Comparative Evaluation of Bioactive Glass (Putty) and Platelet Rich Fibrin in Treating Furcation Defects.

The aim of this study was to compare a second-generation bioactive glass putty biomaterial against platelet rich fibrin in treating grade II furcation defects. Subjects were 15 systemically healthy patients (10 males and 5 females, ages 20-50 with a mean age of 38.33) with 20 mandibular molar class II furcation defects according to Glickman's classification. The 20 mandibular molar furcation defects were randomly allocated as follows: Group I, 10 furcation defects were treated using bioactive glass (NovaBone) bone graft putty material; Group II, 10 furcation defects were treated using platelet rich fibrin (PRF). Customized acrylic stents were fabricated on study casts and trimmed to the height contour of the teeth to serve as a fixed reference point for measurements. The following measurements were collected: gingival index, plaque index, vertical probing depth (from gingival margin to base of the pocket), clinical attachment level (CEJ to the base of the pocket), and horizontal probing depth of furcation involvement (using stent). Results showed that both groups had improvement in gingival index (GI) and plaque index (PI) at the recall intervals. There was an overall reduction in both vertical and horizontal probing depth in both groups; however, the Putty group (Group I) showed consistently more vertical probing depth reduction than the PRF group (Group II) at the end of third month (P-value = 0.0004), sixth month (P-value = 0.00001), and ninth month (P-value = 0.0004). Our conclusion was that use of bioactive glass osteostimulative biomaterial yields superior clinical results, including increased pocket depth reduction of class II furcation defects as compared to an autologous platelet concentrate. The clinical significance of our findings include the ease of use and superior biologic performance of second-generation putty bioglass biomaterials in furcation defects.

Iatrogenic Damage to the Periodontium Caused by Radiation and Radiotherapy.

The radio-sensitivity of a tissue or organ is measured by its response to irradiation. Loss of moderate numbers of cells does not affect the function of most organs. However, with loss of large numbers of cells, all affected organisms display a clinical result. The severity of this change depends on the dosage and thus the extent of cell loss. Moderate doses to a localized area may lead to repairable damage. Comparable doses to a whole organism may result in death from damage to the most sensitive systems in the body.

Iatrogenic Factors Affecting the Periodontium: An Overview.

The principal reason of gingival inflammation is bacterial plaque, along with other predisposing factors. These predisposing factors are calculus, malocclusion, faulty restorations, complications associated with orthodontic therapy, self- inflicted injuries, use of tobacco & radiation therapy. The contributing factors to gingival inflammation & periodontal destruction are deficient dental restorations and prosthesis. Inadequate dental procedures that add to the weakening of the periodontal tissues are referred to as iatrogenic factors.

Iatrogenic Damage to the Periodontium by Chemicals and Dental Materials.

The toxicity and tissue reactions to dental materials are receiving more attention as a wide variety of materials are used and as federal agencies demonstrate more concern in this area. A further indication of the importance of the interaction of materials and tissues is the development of recommended standard practices and tests for the biological interaction of materials.

Iatrogenic Damage to the Periodontium Caused by Orthodontic Treatment Procedures: An Overview.

In orthodontic treatment, teeth are moved in to new positions and relationships and the soft tissue and underlying bone are altered to accommodate changes in esthetics and function. Function is more important than esthetics. The speciality of orthodontics has in addition to its benefits, complications as well as risks associated with its procedures. However the benefits outweigh the risks & complications in most of the treatment cases. Few of the unwanted side effects associated with treatment are tooth discolorations, enamel decalcification, periodontal complications like open gingival embrasures, root resorption, allergic reactions to nickel & chromium as well as treatment failure in the form of relapse.