact the aesthetic outcome of an implant or of a conventional prosthetic rehabilitation. In order to prevent and minimize adverse consequences from such dimensional changes, the present review aims to present some fundamental basis regarding alveolar ridge preservation and biomaterials used to prevent bone resorption

Immunological Insights on Pathogenic Connections between Hepato-Digestive Disorders and Periodontal Conditions

The oral cavity is an integral part of the digestive tract and thus significant diseases, including periodontitis, can have an important impact on the normal nutritional functions of the body. Certain diseases of the hepato-digestive system have an inflammatory component, such as chronic hepatitis, fatty liver disease, or gastric cancer. This inflammatory reaction is mainly driven by pro-inflammatory chemokines. This is also the case for periodontitis, a condition characterized by the inflammation of the supporting tissues of teeth. Thus, significant pathogenic connections mediated by pro-inflammatory chemokines could exist between periodontitis and diseases of the hepato-digestive system

Periodontal Medicine: Impact of Periodontal Status on Pregnancy Outcomes and Carcinogenesis

Periodontal medicine is a broad term commonly used to define the relationship between periodontitis and systemic health. Periodontitis is a highly prevalent, chronic multifactorial infectious disease, induced by the dysbiotic biofilm that triggers a persistent systemic inflammation and recurrent bacteremia. There is a growing body of scientific evidence that suggests the potential implication of periodontitis in the causation and progression of various systemic disease and conditions, such as diabetes, cardiovascular disease, pulmonary disease, adverse pregnancy outcomes and cancer. Some studies consider periodontitis as an independent risk factor for preterm birth, growth restriction, low birth-weight and pre-eclampsia. However not all studies support the association. Despite sparse scientific data, some studies indicate that individuals with periodontitis are at increased risk for cancer development, due to the increased inflammatory burden sustained by the presence of periodontal pathogens. This chapter emphasis the relationship between periodontitis and adverse pregnancy outcomes and the underlying mechanisms that link peridontitis to oral carcinogenesis

Study Regarding some Physico-chemical Properties of Composite Resins for Direct Restorations

Aim: This study investigated the physicochemical properties i.e. water sorption (Wsp) and solubility (Wsl) of one experimental composite in comparison with four commercially available materialsused for direct restorations. Material and Methods: Disc-shaped specimens of each material were prepared and investigated according to the ISO standard 4049:2000. Results: The experimentalcomposite had similar water sorption values with the trade-mark composites after 1 day storage. Significant differences regarding Wsp were found after 7 days and respectively 1 month of immersion (p<0.05). Similarities between the experimental composite and the trade-mark materials were observed regarding Wsl. Conclusion: The Wsp and Wsl values of the experimental material as well as of the trade-mark composites are in accordance with ISO standard 4049:2000, that is Wsp <40 μg/ mm3 and Wsl <7.5 μg/mm3

Postoperative Complications Following Gingival Grafts: A Prospective Cohort Study

Aim: Treating gingival recessions (GRs) is a challenge for the practitioner who must take into consideration objective clinical factors, subjective symptoms and also factors related to the patient’s expectations. The aim of this study was to evaluate the postoperative complications associated with connective tissue graft (CTG) plus coronally advanced flap (CAF) and free gingival graft (FGG) used to cover GRs and to compare post-operative morbidities for the two groups of procedures. Material and Methods: A total of 17 patients diagnosed with Miller class 1 to 3 GRs ≥2mm were surgically treated using CTG plus CAF or FGG. When minimum 2 mm of keratinized gingiva was present apically to GR, CTG plus CAF was used. FGG was chosen to cover GRs when keratinized gingiva was absent. Post-operative complications were evaluated with a questionnaire with six questions given to the patients at 14 days follow-up visit. The study used a 1 to 10 visual analogic scale (VAS) and the levels of outcomes were classified as “none to minimum” “moderate” and “very important/severe”. Results: A total of 21 procedures, 10 CTG plus CAG and 11 FGG were included in the analysis. No palatal bleeding and no severe pain or swelling were recorded. The patients experienced more pain in the grafted area than in the donor area, for both surgical techniques, with a mean value of 3.09 (1.3 standard deviation sd) versus 2.27 (1.4 sd) for CTG plus CAF group and of 3.7 (2.21 sd) versus 2.9 (1.7 sd) for FGG group, respectively. CTG plus CAF generated significantly higher scores of tumefaction than FGG, the mean values being 2.45 (0.93 sd) and 4 (2.21 sd) (t-value=2.12, p<0.05) respectively. Conclusion: The complications associated with the two periodontal surgical approaches seem manageable and clinically acceptable

Perception of the importance of oral hygiene in a group of adults from South-West Romania

Oral hygiene is a dental procedure with the role of removing bacterial plaque and action to prevent oral diseases, including periodontal disease. Oral prophylaxis includes both daily dental hygiene (daily brushing, flossing and mouthwash) and the visits to the dentist for professional hygiene and prophylaxis. The correct brushing of the teeth is important not only for maintaining oral health but also for the health of the whole body, because there are correlations between diseases of the oral cavity and problems of the digestive tract or even heart disease

Patient-centered outcomes after subepithelial connective tissue grafts and coronally advanced flaps

The use of a coronally advanced flap (CAF) and connective tissue graft (CTG) is a well-established procedure to cover single and multiple recessions and improve soft tissue esthetics. However, until now, there are still limited data evaluating patient morbidity, the fear of imminent tooth loss, and modification of sensitivity in surgical areas. The aim of the present study was to evaluate the patient-centered outcomes associated with CAF + CTG