Minimally invasive treatment of gingival recession by vestibular incision subperiosteal tunnel access technique with collagen membrane and advanced platelet-rich fibrin: A 6-month comparative clinical study.

AIM: The study aimed to assess the minimally invasive Vestibular Incision Subperiosteal Tunnel Access (VISTA) technique for treatment of Millers Class I or Class II buccal gingival recession defects and to compare the effectiveness of a bioresorbable collagen membrane or advanced platelet rich fibrin (A-PRF). METHODS AND MATERIAL: 20 sites with Millers Class I or II gingival recession were recruited and allocated into 2 groups with 10 sites each. Group 1: VISTA with A-PRF, Group 2: VISTA with with bioresorbable collagen membrane (Healiguide)®. STANDARDIZED CLINICAL PARAMETERS: Plaque Index (PI), Gingival Index (GI), Clinical attachment level (CAL )Pocket Probing Depth (PPD) Recession Height (RH ) and width of keratinized gingiva (WKG) were measured at baseline 3 months and 6 months. RESULTS: Both groups showed significant improvement in clinical parameters. However reduction in recession height and mean root coverage percentage was greater in A-PRF group after 6 months. CONCLUSIONS: VISTA with both A-PRF and Healiguide showed good clinical outcomes but better results were obtained when A-PRF was used.

Comparison of canine retraction by conventional and corticotomy-facilitated methods: A split mouth clinical study.

OBJECTIVE: The purpose of this split-mouth single-centered, parallel-group, randomized clinical trial was to evaluate the efficiency of corticotomy-facilitated orthodontics in rapid canine retraction. METHODS: The sample consisted of 10 patients (15-25 years old) requiring extraction of the maxillary first premolars with subsequent canine retraction. The patients' right sides were randomly assigned to either the corticotomy (experimental) or control groups. Corticotomy cuts and perforations were performed and canine retraction was initiated bilaterally with closed-coil nickel-titanium springs that applied 150 g of force. The following variables were examined till the end of canine retraction on both sides: Rate of canine retraction, canine root resorption, and patient perception of the procedure. The rate of canine retraction was assessed every month using study models while root resorption was evaluated using CBCT. Patient`s perception was evaluated using a 100 mm VAS. RESULT: Mean time taken for full completion of canine retraction: 5.7 months (test) and 7.1 months (control). Mean root resorption: 0.53 ± 0.10 (control) and 0.24 mm ± 0.10 (test). Mean VAS scores: 16 ± 3.94 (24 hours) and 2 ± 2.58 (1 week) at control side and 46.50 ± 6.69 (24 hours) and 2 ± 2.58 (1 week) at test. CONCLUSION: There was an overall reduction in the time taken for canine retraction with corticotomy; however, an increase in the rate of canine retraction in the corticotomy-facilitated method was evident only for the first four months, compared to the conventional method. Less root resorption was observed in corticotomy-facilitated method than conventional method. Pain perception was more for corticotomy-facilitated method than conventional method at 24 hours, but similar after one week.

Comparative evaluation of efficacy of subepithelial connective tissue graft versus platelet-rich fibrin membrane in surgical reconstruction of interdental papillae using Han and Takie technique: A randomized controlled clinical trial.

BACKGROUND: Platelet-rich fibrin (PRF) has emerged as one of the promising regenerative materials in the field of periodontics. Hence, this study evaluated the efficacy of subepithelial connective tissue graft (SCTG) and PRF in surgical reconstruction of interdental papillae using Han and Takei technique. MATERIALS AND METHODS: A total of 20 sites with Class I and Class II interdental papilla defects were assigned to two groups (Group 1 - Han and Takie technique + SCTG and Group 2 - Han and Takie technique + PRF). Parameters such as papillary height (PH), distance from the contact point to the tip of papillae (CPTP), papilla presence index (PPI), pocket probing depth (PPD), relative clinical attachment level (RCAL), plaque index (PI), gingival index (GI), and distance from contact point to alveolar crest (CP-BC) were measured at baseline and after 3 months. The significance of difference within and between the groups was evaluated with paired and unpaired t-tests. RESULTS: The mean PI, GI, PPD, RCAL, PPI, and CPTP distance decreased significantly, whereas the mean PH increased significantly in Group 1 as well as in Group 2. After 3 months, mean reduction in CPTP distance and mean gain in PH were statistically significant in Group 1 as compared to Group 2. However, there was no significant difference in mean CPBC distance between baseline and 3 months in Group 1 as well as in Group 2. CONCLUSION: Both the techniques were effective in the treatment of papillary recession defects; however, more significant clinical papillary enhancement was achieved after the surgical reconstruction with SCTG.

Establishing an Association between Renal Failure and Periodontal Health: A Cross Sectional Study.

UNLABELLED: Periodontal infections can act as focus of infection, aggravating the immunocompromised state of End Stage Renal Disease patients (ESRD). AIM: Evaluation of the periodontal health status of ESRD patients undergoing haemodialysis and establishing the underlying association between renal failure and periodontal disease. MATERIAL AND METHODS: Eighty control and test subjects were included in the study, after matching age and sex. Creatinine and GFR were measured in each patient. Oral hygiene index- Simplified (OHI-S), Gingival Index (GI), Pocket Depth (PD) and Clinical Attachment Level (CAL) were recorded as periodontal parameters to assess the correlation between the subjects of the two groups. Further, the test group was divided into three sub-groups, on basis of duration, as less than 6 months, from 6 months to one year and more than one year. STATISTICAL ANALYSIS: Student's t - test and ANOVA were used to analyze the inter-group and intragroup comparisons. RESULTS: Statistical significant difference was observed for all periodontal parameters between the test and control group. However, difference amongst periodontal parameters on basis of duration of haemodialysis was seen between the subgroups of test subjects, it was not found to be statistically significant. CONCLUSION: Severity of periodontal diseases in ESRD patients undergoing haemodialysis majorly affected due to debilitating condition of the subjects. Dialysis vintage has only a small role to play in worsening of the condition. Further research is needed to potentiate the establishment of two-way relationship between renal disease and periodontal condition.

Clinical efficacy of subgingivally delivered 0.5% controlled release azithromycin gel in the management of chronic periodontitis.

BACKGROUND: Recent developments suggest that the local delivery of antimicrobials into periodontal pockets can improve periodontal health. Azithromycin (AZM) has a wide antimicrobial spectrum of action toward anaerobic bacteria as well as Gram-negative bacilli. It is effective against periodontal pathogens such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. Therefore, this study was undertaken to investigate the clinical effectiveness of AZM at 0.5% concentration in an indigenously prepared bioabsorbable controlled release gel as an adjunct to non-surgical mechanical therapy in the treatment of chronic periodontitis. MATERIALS AND METHODS: Thirty sites in patients with chronic periodontitis and probing depth (PD) 4-6 mm were categorized randomly into two treatment groups: Scaling and root planing (SRP) plus 0.5% AZM gel (group 1) and SRP only (group 2). Clinical evaluation was undertaken using the Gingival Index (GI) of Loe and Silness and plaque was assessed using the Turesky et al. modification of Quigley Hein Index at baseline and 21 days. Pocket PD and clinical attachment level (CAL) were also measured. STATISTICAL ANALYSIS: Results were expressed as mean±standard deviation and percentages and the data were analyzed using Statistical Package for Social Sciences (SPSS version 16.0, SPSS, Chicago, IL) software. RESULT: Both therapies resulted in significant improvements. Mean reduction in GI from baseline to 21 days was 1.20±0.41 and 0.73±0.45 in group 1 and group 2, respectively. Plaque Index also improved through the study period in both groups, i.e., 0.86±0.51 in group 1 and 1.6±0.97 in group 2. Mean PD reduced significantly with SRP plus AZM gel application in group 1, i.e., 2.1±0.91 mm as compared to 1.0±1.06 mm achieved with SRP alone. A significant gain in mean CAL gain was observed in the test group (1.8±0.63 mm) as compared to control group (1.0±1.06 mm). CONCLUSION: Although both treatment strategies seem to benefit patients, the adjunctive use of 0.5% of AZM showed significant results.