Clinical evaluation of autologous platelet-rich fibrin in the treatment of multiple adjacent gingival recession defects: a 12-month study.

Leukocyte- and platelet-rich fibrin (L-PRF) belongs to a new generation of platelet concentrates. There are limited numbers of studies focused on the use of L-PRF in gingival recession defects. This study evaluated the safety and effectiveness of using L-PRF membranes as a substitute for free connective tissue grafts (CTGs) as a treatment method for gingival recession defects. A total of 44 Miller Class I/II gingival recessions that were bilateral, adjacent, and greater than 3 mm in size were selected. Each recession site was randomly assigned to the test group (L-PRF) or the control group (CTG). After 12 months, root coverage was 76.63% and 77.36% in the L-PRF and CTG groups, respectively. It is suggested that L-PRF membrane may be an alternative graft material for treating multiple adjacent recessions greater than 3 mm in size without a requirement for additional surgery.

An earplug technique to reduce the gag reflex during dental procedures.

BACKGROUND: The gag reflex is a frequent problem occurring during dental treatment procedures, especially while making impressions of the maxillary teeth. The present study aims to evaluate the efficacy of a simple earplug as an external auditory canal stimulator to supress the profound gag reflex and as a second step, to map areas of the oropharynx suppressed by this technique. METHODS: In the first step of the study, 90 patients who had a gag reflex during the impression procedure were allocated to a study group, a sham group, and a control group for evaluating the efficacy of the earplug technique. Second, 20 new patients with a gag reflex were included in order to map the oropharnygeal areas suppressed by this technique. RESULTS: The severity of the gag reflex was reduced in the earplug group (but not in the sham or the control group). The affected area included the hard palate, uvula, and the tongue but not the posterior wall of oropharynx. CONCLUSION: An earplug technique can be a useful, practical, and effective tool to overcome the gag reflex during oral procedures, such as impression procedures of maxillary teeth.

Scintigraphic, histologic, and histomorphometric analyses of bovine bone mineral and autogenous bone mixture in sinus floor augmentation: a randomized controlled trial--results after 4 months of healing.

PURPOSE: To test our null hypothesis stating that the mixture of autogenous cortical bone scrapings and bovine bone mineral (BBM) in a ratio of 1:4, compared with BBM alone, would have no significant effect on new bone formation 4 months after maxillary sinus floor augmentation. PATIENTS AND METHODS: Twenty-four patients presenting with alveolar bone height of less than 5 mm in the narrowest zone between the sinus floor and alveolar crest were randomly assigned to 2 treatment groups in this randomized controlled trial. We augmented 12 maxillary sinuses with a mixture of BBM and cortical autogenous bone graft, which was collected from the lateral wall of the maxillary sinus by a bone scraper, and 12 maxillary sinuses with BBM alone. Four months postoperatively, new bone formation in the augmented sinus sites was evaluated through bone scintigraphy, as well as histologic and histomorphometric analyses of the biopsy specimens obtained during implant placement. Data were statistically analyzed by independent-samples t test. RESULTS: Scintigraphically detectable new bone formation did not differ significantly between the groups (P > .05). Histologic findings showed that the new bone bridged between BBM particles and BBM underwent resorption by osteoclasts with or without the addition of autogenous bone graft. According to histomorphometric findings, the difference between the percentages of newly formed bone in the sinuses augmented with graft mixture (25.73%) and BBM alone (24.19%) was statistically nonsignificant (P > .05). CONCLUSIONS: The addition of autogenous cortical bone scrapings to BBM in a ratio of 1:4, compared with BBM alone, does not markedly increase new bone formation 4 months after maxillary sinus lifting.

Scintigraphic evaluation of osteoblastic activity in extraction sockets treated with platelet-rich fibrin.

PURPOSE: To evaluate the effect of platelet-rich fibrin (PRF) on the early bone healing process with bone scintigraphy based on technetium-99m methylene diphosphonate uptake in third molar extraction sockets. PATIENTS AND METHODS: Fourteen patients with bilaterally soft tissue impacted third mandibular molars were included in the study. The right and left impacted third molars were surgically extracted in the same session. PRF was randomly administered into one of the extraction sockets, whereas the contralateral sockets were left without treatment. Four weeks after surgery, scintigrams were obtained to evaluate scintigraphic differences between PRF-treated and non-PRF-treated sockets. After completion of the clinical study, PRF samples were evaluated by light and scanning electron microscopy. RESULTS: The average increase in technetium-99m methylene diphosphonate uptake as an indication of enhanced bone healing did not differ significantly between PRF-treated and non-PRF-treated sockets 4 weeks postoperatively (P > .05). Abundant fibrin and inflammatory cells were observed by light microscopic examination of PRF samples. Scanning electron microscopic analysis of PRF revealed the existence of platelet aggregates in a fibrin network and crystalline particles on the outer surface of PRF. CONCLUSIONS: PRF might not lead to enhanced bone healing in soft tissue impacted mandibular third molar extraction sockets 4 weeks after surgery. PRF exhibits the potential characteristics of an autologous fibrin matrix. However, whether the presence of crystal-like particles on the outer surface of PRF alters bone healing should be investigated further.

A preoperative appliance for a newborn with cleft palate.

Cleft palate is a commonly observed congenital maxillofacial defect. One of the most important problems with clefts is the interference with feeding. An affected infant cannot produce negative pressure in the oral cavity and therefore cannot move the bolus backward to the pharynx. To obtain better nutritional intake prior to surgical correction, a palatal lift obturator is recommended. In this clinical report, a modified technique of obturator fabrication is presented. The new method uses a piece of tulle, a flexible and durable material that is frequently used in theater attire. With the help of this material, the bulb part is connected to the plate as a labile piece, and this connection acts like a natural velopharyngeal extension. Additionally, because of the softer property of the silicone elastomer, the posterior pharyngeal wall is less irritated.

Scintigraphic evaluation of early osteoblastic activity in extraction sockets treated with platelet-rich plasma.

PURPOSE: The aim of this study was to investigate the early effect of platelet-rich plasma (PRP) on osteoblastic activity during the healing process of soft tissue impacted mandibular third molar extraction sockets by means of bone scintigraphy. PATIENTS AND METHODS: Twelve patients with bilaterally soft tissue impacted mandibular third molars were included in the study. The impacted right and left mandibular third molars were surgically extracted in the same session. PRP was administered randomly into the extraction sockets in the study (S) group whereas the extraction sockets in the control (C) group were left without PRP treatment. Scintigrams were obtained in the first and fourth weeks after surgery to evaluate the osteoblastic activity within extraction sockets in both groups. RESULTS: Scintigraphic findings of postoperative first and fourth weeks did not show significantly increased osteoblastic activity between S group and C group (P > .05). However, the osteoblastic activity in both groups significantly increased in postoperative week 4 in comparison to week 1 (P < .05). CONCLUSION: The application of PRP alone into soft tissue impacted mandibular third molar extraction sockets failed to increase the osteoblastic activity in postsurgical weeks 1 and 4 in comparison to non-PRP-treated sockets.