Effectiveness of the adjunctive use of ozone and chlorhexidine in patients with chronic periodontitis.

BACKGROUND: Scaling and root planning (SRP) is the gold standard approach for treatment of chronic periodontitis but used alone it may not be effective in removing periodontal pathogens from sites where access is poor. OBJECTIVE: To evaluate and compare the clinical and microbiological efficacy of ozone and chlorhexidine (CHX) as an adjunct to SRP in patients with chronic periodontitis. METHODS: Twenty-five patients with generalized moderate to severe chronic periodontitis with presence of at least one site in each quadrant with a probing depth ≥5 mm were recruited. In a split mouth study design, two quadrants were randomly allocated to the SRP and ozone therapy and the remaining two quadrants to SRP and CHX therapy. Plaque index (PI), Gingival index (GI), probing depth (PD), clinical attachment loss (CAL) were assessed. Subgingival plaque samples were obtained for assessment of Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg). RESULTS: Both groups demonstrated significant intragroup reduction in PI, GI, PD, CAL, Pg count and Aa count from baseline to 3 months follow-up. There were no significant differences between two groups for any of the parameters. CONCLUSION: Ozonated olive oil can be used as an adjunctive subgingival irrigant in patients with chronic periodontitis.

Effectiveness of Adjunctive Use of Low-Level Laser Therapy and Photodynamic Therapy After Scaling and Root Planing in Patients with Chronic Periodontitis.

The aim of this split-mouth, randomized controlled clinical trial was to evaluate the efficacy of low-level laser therapy (LLLT) and photodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) in treatment of chronic periodontitis. Each quadrant was categorized into control group (SRP alone; two quadrants per patient), test group 1 (SRP + PDT), and test group 2 (SRP + LLLT. The test groups showed significantly higher reductions in Gingival Index, probing depth, and clinical attachment level as well as reductions in Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans counts at 1-, 3-, 6-, and 9-month follow-ups when compared with the control group.

Lip Repositioning with Vestibular Shallowing Technique for Treatment of Excessive Gingival Display with Various Etiologies.

Improvement of smile esthetics is a major goal of modern dentistry. Various treatment modalities have been proposed to correct excessive gingival display (EGD), depending on the identified etiologies. This study reports on the clinical and patient-centered outcomes of a novel lip repositioning technique with vestibular shallowing approach in the treatment of three types of EGD with varying etiologies. Periosteal fenestration with cicatrization (scarification) was performed at the mucogingival junction to ensure the stability of esthetic outcomes. Suspensory triangular sutures and extraoral tissue stabilization tapes were used to facilitate the cicatrization process during the healing phase of this novel technique. Postoperative clinical examination revealed 84% reduction in gingival display that remained stable for 13 to 16 months with a high level of patient satisfaction.

Periodontal Regenerative Treatment of Intrabony Defects in the Esthetic Zone Using Modified Vestibular Incision Subperiosteal Tunnel Access (M-VISTA).

Periodontal regenerative treatment of intrabony defects in the esthetic zone often poses a significant challenge to clinicians. Various materials and techniques have been proposed to achieve periodontal regeneration. This article presents modified vestibular incision subperiosteal tunnel access (M-VISTA) for treatment of intrabony defects in the esthetic zone. Two cases were treated using the proposed approach with enamel matrix derivatives and demineralized freeze-dried bone allograft to optimize the regenerative outcomes without affecting the soft tissue profile in the esthetic zone. Two different indications were described with addition of acellular dermal matrix and specific suturing techniques based on each particular clinical scenario. Clinical and radiographic follow-up of 18 months revealed successful outcomes of the proposed minimally invasive approach with no postoperative gingival recession. Patient-centered outcomes were highlighted as another major consideration in periodontal regeneration.

A New Prognostication System for Dental Implants.

Given the popularity of dental implants, determining their prognosis is an integral component of dental practice. An accurate prognosis is crucial to development of an appropriate treatment plan and may require alterations as overall status or the status of implants or natural teeth change. The importance of an established set of factors for determining implant prognosis would be highlighted in dentist-patient communication and in interdisciplinary collaboration. The main objective of the proposed prognostication system is short- and long-term success of dental implants. The aim of this study was to review evidence-based prognostic factors including surgical, peri-implant, prosthetic, and overall considerations in implant dentistry and to propose a new prognostication system. A blind survey was taken by 67 prosthodontists, periodontists, and oral surgeons at three dental schools to assess the importance of each consideration based on clinical experience and available evidence. The results supported incorporation of the comprehensive review of evidence-based prognostic factors into the proposed dynamic system for dental implant prognostication.

Socket preservation procedure with equine bone mineral: a case series.

Conventional dentoalveolar osseous augmentation procedures for creating bone volume for dental implant placement often involve the use of grafting materials with or without barrier membranes to foster selective cell and tissue repopulation. A study was conducted to determine the efficacy of equine particulate bone (Equimatrix, Osteohealth) to augment the creation of new bone and preserve the volume of bone at extraction sites for the purpose of placing an implant in an optimal position for restoration. Clinical and histologic evidence supported the suitability of equine particulate bone for extraction site augmentation that allowed dental implant placement after a 6-month healing period.