Coronally advanced flap and connective tissue graft with or without plasma rich in growth factors (PRGF) in treatment of gingival recession

Several researchers have tried to improve the results of gingival recession treatment techniques. One of the methods is to use growth factors The present study was undertaken to evaluate the effect of CAF (coronally advanced flap) + CTG (connective tissue graft) + PRGF (plasma rich in growth factors) in the treatment of Miller Class I buccal gingival recession. Twenty-two teeth with Miller Class I gingival recession in 6 patients 26 ? 47 years of age were included in a split-mouth designed randomized controlled trial (RCT). In each patient, one side was treated with CAF + CTG + PRGF (test) and the other side was treated with CAF + CTG (control). The following parameters were measured before surgery and up to 6 months after surgery on the mid-buccal surface of the tooth: keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), vertical recession depth (VRD), recession depth (RD), gingival thickness (GT), root coverage in percentage (RC%) and the distance between the CEJ and mucogingival junction (MGJL). Data were analyzed with paired t-test and repeated measures ANOVA. After 6 months noticeable improvements were observed in both groups in all the variables measured except for PD; however, the differences between the two groups were not significant. RC% was 80 ± 25% and 67 ± 28% in the test and control groups, respectively, after 6 months. Both CAF + CTG + PRGF and CAF + CTG treatment modalities resulted in favorable root coverage; however, the addition of PRGF added no measurable significant effect

Analyzing Equivalency and Accuracy of Three Different Periodontal Probes in Measuring Pocket Depth – An In-Vitro Study

ABSTRACTBackground The periodontal probe is an essential instrument designed for the purposes of recording clinical periodontal data. As such, accurate periodontal measurements remain a critical factor in providing individualized care to patients. The purpose of this study is to determine the compatibility and accuracy of three different periodontal probes on a periodontal typodont model.Materials and Methods Forty-one D3, D4, and DH students were randomly selected to perform a 6-point pocket depth measurement on the mandibular teeth of a previously verified periodontal typodont mounted on a manikin. Each measurement site was outlined with black marking on the tooth to facilitate consistent reproducibility in periodontal probe placement and angulation.Results Probing depth measurements between the UNC-15, PCP-126, and Disposable i-PAK® periodontal probe rendered an excellent equivalency (ICC = 0.960) with narrow CI (0.947, 0.971). There is significant difference among these three instruments in their capability to replicate the manufacturer’s suggested probing depth on the periodontal typodont (p < .001). The UNC-15 probe was the most accurate, followed by PCP-126, with the Disposable i-PAK® being the least accurate.Conclusions This study demonstrated that the UNC-15, PCP-126, and Disposable i-PAK® yielded equivalent results when measuring probing depths on a periodontal typodont. Furthermore, the UNC-15 was most accurate in its ability to replicate the manufacturer’s suggested pocket depth on the periodontal typodont.Practical Implications This study emphasizes the importance in consistency of periodontal probe types in the dental practice

The Additive Effect of Clonidine to Lidocaine on Postoperative Pain Management After Root Canal Treatment on Mandibular Molars with Symptomatic Irreversible Pulpitis: A Prospective Randomised Double-Blind Clinical Trial

CONTEXT: Postoperative pain control has been a common challenge to clinicians in endodontics. AIMS: This double-blind randomized clinical trial assessed the efficacy of clonidine added to lidocaine for postoperative pain following endodontic treatment of mandibular molars with symptomatic irreversible pulpitis (SIP). METHODS: One hundred participants with lower molars experiencing SIP were recruited and randomly assigned to two groups. 1.8 mL of 2% lidocaine with either epinephrine (1:80,000) or clonidine (15 µg/mL) was administered to each group via an inferior alveolar nerve block. A Heft-Parker Visual Analog Scale was used to rate preoperative pain and at 6, 12, 24, 36, 48, and 72 h following endodontic treatment. Their postoperative analgesic consumption was recorded. STATISTICAL ANALYSIS USED: The analgesic efficacy was analyzed by Chi-square test, paired RESULTS: Early postoperative pain was significantly lower in the lidocaine/clonidine group than the lidocaine/epinephrine group (6 h: CONCLUSIONS: The administration of clonidine added to lidocaine may reduce early postoperative pain and consumption of analgesics following endodontic treatment in lower molars with SIP

Acute Local Spontaneous and Profuse Gingival Hemorrhage during Neoadjuvant Treatment with Paclitaxel and Trastuzumab

This case report describes a 33-year-old female currently undergoing breast cancer treatment following the AC-T-T (doxorubicin hydrochloride (Adriamycin) and cyclophosphamide followed by paclitaxel (Taxol) and trastuzumab (Herceptin)) treatment regimen. Her chief complaint at the time of the emergency visit at the dental office was that she had an episode of profuse spontaneous bleeding located at the palatal gingiva in the maxilla between the left central and lateral incisor. To our knowledge, this is a novel finding related to the medications she is utilizing and should be further investigated

Comparative evaluation of intermediate solutions in prevention of brown precipitate formed from sodium hypochlorite and chlorhexidine gluconate

Abstract Objectives To evaluate intermediate treatments between sodium hypochlorite and chlorhexidine gluconate irrigations for the prevention of a toxic brown precipitate in root canal therapy. Materials and Methods Thirty‐nine premolars were irrigated with 6% sodium hypochlorite and divided into either: No intermediate treatment; Dry paper points; three different irrigations with 17% ethylenediaminetetraacetic acid, deionized water, or 5% sodium thiosulfate. 2% chlorhexidine gluconate was the final irrigant in all groups. Sectioned teeth were analyzed for brown precipitate intensity and area using stereomicroscopy and components related to para‐chloroaniline using Time‐of‐Flight Secondary Ion Mass Spectrometry (ToF‐SIMS). Results Stereomicroscopy showed that 5% STS significantly reduced brown precipitate intensity and area as compared with no intermediate irrigation (p < .05, Chi‐square, generalized linear model, and Tukey's multiple comparison tests). Utilizing ToF‐SIMS, 5% sodium thiosulfate was most effective in reducing the components representing para‐chloroaniline and chlorhexidine gluconate. Conclusion The 5% sodium thiosulfate was most effective among other intermediate treatments, assessed by stereomicroscopy and ToF‐SIMS

Glycogen Storage Disease Ib and Severe Periodontal Destruction: A Case Report

Background: Glycogen storage diseases (GSDs) are genetic disorders that result from defects in the processing of glycogen synthesis or breakdown within muscles, liver, and other cell types. It also manifests with impaired neutrophil chemotaxis and neutropenic episodes which results in severe destruction of the supporting dental tissues, namely the periodontium. Although GSD Type Ib cannot be cured, associated symptoms and debilitating oral manifestations of the disease can be managed through collaborative medical and dental care where early detection and intervention is of key importance. This objective of the case report was to describe a child with GSD Ib and its associated oral manifestations with microbial, immunological and histological appearances. Case Presentation: An eight-year-old Hispanic male with a history of GSD type Ib presented with extensive intraoral generalized inflammation of the gingiva, ulcerations and bleeding, and intraoral radiographic evidence of bone loss. Tannerella forsythia was readily identifiable from the biofilm samples. Peripheral blood neutrophils were isolated and a deficient host response was observed by impaired neutrophil migration. Histological evaluation of the soft and hard tissues of the periodontally affected primary teeth showed unaffected dentin and cementum. Conclusions: This case illustrates the association between GSD Ib and oral manifestations of the disease. A multi-disciplinary treatment approach was developed in order to establish healthy intraoral conditions for the patient. Review of the literature identified several cases describing GSD and its clinical and radiographic oral manifestations; however, none was identified where also microbial, immunological, and histological appearances were described