[ impact of clinical steps of porcelain fused to metal restorations on periodontal health]

Statement of Problem: Periodontal health plays a key role in the success of restorative treatment and clinical stages of restorative treatments may affect the health of periodontium

Purpose: The aim of the present study was to investigate the effects of clinical stages of porcelain fused to metal [PFM] restorations on free gingival margin [FGM], clinical attachment level [CAL], plaque [PI], and gingival [GI] indices

Material and Method: 15 patients requiring PFM restoration on the maxillary central incisor or maxillary and mandibular premolars [test group] with an intact adjacent counterpart [control group] were selected. FGM, CAL, PI, and GI were measured and recorded at baseline [0], after preparation [1], after impression [2], after final cementation [3], 7 days after cementation [4], 1 and 6 months after cementation [5 and 6]. Independent Sample T-test and Man-Whitney U Test were used for comparison of intra-group and inter-group differences, respectively

Results: Statistically significant differences were seen between the test and control groups in FGM [3], CAL [2, 3 and 6], and GI [6]. In the test group, significant differences were observed in FGM [1-3], CAL [1-6], and GI [3 and 6] compared to the baseline. In the control group, however, the variables did not show any significant difference compared to the baseline except for PI [4-6] and GI [6]

Conclusion: The findings of the present study indicated that clinical stages of making porcelain fused to metal [PFM] restorations were accompanied by a significant loss of clinical attachment level, increase in GI, and deepening of the gingival sulcus

[Evaluation of alteration in mucogingival junction location following use of connective tissue graft and coronally advanced flap]

One of the most successful procedures in root coverage is free connective tissue graft combined with coronally advanced flap. The assessment of mucogingival junction [MGJ] changes during healing period is of great importance. The aim was to assess the positional changes of MGJ following use of connective tissue graft in combination with coronally advanced flap in 3- 6- and 12- month intervals. In this cross sectional and interventional study, 19 cases of gingival recession in 10 patients with Miller class I and II defects >/= 4 mm were treated with connective tissue graft and coronally advanced flap. After phase I therapy, an acrylic stent was made. Clinical parameters monitored in this study included clinical attachment level [CAL], mucogingival junction [MGJ], keratinized gingival [KG] width and attached gingival [AG] width. Each parameters were measured at baseline, and 3- 6- and 12- month intervals. For comparison, statistical analysis was performed using Paired-T test at p < 0.05.The mean distance from MGJ to acrylic stent at baseline was 5.94 +/- 0.88 mm which during surgery, was moved coronally by 4.39 +/- 0.65 mm. Distance from MGJ to CEJ immediately after surgery was 1.55 +/- 0.58 mm. This distance during healing periods at 3, 6, and 12 months changed to 3.13 +/- 0.87, 3.34 +/- 0.66, and 3.65 +/- 0.64 mm, respectively indicating a gradual regression of MGJ to presurgical position. Keratinized gingival width had remarkable changes in 3-, 6- and 12 month intervals in comparison to the baseline. Mean presurgical width of keratinized gingiva was 1.55 +/- 0.76 mm which increased to 3.44 +/- 0.49 mm [p <0.05]. Mean presurgical attached gingival was 0.36 +/- 0.62 mm and 12 months after surgery it was increased to 2.18 +/- 0.50 mm 12 month after surgery [p <0.05]. Presurgical clinical attachment level was 5.81 +/- 0.88 mm which was decreased to 1.55 +/- 0.57 mm, 12 month after surgery.Based on the findings, it seems that mucogingival junction has a gradual tendency to moved back to its presurgical position after use of free connective tissue graft with coronally advanced flap technique

[Effect of cigarette smoking quantity on periodontal tissue response to phase I therapy]

Although bacterial plaque is the primary ethiologic factor in the initiation of chronic periodontitis, there is some predisposing factors such as smoking which may aggravates disease process and its roll appears to be considered more important recently. The purpose of the present study was the evaluation of the effect of the quantity of cigarette smoking on periodontal tissue response following phase I therapy. Thirty patients [26 male and 4 female] with mean age of 48 +/- 11 years participated in this interventional and cross-sectional study. All patients suffered from generalized moderate chronic periodontitis. The patients were divided into three equal groups of 10 [heavy smokers, light smokers and non smokers], according to the number of cigarette consumption. The smoker groups had a history of cigarette consumption at least for the past two years. Clinical probing depth, clinical attachment level and bleeding on probing were evaluated for the patients at baseline and eight weeks following completion of phase I therapy. The results were analyzed using Wilcoxon rank and Kruskal- Wallis tests. No statistically significant differences were found in the evaluated variables between the groups except for BOP at baseline. All parameters decreased significantly eight weeks after completion of phase I therapy, but in comparison between three groups, only differences of CPD reduction and CAL gained between heavy and non-smokers were statistically significant. The present study indicated that heavy cigarette smoking have a negative effect on periodontal tissue response to phase I therapy. This effect depends on the number of daily smoked cigarettes and is increased with more than 20 cigarettes smoking per day