Gingival Abscess Removal Using a Soft-Tissue Laser

Gingival abscess, also known as parulis, is defined as a localized, acute inflammatory lesion that may arise from a number of sources, including microbial plaque infection, trauma, and foreign body impaction. It often presents as a smooth, fluctuant, red-color swelling and can occasionally be painful. It is generally limited to marginal and interdental gingiva. Based on its location it has been classified as a type of periodontal abscess which does not involve any attachment loss. The treatment comprises of removal of the cause and, in acute situations, excision of the abscess. A typical gingival abscess is easy to diagnose; however, as suggested by the lack of literature, it is rarely seen in clinical situations. This article presents a clinical case of a gingival abscess located adjacent to recently-placed implants, and discusses its etiology, histopathology, and treatment with an 810-nm soft-tissue diode laser

The Effect of EDTA in Attachment Gain and Root Coverage

Root surface biomodification using low pH agents such as citric acid and tetracycline has been proposed to enhance root coverage following connective tissue grafting. The authors hypothesized that root conditioning with neutral pH edetic acid would improve vertical recession depth, root surface coverage, pocket depth, and clinical attachment levels. Twenty teeth in 10 patients with Miller class I and II recession were treated with connective tissue grafting. The experimental sites received 24% edetic acid in sterile distilled water applied to the root surface for 2 minutes before grafting. Controls were pretreated with only sterile distilled water. Measurements were evaluated before surgery and 6 months after surgery. Analysis of variance was used to determine differences between experimental and control groups. We found significant postoperative improvements in vertical recession depth, root surface coverage, and clinical attachment levels in test and control groups, compared to postoperative data. Pocket depth differences were not significant (P\u3c.01)

Alveolar antral artery management during sinus elevation: A case report of a novel approach with review of the literature

Maxillary sinus elevation is a widely used and relatively safe and predictable technique. Frequently, when aberrant anatomical conditions of the sinus are present, the handling of such a procedure might become more complex, and subjected to possible intra- and post-operatory complications. One of the most challenging anatomical conditions to manage is the alveolar antral artery (AAA), when it is unusually wide in diameter and passes through the area of the osteotomy with a complete intraosseous course. In the literature, many treatment options have been proposed for the surgical management of such an anatomical condition. The aim of this case report is to describe the clinical handling of an AAA with a piezosurgical approach, including the artery in the bony window design, but avoiding its displacement and possible tearing that might cause severe intra-operatory bleeding and post-operatory complications

Calcium Sulfate and Platelet-Rich Plasma make a novel osteoinductive biomaterial for bone regeneration

BACKGROUND: With the present study we introduce a novel and simple biomaterial able to induce regeneration of bone. We theorized that nourishing a bone defect with calcium and with a large amount of activated platelets may initiate a series of biological processes that culminate in bone regeneration. Thus, we engineered CS-Platelet, a biomaterial based on the combination of Calcium Sulfate and Platelet-Rich Plasma in which Calcium Sulfate also acts as an activator of the platelets, therefore avoiding the need to activate the platelets with an agonist. METHODS: First, we tested CS-Platelet in heterotopic (muscle) and orthotopic (bone) bone regeneration bioassays. We then utilized CS-Platelet in a variety of dental and craniofacial clinical cases, where regeneration of bone was needed. RESULTS: The heterotopic bioassay showed formation of bone within the muscular tissue at the site of the implantation of CS-Platelet. Results of a quantitative orthotopic bioassay based on the rat calvaria critical size defect showed that only CS-Platelet and recombinant human BMP2 were able to induce a significant regeneration of bone. A non-human primate orthotopic bioassay also showed that CS-Platelet is completely resorbable. In all human clinical cases where CS-Platelet was used, a complete bone repair was achieved. CONCLUSION: This study showed that CS-Platelet is a novel biomaterial able to induce formation of bone in heterotopic and orthotopic sites, in orthotopic critical size bone defects, and in various clinical situations. The discovery of CS-Platelet may represent a cost-effective breakthrough in bone regenerative therapy and an alternative or an adjuvant to the current treatments

A Combined Treatment for a Case of Peri-Implant Bisphosphonate-Related Osteonecrosis of the Jaw

Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is rarely reported as a complication after implants placement. In this article we report a combined treatment for a rare case of peri-implant BRONJ

What Grows on Your Implants?

What happens to implants after we introduce them into the oral environment? Do they keep their sterility, or are they colonized by bacteria? How fast is the surface of the implants colonized by the bacteria, and which bacteria will colonize it? Do healthy implants have the same microbial populations as diseased implants? What’s the role of the remaining teeth in the contamination of the dental implants? This short review of the literature will give a general overview of critical concepts in terms of peri-implant microbiology, based on the most important evidence in the literature

Maxillary sinus elevation for implant placement using calcium sulfate with and without DFDBA: Six cases

Maxillary sinus lift is a surgical procedure performed to increase the volume of bone mass so that dental implants can be placed in the maxillary arch. Several materials have been suggested to be used for this procedure. The purpose of this study was to present the clinical and histologic results of using calcium sulfate with and without demineralized freeze-dried bone allograft (DFDBA) in sinus lift. Medical-grade sterile calcium sulfate was used alone or in combination with DFDBA in 6 patients undergoing sinus lift surgery for implant placement. Bone biopsies were taken at different times ranging from 6 to 24 months. All samples examined showed bone growth with some possible remnants of the grafted DFDBA. Implants were inserted either at the time of the lift or 6 months later. All of them were secure with primary stability. The cases reported indicate that calcium sulfate can be successfully used alone or in combination with DFDBA for sinus lift procedures and that possible residues of DFDBA can be found within newly generated bone

In vitro evaluation of controlled-release 14% doxycycline gel for decontamination of machined and sandblasted acid-etched implants

Peri-implant infections are associated with the establishment and maturation of a bacterial biofilm characterized by a predominance of Gram-negative fusiform anaerobic species. The decontamination of implant surfaces is then crucial for a successful peri-implant therapy. METHODS: Twenty-one smooth and 21 rough implants, divided into four groups according to surface and treatment modality, were contaminated with Streptococcus sanguinis and then placed in an incubator with the atmosphere of 5% CO2 at 37\ub0C for 24 hours to allow the bacteria to grow. After 24 hours, the test groups were treated with controlled release 14% doxycycline gel injecting the gel circumferentially over the surface of the implant for 3 minutes, while the control groups were irrigated with sterile saline for 1 minute. The implants were then vortexed into triptych soy broth to allow the bacteria to detach from the surface, diluted 1:100 and plated. Colony forming units (CFU) were counted 48 hours after incubation. RESULTS: The use of a 14% doxycycline gel minimized CFU counts compared to control groups, with the difference being statistically significant (P < 0.05). The reduction of CFUs in the smooth test group is more marked than in the rough test group, but the difference doesn't reach statistically significance (P = 0.215). CONCLUSIONS: The use of 14% doxycycline gel in implant surface decontamination was efficacious in this in-vitro study. Adjunctive use of locally delivered 14% doxycycline gel might be a viable option in the management of peri-implantitis and peri-implant mucositis considering its efficacy in reducing bacterial colonization