Multiple Marginal Tissue Recession Treated with a Simplified Lateral Sliding Flap Technique

Marginal tissue recession is a common esthetic problem that is usually accompanied by dentin sensitivity, and patients frequently report a fear of dental loss. Lateral sliding flaps have been used for localized recession, but they are rarely used for multiple recessions. The aim of this paper was to report a case of coverage of multiple marginal tissue recessions by means of a lateral sliding flap associated with a connective tissue graft. This was a modification of Nelson’s technique, which was originally described as the combination of the double papilla technique, lateral sliding flap, and connective tissue graft. In the present case, double papilla was not performed, rendering the maneuver less complicated. After surgery on teeth #23 to #25, total root coverage, decreased dentin sensitivity, and increased keratinized tissue band and gingival thickness were achieved. In the present case, modified Nelson technique proved to be a more simple procedure for the treatment of multiple recessions in one session, resulting in adequate healing, predictable root coverage, and, more importantly, esthetic and functional success

Measurements of simulated periodontal bone defects in inverted digital image and film-based radiograph: An in vitro study

Purpose: This study was performed to compare the inverted digital images and film-based images of dry pig mandibles to measure the periodontal bone defect depth. Materials and Methods: Forty 2-wall bone defects were made in the proximal region of the premolar in the dry pig mandibles. The digital and conventional radiographs were taken using a Schick sensor and Kodak F-speed intraoral film. Image manipulation (inversion) was performed using Adobe Photoshop 7.0 software. Four trained examiners made all of the radiographic measurements in millimeters a total of three times from the cementoenamel junction to the most apical extension of the bone loss with both types of images: inverted digital and film. The measurements were also made in dry mandibles using a periodontal probe and digital caliper. The Student's t-test was used to compare the depth measurements obtained from the two types of images and direct visual measurement in the dry mandibles. A significance level of 0.05 for a 95% confidence interval was used for each comparison. Results: There was a significant difference between depth measurements in the inverted digital images and direct visual measurements (p>|t|=0.0039), with means of 6.29 mm (IC95%:6.04-6.54) and 6.79 mm (IC95%:6.45-7.11), respectively. There was a non-significant difference between the film-based radiographs and direct visual measurements (p>|t|=0.4950), with means of 6.64mm (IC95%:6.40-6.89) and 6.79mm(IC95%:6.45-7.11), respectively. Conclusion: The periodontal bone defect measurements in the inverted digital images were inferior to film-based radiographs, underestimating the amount of bone loss. copy; 2012 by Korean Academy of Oral and Maxillofacial Radiology

Comparison between embossed digital imaging and unprocessed film-based radiography in detecting periodontal bone defects: an in vitro study

Our aim was to compare bone-loss measurements between embossed digital radiographic imaging and unprocessed film-based radiography.Forty two-wall bone defects were made in the proximal region of the premolar in dry pig mandibles. Digital and conventional radiographs were taken using a Schick sensor and Kodak InSight F-speed intraoral dental film stabilized by a fixing device. Image manipulation was done using Adobe Photoshop 7.0 software with an embossing tool. Four trained examiners made all the radiographic measurements in millimeters a total of three times-from the cementoenamel junction to the most apical extension of the bone loss-with both types of imaging (embossed digital and unprocessed film). As a gold standard, the measurements were also made in dry mandibles using a periodontal probe and digital caliper. Analysis of variance was applied to compare the measurements with both types of imaging and from the dry mandibles. The level of significance was 0.05 for a 95 % confidence interval.The mean values of the measurements for embossed digital imaging, unprocessed film-based imaging, and visual measurement in the dry mandible were, respectively, 5.91, 6.62, and 6.67 mm. There was a statistically significant difference among the three methods (p = 0.007). Tukey's post hoc analysis indicated a similarity between the mean values for unprocessed film-based imaging and dry mandible measurement, but not with embossed imaging.Bone-loss measurement using embossed digital imaging was inferior to unprocessed film-based imaging, and it underestimated the amount of bone loss.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Detection of Simulated Periodontal Bone Defects Using Digital Images. An in vitro Study

Aim: The aim of this study was to evaluate the periodontal bone defects created only mechanically and by combined mechanical and chemical techniques. Materials and Methods: The samples comprised 24 hemi-mandibles from pigs, which were allocated into 3 groups; G1 (before acid application), G2 (after acid application and G3 (without bone defect and acid treatment). Periodontal bone defects were created with round burs between the second and third pre-molar. The radiographs were taken using the Visualix eHD sensor. The central ray was perpendicular to the sensor and to the hemi-mandible at a 40 cm focal-spot to sensor distance (settings 70 kVp, 10 mA and 15 impulses). After the defects were created in groups G1 and G2, they were treated with 100% perchloric acid for 48 hours. Images were zoomed to the level of 125% and interpreted by three examiners. Sensitivity and specificity were computed for the detection of periodontal bone defects with acid application and created using only round burs. The examiner's radiographic interpretation produced a diagnosis based on a five-point confidence scale. If the interpretation received the scores 1 or 2, it was concluded that no bone defect was present, whereas the scores 3, 4, or 5 were considered to reflect evidence of a bone defect. Results: There was no difference between groups G1 (Sen -95%CI=0.9167; Spec -95%CI=0.9167) and G2 (Sen -95%CI=0.8333; Spec -95%CI=0.9167). Conclusions: There is no difference in the detection of periodontal bone defects created using round burs and defects created using round burs followed by acid treatment. [Arch Clin Exp Surg 2014; 3(4.000): 220-225