Clinical efficacy of subepithelial connective tissue graft and A-PRF in the treatment of gingival recession.

OBJECTIVE: The current study was designed to clinically compare and evaluate subepithelial connective tissue graft (SCTG) and advanced platelet-rich fibrin (A-PRF) membrane-based root coverage in the treatment of gingival recession type 1 (RT1). METHOD AND MATERIALS: The current study involved 17 patients with bilateral gingival recession (RT1). Thirty-four sites were randomly allocated to test (A-PRF) and control (SCTG) sites and all the procedures were performed by a single operator. A single blinded observer evaluated the test and control sites at baseline, 3 months, and 6 months. The clinical parameters such as recession depth, recession width, width of keratinized gingiva, clinical attachment level, and percentage of root coverage were recorded. P < .05 was considered statistically significant. RESULTS: The mean recession depth at baseline for control and test groups was 3.06 ± 0.56 mm and 2.35 ± 0.49 mm, respectively (P < .001). At the end of the study period, the mean recession depth was 0.53 ± 0.62 mm in the control group and 1.12 ± 0.49 mm in the test group (P < .05). No complications were associated with both the groups. The mean percentage of root coverage was 84.31 ± 17.89% in the control group and 51.96 ± 15.45% in the test group (P < .001). CONCLUSION: In conclusion, the study results suggest that both SCTG and A-PRF can be used in treating gingival recessions. However, SCTG is a better material in achieving root coverage and increasing keratinized tissue width. (Quintessence Int 2023;54:134-141; doi: 10.3290/j.qi.b3512389).

Autologous platelet-rich fibrin as an adjunct to non-surgical periodontal therapy-A follow up clinical pilot study.

The aim was to evaluate the effectiveness of autologous platelet-rich fibrin (PRF) as an adjunct to scaling and root planing (SRP) in moderate periodontal pockets. The split-mouth study involved 32 sites from 16 patients. Baseline parameters were recorded followed by complete full-mouth SRP. The test and control sites were randomly selected and autologous PRF was placed in the test site and other site served as control. The blinded examiner recorded clinical parameters at baseline, 60 days, and 90 days. No statistical significance was found at baseline in probing depth (PD) and clinical attachment level (CAL). Statistically, significant improvement was observed within test and control groups at 90 days compared to baseline values. A statistically significant difference in test sites was found in terms of reduction in PD and clinical attachment gain (CAG) compared to the control sites at the end of the study period (p value <0.05). This split-mouth pilot study emphasized a statistically significant improvement in pocket depth reduction and CAL gain when PRF was used as an adjunct to SRP in moderate periodontal pockets.

Gingival biotype as an indicator for the buccal bone thickness - a systematic review of the literature.

Introduction A relationship between thin gingiva and thin buccal bone has been proposed but concrete evidence for this is lacking. This study was undertaken to assess the reliability of measuring gingival thickness in estimating the buccal bone thickness.Objectives To answer the following PICO question: do periodontally healthy individuals exhibit any correlation between gingival biotype and buccal/labial/facial bone thickness?Data sources and selection An electronic search was performed in PubMed and Embase databases. English language articles that have met the inclusion and exclusion criteria were selected. Only observational studies were considered. Since the studies have demonstrated heterogeneity, conducting a meta-analysis was not possible, so the results were synthesised using a vote counting method and narrative synthesis.Data synthesis After screening the titles and abstracts, 13 studies which met the study criteria were included in the systematic review. Out of these 13 studies, nine studies assessed only the maxillary anterior/premolars; one study assessed the mandibular anterior, and three studies assessed both maxillary and mandibular anterior/premolars.Conclusions The findings of this systematic review indicated that the gingival biotype may be a reliable indicator for estimating the thickness of buccal bone in maxillary anterior. However, its relation to the buccal bone thickness in mandible is unclear.

Interproximal Papilla Volumization Using Vestibular Incision Subperiosteal Tunneling Access Technique in Esthetic Rehabilitation.

An accurate diagnostic and interdisciplinary approach is essential for obtaining suitable, conservative, and predictable results in areas with high esthetic demand. Patients reporting with an improper prosthesis that has a black triangle pose a challenge for soft-tissue esthetic rehabilitation. Re-restoration of such cases with conventional fixed prosthesis would be undesirable due to imbalance in pink and white esthetics. This case report describes an interdisciplinary approach to maintain the existing midline diastema and correction of black triangle in the interproximal area between abutment and pontic in the esthetic zone. Minimally invasive vestibular incision subperiosteal tunneling access technique with connective tissue graft was planned for reconstructing the interdental papilla, followed by prosthetic rehabilitation of edentulous site with fixed partial denture using loop connector design to maintain the midline diastema. Postoperative result showed a comprehensive, pink and white rehabilitation to meet the patient's esthetic demand.

Comparison of Endothelial Function in Healthy Patients and Patients With Chronic Periodontitis and Myocardial Infarction.

BACKGROUND: The inflammatory burden as a result of severe periodontal disease acts as an insult to the endothelium. This disruption in the function of the endothelium predisposes it toward formation of atherosclerotic plaque, which may be a subsequent risk for coronary artery disease. The aim of this study is to estimate and compare endothelial function via flow-mediated dilation (FMD) assessment in periodontal health and disease. METHODS: A total of 120 patients were selected and categorized equally into three groups: 1) healthy (control); 2) chronic periodontitis (CP); and 3) myocardial infarction (MI). Periodontal inflamed surface area (PISA) and FMD were assessed in all patients. Fasting blood samples were collected to estimate lipid profile. Analysis of variance was used for comparison of lipid profile, whereas Kruskal-Wallis test was used for comparison of FMD and PISA scores among the study groups with P <0.05. RESULTS: Comparison of FMD levels among the three groups showed statistically significant difference, with P <0.001. The value was statistically significant when the healthy group was compared with the CP and MI groups but not when the CP group was compared with the MI group. Lipid profile levels were statistically significant on comparison between the healthy and CP groups and between the CP and MI groups. CONCLUSION: Endothelial function was impaired in patients with CP compared with healthy patients, and the dysfunction observed was similar to that observed in the MI group based on FMD values.