Possibilities of modern procedures in gingival recession therapy

This study was designed to compare the effectiveness and predictability of GTR and connective tissue graft in the treatment of gingival recession. 15 recessions Miller class II and III were treated with bioabsorbable barrier and coronally advanced flap. The same number of defects was treated with connective tissue graft in combination with coronally advanced flap. Clinical recordings included hygiene standards and recession depth (RD) probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KT) Mean (RD) was statistically significant decreased from 5,47mm presurgery to 0.73mm with GTR (87,76%) and from 5,93mm to 0.60 with CTG (89.9%). Prevalence of complete root coverage was 40% for the GTR and 46,66% for CTG group. No statistically significant differences between treatment groups were observed in this study Treatment of gingival recessions with CTG and GTR present effective and highly predictable mucogingival plastic surgical procedures

Investigation of the mutagenic effects of aluminium trioxide implants on embrions in experimental animals

Several diseases as well as trauma can affect the composition and integrity of periodontal tissues loading eventually to the destruction of connective tissue matrix and cells, loss of attachment and resorption of alveolar bone often followed by tooth loss. Replacement of the missing tooth could then be provided by endosseous dental implants healing in a form of osseo -or fibrosseal integration to the alveolar bone. Aluminium oxide ceramics, a form, of endosseous implant, allows osseointegration type of healing and has demonstrated excellent biocompatibility. However, potential aluminium toxicity has been implicated in the pathogenesis of a number of clinical disorders and for this reason we examined the reproductive and mutagenic effect of aluminium trioxide ceramic implant in experimental mice. 720 female and 45 fertile male BALB-cAn NCR mice were included in the study. 3 experimental groups of fertile male mice (15 for each group) were treated with an intraperitoneal injection of aluminium trioxide (I g/kg of body weight, group I), with ethyl-methane-sulphonate as a positive control (200 mg/kg, group II) and with Tween-80 (10 ing/kg as negative control, Group III). Each of the labeled male mice fertilized previously uncoupled female mice during 8 weeks (a pair per week) to facilitate appropriate pre-and post-meiotic conditions of spermatogenesis to occur. Female mice were sacrificed with cervical dislocation at day 13 after fertilization. Immediately upon sacrifice the uterus was removed and the number of alive and healthy, or alive but mutated and/or dead embryos was computed to determine the dominant lethal of mutagenic effects. Animals treated with aluminium trioxide demonstrated similar effects on the reproductive and mutagenic capacity as the negative control, whereas the animals treated as positive controls exhibited significantly reduced reproductive and mutagenic capacity. Collectively, we concluded that aluminium trioxide has a very low rate of embryonal mortality and mutagenicity in mice. This finding is in general agreement with the biocompatibility of aluminium trioxide (Aldovit) as an implant material

Primena plazme bogate trombocitima u rekonstruktivnoj mukogingivnoj hirurgiji

Introduction Root coverage supported with complete regeneration of lost periodontal tissues represents the ultimate goal of gingival recession treatment. Objective This study was designed to evaluate clinical effectiveness of platelet rich plasma gel (PRP) with connective tissue graft (CTG) in the treatment of gingival recession. METHOD 15 gingival recessions Miller class I or II were treated with CTG and PRP (group PRP). Connective tissue graft was harvested from the premolar region using trap door technique. After elevation of the flap, the regional bone and root surface were smeared with activated PRP gel. CTG was also irrigated with PRP gel before placement over the exposed root surface and local bone. Fixed CTG was covered with a coronally advanced flap. The same number of gingival recessions were treated with CTG in combination with the coronally advanced flap with no PRP gel (group TVT). Clinical recordings included recession depth (RD), probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KT) before and 1 year after mucogingival surgical treatment. Results Mean value of RD was significantly decreased from 4.93±0.86 mm to 0.60±0.37 (p lt 0.01) with CTG and PRP and from 4.76±0.74 mm to 0.63±0.29 mm (p lt 0.01) in CTG group. This difference was not statistically significant. Results of the keratinized tissue width showed significant increase from 0.88± 0.30 mm presurgery to 3.78±0.49 mm (p lt 0.01) six months after treatment in PRP group and from 0.90±0.34 mm to 3.15±0.41 in TVT group (p lt 0.01). This difference was statistically significant (p>0.05). No statistically significant differences were observed between treatment groups in CAL and PD. Conclusion Clinical results validate both procedures as effective and highly predictable surgical techniques in solving gingival recession problem. Histological evaluation may confirm advantage of PRP use related to regeneration of periodontal tissues.Uvod. Recesija gingive je jedan od najsloženijih problema savremene stomatologije. Iznalaženje novih terapijskih metoda za rešavanje ovog problema je značajan segment istraživanja u parodontologiji. Cilj rada. Cilj rada je bio da se procene klinički efekti primene plazme bogate trombocitima (PBT) u kombinaciji sa transplantatom vezivnog tkiva (TVT) u lečenju recesije gingive. Metod rada. Istraživanje je obuhvatilo 15 bolesnika s obostranim recesijama gingive klase II i III po Mileru (Miller). Metodološki koncept se zasnivao na metodu podeljenih usta. U lečenju 15 recesija primenjen je TVT u kombinaciji sa koronarno pozicioniranim režnjem uz primenu aktiviranog koncentrata trombocita (PBT grupa). Isti broj recesija na suprotnoj strani vilice zbrinjavan je autotransplantatom vezivnog tkiva i periosta u kombinaciji sa koronarno pozicioniranim režnjem (TVT grupa). Za procenu stanja parodoncijuma i efikasnosti primenjenih hirurških postupaka korišćeni su sledeći klinički parametri: vertikalna dubina recesije (VDR), nivo pripojnog epitela i širina keratinizovane gingive. Nivo oralne higijene je utvrđivan plak-indeksom po Silnes- Lou (Silness-Löu), a stanje gingive gingivnim indeksom po Lou-Silnesu (Löu-Silness). Rezultati. Na osnovu analize srednje vrednost za dubinu recesije (VDR), ustanovljeno je statistički značajno smanjenje vrednosti ovog parametra šest meseci posle tretmana u PBT grupi (sa 4,93±0,86 mm na 0,60±0,37 mm; p lt 0,01). U TVT grupi, u kojoj je vrednost VDR pre lečenja bila 4,76±0,74 mm, posle šest meseci dobijena je vrednost od 0,63±0,29 mm (p lt 0,01). U PBT grupi je posle opservacionog perioda zabeleženo proširenje zone keratinizovanog tkiva za 2,90 mm, dok je u istom periodu vrednost ovog parametra u TVT grupi bila 2,25 mm. Poređenjem prosečne promene vrednosti kliničkih parametara u okviru obe eksperimentalne grupe, samo je kod promene širine keratinizovanog tkiva zabeležena statistička značajnost (p lt 0,05). Zaključak. Rezultati ove kliničke studije ukazuju na izuzetnu efikasnost oba primenjena postupka u lečenju recesije gingive

Klinička primena fibrinske membrane u lečenju recesija gingive

Introduction. Fibrin, fibronectin, platelet derived growth factor, and transforming growth factors from platelet concetrate are crucial for tissue reparation and regeneration. Objective. This study was designed to evaluate clinical effectiveness of activated platelet-rich fibrin (PRF) membrane in treatment of gingival recession. Methods. 19 gingival recessions Miller class I or II were treated with a coronally advanced flap and the PRF membrane (PRF group). Following the elevation of the flap, bone and root surfaces were covered with the PRF membrane. After suturing, the PRF membrane was covered with a coronally advanced flap. In the same patients, 19 other gingival recessions were treated with CTG in combination with the coronally advanced flap (the CTG group). Clinical recordings were made of vertical recession depth (VRD), probing depth (PD), clinical attachment level (CAL) and keratinized tissue width (KTW) before and 12 months after mucogingival surgical treatment. Clinical evaluation of healing events was estimated with recordings of the healing index (HI). Recordings of HI were performed in the 1st, 2nd and 3rd week post-surgically. Results. Mean root coverage was significant in both groups (the PRF group 79.94% and the CTG group 88.56% %; p lt 0.01). The difference between the two tested groups was not statistically significant. Results of the keratinized tissue width showed significant increase (p lt 0.05) 12 months after the surgery in both, the PRF and CTG groups. Results of KTW showed statistical significance of recorded differences obtained in the two evaluated groups (p lt 0.05). There was no statistical significance in reduction of PD and CAL recorded in the PRF and CTG groups. The values of HI recorded in the 1st and 2nd week postoperatively were significantly enhanced in the PRF group (p lt 0.05). Conclusion. Results of this study confirm both procedures as effective with equivalence of clinical results in solving gingival recession problems. The utilization of the PRF resulted in a decreased postoperative discomfort and advanced tissue healing.Uvod. Fibrin, fibronektin, faktor rasta poreklom iz trombocita i transformišući faktor rasta imaju presudnu ulogu u regeneraciji i reparaciji tkiva. Cilj rada. Ispitati i utvrditi značaj primene membrane od fibrina bogatog trombocitima (engl. plateletrich fibrin - PRF) u lečenju recesija gingive. Metode rada. Devetnaest obostranih gingivalnih recesija klase I ili II po Mileru lečeno je sa dva različita terapijska modaliteta. U eksperimentalnoj grupi recesija je, nakon odizanja mukoperiostnog režnja, preko izložene alveolarne kosti i korena zuba postavljena PRF membrana kao augmentacioni materijal, koja je zatim pokrivena koronarno pomerenim režnjem. U kontrolnoj grupi su izložena alveolarna kost i koren zuba prekriveni transplantatom vezivnog tkiva (TVT) uz koronarno pomereni režanj. Kod obe grupe recesija posmatrani su sledeći parametri: veličina recesije gingive, širina keratinizovane gingive, nivo pripojnog epitela i dubina sondiranja. Parametri su mereni neposredno pre hirurškog zahvata i 12 meseci kasnije. Zabeležen je i indeks zarastanja rane tokom prve tri nedelje posle operacije. Rezultati. Kod obe grupe recesija postignuto je značajno prekrivanje ogoljenog korena zuba (PRF membrana 79,94% i TVT 88,56%; p lt 0,01), dok između dve ispitivane grupe nije uočena statistički značajna razlika. Rezultati ispitivanja širine keratinizovane gingive su pokazali značajno povećanje u obe ispitivane grupe dvanaest meseci nakon hirurškog lečenja (p lt 0,05). Takođe je uočena statistički značajna razlika između posmatranih grupa (p lt 0,05) kod parametra širina keratinizovane gingive. Statističke značajnosti kada je reč o smanjenju nivoa pripojnog epitela i dubine sondiranja, kako u okviru grupa, tako i između obe ispitivane grupe (p>0,05), nije bilo. Merenjem indeksa zarastanja rane uočeni su značajno bolji rezultati u eksperimentalnoj grupi nakon prve i druge nedelje nego u kontrolnoj (p lt 0,05). Zaključak. Oba postupka pokazala su se adekvatnim u lečenju gingivalnih recesija. U kontrolnoj grupi bili su bolji rezultati u dobitku keratinizovanog tkiva, dok se eksperimentalna procedura pokazala jednostavnijom i komfornijom za samog bolesnika, uz značajno bolji postoperacioni tok

On the diversity of pseudoscorpions in Macedonia: Neobisium maksimtodorovici n. sp. Neobisiidae, Pseudoscorpiones

A new troglobitic species, Neobisium maksimtodorovici n. sp. (Neobisiidae Pseudoscorpiones), inhabiting the Momiček Cave, v. Belica, nr. Makedonski Brod, Macedonia, has been discovered and its diagnosis presented. In support of some earlier findings, this novelty points to the pronounced biodiversity of the area studied

Impact of Interleukin 1 Gene Polymorphism and Smoking on Long-Term Stability Following Gingival Recession Treatment

Risk factors such as smoking, genetic factors, and tissue biotype play an important role in the etiology, predictability, and long-term stability of gingival recession treatment. This study was designed to evaluate the influence of interleukin 1 (IL-1) polymorphism and smoking on the stability of gingival recession treatment after 1 and 3 years. All patients (n = 55) were treated for type I and II recession defects using a connective tissue graft. Clinical evaluations were performed, which included assessment of vertical recession depth, gingival inflammation, and clinical attachment level. A fingerstick blood sample was collected using specially provided DNA filter paper and mailed for processing in a laboratory using polymerase chain reaction-based methodology. The results indicated that 19 subjects were genotype positive (34.5%). Treatment of the localized recessions was effective and provided a similar amount of coverage in genotype-positive and genotype-negative subjects within smoking and nonsmoking groups after 1 year. In a 3-year period, nonsmoking patients with positive IL-1 genotype lost approximately 20% of the root coverage gained at 1 year and were almost four times more inferior compared with genotype-negative patients. Patients who smoked and had a positive IL-1 genotype lost approximately 35% of the gained root coverage. IL-1 polymorphism and smoking habit did not affect gingival recession treatment at 1 year but had a great impact on long-term stability

Use of Platelet-Rich Fibrin Membrane Following Treatment of Gingival Recession: A Randomized Clinical Trial

This 6-month randomized controlled clinical study primarily aimed to compare the results achieved by the use of a platelet-rich fibrin (PRF) membrane or connective tissue graft (CTG) in the treatment of gingival recession and to evaluate the clinical impact of PRF on early wound healing and subjective patient discomfort. Use of a PRF membrane in gingival recession treatment provided acceptable clinical results, followed by enhanced wound healing and decreased subjective patient discomfort compared to CTG-treated gingival recessions. No difference could be found between PRF and CTG procedures in gingival recession therapy, except for a greater gain in keratinized tissue width obtained in the CTG group and enhanced wound healing associated with the PRF group. (Int J Periodontics Restorative Dent 2012;32:e41-e50.