effect of locally delivered doxycycline as an adjunctive therapy to scaling and root planning in smokers

Locally delivered doxycycline is found to be effective in managing periodontitis as an adjunct to scaling and root planing. To evaluate the effect of locally delivered doxycycline [10%] with scaling and root planing in the periodontal treatment of smokers and to compare it with scaling and root planing alone. Twelve smokers with chronic periodontitis and a pocket depth [>/= 5 mm] on posterior teeth that bleed on probing were selected. Patients were randomly assigned to scaling and root planing [SRP] or scaling and root planing followed by local application of doxycycline [SRP-D]. Plaque, bleeding on probing, gingival recession, clinical attachment level [CAL], and probing depth [PD] were recorded at the baseline, 6 and 12 weeks. Both groups showed a significant reduction in Plaque, Bleeding on Probing and pocket depth at 6th and 12th week from the baseline. A statistically significant gain of attachment was observed in both groups after treatment. Even though the doxycycline group showed slightly higher attachment gain it was not statistically significant compared to the control group. The observations of the study reveal that the additional benefit of topical application of doxycycline as an adjunct to scaling and root planing in smokers is not convincing. However, further clinical studies may be necessary to substantiate the present observations

New attachment of surgically induced buccal gingival recessions using enamel matrix derivative. A histologic and histometric study in dogs

The present study was designed to evaluate the healing process of gingival recession defects treated with enamel matrix derivative [EMD] and to compare it to that obtained with 24% ethylenediamine tetra acetic acid [EDTA] and the laterally repositioned flapsalone. Gingival recessions were surgically created on the buccal surfaces of maxillary canines and fourth premolars and mandibular first molars of eight beagle dogs. Plaquewas allowed to accumulate for five weeks. Following apreparation period, the defects were randomly assigned to one of the three treatment groups [EMD, EDTA, and control groups]. Four dogs each were sacrificed at three and six months post-treatment. Clinical parameters which included the gingival recession depth and width were measured, and the length of the total epithelium and connective tissue attachment were histometrically evaluated. All three treatments resulted in a statistically significant decrease of the gingival recession depthand width when compared to the baseline [P < 0.05]. Three and six months following surgery, EMD and EDTA groups demonstrated significantly higher percentage of root coverage when compared to the control group. There was no statistically significant difference in the percentage of root coverage between EMD and EDTA groups. Histologically, all three treatment groups demonstrated a new connective tissue attachment. Histometrically, EMD treated sites showed a statistically significant increase of new connective tissue attachment when compared to the EDTA treated sites and controls at three and six months [P < 0.05]. The epithelium length was similar in the EMD and EDTA treated sites [P > 0.05] and it was significantly shorterin the EMD group when compared to the control group [P < 0.05] at three and six months. There were no statistically significant differences between the EDTA and control groups in the length of the epithelium and connective tissue attachment. EMD seemed to significantly improve the clinical and histological outcomes of gingival recessions treated by means of the laterally repositioned flapsurgery

Regeneration of bifurcation in beagle dogs: histologic evaluation of two regeneration materials

The aim of this study was to compare Emdogain and Guidor resorbable materials in the regeneration and/or healing of experimental Class II furcation lesions. Class ll premolar furcation defects 3-5 mm high and 2.5-5 mm deep were experimentally induced in four beagle dogs. Dogs 1 and 2 were assigned to one-stage surgery where the defect created was immediately followed by the placement of either Guidor or Emdogain or nothing [control]. Dogs 2 and 4 were assigned to a two-stage approach where the creation of the defect was followed one month later with the membrane placement or nothing [control]. After six months of healing animals were sacrificed. Subsequently, decalcified sections were prepared from all animals and used for histological evaluation. Accelular cementum was not a constant finding with the use of Emdogain. It was concluded that the two-stage surgery approach is a more predictable experimental model for the healing of Class II furcation

Effective and affordable periodontal maintenance therapy

Mechanical and chemical antimicrobial intervention is the mainstay of preventive periodontal therapy. Successful periodontal maintenance care depends upon the ability of dental professionals to combat periodontal infections and patient compliance with prescribed follow-up care. Since tooth brushing, flossing and oral rinsing do not reach pathogens residing in furcations and at the depths of deep periodontal pockets, adequate oral hygiene should include subgingival treatment with home irrigators or other appropriate self-care remedies in patients with increased pocket depths. Povidone-iodine for professional use and diluted bleach for self-care are inexpensive and valuable antimicrobial agents in periodontal maintenance. The present article outlines the prudent use of antimicrobial therapy in periodontal maintenance therapy

Smear later removal with 8 0/0 EDTA root conditioning: an SEM study of the effect of different application times

The purpose of this SEM study was to evaluate and compare in vitro effects of different timing applications of 8% EDTA on dentin. The surface characteristic was also evaluated. A flat dentin surface was created on human teeth extracted due to severe periodontitis. The teeth were etched with 8% EDTA [pH 7.3] for 1 min [Group I], 3 min [Group II], 5 min [Group III]. Group IV served as control and the teeth were soaked in saline [pH 5.1]. The teeth were evaluated with scanning electron microscope with respect to smear layer removal. Results showed that 1 min etching with 8% EDTA was not sufficient to dissolve the smear layer. Five min etching dissolved the smear layer more effectively than the 3 min group. Based on these findings, the 5min application of 8% EDTA on root dentin completely removed the smear layer from the tubule opening

effect of tetracycline hydrochloride on the smear layer formed by various root planing modalities: a scanning electron microscopy study

The purpose of the present study was to examine the smear layer formation following different root planing modalities and its removal using tetracycline hydrochloride. Thirty-two periodontitis involved human teeth were randomly divided into 8 groups of 4 each. Groups 1 and 2 were root planed with hand Instrument [Gracey 11/12] while In groups 3 and 4, a flat diamond bur was used. In groups 5 and 6, the roots were scaled with a piezoelectric unit [Piezon] while In groups 7 and 8, a magnetostrictive unit [Amdent] was used. sixteen teeth [two In each group] were condItIoned with tetracycline hydrochloride for 3 minutes while the other sixteen teeth were not conditioned and served as controls. The surfaces were examined by a scanning electron microscope. The results showed that root planing resulted in a smear covering the root surfaces, irrespective of the treatment modality. Tetracycline hydrochloride efficiently removed the smear layer with collagen fibers exposed to varying degrees

Effect of Miswak Extract on Healthy Human Dentin: an In Vitro Study

The purpose of this study was to compare the texture of dentin surfaces after the application of saline, aqueous and alcohol-derived miswak extracts using different modes of application and exposure times. It was concluded that alcohol derived miswak extract at pH of 2.5 to 2.9, selectively removed the smear layer from the dentin surface exposing the dentinal tubules. This result was In contrast to burnishing dentin surface with aqueous - miswak extract of higher pH 6.3 to 6.6 or with saline, both of which partially removed the smear layer without dentinal tubules exposure. It cannot be excluded that the pH of the solutions used is an important factor in determining whether etching occurs