Alveolar Bone Housing- A Modified Wilkodontics Approach- A Case Report.

Accelerated orthodontic treatment is the need of the hour in current scenario as the conventional orthodontics is time taking. Corticotomy assisted orthodontics have been used for years to reduce the treatment duration by reducing the resistance provided by alveolar bone housing. This case report describes the orthodontic treatment combined with the modification in conventional wilkodontic technique in a patient to accelerate tooth movement and shorten the treatment time with an anterior open bite and flared and spaced upper and lower incisors. Firstly plaque control was achieved with supra and subgingival scaling. A modified approach using periodontal access flap followed by vertical bone cuts in the cortical bone from the crest of the alveolar bone margin to 2mm-3mm below the apices of all the anterior teeth extending from upper left canine to upper right canine were performed. These vertical cuts were joined by horizontal cuts apically and flap repositioned. An MBT 0.018 inch appliance was bonded. Orthodontic therapy proceeded with frequent activation of the appliances to retract the incisors every two weeks. The total treatment time was four and half months with active period of two months and no adverse effects were observed at the end of active treatment. The modified decortication technique reduced the treatment time to a considerable extent. The interdental spacing closed and optimum overjet and overbite was achieved.

Genetic mapping in papillon-lefèvre syndrome: a report of two cases.

Papillon-Lefevre syndrome (PLS) is a rare autosomal recessive heterogeneous trait which is characterized by erythematous palmoplantar hyperkeratosis, early-onset periodontitis, and associated calcification of dura mater. The etiology of PLS is multifactorial with genetic, immunological, and microbial factors playing a role in etiopathogenesis. Recently identified genetic defect in PLS has been mapped to chromosome 11q14-q21, which involves mutations of cathepsin C. This paper presents a report of 2 cases of Papillon-lefevre syndrome in which diagnosis is based on clinical presentation and genetic mapping.

Periodontal regeneration using platelet-derived growth factor in infrabony defects: a series of three cases.

The periodontal researchers and clinicians, in an effort to develop effective regenerative therapies, have sought to understand key events involved in the regeneration of periodontium. Polypeptide growth factors are a class of natural biological mediators which regulate key cellular events in tissue repair. Platelet-derived growth factor (PDGF) is the most thoroughly studied growth factor in periodontal regeneration. The present case series evaluate the effectiveness of platelet-derived growth factor (rh-PDGF-BB) in combination with beta-tricalcium phosphate ( ß -TCP) to achieve periodontal regeneration in 3 infrabony defects.

The effectiveness of enamel matrix protein (Emdogain(®)) in combination with coronally advanced flap in the treatment of multiple marginal tissue recession: A clinical study.

BACKGROUND: Gingival recession resulting in root exposure is a common problem faced by clinicians. This clinical study compared the results obtained by treating gingival recession using enamel matrix derivative (Emdogain gel(®)) along with coronally positioned flap and coronally positioned flap alone. MATERIALS AND METHODS: Twenty patients with a total of 46 gingival recession defects, each patient with a minimum of two recession defects, were included in the study. The test group, which consisted of 10 patients with 22 recession defects, was treated by enamel matrix derivatives (Emdogain gel) in combination with a coronally positioned flap, while the control group, which consisted of 10 patients with 24 gingival recession defects, was treated with 24% ethylenediaminetetraacetic acid (EDTA; Prefgel(®)) in combination with coronally positioned flap. RESULTS: Student's paired and unpaired t-test was used for statistical analysis. If the probability value (P) was less than 0.05, it was considered significant. Data from this study demonstrated that application of (EMD) Emdogain gel resulted in a statistically significant increase in root coverage, gain in the clinical attachment level (CAL), and probing pocket depth (PPD) reduction when compared with coronally advanced flap (CAF) alone, but there was no statistically significant difference in the width of keratinized gingiva (WKG) between the two groups.

Interimplant papilla reconstruction by using demineralized freeze dried bone allograft block fixed by titanium screw: a case report.

Dental implants are now considered as a predictable treatment modality for the oral rehabilitation of partially or fully edentulous patients. Recently emphasis has changed towards achieving a predictable esthetic success. Creating aesthetically successful implant-supported restoration in the anterior region of oral cavity depends on the presence of interimplant papilla when multiple implants are used. The present paper reports a case of interimplant papilla reconstruction in esthetic zone of maxilla during one stage early loading multiple implant procedure using demineralized freeze dried bone allograft block fixed by titanium screw.

Pathogenesis of periodontitis: role of cytokines in host response.

There is no doubt that plaque bacteria are necessary to initiate disease and drive the chronic inflammatory response in the periodontal tissues. At the same time, there is strong evidence that destructive processes occurring as part of the host inflammatory response are responsible for the majority of the hard- and soft-tissue breakdown leading to the clinical signs of periodontitis. The characteristic clinical signs of chronic periodontitis occur mainly as a result of activation of host-derived immune and inflammatory defense mechanism. IL-1 and TNF induce expression of other mediators that amplify the inflammatory response, such as prostaglandins, and lead to production of lytic enzymes and stimulate the production of chemokines. Investigations on the soluble protein delivery of antagonists to IL-1 and TNF in animal models have shown promising results. Collectively, the clinical, radiographic, and biochemical findings of these experiments show that IL-1 and TNF-alpha antagonists block the progression of the inflammatory cell infiltrate towards the alveolar crest and the recruitment of osteoclasts, and prevent the periodontal lesions may destroy the soluble cytokine antagonists prior to their peak activity, which may necessitate more frequent administration of the active agents to the defects. Thus, gene transfer of TNF receptor antagonists and IL-1ra may offer a more efficient mode of delivery of disease controlling agents to the periodontal structures. Periodontal treatment through the ages has focused on the reduction of bacterial infection by mechanical removal of infectious agents (i.e., SRP). Attempts at elimination of infectious agents often do not represent a definitive therapy in periodontitis, necessitating the administration of more sophisticated biological treatment modalities. A thorough understanding of the host inflammatory response in periodontal pathogenesis presents the opportunity for exploiting new treatment strategies for periodontitis by means of host response modulation. The rationale behind this approach is to aid the host in its fight against infectious agents by supplementing the natural inherent defense mechanism or to modify its responses by changing the course of inflammatory systems. Therefore, pharmaceutical inhibition of host response pathways that mimic endogenous anti-inflammatory mechanisms may prove to be an effective strategy for treating periodontal diseases. This would require the development of polypharmaceutical approaches controlling all pathways associated with inflammation and tissue destruction. Current research has focused on the use of SDD as a treatment modality, and SDD is the only systemically used host modulatory drug approved by the United States Food and Drug Administration.