Root coverage by modified coronally advanced flap with and without platelet-rich fibrin: A clinical study

Marginal gingival recession can cause major functional and esthetic problems. Advanced flaps are the simplest, yet unpredictable procedures for managing these conditions. The predictability of root coverage can be increased by combining coronally advanced flap (CAF) or its modified approach with other regenerative techniques. Objective: To ascertain the potential benefits of platelet-rich fibrin (PRF) on modified CAF for the treatment of gingival recession. Materials and Methods: Study comprised of 12 patients with Millers' class I and class II gingival recession in two non-adjacent anterior teeth having a minimum 3 mm width of attached gingiva. Following split-mouth design, one tooth with gingival recession was subjected to modified CAF, while another was treated by CAF with PRF. The clinical parameters, i.e., plaque index, modified sulcular bleeding index, vertical gingival recession depth (VGRD), gingival recession width (GRW), clinical attachment level (CAL), and gingival thickness (GT) were recorded at baseline, 1 month, 3 months, and 6 months. Results: VGRD, GRW, CAL, and GT improved significantly from baseline to 1 month in both test and control groups. However, change in these parameters from 1 month to 3 months and 3 months to 6 months were statistically nonsignificant in both groups. On intergroup comparison, only the change in GT was found to be statistically significant (P < 0.05) at all three post-treatment visits. Conclusion: Benefits of the combined technique in terms of increased GT appear to justify the use of PRF along with modified CAF for the treatment of mild to moderate gingival recessions.

Evaluation of two-dimensional and three-dimensional radiography with direct surgical assessment of periodontal osseous defects: A clinical Study.

Aim: To compare the diagnostic values of radiovisiograph (RVG) and computed tomography (CT) images in comparison with direct surgical measurements for the determination of periodontal bone loss. Materials and Methods: Thirty‑one vertical defects were included for direct measurements during surgery with a periodontal probe. RVG and CT images were taken prior to the surgery. Similar measurements were done on their images and compared with the direct surgical values. Results: Mean difference (in mm) of RVG and CT scan in vertical defects, and intrabony component was 0.814, 0.474 and 0.073, 0.066 respectively. Intra class correlation of CT scan (0.997 and 0.990) was highest with the smallest length of 95% confidence interval. CT scan furthermore depicted maximum agreement with the surgical value. CT scan overestimated in the maximum percentage of sites in vertical defects. CT scan outscored over RVG in evaluation of the osseous defects. Conclusions: CT scan demonstrated more precise and clinically useful images of the osseous defects closer to the gold standard.

Treatment of oral submucous fibrosis with ErCr: YSGG laser.

Oral submucous fibrosis (OSMF) is one of the most poorly understood and unsatisfactorily treated diseases. Various medical and surgical treatments have been used but with limited benefits. However, with advent of lasers, oral surgeons are provided with new modality for treating OSMF. This case report highlights the pioneering effort in treating a moderate case of bilateral OSMF with Erbium Chromium Yttrium Scandium Gallium Garnet (ErCr:YSGG) laser showing promising result during follow-up.