Description of the periodontal pocket in preclinical models: limitations and considerations.

Establishment of periodontal health and regeneration of the lost periodontal tissues are always the ultimate goal of periodontal treatment. The development of new therapeutic approaches raises the necessity for appropriate experimental models that present periodontal structures and healing capability comparable to humans. Preclinical research and extrapolation of the data to human conditions remains a stage of great importance before the clinical application of the new biomaterials and techniques. Periodontal pockets/defects in preclinical models can be induced experimentally through acute or chronic or a combination of both (induced) modalities. The features of the created defects and those of humans vary greatly mostly due to the nature of the periodontal disease. This is an important point to take into account, since it is well recognized that the potential of periodontal therapy may be dependent on both the biological background and the defect morphology. This review provides insight into the commonly used preclinical models for the reproduction of the periodontal pocket and discusses the advantages and disadvantages of each model in terms of similarity to human conditions, standardization and reproducibility.

Non-surgical treatment of gingival overgrowth induced by nifedipine: a case report on an elderly patient.

Drug-induced gingival overgrowth (DIGO) is a significant problem for periodontologists and this side effect is frequently associated with three particular drugs: phenytoin, cyclosporin A and nifedipine. A case report of gingival overgrowth induced by nifedipine in an elderly patient treated with non-surgical periodontal therapy is described. A 75-year-old male with generalised gingival overgrowth reported the problem of oral malodour and significant gingival bleeding. The medical history revealed a controlled hypertensive state and Cerebral Vascular Accident (CVA) 3 years prior to consultation. The diagnosis was gingival overgrowth associated with nifedipine, no other risk factors being identified. The patient had been taking nifedipine for 18 months, but after the consultation with the patient's doctor, nifedipine was suspended, as the hypertension was controlled. Treatment consisted of meticulous oral hygiene instruction, scaling, root surface instrumentation and prophylaxis. Six months after the first intervention, clinical parameters revealed a significant improvement with a considerable reduction in gingival overgrowth, demonstrating the effect of non-surgical periodontal therapy in severe cases of gingival overgrowth. Non-surgical treatment of DIGO is a far less invasive technique than surgical approaches and has demonstrated an impressively positive treatment response. It should therefore be considered as a first treatment option for DIGO.