Nondiseased dentinal root surface following citric acid or tetracycline hydrochloride conditioning: a scanning electron microscopic study on the effects of ultrasonic irrigation before and after root conditioning.

The scanning electron microscope was used to evaluate the effects of ultrasonic irrigation before and after root conditioning. Six groups of five specimens each received saline irrigation; ultrasonic irrigation; saline irrigation followed by root conditioning with either citric acid or tetracycline hydrochloride; or ultrasonic irrigation followed by root conditioning with either citric acid or tetracycline hydrochloride. After immersion in citric acid or tetracycline hydrochloride solutions, root dentin was rinsed again with saline or irrigated ultrasonically. Control specimens exhibited an amorphous, irregular surface smear layer. Ultrasonic irrigation, citric acid, and tetracycline hydrochloride were effective in removing the smear layer. Use of ultrasonic irrigation before and after acid application improved the exposure of dentinal fibrils.King Saud Universit

A four-year clinical follow-up of non-vital root resection in maxillary molar teeth

The aim of the study was to evaluate the success of non-vital root resected maxillary molar teeth over a period of four years. Fourteen root resected maxillary molar teeth were evaluated for mobility and probing depth in the area of root resection. Only one failure was observed over a period of four years follow-up. It was observed that removal of one root neither increase the tooth mobility nor the probing depth in most of the cases. It is concluded that non-vital root resection should be considered before molar extraction, because this treatment can provide good results with long term success, provided appropriate patient selection. This procedure can be practised by general dentists with little effort.King Saud Universit

Subgingival irrigation effects of chlorhexidine or sanguinarine on gingivitis in orthodontic patients.

This clinical investigation examined the effect of a single subgingival irrigation of chlorhexidine 0.2% or sanguinarine on gingivitis affecting orthodontically banded first molars in adolescent patients. Eighteen patients with gingivitis participated in the study. Probing depth, papilla bleeding index and plaque index were recorded at four sites for three molars at baseline, 2 weeks and 4 weeks by one investigator. A second investigator irrigated a single application of 3 ml of either chlorhexidine, sanguinarine or saline. The gingival bleeding as determined by papilla bleeding index was almost eliminated in the 4 week period. A reduction of the plaque index and probing depth was observed in all three groups. A significant difference related to probing depth between the effect of saline and chlorhexidine (p<0.01) was noted.King Saud Universit

Clinical Effects of Chlorhexidine, Sanguinarine and Saline as Coolants during Ultrasonic Scaling on Gingivitis in Orthodontics Patients.

This clinical investigation examined the effect of chlorhexidine, sanguinarine and saline as coolants during ultrasonic scaling on gingivitis in orthodontic patients. Eighteen females with gingivitis participated in this study. Plaque Index (PI), Gingival Index (Gl), Interdental Bleeding Index (Bl) and Probing Depth (PD) were recorded for the following teeth 16, 21, 25, 36, 41 and 45 at baseline, 2 weeks and 4 weeks respectively. The application of solutions (chlorhexidine, sanguinarine and saline) as coolants was delivered by the use of an ultrasonic handpiece (Piezon) in each group consisting of 6 patients. A reduction of the PI, Gl, Bl and PD was observed in all three groups. Irrigation with chlorhexidine, sanguinarine and saline as coolants respectively is an effective clinical procedure during ultrasonic scaling in orthodontic patients with gingivitis.King Saud Universit

Regeneration of bifurcation in beagle dogs: histologic evaluation of two regeneration materials

The aim of this study was to compare Emdogain and Guidor resorbable materials in the regeneration and/or healing of experimental Class II furcation lesions. Class II premolar furcation defects 3-5 mm high and 2.5-5 mm deep were experimentally induced in four beagle dogs. Dogs 1 and 2were assigned to one-stage surgery where the defect created was immediately followed by the placement of either Guidor or Emdogain or nothing (control). Dogs 2 and 4 were assigned to a two-stage approach where the creation of the defect was followed one month later with the membrane placement or nothing (control). After six months of healing animals were sacrificed. Subsequently, decalcified sections were prepared from all animals and used for histological evaluation. Accelular cementum was not a constant finding with the use of Emdogain. It was concluded that the two-stage surgery approach is a more predictable experimental model for the healing of Class II furcation.King Saud Universit

New attachment of surgically induced buccal gingival recessions using enamel matrix derivative: A histologic and histometric study in dogs

The present study was designed to evaluate the healing process of gingival recession defects treated with enamel matrix derivative (EMD) and to compare it to that obtained with 24% ethylenediamine tetra acetic acid (EDTA) and the laterally repositioned flapsalone.MATERIALS and METHODS: Gingival recessions were surgically created on the buccal surfaces of maxillary canines and fourth premolars and mandibular firstmolarsofeightbeagledogs.Plaquewas allowed to accumulate for fiveweeks.Followingapreparationperiod,thedefectswererandomlyassignedtooneofthe three treatment groups (EMD, EDTA, and control groups). Four dogs each were sacrificedatthreeandsixmonthspost-treatment. Clinical parameters which included the gingival recession depth and width were measured, and the length of the total epithelium and connective tissue attachment were histometrically evaluated. RESULTS: All three treatments resulted in a statistically significantdecreaseofthegingivalrecessiondepthandwidthwhencomparedtothebaseline (P<0.05). Three and six months following surgery, EMD and EDTA groups demonstrated significantly higher percentage of root coverage when compared to the control group. There was no statistically significantdifferenceinthepercentageofroot coverage between EMD and EDTA groups. Histologically, all three treatment groups demonstrated a new connective tissue attachment. Histometrically, EMD treated sites showed a statistically significant increase of new connective tissue attachment when compared to the EDTA treated sites and controls at three and six months (P<0.05). The epithelium length was similar in the EMD and EDTA treated sites (P>0.05) and it was significantly shorter in the EMD group when compared to the control group (P<0.05) at three and six months. There were no statistically significant differences between the EDTA and control groups in the length of the epithelium and connective tissue attachment. CONCLUSION: EMD seemed to significant lyimprove heclinical and histological outcomes of gingival recessions treated by means of the laterally repositioned flapsurgery.King Saud Universit

Healing of peri-implant tissues after flapless and flapped implant installation

AIM: The aim of this study was to investigate the consequences of different flapless procedures for the installation of dental implants on peri-implant bone response. MATERIALS AND METHODS: After bilateral extraction of the mandibular second and third premolars and a 3-month healing period, 30 SLActive((R)) implants were installed for 3 months in 10 Beagle dogs according to three different surgical approaches, i.e.: (1) flapped (F), (2) tissue punch flapless (P), and (3) direct flapless (DF). Results : At harvesting, 29 implants were analysed. Micro-computed tomography and histomorphometrical evaluation (which also included the mobile implants) showed comparable results in bone volume (F=55 +/- 9, P=51 +/- 4, DF=54 +/- 5) and crestal bone level (F=3420 +/- 762, P=5358 +/- 1681, DF=3843 +/- 433). However, the implants inserted using the punch approach revealed a significantly lower first bone contact (F=3420 +/- 762, P=5358 +/- 1681, DF=3843 +/- 433) and bone-to-implant contact percentage (F=70 +/- 12, P=48 +/- 23, DF=73 +/- 12). Considering the gingival response, the barrier epithelium was also significantly deeper around the implants installed using the punch approach (F=1383 +/- 332, P=2278 +/- 1154, DF=1107 +/- 300). CONCLUSIONS: The results indicate that a flapless surgical technique can be used for the installation of oral implants. In addition, using a tissue punch wider than the implant diameter should be avoided, as it can jeopardize the outcome of the implantation procedure