Effect of enamel matrix proteins on the treatment of intrabony defects: a split-mouth randomized controlled trial study. (25/88)

The objective of this split-mouth, double-blind, randomized controlled trial was to compare the clinical effect of treatment of 2- or 3-wall intrabony defects with open flap debridement (OFD) combined or not with enamel matrix proteins (EMP). Thirteen volunteers were selected with one pair of or more intrabony defects and probing pocket depth (PPD) > or = 5 mm. All individuals received instructions regarding oral hygiene and were submitted to scaling and root planing. Each participant received the two treatment modalities: test sites were treated with OFD and EMP, and control sites received only OFD. After 6 months, a significant reduction was observed in PPD for the EMP group (from 6.42 +/- 1.08 mm to 2.67 +/- 1.15 mm) and for the OFD group (from 6.08 +/- 1.00 mm to 2.00 +/- 0.95 mm) (p < 0.0001), but with no significant difference between groups (p = 0.13). A significant gain in relative attachment level (RAL) was observed in both groups (EMP: from 13.42 +/- 1.88 mm to 10.75 +/- 2.26 mm, p < 0.001; OFD: from 12.42 +/- 1.98 mm to 10.58 +/- 2.23 mm, p = 0.013), but with no significant difference between groups (p = 0.85). Gingival recession (GR) was higher in the EMP group (from 1.08 +/- 1.50 mm to 2.33 +/- 1.43 mm; p = 0.0009) than in the OFD group (from 0.66 +/- 1.15 mm to 1.16 +/- 1.33 mm; p = 0.16), but this difference was not significant (p = 0.06). In conclusion, the results showed that OFD combined with EMP was not able to improve treatment of intrabony defects compared to OFD alone.  (+info)

Periodontal therapy alters gene expression of peripheral blood monocytes. (26/88)

AIMS: We investigated the effects of periodontal therapy on gene expression of peripheral blood monocytes. METHODS: Fifteen patients with periodontitis gave blood samples at four time points: 1 week before periodontal treatment (#1), at treatment initiation (baseline, #2), 6-week (#3) and 10-week post-baseline (#4). At baseline and 10 weeks, periodontal status was recorded and subgingival plaque samples were obtained. Periodontal therapy (periodontal surgery and extractions without adjunctive antibiotics) was completed within 6 weeks. At each time point, serum concentrations of 19 biomarkers were determined. Peripheral blood monocytes were purified, RNA was extracted, reverse-transcribed, labelled and hybridized with AffymetrixU133Plus2.0 chips. Expression profiles were analysed using linear random-effects models. Further analysis of gene ontology terms summarized the expression patterns into biologically relevant categories. Differential expression of selected genes was confirmed by real-time reverse transcriptase-polymerase chain reaction in a subset of patients. RESULTS: Treatment resulted in a substantial improvement in clinical periodontal status and reduction in the levels of several periodontal pathogens. Expression profiling over time revealed more than 11,000 probe sets differentially expressed at a false discovery rate of <0.05. Approximately 1/3 of the patients showed substantial changes in expression in genes relevant to innate immunity, apoptosis and cell signalling. CONCLUSIONS: The data suggest that periodontal therapy may alter monocytic gene expression in a manner consistent with a systemic anti-inflammatory effect.  (+info)

The association between embrasure morphology and central papilla recession: a noninvasive assessment method. (27/88)

BACKGROUND: The distance from bone crest to contact point is only the most frequently studied of the many factors that influence whether interdental papilla are present. The purpose of this study was to discover the association between embrasure morphology and central papilla recession. METHODS: The central papilla was visually assessed in 310 adults using paralleling periapical radiographs of the maxillary central incisors. The following vertical distances were measured: the recession distance, i.e., papilla tip (PT) to contact point (PT-CP), bone crest (BC) to contact point (BC-CP), proximal cementoenamel junction (pCEJ) to contact point (pCEJ-CP), papilla height (PH), and bone crest to proximal cementoenamel junction (BC-pCEJ). Interdental width was measured horizontally. Subjects were divided into 4 groups according to interdental width and pCEJ-CP distance: long-narrow, short-narrow, long-wide, and short-wide. RESULTS: Statistical analysis revealed the following for all four study groups: a positive correlation between papilla recession distance and age, a positive correlation between bone crest-contact point distance and age, and a negative correlation between age and papilla height. CONCLUSION: Central papilla recession as a result of aging occurs most frequently in the long-wide group, that is, among people who have both a wide interdental width and a long distance between the proximal cementoenamel junction and the contact point. However, other factors also affect the likelihood of central papilla recession. Thus, there is a need for further study of the interaction among these causal factors.  (+info)

Effect of chewing a mixture of areca nut and tobacco on periodontal tissues and oral hygiene status. (28/88)

The present study was conducted to clarify the effects of chewing a quid containing areca nut and tobacco on periodontal tissue and oral hygiene status. A total of 365 subjects (168 chewers and 197 non-chewers with a mean age of 32.5 +/- 0.7 and 30.4 +/- 0.8 years, respectively) were enrolled. Clinical data on periodontal tissues, oral hygiene status, as well as information on bleeding from gums, ulcers in the oral cavity, or a burning sensation in the soft tissues, were collected as indicators of the possible presence and extent of periodontal lesions. The results indicated that a significantly higher number of quid-chewers suffered bleeding from the gums, halitosis, difficulty in opening the mouth and swallowing solid food, a burning sensation in the soft tissues, and ulcers in the oral cavity than non-chewers. There was no significant difference between quid-chewers and non-chewers with respect to oral hygiene measures adopted. However, clinical examination using the oral hygiene index score indicated that the oral hygiene status of quid-chewers was significantly deteriorated. The effect of quid-chewing on the periodontium, i.e. the occurrence of periodontal pockets, gingival lesions and gum recession, were significantly higher in quid-chewers than in non-chewers. Age, sex and smoking adjusted odds ratios for quid-chewers against non-chewers using logistic regression analysis indicated that, in general, chewers were at significantly higher risk for various oral complaints and periodontium status. The present data indicate that chewing quid comprising areca nut and tobacco has adverse effects on periodontal tissues, oral hygiene and incidence of oral lesions.  (+info)

Subepithelial connective tissue grafts for the coverage of denuded root surfaces: a clinical report. (29/88)

AIMS AND OBJECTIVES: The aim of this study is to determine the effectiveness of subepithelial connective tissue grafts (SCTG) in the coverage of denuded roots. MATERIALS AND METHODS: A total of 16 sites with > or =2 mm of recession height were included in the study for treatment with SCTG. The clinical parameters, such as recession height, recession width, width of keratinized gingiva, probing pocket depth, and clinical attachment level were measured at the baseline, third month, and at the end of the study [sixth month]. The defects were treated with a coronally positioned pedicle graft combined with connective tissue graft. RESULTS: Out of 16 sites treated with SCTG, 11 sites showed complete (100%) root coverage; the mean root coverage obtained was 87.5%. There was a statistically significant reduction in recession height, recession width, and probing pocket depth. There was also a statistically significant increase in the width of keratinized gingiva and also a gain in clinical attachment level. The postoperative results were both clinically and statistically significant ( P 0.05). CONCLUSION: From this study, it may be concluded that SCTG is a safe and effective method for the coverage of denuded roots.  (+info)

Interdental papilla reconstruction combining periodontal and orthodontic therapy in adult periodontal patients: a case report. (30/88)

Migration of maxillary anterior teeth because of the loss of periodontal support can alter the appearance of the esthetic zone. The loss of contacts between adjacent teeth results in the recession of interdental papillae. To restore sustainable periodontal health and the normal, esthetic appearance of a healthy 37-year-old woman with generalized advanced chronic periodontitis in the maxillary arch, a combined periodontal and orthodontic technique was used. This approach resulted in stable periodontium and an esthetically pleasing appearance of the maxillary anterior area.  (+info)

Oral health-related quality of life in a birth cohort of 32-year olds. (31/88)

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Treatment of intrabony periodontal defects with enamel matrix derivative in private practice: a long-term retrospective study. (32/88)

The present study describes treatment of intrabony periodontal defects with enamel matrix derivative (EMD) in private practice. Ten patients with clinical diagnosis of chronic periodontitis were subjected to data analysis. A total of 18 teeth with various osseous defects received regenerative therapy with EMD, and were followed for a minimum of 2 years. Treatment of the intrabony defects with EMD led to a statistically significant improvement in the mean value of probing depth at 1-year when compared with at the baseline (p<0.01). Reduction in probing depth was achieved with minimal recession of the gingival margin, and was maintained over the 2-year observation period with no significant change. Mean values of attachment gain at 1 and 2 years were of clinical significance: 3.39+/-1.46 mm and 3.22+/-1.40 mm, respectively. Although one tooth was extracted because of subsequent loss of attachment and bone, most teeth treated have been successfully maintained for 2 to 7 years with no significant signs of disease progression. In conclusion, EMD treatment of intrabony osseous defects yielded clinically favorable responses. The gain in clinical attachment can be longitudinally maintained in a private practice setting. Further controlled studies are needed to elucidate the clinical significance of EMD treatment.  (+info)