Coronally positioned flap plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesions: A randomized controlled clinical trial

Background: The aim of this randomized clinical trial was to evaluate the treatment of gingival recession associated with non-carious cervical lesions by a coronally advanced flap alone (CAF) or in combination with a resin-modified glass ionomer restoration (CAF+R). Methods: Nineteen subjects with bilateral Miller Class I buccal gingival recessions associated with non-carious cervical lesions were selected. The recessions were assigned randomly to receive CAF or CAF+R. Bleeding on probing (BOP), probing depth (PD), relative gingival recession (RGR), clinical attachment level (CAL), non-carious cervical lesion height (CLH), and dentin sensitivity (DS) were measured at baseline; 45 days; and 2, 3, and 6 months postoperatively. Keratinized tissue width (KTW) and keratinized tissue thickness (KTT) were measured at baseline and 6 months. The height of the non-carious cervical lesion located on the root and crown were estimated, allowing calculation of root coverage. Results: Both groups showed statistically significant gains in CAL and soft tissue coverage. The differences between groups were not statistically significant for BOP, PD, RGR, CAL, KTW, and KTT after 6 months. The percentages of CLH covered were 56.14% +/- 11.74% for CAF+R and 59.78% +/- 11.11% for CAF (P >0.05). The root and crown surfaces affected by the non-carious cervical lesion were 1.67 +/- 0.31 mm and 0.96 +/- 0.29 mm, respectively, for CAF+R and 1.59 +/- 0.37 mm and 1.01 +/- 0.33 mm, respectively, for CAF. The estimated root coverage was 88.02% +/- 19.45% for CAF+R and 97.48% +/- 15.36% for CAF (P>0.05). CAF+R reduced DS significantly compared to CAF (P<0.05). Conclusions: Both procedures provided similar soft tissue coverage after 6 months. Despite the fact that a greater reduction in DS was observed after CAF+R, longitudinal observations are necessary to confirm these results.79462162

Periodontal surgery and glass ionomer restoration in the treatment of gingival recession associated with a non-carious cervical lesion: Report of three cases

Background: Buccal gingival recession is a prevalent problem in populations with a high standard of oral hygiene and is very often associated with. a non-carious cervical lesion, complicating treatment. The purpose of this report is to show three cases treated by an integrated periodontal and restorative dentistry approach. Methods: Three patients with Miller Class I gingival recessions associated with non-carious cervical lesions were enrolled for treatment. One patient received a coronally positioned flap and a resin-modifled glass ionomer restoration, and two patients were treated with a coronally positioned flap, resin-modifled glass ionomer restoration, and connective tissue graft. Probing depth (PD), relative gingival recession (RGR), and clinical attachment level (CAL) were measured at baseline and at 6 and 8 months after surgery. Results: After the healing period, all patients showed CAL gain and reduction in RGR. No difference was observed on PDs compared to baseline. No signs of gingival inflammation or bleeding on probing were seen. The patients were satisfied with the final esthetics and had no more dentin hypersensitivity. Conclusion: This report indicates that teeth with Miller Class I gingival recessions associated with non-carious cervical lesions can be successfully treated by an integrated periodontal and restorative dentistry approach; however, longitudinal randomized controlled clinical trials must be performed to support this approach.7861146115

Platelet-rich plasma plus bioactive glass in the treatment of intra-bony defects: a study in dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Objective: This study was designed to evaluate, histomorphometrically, the association of platelet-rich plasma (PRP) and bioactive glass (BG) in the treatment of periodontal intrabony defects. Material and Methods: Nine mongrel dogs were included in the study. Three-wall intrabony defects were surgically created at the mesial and distal aspect of first mandibularmolar and exposed to plaque accumulation for 1 month. The defects were randomly assigned to the groups: control, BG, PRP, PRP+BG. Dogs were sacrificed 90 days after the surgeries. The histometric parameters evaluated were: length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, defect extension and area of new bone filling the defect. Results: A superior area of new bone was observed in PRP+BG and BG (13.80 +/- 2.32 mm(2) and 15.63 +/- 2.64 mm(2), respectively) when compared to the other groups (8.19 +/- 1.46 mm(2) and 8.81 +/- 1.47 mm(2) for control and PRP, respectively). No statistically significant differences were observed in the reamining parameters. Conclusions: Within the limits of this study, it may be concluded that PRP failed to provide statistically significant improvements in the histometric parameters.1918289Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [04/12428-8]CNPq [300817/2007-0

Healing Patterns After Subgingival Placement of a Resin-Modified Glass-Ionomer Restoration: A Histometric Study in Dogs

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)The aim of this study was to evaluate, clinically and histometrically, the effects of subgingival placement of a resin-modified glass-ionomer restoration during flap surgery. Nine dogs were included in this study. The mandibular canines were randomly assigned to receive either a transgingival resin-modified glass-ionomer restoration (test group) or no restoration (control group). The apical margins of the restorations in the test group and a reference notch on those in the control group were placed at the level of the bone crest. Clinical parameters were recorded 7 days before sacrifice. The dogs were sacrificed after 107 days, and undecalcified sections were obtained for histologic evaluation. Clinically, both groups presented significant clinical attachment loss and an increase in probing depth, but differences between groups were not statistically significant (P > .05). Histologically, a significant difference between groups was observed for length of epithelium (test, 4.05 +/- 0.57 mm; control, 3.36 +/- 0.63 mm; P = .01). The test group showed more bone resorption (2.02 +/- 1.47 mm) when compared with the control group (0.74 +/- 0.37 mm) (P = .048). It can be concluded that even with the claimed favorable properties of resin-modified glass ionomer, the presence of the restoration within the biologic width causes increased migration of the apical epithelium and bone resorption.335679U137Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Platelet-rich plasma and connective tissue grafts in the treatment of gingival recessions: A histometric study in dogs

Background: The aim of this study was to histometrically evaluate the healing process of gingival recessions treated with platelet-rich plasma (PRP) in combination with a subepithelial connective tissue graft (SCTG) and to compare it to that obtained with SCTG alone. Methods: Six mongrel dogs were used in the experiment. Gingival recessions (5 x 7 mm) were surgically created and exposed to plaque accumulation for I month. Contralateral defects were randomly assigned to the test group (SCTG + PRP) or the control group (SCTG). Dogs were sacrificed 45 days after the surgeries, and the blocks containing the experimental specimens were processed for histologic analysis. The histometric parameters evaluated were length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, and defect extension. Results: A greater length of new cementum was observed in the sites treated with PRP (2.18 +/- 0.78 mm) compared to the control group (1.19 +/- 0.62 mm) (P <= 0.05). No statistically significant differences were observed in the remaining parameters. The extension of total epithelium (sulcular and junctional epithelium) was 2.04 +/- 0.57 mm for the test group and 2.49 +/- 0.82 mm for the control group. The new connective tissue adjacent to the root-without cementum formation was 0.29 +/- 0.28 mm and 0.23 +/- 0.18 mm for the test and control groups, respectively. Bone position was -0.57 +/- 0.95 mm for the test group and -0.46 +/- 1.34 mm for the control group. Conclusion: Within the limits of this study, the combination of PRP with SCTG was more effective in promoting new cementum formation than the graft alone.79588889

Effect of autologous bone marrow-derived cells associated with guided bone regeneration or not in the treatment of pen-implant defects

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)This study investigated the effect of bone marrow-derived cells associated with guided bone regeneration in the treatment of dehiscence bone defects around dental implants. Iliac-derived bone marrow cells were harvested from dogs and phenotypically characterized with regard to their osteogenic properties. After teeth extraction, three implant sites were drilled, dehiscences created and implants placed. Dehiscences were randomly assigned to: bone marrow-derived cells, bone marrow-derived cells + guided bone regeneration, and control (no treatment). After 3 months, implants with adjacent tissues were processed histologically, bone-to-implant contact, bone fill within the threads, new bone area in a zone lateral to the implant, new bone height, and new bone weight at the bottom of the defect were determined. Phenotypic characterization demonstrated that bone marrow-derived cells presented osteogenic potential. Statistically higher bone fill within the threads was observed in both bone marrow-derived cells + guided bone regeneration bone marrow-derived cell groups compared with the control group (P 0.05). For the other parameters (new bone area, bone-to-implant contact, new bone height and new bone weight), only the bone marrow-derived cells + guided bone regeneration group presented higher values compared with the non-treated control (P < 0.05). Bone marrow-derived cells provided promising results for peri-implantar bone regeneration, although the combined approach seems to be relevant, especially to bone formation out of the implant threads.411121127Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [07/55596-4, 06/59431-7]CNPq [303693/2009-6

Autologous periodontal ligament cells in the treatment of class III furcation defects: a study in dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Aim: This study aimed to evaluate, histomorphometrically, the use of periodontal ligament cells (PDL cells) in the treatment of class III furcation defects. Material and Methods: PDL cells were obtained from the mandibular tooth extracted from each dog (7), cultured in vitro and phenotypically characterized. Bilateral class III furcation defects were created at mandibular 3rd and 4th premolars and were randomly assigned to: Control Group: coronally positioned flap, GTR Group: GTR, Sponge Group: carrier + GTR, Cell Group: carrier + PDL cells + GTR. Results: After 3 months of healing, data analysis demonstrated that the Cell Group presented a superior length of new cementum (4.82 +/- 0.61 mm; 3.66 +/- 0.95 mm; 2.87 +/- 0.74 mm and 1.70 +/- 0.60 mm, p < 0.001), a greater extension of periodontal regeneration (3.43 +/- 1.44 mm; 2.33 +/- 0.95 mm; 1.52 +/- 0.39 mm and 0.69 +/- 0.59 mm, p = 0.001) and a larger area of new bone (5.45 +/- 1.58 mm 2; 3.94 +/- 1.52 mm 2; 2.91 +/- 0.56 mm 2 and 1.89 +/- 0.95 mm 2, p = 0.0012), when compared with Sponge, GTR and Control Group, respectively. Conclusion: The PDL cells in association with GTR may significantly promote periodontal regeneration in class III furcation defects surgically created in dogs.394377384Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [06/5882-5]CNPq [301221/2010-3

Periosteum-Derived Cells as an Alternative to Bone Marrow Cells for Bone Tissue Engineering Around Dental Implants. A Histomorphometric Study in Beagle Dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Background: The aim of this study is to investigate the potential use of periosteum-derived cells (PCs) for tissue engineering in pen-implant defects. Methods: Bone marrow cells (BMCs) and PCs were harvested from seven adult beagle dogs, cultured in vitro, and phenotypically characterized with regard to their osteogenic properties. The animals were then subjected to teeth extraction, and 3 months later, two implant sites were drilled, bone dehiscences created, and dental implants placed. Dehiscences were randomly assigned to one of two groups: PCs (PCs + carrier) and BMCs (BMCs + carrier). After 3 months, the animals were sacrificed and the implants with adjacent hard tissues were processed for undecalcified sections. Bone-to-implant contact, bone fill within the limits of implant threads, and new bone area in a zone lateral to the implant were histometrically obtained. Results: In vitro, phenotypic characterization demonstrated that both cell populations presented osteogenic potential, as identified by the mineral nodule formation and the expression of bone markers. Histometrically, an intergroup analysis showed that both cell-treated defects had similar bone fill within the limits of implant threads and bone-to-implant contact (P>0.05), and although a trend toward higher new bone area values was found for the PC group, there was no significant difference between the experimental groups (P>0.05). Conclusions: Periosteal and bone marrow cells presented a similar potential for bone reconstruction. As such, periosteum may be considered as an alternative source of osteogenic cells in implant dentistry. J Periodontol 2010;81:907-916.816907916Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [07/55596-4, 06/59431-7

Peri-implant reconstruction using autologous periosteum-derived cells and guided bone regeneration

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)P>Aim This investigation evaluated the bone healing in peri-implant defects treated with periosteum-derived cells (PCs) and guided bone regeneration (GBR). Material and Methods PCs were harvested from six beagle dogs and characterized in vitro with regard to their osteogenic properties. The animals were subjected to teeth extraction in the mandible, and after 3 months of healing, implant sites were drilled, bone dehiscences were created and implants were placed. Dehiscences were randomly assigned to: PCs+GBR, GBR, PCs and non-treated defects. After 3 months, the implants/adjacent tissues were processed. Bone-to-implant contact (BIC) bone fill (BF) within implant threads, and bone area (BA) in a zone lateral to the implant were obtained. Results In vitro analyses confirmed the osteogenic potential of PCs. Histometrically, no statistically significant differences were observed among the PCs+GBR, GBR and PCs groups for both BF and BIC (p > 0.05), whereas these groups showed statistically higher values, as compared with the non-treated group (p < 0.05). With respect to BA, the PCs+GBR and GBR groups presented significantly higher means, as compared with the PCs and non-treated groups (p < 0.05). Conclusion Although successful outcomes have been promoted by using the combined approach, PCs in conjunction with membranes did not provide additional benefit during peri-implant bone regeneration, when compared with the therapeutic approaches used alone.371211281136Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [Proc. 07/55596-4, 06/59431-7

Autologous periodontal ligament cells in the treatment of class II furcation defects: a study in dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)P>Aim The goal of this study was to histologically investigate the use of periodontal ligament cells (PDL cells) in tissue engineering to regenerate class II furcation defects. Material and Methods PDL cells were obtained from the mandibular tooth extracted from each dog (seven), cultured in vitro and phenotypically characterized with regard to their biological properties. Following, bilateral class II furcation lesions were created at maxillary 3rd premolars and were randomly assigned to the test group [PDL cells+guided tissue regeneration (GTR)] or the control group (GTR). After 3 months, the animals were euthanized to evaluate the histometric parameters. Results In vitro, PDL cells were able to promote mineral nodule formation and to express bone sialoprotein, type I collagen and alkaline phosphatase. Histometrically, data analysis demonstrated that the cell-treated group presented a superior length of new cementum (6.00 +/- 1.50 and 8.08 +/- 1.08 mm), a greater extension of periodontal regeneration (3.94 +/- 1.20 and 7.28 +/- 1.00 mm), a lower formation of connective tissue/epithelium (2.15 +/- 1.92 and 0.60 +/- 0.99 mm), a larger area of new bone (7.01 +/- 0.61 and 9.02 +/- 2.30 mm2) and a smaller area of connective tissue/epithelium (5.90 +/- 1.67 and 4.22 +/- 0.95 mm2), when compared with control group. Conclusion PDL cells in association with GTR may significantly promote periodontal regeneration in class II furcation defects in dog.385491498Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [06/5882-5]CNPq [118176/2007-2