Treatment of Human Intraosseous Periodontal Defects Using Recombinant Human Bone Morphogenetic Protein-2: A Randomized Controlled Clinical Trial.

Aim The purpose of this research was to assess the clinical and radiographic outcomes of recombinant human bone morphogenetic protein-2 (rhBMP-2) for the treatment of intraosseous abnormalities after periodontal flap surgery. Material and methods Patients aged 35-55 years who had undergone periodontal treatment at Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, and had a total of 14 intraosseous abnormalities were included in the research. Those in the control group had open flap debridement with alloplast, whereas those in the experimental group underwent the same procedure with the addition of rhBMP-2. Clinical indicators, such as plaque index (PI), gingival index, probing pocket depth (PPD), clinical attachment level, and radiographic defect fill, were collected at baseline at three months, six months, and nine months. Results The findings demonstrated that following periodontal treatment, both sets of patients had considerable improvements in their PI, gingival index, and PPD. The degree of relative connection improved significantly in both groups. When comparing the two groups radiographically, we saw that the test group had significantly better defect fill than the control group. Conclusion According to this research, there was a statistically significant decrease in PI, gingival index, PPD, clinical attachment level, and radiographic bone fill in patients who received rhBMP-2. Open flap debridement with rhBMP-2 and alloplastic bone grafts showed better reduction than open flap debridement with alloplastic bone grafts group in the radiographic defect fill.

Gingival Augmentation in the Thin Phenotype Using Injectable Platelet-Rich Fibrin and Microneedling.

Objective This study set out to examine the results of microneedling (MN) with and without injectable platelet-rich fibrin (i-PRF) in treating individuals with thin periodontal phenotypes, specifically focusing on the effects on gingival thickness (GT) and keratinized tissue width (KTW). Materials and methods This was a split-mouth study involving 32 healthy patients with 64 sites having thin phenotypes classified into two groups. On the one side, i-PRF was injected (Group A), while on the other side (Group B), MN along with i-PRF was used at intervals of 10 days for a month. GT and KTW were measured at baseline, three months, and six months. The parameters were compared intra and intergroup-wise at baseline, three months, and six months using the IBM SPSS Statistics software version 24 (IBM Corp., Armonk, NY) and the chi-square test. Results The findings revealed that when comparing Group A, which received just i-PRF, to Group B, which had i-PRF in conjunction with MN, there was a statistically significant increase in GT in Group B. Conclusions This is a novel method in that it does not need surgical innervations to expand the gingiva in breadth or thickness. Although MN's neoangiogenesis impact contributed to thicker gingiva, i-PRF showed a greater capacity for the release of several growth factors.

Comparative evaluation of coronally advanced flap with and without Biomesh® membrane for the treatment of localized gingival recession defects - a clinical study.

Numerous surgical procedures are used to correct gingival recession, like free gingival graft, pedicle graft, and connective tissue graft. Our study aimed to compare and clinically evaluate root coverage using a coronally advanced flap (CAF) with and without Biomesh® membrane to treat recession type 1 (RT1) and type 2 (RT2) defects. A total of 20 systemically stable patients, both males and females between the ages of 20 and 40, with bilateral recession defects in maxillary canines and premolars, were included in the study. Patients were divided into two groups: the control group: coronally advanced flap only and the test group: coronally advanced flap with Biomesh® membrane. All clinical parameters showed significant reductions from baseline, 1 month, 3 months, and 6 months post-surgery. Gingival recession significantly reduced both in test and control groups with no intergroup difference. The exposed root was covered by 70% in the test group and 78% in the control group. Clinical attachment level, the width of keratinized tissue, recession height, and recession width was significantly increased in the case of coronally advanced flap alone with significant intragroup comparison. The results for both treatment techniques for recession coverage were compared. CAF displayed superior results than CAF along with Biomesh® membrane in terms of clinical attachment level, root coverage percentage, and attached gingiva width.

To compare the stability and crestal bone loss of implants placed using osseodensification and traditional drilling protocol: A clinicoradiographical study.

AIM: The present study was done to evaluate and compare the stability of the implant and the loss of crestal bone in the implants placed using OD drilling and traditional drilling technique. SETTING AND DESIGN: In vivo-comparative study. MATERIALS AND METHODS: A total of 20 implants were placed in the anterior maxilla, and the patients were divided into two groups. In Group I, the implants were placed using traditional drilling technique, and in Group II, implant placement was done using OD drilling technique. Primary stability was measured in both the groups at baseline (immediate postoperative), and at an interval of 6 months, while crestal bone levels were measured at baseline, 6, and 8 months. STATISTICAL ANALYSIS USED: The data obtained were subjected to unpaired t-test to make intergroup comparisons, while one-way ANOVA F-test was used to make intragroup comparisons. RESULTS: The primary stability of implant placed using OD drills was found to be slightly higher than implant placed with traditional drilling; however, there was no statistical significance (P > 0.05). When the data obtained for crestal bone levels were statistically analyzed, no significant difference between the two groups was obtained (P > 0.05). CONCLUSION: Within the limitations of this study following conclusions were drawn: there was no statistically significant difference in implant stability between the traditional drilling and OD drilling (P < 0.05). On comparison of crestal bone levels between OD and traditional drilling, no statistically significant difference was found between the two groups (P < 0.05).

Comparative Evaluation of Peri-implant Soft and Hard Tissue with and without Application of Bisphosphonate on Implant Surface and Osteotomy Site - A Clinico-radiographic, Cone-beam Computed Tomographic Study.

BACKGROUND: The requisites to long-term success of dental implant are good-quality bone and healthy gingiva. Long-term risk with regard to dental implant is crestal bone loss. The cause of this crestal bone loss is inflammation of surrounding soft tissue and bone. One of the techniques used to prevent crestal bone loss includes the use of biological mediators. Bisphosphonates are antiresorptive drugs that act on osteoclasts and maintain bone density and strength by inhibiting osteoclast activity. MATERIALS AND METHOD: 16 systemically healthy patients aged between 20 and 50 years desirous of replacing single missing posterior tooth with an adequate width and height of edentulous space included in the study. 8 patients were treated with application of bisphosphonate on implant surface and osteotomy site and 8 patients were treated only with implant therapy. RESULTS: Crestal bone level changes were observed both in the study and control group. At 12 months, bisphosphonate-treated group showed less amount of crestal bone loss than control group. CONCLUSION: Local application of bisphosphonate (sodium alendronate) application around the implant and osteotomy site shows reduction in the amount of crestal bone loss but it is not statistically significant when compared with control group.

Combined endodontic therapy and peri-radicular regenerative surgery in the treatment of dens invaginatus type III associated with apicomarginal defect.

Dens invaginatus (DI) is a dental developmental abnormality, probably resulting from an infolding of the dental papilla during tooth development. The following case report presents a case of Type III DI with apicomarginal defect and peri-radicular lesion, diagnosed with cone-beam computed tomography scan and treated with combined orthograde endodontic therapy and peri-radicular regenerative surgery. Follow-up examination at 2 years revealed uneventful healing and improvement in the status of the tooth-supporting structures.

Gore-tex(®) versus resolut adapt(®) GTR membranes with perioglas(®) in periodontal regeneration.

BACKGROUND: Successful reconstruction of periodontal tissues destroyed due to periodontitis has been an evasive goal for the periodontists. Several GTR materials and bone grafts have been tried with varied success rates. AIMS AND OBJECTIVES: The aim of the present study was to evaluate and compare the efficacy of non-resorbable (GoreTex(®)) and bioabsorbable (Resolut Adapt(®)) membranes in combination with bioactive glass (PerioGlas(®)) in the treatment of periodontal intrabony defects. MATERIALS AND METHODS: Ten chronic periodontitis patients having bilateral matched intrabony defects were treated with non-resorbable membrane (GoreTex(®)) and bioactive glass or the bioresorbable membrane (Resolut Adapt(®)) and bioactive glass in split mouth design. Clinical parameters like plaque index, gingival index, probing pocket depth, clinical attachment level, and gingival recession were recorded at baseline and 9 months post-operatively. Similarly, radiographic (linear CADIA) and intra-surgical (re-entry) measurements were evaluated at baseline and 9 months post-operatively). RESULTS: Both the membrane groups showed clinically and statistically significant improvement in clinical parameters i.e., reduction in probing depth (4.6 ± 1.4 mm) vs. 3.7 ± 1.3 mm) and gain in clinical attachment level (4.6 + 1.6 vs. 3.2 ± 1.5 mm) for non-resorbable and bioresorbable membrane groups, respectively. Similar trend was observed when radiographical and intra-surgical (re-entry) measurements were evaluated and compared, pre- and post-operatively at 9 months. However, on comparison between the two groups, the difference was statistically not significant. CONCLUSION: Both the barrier membranes i.e., non-resorbable (Gore-Tex(®)) and bioabsorbable (Resolut Adapt(®)) membranes in combination with bioactive glass (PerioGlas(®)) were equally effective in enhancing the periodontal regeneration.