Effects of CO2 laser treatment on fibroblast attachment to root surfaces. A scanning electron microscopy analysis.

BACKGROUND: The aim of this study was to analyze the CO2 laser effects on root surfaces affected by periodontal disease in comparison to scaling and root planing for fibroblast attachment. METHODS: Thirty single-rooted human teeth extracted because of advanced periodontal disease were included in this study. A total of 60 specimens, obtained from all selected teeth, were randomly assigned to 3 groups: 1) control (untreated); 2) hand scaling and root planing (SRP); or 3) laser (CO2 defocused pulsed) and ultrasonic scaling. All the specimens were incubated in Petri dishes with fibroblast suspension, and then observed by scanning electron microscopy (SEM). RESULTS: The control group showed the lowest number of attached cells, with no tightly attached fibroblasts. The laser plus scaling group showed the highest number of attached fibroblasts, with the tightly attached fibroblast prevailing. The laser-treated and scaled root specimens did not show any damage or morphologic alteration of the root surfaces. CONCLUSION: CO2 laser treatment in defocused, pulsed mode with a low power of 2W combined with mechanical instrumentation constitutes a useful tool to condition the root surface and increase fibroblast attachment to root surfaces.

Longitudinal study of dental implants in a periodontally compromised population.

BACKGROUND: The purpose of this longitudinal study was to determine the clinical status and the composition of the subgingival microbiota of dental implants and natural teeth in patients with a history of periodontitis. METHODS: Twenty-five partially edentulous patients treated for moderate to advanced adult periodontitis and having a total of 42 implants participated in this 3-year study. The assessment of clinical status was done 1, 2, and 3 years after prosthetic loading (T1, T2, and T3, respectively). Clinical parameters evaluated included probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI). The subgingival microbiota at peri-implant and periodontal sites were analyzed at T1 and T2. RESULTS: No significant difference in clinical parameters between implants and teeth and within the 2 groups between different time points was observed through the study. PD and CAL measurements of sampled periodontal and peri-implant sites did not show any statistically significant difference through the study and between the 2 groups. PI of sampled periodontal sites showed a statistically significant improvement during the study. From the morphological observation of the subgingival microbiota, a significant difference in the composition of motile rods between implants and teeth was found at T1. There were no differences detected in the subgingival microbiota, culturally identified at peri-implant and periodontal sites for the duration of the study. CONCLUSIONS: In conclusion, implants were colonized by the indigenous periodontal microbiota and were well maintained in patients with a history of periodontitis. No significant association between progressing or non-progressing periodontal or peri-implant sampled sites in terms of loss of attachment and infection with at least one of the searched periodontal pathogens was found, suggesting that the presence of putative periodontopathogens at peri-implant and periodontal sites may not be associated with future attachment loss or implant failure.

A clinical comparison of the efficacy and efficiency of two professional prophylaxis procedures in orthodontic patients.

This study compared the efficacy and efficiency of two professional prophylaxis procedures in orthodontic patients performing different oral hygiene regimens: the air powder polishing system (APP), and the rubber cup and pumice (RCP) technique. Sixty-two patients were divided into two groups: group I included 40 subjects who did not use any chlorhexidine mouthwash and group II comprised 22 subjects who regularly rinsed with a chlorhexidine mouthwash (at a 0.12 per cent concentration) and showed increased tooth staining. Using a split-mouth experimental design, the buccal and lingual tooth surfaces were cleaned in half of the mouth by the APP and in the opposite half by the RCP technique. Tooth surfaces were scored before (PRE) and after (POST) the experimental procedures for the plaque index (PI), and for the presence of tooth staining. In addition, the treatment time required by each procedure was recorded. In test group I, significant reductions in the PI after APP and RCP were observed. Likewise, in test group II, both procedures significantly reduced the baseline PI values. In both experimental groups, the percentage of stained sites significantly decreased after APP and RCP, but in test group II, APP seemed to be more effective than RCP. In addition, APP required significantly less time than RCP to remove dental plaque and staining. These data show that both professional prophylaxis procedures are effective in orthodontic patients, with APP being the most time-efficient technique and the most effective method for removal of tooth staining.

Microbiotica associated with refractory periodontis. Prevalence and antibiotic susceptibility.

BACKGROUND: The aim of the present study was to analyze the composition of subgingival microflora in patients with refractory periodontitis and to evaluate the antimicrobial sensitivity of isolated periodontopathic microorganisms to different antibiotics. METHODS: Eleven subjects with a mean age of 46.4 years were selected for the present study. All had been treated for periodontal disease in the past. After further disease progression patients were included in this study. Eight subgingival plaque samples per patients were collected for cultural analysis. RESULTS: "Black pigmenting anaerobic bacilli" were the pathogenic microorganisms more frequently isolated. The findings from antibiotic susceptibility test showed that high number of bacteria associated with refractory periodontitis resulted resistant to erythromycin, metronidazole and tetracycline. The most effective antibiotics were ciprofloxacin, amoxicillin-metronidazole and amoxicillin-clavulanic acid. CONCLUSIONS: Microbiological analysis and antibiotic susceptibility test should be considered important tools in the management of patients with poor clinical response to conventional periodontal treatment.

Periodontal status and subgingival microbiota of insulin-dependent juvenile diabetics: a 3-year longitudinal study.

This study examined for 3 years the changes in periodontal status and the possible correlations with selected subgingival microbiota and diabetic conditions in a group of 16 insulin-dependent diabetes mellitus (IDDM, JD) patients as compared with their 16 healthy cohabiting siblings (HS). JD patients were monitored every 3 months for levels of glycosylated hemoglobin (HbA1C). Clinical and microbiological parameters were measured 6 weeks before drawing blood to determine levels of HbA1C. Periodontal parameters were measured at baseline (TO), year 2 (T2), year 3 (T3) and included: probing depth (PD), attachment level (AL), sulcus bleeding index (SBI), and plaque index (PI). Two sites in each patient were selected for microbial samples: a mesio-facial aspect of the maxillary right first molar (defined as constant site, CS) and a site with the greatest probing depth (defined as deepest site, DS). Microbial samples were analyzed by culture techniques. No significant differences in clinical parameters were found between diabetics and healthy siblings at any examination. The SBI in the non-diabetic group at T2 and at T3 was significantly lower than at baseline. PD and AL of constant sites in the diabetic group at T3 were significantly higher than baseline. There was a significant increase in Prevotella intermedia at T3 as compared with baseline for deepest sites in the diabetic group. Cluster analysis revealed, in a former study, two clusters (IV and V) at baseline which were significantly different from the overall mean regarding composition of Porphyromonas gingivalis and Capnocytophaga spp. They were not significantly different for periodontal parameters from TO to T3. These data would suggest no significant differences in clinical parameters between the diabetics and non-diabetic siblings throughout this 3-year longitudinal study.

Periodontal status and selected cultivable anaerobic microflora of insulin-dependent juvenile diabetics.

The periodontal status and subgingival microflora of insulin-dependent juvenile diabetic (JD) patients (n = 16, mean age = 11.3) were compared with that of their non-diabetic cohabiting healthy siblings (HS, n = 16, mean age = 13.2). JD patients were monitored every 3 months for levels of glycosylated hemoglobin (HbA1c) and clinical and microbial parameters were measured 6 weeks before drawing blood for levels of HbA1c (M% = 8.76). Clinical indices, measured for the entire permanent dentition, included: probing depth (PD), attachment level (AL), sulcus bleeding index (SBI), and plaque index (PI). Subgingival plaque samples were obtained at 2 sites from each subject; whenever possible, the site with the deepest probing depth and the mesial aspect of the maxillary right first molar were used. Microbial analyses were determined by cultural characteristics and biochemical tests. No significant differences were detected in any of the clinical indices for the entire dentition. The mean AL for JD sites was 2.32 +/- 0.83 mm and for HS sites was 2.2 +/- 0.85 mm. Mean percentage of total cultivable anaerobic microflora included Capnocytophaga spp. (JD, 13.21%; HS, 11%) and Porphyromonas gingivalis (JD, 5.1%; HS, 7.9%). Differences between the two groups were not statistically significant. When cluster analysis was performed on sampled sites, one cluster group in JD patients showed significantly elevated P. gingivalis and lower Capnocytophaga spp. levels as compared to the overall mean. The clinical parameters of this cluster were characterized by statistically significant greater loss of attachment and probing depth. These data would suggest few differences between JD patients and their HS in this population.

Antimicrobial susceptibility of periodontopathic bacteria associated with failing implants.

The aim of this study was to examine the subgingival microflora associated with failing implants, and to determine their susceptibility to commonly used antibiotics in periodontal therapy and dental practice. Thirteen partially edentulous patients with 19 failing implants were selected. Clinical examination included probing depth, attachment level, gingival index, plaque index, and radiographic analyses. Two subgingival plaque samples were taken from each failing implant and analyzed for microbial composition. Fusobacterium nucleatum, Porphyromonas gingivalis, and Prevotella intermedia were the prevalent cultivable microflora. Antimicrobial susceptibility of isolates was determined by the agar dilution technique. Antibacterial activity of penicillin G, amoxicillin, amoxicillin-clavulanate, and the combination amoxicillin-metronidazole was significantly higher than with other antibiotics tested. These data indicated that the commonly-used antibiotics were highly effective against bacteria isolated around failing implants, which would suggest the use of these antibiotics to control peri-implant infections.

[Guided regeneration of the periodontal tissues with resorbable and nonresorbale membranes. I. Clinical evaluation]. / Rigenerazione guidata dei tessuti parodontali con membrane riassorbibili e non. Nota I. Valutazioni cliniche.

The present experimental study has been undertaken in order to analyse clinically, in humans, the regeneration of periodontal tissue following two different surgical techniques of guided tissue regeneration therapy using a resorbable and a nonresorbable membrane. Clinical results have demonstrated no statistically significant difference between the techniques employed, both of the showing a favourable outcome if perfect plaque control in the postoperative period is performed.

[Guided regeneration of the periodontal tissues with resorbable and nonresorbable membranes. II. Microbiological evaluation]. / Rigenerazione guidata dei tessuti parodontali con membrane riassorbibili e non. Nota II: Valutazioni microbiologiche.

The present experimental study has been undertaken in order to analyze the influence of bacterial recolonization on periodontal wound healing following guided tissue regeneration therapy in humans. Two different surgical techniques has been carried out: one using a non absorbable membrane and the other a absorbable one. Microbiological data indicate no statistically significant difference between the techniques employed. Furthermore our data have confirmed the necessity of maintaining the healing sites free from the main periodontal pathogens.

[Oral localization of condyloma acuminata: clinical case]. / Localizzazione orale di condilomi acuminati: caso clinico.

A case report on oral cavity location of condyloma acuminatum.

[Bacterial recolonization in the guided regeneration of the inter-radicular periodontal tissues]. / La ricolonizzazione batterica nella rigenerazione guidata dei tessuti parodontali interradicolari.

The present experimental study has been undertaken in order to analyse clinically and microbiologically the formation of new periodontal attachment in class II furcation lesions in mandibular molars, comparing healing after surgical conventional therapy and after guided periodontal tissue regeneration technique using non-resorbable membranes and evaluating at the same time, with cultural anaerobic technique, the influence on healing of the bacterial recolonization of some periodontally pathogenic species. Clinical results have demonstrated that, after therapy, may occur a certain discrepancy between soft and hard tissue regeneration and that the bone tissue shows a different pattern of apposition in the horizontal and vertical direction. Microbiological data have underlined the significance of surgical instrumentation in the guided inter-radicular periodontal tissue regeneration and have confirmed the necessity of maintaining the healing sites free from the main periodontal pathogens.

[Current trends in therapy of periodontal disease]. / Attuali orientamenti della terapia della malattia parodontale.

A comprehensive literature review on biological principles guiding present research lines of Periodontal Therapy has been carried out, focusing mainly on the repair potential of the periodontal tissues.

[Periodontal osseous surgery: osteoplasty and osteotomy]. / Chirurgia ossea parodontale: osteoplastica e osteotomia.

Elimination of the periodontal pocket is a prime objective of periodontal therapy. Normally the gingiva is consistent with the underlying bone, and aberration in gingival form can be corrected by gingivectomy or gingivoplasty if the gingiva is supported by good bony architecture. If periodontitis has caused marginal irregularities or septal deformities the complete elimination of the periodontal pocket is done by osteoplasty or osteoectomy. The Authors through a review of the literature have examined these surgical techniques.