[ clinical comparison of free gingival graft harvested from palate versus attached gingival]

Despite doubts about the necessity of the presence of keratinized gingival tissue around teeth, increasing its width is still of special importance in particular situations. Among currently used procedures, free gingival autograft is more common. The aim of this study was to clinically compare the free gingival graft taken from palate[FGGP] versus free gingival graft taken from attached gingival [FGGA] following a healing period of one, two and three month that will determine and introduce the superior procedure to be used in practice. The present study was a controlled, split mouth clinical trial which 10 pairs of lower anterior and premolar teeth requiring gingival augmentation were exposed to surgery using [FGGP] and [FGGA]. Statistical data analysis was done using SPSS software. Chi- square [X[2]] test was used for comparison of color matching between two groups. Nonparametric Mann- Whitney test was used for comparison of mean keratinized gingival width and dimensional changes of graft between two groups. This study demonstrated that the increased amount of keratinized gingival width three months following the surgery, was significant for both groups but there were no statistically significant differences between two groups. [P>0/05]. With regard to the color matching with adjacent tissue, the results of [FGGA] was superior to [FGGP] [P<0.05]. The amount of dimensional changes in the [FGGP] was more than [FGGA][P<0.05]. Both procedures had the ability to increase the keratinized gingival width, however [FGGA]had lower dimensional changes. In addition, [FGGA] had better color matching and esthetic

[ correlation between obesity and impaired glucose tolerance with periodontal diseases]

Numerous evidence indicates the deteriorating effects of obesity on body organs and its role in predisposition to systemic diseases such as diabetes. On the other hand, diabetes has been recognized as a risk factor for periodontal breakdown. This study aimed to determine the relationship between obesity and periodontal diseases. The second aim was to clarify if periodontal diseases make the individuals prone to impaired glucose tolerance. A total of 166 patients [age 35- 59 years] who sought dental care in Tabriz Dental Faculty were recruited in this study. Eighty three people had periodontitis in accordance with NHANES III index [test group] and the remaining who did not have periodontal disease served as the control group. The body weight [BW], height and waist circumference [WC] were measured in both of the study groups followed by fasting plasma glucose [FPG] and oral glucose tolerance test [OGTT]. Data were analyzed by student t-test and Chi-Square followed by calculating the odds ratio and Spearman correlation. All of the studied variables expressed a higher score in the test group than the control one [p<0.05]. Evaluation of the correlation of obesity [OB], overweight [OW], WC, and impaired glucose tolerance [IGT] with periodontal disease severity, revealed the highest correlation between OB [r=1 and p<0.001] and the lowest between OW [r=0.4 and p=0.07]. Regarding the association of OB, WC and OW with IGT among women, the strongest association was found in OB [odds ratio, 6.5; 95% CI, 1.26- 23.6] and the weakest was in OW [odds ratio, 0.43; 95% CI, 0.07-2.6]. These associations were similar among the males and the highest was between OB [odds ratio, 5; 95% CI, 0.82- 19.41] VS. the weakest that was observed in OW [odds ratio, 0.39; 95% CI, 0.07-2.17]. The association of obesity and periodontal disease is stronger than that with impaired glucose test. This may be attributed to different mechanisms involved in relationship between periodontal disease, obesity and diabetes

[ clinical comparison of Azithromycin versus Doxycycline in non-surgical periodontal treatment of smokers]

Weaker immune system in smokers reduces the favorable response of these patients to both surgical and non-surgical periodontal treatments in comparison with non smokers and ex-smokers. The aim of the present study was to compare the healing of periodontal tissues following phase 1 therapy alone, or along with taking Azithromycin or Doxycycline in smokers with chronic periodontitis. In this investigation a total of 45 male smokers with chronic periodontitis were randomly assigned into 3 groups, each containing 15 patients. All patients were initially examined by measuring the periodontal indices, such as Bleeding On Probing [BOP], Clinical Attachment Level [CAL], and Probing Depth [PD]. The control. group received phase 1 therapy only. While the second and third groups received Doxycycline and Azithromycin respectively along with phase 1 therapy. The periodontal indices were measured and recorded again after six months. The results showed that, there was a significant difference between all recorded parameters before and after the treatment [P<0.05]. However, there was no statistically significant difference between Doxycycline and Azithromycin groups regarding PD index [P >0.05], but groups receiving antibiotics showed statistically significant reduction in PD compared to control group [P<0.05]. The best result for CAL was obtained in Azithromycin group when compared with Doxycycline and control groups. Also, a statistically significant difference was detected between the two antibiotic groups [P<0.05]. Furthermore. Doxycycline group showed a statistically significant reduction in CAL in comparison with the control group [P<0.05]. Regarding BOP index no statistical significant difference was seen between the results of the 3 groups under investigation [P>0.05]. Azithromycin and Doxycycline consumption along with phase 1 therapy may improve the clinical periodontal indices in comparisons with phase 1 therapy alone

Interdental subgingivalplaque removal: a comparison between hand instruments, ultrasonic sealer and air powder polishing devices with and without abrasive powder

The aim of this study was to compare the efficacy of air-polishing devices [APDs] with hand instruments and ultrasonic sealers when used for interdental subgingival plaque removal. Likewise, the effectiveness of APD with and without abrasive powder was evaluated. A total of sixty single-rooted teeth were treated in fifteen periodontal patients with 4-6mm mesial probing depth [PD]. The selected procedures were hand instruments [Gracey curettes], ultra sonic scalar, APD without powder and APD with powder. Before and immediately after the treatment procedures, subgingival plaque samples were collected from the mesial aspects of these teeth. The anaerobe cultivation method was utilized to assess the mean reduction of total colony forming units [CFU] immediately after treatment. Subgingival microorganisms were significantly reduced in all methods. The mean CFU differences between before and after treatments were significant [P < 0.001] for all procedures. However, no significant difference was observed in the effectiveness of various methods. On average, all methods were able to reduce subgingival microorganisms by 92%. There was also a positive correlation between the colony counts before and after treatments [r = 0.52]. Using APD is as effective as hand instruments and ultrasonic sealers for interdental subgingival plaque removal in cases with up to 6mm probing depth. The use of abrasive powder does not enhance the effectiveness of APD in subgingival plaque removal

comparison on the amount of root coverage by two techniques: connective tissue graft and bioabsorbable bovine collagen membrane

Periodontal diseases are one of the most prevalent diseases among human population and of them gingival recession has a high prevalence. The goal of this study was to compare the amount of root coverage by two techniques: Guided tissue regeneration [GTR] with a bioabsorbable bovine collagen membrane [Biomend] and the connective tissue graft with Harris technique. In this controlled clinical trial, twenty anterior and premolar teeth were selected. All samples had Miller class 1 and II gingival recession. Following oral hygiene instruction and reevaluation of all teeth, they were randomly assigned to treat with either guided tissue regeneration [GTR] or connective tissue graft [CTG]. In order to insert a connective tissue graft, Harris technique was used. Guided tissue regeneration technique was performed via a sulcular and two oblique incisions. The full thickness flap was replaced by a blunt dissection to expose the bone and then the apical protion was dissected by a sharp dissection. The later dissection was continued in a manner to facilitate the coronally repositioned flap. A bioabsorable membrane was adapted in the area so as at least 3mm of the apical and lateral were covered by the membrane. Finally, the flap was sutured coronally by sling sutures. Patients were visited in one and two weeks, one and six months periods. Information about recession depth [RD], probing depth [PO], the width of attached gingiva and the amount of root coverage were recorded at the base line and six months after surgery. The gathered data were analyzed using wilcoxaon Signed Ranks test, U-Mann-Whitney test and SPSS software. The mean root coverage, after six months, were [71.22 +/- 10.2]% for GTR procedure and [80.67 +/- 16.06]% for the connective tissue graft technique, the difference was not statistically significant [P=0.134]. Both procedures produced similar reductions in recession and probing depth but the connective tissue graft procedure gained a greater increase in keratinized tissue comparing to GTR technique [3/4[mm] vs 0/1[mm] respectively]. The difference was statistically significant [P<0.001]. Both techniques can be successfully applied in the treatment of periodontal recession defects but when an increase in keratinized tissue is desirable, the connective tissue graft technique is preferred to GTR technique. On the contrary, if keratinized tissue increase is not required, an absorbable membrane, due to the lack of need to a donor tissue, is more suitable