Evaluation of the effect of subgingival placement of chlorhexidine chips as an adjunct to scaling and root planing.

BACKGROUND: The purpose of this 9-month study was to compare the effect of scaling and root planing alone (control) to that of scaling and root planing plus application of chlorhexidine chips (test). METHODS: Twenty-six subjects having two non-adjacent sites in non-molar teeth with probing depth > or =5 mm and bleeding on probing participated in this split-mouth trial. At baseline, the patients received full-mouth scaling and root planing followed by placement of chlorhexidine chips secured by cyanoacrylate at test sites and placement of cyanoacrylate alone at control sites. Test sites still > or =5 mm deep at 3 and 6 months were retreated with renewed chlorhexidine chip application. Recordings of bleeding on probing, probing depths, and clinical attachment levels were performed at baseline, after 6 weeks, and after 3, 6, and 9 months. RESULTS: Improvements of bleeding scores, probing depths and clinical attachment levels were observed for both test and control sites at 6 weeks compared to baseline. Subsequently, all three measurements remained comparatively stable throughout the study. No differences in improvements were found comparing test and control sites. CONCLUSION: This study failed to observe any adjunctive effect of subgingival placement of chlorhexidine chips after scaling and root planing.

Prevalence of interleukin 1 periodontal genotype in a Hispanic dental population.

OBJECTIVE: A genetic polymorphism in the interleukin 1 gene has been implicated as a factor in determining the severity of adult periodontitis. Among white Europeans, the prevalence of genotype-positive subjects has been reported to be around 30%. The purpose of this study was to assess the prevalence of genotype-positive individuals in a Hispanic population. METHOD AND MATERIALS: Fifty Mexicans were evaluated for their interleukin 1 genotype with a commercially available test. Subjects were divided into groups, as determined by their genotype (positive or negative), and were then analyzed according to age, sex, and smoking habits. RESULTS: Thirteen of 50 subjects were genotype positive, a prevalence of 26%. The most common polymorphisms found in genotype-positive subjects were allele 1.2 for the IL 1A gene and allele 1.2 for the IL 1B gene. When only subjects older than 30 years were evaluated, the prevalence of genotype-positive individuals was 31%. CONCLUSION: The prevalence of genotype-positive subjects in a Hispanic population was 26%, similar to the prevalence found among ethnic populations from or descended from Northern, Central, and Southern Europe.

Regeneration of soft and hard tissue periodontal defects.

Periodontitis is characterized by the formation of periodontal pockets and bone loss. Although the basic treatment emphasizes the control of bacterial plaque, the clinician is confronted with the need to correct soft and/or hard tissue defects that develop as a consequence of the disease. This article reviews the current status of regenerative approaches in treating soft and hard tissue defects (based mainly on findings from our own laboratory) and assessed the global applicability of these procedures. Many different techniques have been suggested to treat those defects with, in general, a high degree of success. From the present knowledge it can be concluded that periodontal soft and hard tissue regeneration is possible. Treatment of areas with localized gingival recession or insufficient keratinized gingiva can be achieved with soft tissue grafts or pedicle flaps, as well as with the use of dermal allografts. The treatment of hard tissue defects around teeth and implants can be approached using different types of bone grafts, guided tissue or bone regeneration, or a combination of these. The predictability of many of these therapies, however, still needs to be improved. Since most of these techniques are sensitive, specific, and expensive, their present universal application is limited.