Periosteum for Root Coverage in an Isolated Gingival Recession as an Autogenous Graft: A Case Report.

In periodontal care, where patient results are crucial in guiding the development of surgical techniques, gingival recession management is a critical issue. The periosteum eversion technique (PET) emerges as a modern strategy that leverages the intrinsic regenerative capabilities of the periosteum to attain root coverage. A detailed case study showcases the effectiveness of PET in managing a Miller Class I gingival recession alongside an adjunctive platelet-rich fibrin (PRF) procedure. This approach entailed the deliberate elevation and eversion of the periosteal flap to encompass the recession area, securing it meticulously through suturing. Across a six-month observation period, this method exhibited successful root coverage, augmentation of keratinized tissue, and enhanced patient comfort, as reported, with no significant complications observed. These outcomes provide support for the incorporation of PET into standard periodontal protocols, underscoring its capacity to reshape the treatment landscape for gingival recession.

Survival Rate of Immediate Implants in Periodontally Compromised Patients: A Systematic Review.

Background: Immediate implant placement into a fresh extraction socket has been developed as a consistent treatment, allowing for a reduction in the duration of time necessary for prosthetic rehabilitation. The study will evaluate the clinical and radiologic outcomes of implants placed immediately for a 10-year follow-up period. Aim: The aim of this systematic review is to evaluate the durability of the immediate implant in periodontally compromised individual placement. Methods: Studies reporting clinical and radiologic implant outcomes from periodontally compromised individuals who were treated and followed periodontal and implant maintenance for ≥5 years were considered eligible for the review. Screening of the articles, data extraction, and quality assessment were conducted independently and in duplicate. Results: There were 99 papers, and of them, 55 were excluded after title/abstract assessment. The full texts of 28 potentially eligible publications were screened, but only seven studies met the inclusion criteria. Conclusions: The study confirms that immediate implant therapy is safe, effective, and predictable for successful osseointegration and long-term functioning in periodontally compromised individuals, with minimal differences in clinical and radiographic outcomes.

Biphasic Calcium Phosphate in the Extraction Socket Preservation: A Systematic Review.

Introduction: Various studies have suggested use of socket grafting materials after dental extraction for socket preservation. However, there is no single material that has been accepted as standard for preserving the socket. The purpose of this systematic review was to analyze the evidence for the use of biphasic calcium phosphate for socket regeneration. Materials and Methods: The team conducted a systematic literature search in accordance with the protocol registered at PROSPERO. PubMed, OVID, and EMBASE databases were used in the search. The articles were then screened using RAYYAN open-source software for the synthesis of evidence. Results: Of the 240 articles found in the search, two studies could be included in the review. Conclusion: Biphasic calcium phosphate (60% hydroxyapatite, HA and 40% beta-tricalcium phosphate, ß-TCP) has a significant effect in the socket preservation and quality of bone regeneration.

The Unilateral Enigma: An Oral-contraceptive Related Gingival Enlargement.

This article's goal is to describe a case of oral contraceptives-related drug-induced gingival hypertrophy that was treated with nonsurgical and surgical periodontal therapy. The most prevalent negative side effect of systemic medicine on the periodontal tissues continues to be drug-induced gingival overgrowth. Specific regulatory molecules known as hormones control a variety of bodily processes. Gingival hypertrophies are sometimes linked to oral contraceptives that contain oestrogen and/or progesterone. A 32-year-old female presented with a complaint of swelling of the gingiva with spontaneous bleeding in the maxillary right quadrant region for a period of two months. The medical history documented the use of contraceptives for three months, and a clinical examination revealed the existence of poor oral hygiene and enlarged painful gingival tissues that bled when touched. Intraoral examination revealed that there was unilateral, generalized, diffuse gingival enlargement with pseudo pockets. Patient was diagnosed with gingival fibromatosis a based on the clinical, histological, and radiographic findings. The gingival enlargement was treated by conventional gingivectomy under local anaesthesia. The postoperative result was uneventful. Women who use oral contraceptives are a "risk group" for periodontal infections. On oral contraceptives, not every female reacts the same way. In periodontal therapy, plaque management is the most crucial step. Patient compliance is another element that affects a therapy's response. The patient demonstrated appropriate oral hygiene practices and adhered to home care guidelines adequately.

Porphyromonas levii - A Boon for Periodontists?

The majority of species previously categorized as Bacteroides have been reassigned into new genera. Bacteroides levii (Holdeman, Cato, and Mooretaxonomic)'s status has remained uncertain. This species shares a high degree of similarity with members of the genus Porphyromonas based on biochemical, chemical, and comparative 16s rRNA sequence analysis. As a result, Bacteroides levii (Holdeman, Cato, and Moore) was reclassified as Porphyromonas levii comb. now under the genus Porphyromonas.

Preserving Peri-Implant Soft Tissue Health: A Case Report on Immediate Implant Placement Using the Socket Shield Technique.

Alveolar bone resorption is a natural occurrence following tooth extraction, complicating the process of prosthetic rehabilitation with implants. Techniques such as socket preservation, atraumatic extraction, and immediate implant placement are employed to reduce the dimensional changes associated with extraction. The socket shield technique (SST) is effective in preserving the alveolar ridge's contour, enhancing the aesthetic results of rehabilitation by maintaining the integrity of the bundle bone complex even when the buccal bone is less than 1mm.  This case report presents a 23-year-old female patient with a fractured upper central incisor. The socket shield technique was chosen based on the clinical findings from the cone beam computed tomography (CBCT) scan. Immediate temporization was provided to preserve soft tissue integration. A comparison of the initial and subsequent cone beam computed tomography (CBCT) scans, along with clinical observations, suggests that the socket shield technique is a viable method for preserving both hard and soft tissue structures in the anterior dental region, thereby improving aesthetic outcomes.

Conventional Versus Osseodensification Drilling in the Narrow Alveolar Ridge: A Prospective Randomized Controlled Trial.

Background Conventionally, undersized osteotomies were used to increase initial bone-to-implant contact to achieve primary stability in implantology. This is particularly evident in regions with low bone density. The potential for severe bone compression and ischemia poses a challenge to secondary stability. Instead, lateral bone compaction is caused by the idea of osseodensification. Research on the potential benefits of this method for narrow ridges is lacking. This study aimed to determine if the osseodensification drilling technique affects primary stability and how much the alveolar ridge expands following implant site preparation. Methodology A total of 30 participants aged 20 to 80 years were included in this randomized controlled clinical investigation. Each participant was randomly assigned to one of the following two groups: one that received standard drill preparation, and another that received osseodensification drill preparation. Implant stability using implant stability quotient values, crest width, apical width (5 mm from crest), and bone density were assessed both before and after six months using cone-beam computed tomography. Results Osseodensification impacted the width at the apex (5 mm from the crest) and radiographic bone density, adding to the quality, but did not affect implant stability and crestal width after osseointegration. The mean difference in conventional and osseodensification groups was 0.46 and 0.68 mm, respectively, concerning the crestal width. Moreover, the mean difference was 0.74 and 0.58 mm for conventional and osseodensification groups, respectively, concerning the width at the apex (5 mm from the crest). Conclusions This study demonstrates that the osseodensification process increased both the radiographic bone density and the width at the apex, demonstrating that osseodensification drilling techniques allow for the placement of implants with larger diameters in narrow alveolar ridges.

Salivary Interleukin-6 - A pioneering marker for correlating diabetes and chronic periodontitis: A comparative study.

BACKGROUND: Periodontitis is a chronic inflammatory disease which is multifactorial. Diabetes mellitus (DM) is one of the major systemic factors to influence the severity of chronic periodontitis. Numerous inflammatory markers are produced in the course of the disease which is secreted in saliva too. This study evaluates the salivary concentrations of interleukin-6 (IL-6) in periodontitis patients with type 2 diabetes. MATERIALS AND METHODS: Whole saliva samples were collected from eighty patients who were further divided into four groups; healthy (control group; n = 20), untreated periodontitis (UPD; n = 20), DM (DM; n = 20), and UPD + DM (n = 20 groups). Salivary IL-6 concentrations were determined by standard enzyme-linked immunosorbent assay. RESULTS: Results show that the UPD patients with and without DM exhibited higher concentrations of salivary IL-6 than the control group and diabetes groups. Further, the salivary IL-6 was correlated with glycosylated hemoglobin A levels in patients with diabetes. CONCLUSION: Concentration of salivary IL-6 was elevated in patients with periodontitis with and without diabetes. Thus, salivary IL-6 levels can be considered as an important biomarker in the diagnosis of periodontitis and diabetes.

Angiotensin II Levels in Gingival Tissues from Healthy Individuals, Patients with Nifedipine Induced Gingival Overgrowth and Non Responders on Nifedipine.

CONTEXT: The Renin Angiotensin system has been implicated in the pathogenesis of Drug Induced Gingival Overgrowth (DIGO), a fibrotic condition, caused by Phenytoin, Nifedipine and Cyclosporine. AIM: This study quantified Angiotensin II levels in gingival tissue samples obtained from healthy individuals, patients on Nifedipine manifesting/not manifesting drug induced gingival overgrowth. MATERIALS AND METHODS: Gingival tissue samples were obtained from healthy individuals (n=24), patients on nifidipine manifesting gingival overgrowth (n= 18) and patients on nifidipine not manifesting gingival overgrowth (n=8). Angiotensin II levels were estimated in the samples using a commercially available ELISA kit. RESULTS: Angiotensin II levels were significantly elevated in patients on Nifedipine manifesting gingival overgrowth compared to the other 2 groups (p<0.01). CONCLUSION: The results of the study give an insight into the role played by Angiotensin II in the pathogenesis of drug induced gingival overgrowth.

A pilot study of mini implants as a treatment option for prosthetic rehabilitation of ridges with sub-optimal bone volume.

INTRODUCTION: Implants are the latest development in the field of prothodontics, but still not widely used because of its expensive and its lengthier duration. Patients with ideal bone quantity and quality accommodate the conventional implants. The selection of the width of the implants has been widely speculated and the manufacturers have recently launched a series of 'mini' implants of narrower diameter. The long-term success rate of these narrow diameter implants, needs to be assessed. STUDY: This 2 year retrospective study summarizes the recorded observations from 11 patients who received 2.4 mm diameter implants for single tooth restorations. RESULTS: One implant failed 10 months after loading. The success rate was 90.9%. The clinical evaluation of the peri implant mucosa using periodontal indices gave satisfying results for the implant-mucosa interfaces. CONCLUSION: The success rate of the mini implants of 90.9%, is encouraging and hence studies involving larger number patients can be undertaken to study the efficacy of this novel treatment plan.

Placement of endosseous implant in infected alveolar socket with large fenestration defect: A comparative case report.

Placement of endosseous implants into infected bone is often deferred or avoided due to fear of failure. However, with the development of guided bone regeneration [GBR], some implantologists have reported successful implant placement in infected sockets, even those with fenestration defects. We had the opportunity to compare the osseointegration of an immediate implant placed in an infected site associated with a large buccal fenestration created by the removal of a root stump with that of a delayed implant placed 5 years after extraction. Both implants were placed in the same patient, in the same dental quadrant by the same implantologist. GBR was used with the fenestration defect being filled with demineralized bone graft* and covered with collagen membrane**. Both implants were osseointegrated and functional when followed up after 12 months.