Demineralized freeze-dried bone allograft with/without i-Platelet-rich fibrin in 3 wall intrabony defects

Demineralized freeze-dried bone allograft (DFDBA) contains bone morphogenetic proteins (BMPs), hence is osteoinductive. Autologous platelet concentrates exhibit a higher quantity of growth factors. Both these biomaterials aid in bone regeneration when placed in three-wall intrabony defects. However, their efficacy when used alone and in conjugation is not clear. Aim: To assess clinical and radiographic efficacy of injectable platelet-rich fibrin (i-PRF) with microsurgical access flap in the treatment of three-wall intrabony defects in chronic periodontitis patients. Methods: Thirty sites with three-wall intrabony defects were randomly assigned to control and test group by computer generated method. The test group obtained i-PRF mixed with DFDBA while the control group received only DFDBA. Clinical parameters such as site-specific Plaque index (PI), Radiographic intrabony defect depth (IBDD), modified- Sulcular bleeding index (mSBI), Clinical attachment level (CAL), and Probing pocket depth (PPD) were measured at baseline, three and six months. Results: Intragroup comparison within the control group and test group exhibited statistically highly significant variation of mean PI, mSBI, PPD, CAL, and IBDD score from baseline to 3 months and from 3-6 months (p<0.001). However, intergroup comparison demonstrated no statistically significant variation of mean IBDD at all 3 intervals (p>0.05). Conclusion: i-PRF combined with DFDBA enhanced the radiographic and clinical parameters as opposed to DFDBA alone. The role of i-PRF is promising in its capacity for easy obtainability and increased potential to aid in regeneration

Intraoral hematoma formation following infusion of streptokinase in the treatment of myocardial infarction.

A 65 year old female with recent inferior wall MI underwent an intravenous streptokinase infusion in an attempt to re-establish coronary reperfusion. Although the cardiac catheterization and streptokinase infusion were technically uncomplicated, an intraoral hematoma was found in the buccal mucosal oral cavity three hours following the procedure. The case was successfully managed with local therapy.

Palatogingival Groove: Management of an Innocuous Culprit of a Perio-endo Lesion.

Morphological defects occurring in dental structure can be sometimes predisposing factors for the onset of inflammatory processes in the periodontal and/or pulpal tissues. Palatogingival groove is one such defect, most frequently found on the lingual surface of maxillary laterals. Recognition of such a defect is critical and important, especially because of its diagnostic complexity and its further consequences. This case report discusses about the diagnosis and management of such a defect that predisposed the maxillary lateral incisor to periodontal defect leading to retrograde pulpitis.