Clinical comparison of full and partial double pedicle flaps with connective tissue grafts for treatment of gingival recession

Statement of the Problem: Gingival recession has been considered as the most challenging issue in the field of periodontal plastic surgery

Purpose: The purpose of this study was to evaluate the clinical efficacy of root coverage procedures by using partial thickness double pedicle graft and compare it with full thickness double pedicle graft

Materials and Method: Eight patients, aged 15 to 58 years including 6 females and 2 males with 20 paired [mirror image] defects with class I and II gingival recession were randomly assigned into two groups. Clinical parameters such as recession depth, recession width, clinical attachment level, probing depth, and width of keratinized tissue were measured at the baseline and 6 months post-surgery. A mucosal double papillary flap was elevated and the respective root was thoroughly planed. The connective tissue graft was harvested from the palate, and then adapted over the root. The pedicle flap was secured over the connective tissue graft and sutured. The surgical technique was similar in the control group except for the prepared double pedicle graft which was full thickness

Results: The mean root coverage was 88.14% [2.83 mm] in the test group and 85.7% [2.75 mm] in the control group. No statistical differences were found in the mean reduction of vertical recession, width of recession, or probing depth between the test and control groups. In both procedures, the width of keratinized tissue increased after three months and the difference between the two groups was not statistically significant in this respect

Conclusion: Connective tissue with partial and full thickness double pedicle grafts can be successfully used for treatment of marginal gingival recession

Maternal Periodontitis, Preeclampsia and adverse pregnancy outcomes

Preeclampsia is a considerable problem of pregnancy. Endothelial dysfunction and placental hypoxia are the current hypotheses for the pathogenesis of preeclampsia. Chronic inflammation, including periodontitis may provoke systemic maternal and placental pro-inflammatory endothelial dysfunction, which represent a significant risk factor for diseases of vascular origin. So this study was carried out to evaluate the possible relationship between periodontitis and preeclampsia. A total of 360 pregnant women were included, [180 pregnant women with mild or sever periodontitis in one group and 180 pregnant women with healthy periodontal status in the other group]. Periodontitis was determined by the sum of all pockets with pocket probing depth [PPD] >/= 4mm and bleeding on probing. Healthy periodontal status was defined as the absence of PPD>/= 4mm. Then two groups evaluated to determine the presence of preeclampsia. After delivery, weight birth and gestational age was also recorded. Chi square and t test were used to analyze the data. There was statistically significant difference between two groups in terms of preeclampsia development [P=0.003]. Women who had a worse periodontal condition were at higher risk for preeclampsia. In addition, birth weight and gestational age was statistically lower in the case group than the control group [P<0.001]. The results indicate that the development and severity of peridontitis increase the risk for occurrence of preeclampsia and adverse pregnancy outcomes

Detection of IL-4, IL-6 and IL-12 serum levels in generalized aggressive periodontitis

Periodontitis is a multifactorial chronic inflammatory disease characterized by destruction of tooth-supporting tissues. Environmental and genetic factors as well as the immune system participate in this process. Recent studies have attempted to elucidate the role of cytokine networks involved in periodontal diseases. To assess and compare the levels of IL-4, IL-6 and IL-12 in serum samples of patients with generalized aggressive periodontitis [GagP] and control individuals. A total of 50 subjects were included in the study of which 25 patients had generalized aggressive periodontitis and 25 were healthy unrelated age and gender matched patients undergoing extraction and surgical crown lengthening [control group]. Local blood samples of patients were collected from surgical sites of pocket reduction and from healthy individuals before tooth extraction or crown lengthening from non inflamed sites. The levels of IL-4, IL-6 and IL-12 were determined by an ELISA assay using serum samples separated from the whole blood of both groups. The level of IL-4 increased significantly in control group in comparison with the test group [p=0.002]. The amount of IL-6 in GagP patients increased strongly compared with control group [p<0.0001]. There was no significant difference between the two groups concerning the level of IL-12. There is an association between generalized aggressive periodontitis and low level of IL-4 as an anti-inflammatory cytokine, and high level of IL-6 as a proinflammatory cytokine. No correlation between IL-12 and generalized aggressive peridontitis was found