Clinical effectiveness of subgingival irrigation with a pulsated jet irrigator versus syringe.

Previous studies have shown clinical and microbiological improvement with subgingival irrigation particularly after scaling and root planing. In this study we monitored the effects of saline irrigation on non-treated periodontal pockets. Ten subjects with severe periodontal disease and symmetrical lesions on multirooted teeth were selected. They had not received periodontal treatment or antibiotics for the previous 6 months. Patients were given simplified oral hygiene instructions. Neither scaling nor root planing was provided during the study. Two teeth were randomly selected per quadrant for subgingival irrigation with saline solution. One side was treated with a syringe and the other side with a pulsated jet irrigator with a modified tip, professionally administered. Clinical parameters (pocket depth, plaque index, gingival index, crevicular fluid, bleeding index, attachment level, and subgingival microflora) were evaluated on days 0, 15, 30, 60, and 90. Both subgingival irrigation products induced changes (reductions) in these indices during the study. Significant differences (P less than 0.001) with the oral irrigator were found for the following parameters: microscopy, pocket depth, crevicular fluid, and plaque index. In this study, professionally administered saline irrigation with a pulsated jet irrigator was more effective than syringe treatment with the same solution. Neither treatment resulted in a detectable gain in probing attachment level. Since gain in attachment level is achievable by other techniques, neither of these subgingival irrigation procedures alone can be considered adequate for periodontal therapy.

[Biological glues and biomaterials in periodontal surgery. Description of a surgical reattachment technic]. / De l'interet des colles biologiques et des biomateriaux en chirurgie parodontale. Description d'une technique chirurgicale régénératrice.

A major research problem over the past 10 years is to obtain a new attachment after treatment of roots previously exposed to periodontal disease. Among the most recent studies, two main objectives of surgery are suggested: a selection of cell population and to arrest epithelial migration by guided tissue regeneration with a membrane, and a biological and chemical root preparation with citric acid and fibronectin. A technique for the treatment of deep osseous lesion is put forward here: the association of biodegradable membrane--natural coral--citric acid and fibronectin.

[Endosteal stimulation in implantology. Study and results after 2 years]. / La stimulation endostée en implantologie. Etude et résultats après 2 ans.

Analysis of implant failure in the maxilla has showed that these failures were predominant on bone that had remained toothless for a period exceeding 2 years. Histological and osseostructural studies demonstrate that the loss of maxillary teeth has an essential effect on its vascularisation, more than on the bone loss; this vascularisation is absolutely necessary in order to obtain an adequate and lasting osseointegration. When, after surgical preparation of the receiver bony site, no bleeding is noted, insertion of the implant is postponed. Six weeks later, the new socket is curetted and the scar tissue removed; this showed that, systematically, the vascularisation was markedly increased. Results at 2 years of this "endostal stimulation", applied to Brånemark and I.M.Z. implants, are: 95.5% success in the maxilla, compared to 83% with osseointegration during the same period. This technique may be applied in the posterior mandibular area, when there is a marked resorption and the short implant is only inserted in cortical bone, minimally vascularized, because of the presence of the mandibular canal; the results of this latter technique are actually poor.