Evaluation of the healing response following placement of Coe-pak and an experimental pack after periodontal flap surgery.

2 periodontal dressings, Coe-pak and RD8 (a product under development), were assessed following periodontal surgery, using a double-blind study of randomised split-mouth design, with each patient acting as their own control. Matched sites were selected for periodontal flap surgery under local analgesia. Sites were randomly allocated to each group. The dressings were applied by a single operator and both patients and clinical assessors were blind as to the dressing employed. The dressings were assessed as to their handling properties, in addition to a 7-day post-operative assessment of the surgical sites and a subjective patient report. Maximum pain levels were relatively low (4 in a scale 0-10); subjects reported more pain and analgesics required with RD8 than with Coe-pak. This was reflected in the results of the patient assessment which indicated that 50% preferred Coe-pak, compared to 25% who preferred the RD8 dressing. The results showed RD8 to be an acceptable periodontal dressing when compared to Coe-pak. There were no statistically significant differences between treated sites in both groups with regard to post-operative plaque scores, bleeding scores or tissue healing.

Evoluçäo do conhecimento em cicatrizaçäo periodontal / The development of knowledge on periodontal healing

Desde o conceito de Gottlieb e de Waerhaug até o presente, o conhecimento de cicatrizaçäo periodontal passou por várias fases que influenciaram diferentemente a terapia periodontal. Nesta revisäo, analisa-se a evoluçäo desse conhecimento, cuja dinâmica tem sido tal, que a própria Academia Americana de Periodontia, em 6 anos (1986/1992), redefiniu "nova inserçäo". O conhecimento inicial é descrito sob uma análise crítica das limitaçöes das medidas clínicas de avaliaçäo do potencial de cicatrizaçäo dos diferentes tecidos do periodonto, e introduz-se a atual mudança de perspectiva de dirigir a participaçäo desses tecidos

Apósito quirúrgico y clorhexidina en cirugía periodontal. Molestias postoperatorias / Surgical dressing and chlorhexidine in periodontal surgery. Postoperative discomfort

En 24 pacientes, 9 hombres y 15 mujeres, se practicaron intervenciones a colgajo de bisel reverso bilaterales, equiparadas en número y tipo de dientes y profundidad de las bolsas al sondaje. Previamente todos los pacientes recibieron instrucciones para mantener buena higiene bucal, detartraje, alisamiento radicular y equilibración de la oclusión. El sitio de intervención fue protegido por un apósito quirúrgico o se lo dejó sin protección, y esto se realizó en forma alternada en cada paciente, después de por lo menos un mes de la primera intervención. En todos los casos se prescribió enjuagatorios de clorhexidina 0,12 por ciento por un minuto, dos veces al día, por 7 días postoperatorios. Cada paciente llenó una ficha para anotar el dolor postoperatorio en una escala de 0 a 3, y un cuestionario para evaluar los efectos secundarios postoperatorios de los procedimientos quirúrgicos. En base al análisis de los resultados se concluye que cuando se ha practicado enjuagatorios postoperatorios con clorhexidina 0.12 por ciento parece no ser necesaria la utilización de un apósito quirúrgico en cuanto se refiere al dolor después de la cirugía periodontal empleando el colgajo de espesor total colocado apicalmente

Postoperative pain and discomfort with and without periodontal dressing in conjunction with 0.2% chlorhexidine mouthwash after apically positioned flap procedure.

The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of a periodontal dressing in combination with a 0.2% chlorhexidine mouthwash after internal bevelled, full thickness, apically positioned flap procedure. Twenty-four patients requiring comparable bilateral flap procedures were selected. Using a split-mouth design, one site received a periodontal dressing while the other site did not. A 0.2% chlorhexidine mouthwash (10 ml for 1 minute twice daily) was prescribed postoperatively for all patients. Pain assessment was made according to a structured, categorized scale (0 = no pain; 1 = mild pain; 2 = moderate pain; and 3 = severe pain). Analgesic drug consumption was recorded during the first postoperative week. After at least a one-month period, the second flap procedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered. Results indicated a similar trend for mean pain scores as assessed by patients for both dressed and undressed sides during the 7-day postoperative period. Statistical analysis revealed no significant differences between treatment groups with respect to frequency distribution of patients who did or did not take analgesics or the daily and total consumption of analgesic drops. Although patients with dressing frequently experienced eating difficulty, most stated a psychological feeling of protection and well-being with its use.

[The effect of nitazole preparations on the microflora in periodontitis]. / Vliianie preparatov nitazola na mikrofloru pri parodontite.

Twenty-three patients with generalized periodontitis were examined. Microbiologic examination of the periodontal pouch contents, making use of anaerobic cultivation, resulted in isolation and identification of 103 strains, 76 (72.8%) of which were referred to obligate anaerobes. Facultative anaerobes made up 27.2% of the total number of the isolates. Therapy with water-soluble nitasole resulted in reduction of the number of microorganisms, decrease or arrest of pus discharge from the pouch, resolution of the edema and gingival ridge hyperemia, etc. Diffusion of nitasole (water-soluble) and cliostom from various dressings used in periodontitis was studied and the efficacy of combining these dressings revealed.

Postoperative pain experience after gingivectomies using different combinations of local anaesthetic agents and periodontal dressings.

The present study examines postoperative pain experience following 243 gingivectomies in Norwegian patients using possible combinations of 3 local anaesthetics (lidocaine-adrenalin, prilocaine-felypressin or mepivacaine) and 3 periodontal dressings (Coe-pak, Wondrpak or Nobetec). When Coe-pak was used, the mean pain score was higher (P less than 0.05) in the group treated with lidocaine-adrenalin 4 to 6 h after gingivectomy than the groups treated with prilocaine-felypressin or mepivacaine. There was no significant difference between the groups treated with prilocaine-felypressin or mepivacaine. When Wondrpak or Nobetec were used, there was no significant difference between any of the local anaesthetics used. The present finding shows that the local anaesthetic combination of lidocaine-adrenalin (1:80,000) gives rise to a higher mean postoperative pain experience after gingivectomy than prilocaine-felypressin or mepivacaine. However, the relative difference in pain experience seen after gingivectomy when using the present local anaesthetic agents is masked when using an eugenol-containing periodontal dressing. Thus, the higher pain experience reported after lidocaine-adrenalin may only be clinically important when using periodontal dressings without local anaesthetic components such as eugenol.

Effect of non-eugenol- and eugenol-containing periodontal dressings on the incidence and severity of pain after periodontal soft tissue surgery.

This study examines the incidence and severity of postoperative pain after gingivectomy using one non-eugenol-containing periodontal dressing, Coe-pak (n = 76) and 2 eugenol-containing periodontal dressings, Wondrpak (n = 64) and Nobetec (n = 86). All patients were subjected to gingivectomy using 1 type of local anaesthesia (lidocaine + adrenalin) only and covering the surgical areas with either of the 3 different dressings in a randomized study. Postoperative pain was assessed on 100 mm visual analogue scales over 5 days starting immediately after surgery. No pain was reported by 22.0% of the patients after Coe-pak, 23.4% after Wondrpak and 30.2% after Nobetec. 13.2% of the patients took analgesics after Coe-pak treatment, 3.1% after Wondrpak and 1.2% after Nobetec. Mean pain score after Coe-pak was higher (P less than 0.05) than after Nobetec 2 h after operation until the morning on the 3rd postoperative day. Mean pain score after Coe-pak was higher (P less than 0.05) than after Wondrpak 3 h to 9 h after operation. No statistically significant difference was found between Wondrpak and Nobetec regarding mean pain score.

Electro-thermometric study on the healing of free gingival grafts covered by two different dressings.

The aim of the study was to evaluate the healing of the gingival grafts covered with Solcoseryl dental adhesive paste (Solco Basel AG) in comparison with the grafts covered with Peripac. By means of thermistor thermometer coupled with a chart recorder, three series of temperature as time recordings of grafted tissues after normalized cooling were performed--before grafting, 2 and 12 weeks after grafting. On the basis of temperature recovery curves obtained, the blood supply coefficients were computed. It was revealed that in the Solcoseryl group there was an improvement in blood supply in 75% of the cases--2 weeks, and 66%--12 weeks after grafting. In the other group, the same reaction was observed only in 50% and 30% of the cases respectively.

The effect of chlorhexidine supplementation in a periodontal dressing.

Most commercial periodontal dressings claiming antibacterial activity lose this activity shortly after application. Chlorhexidine (CH) is an antibacterial agent with long-term activity in the oral cavity owing to its substantiveness and slow-release properties. In a double-blind split-mouth-designed clinical trial the effect of incorporating CH acetate in periodontal dressing was tested on wound healing after gingivectomy. Eleven patients, each needing at least two gingivectomies, constituted the test panel. Wound healing, as assessed by bleeding tendency after removal of dressing 7 days postoperatively was significantly delayed when control dressings were applied as compared with test dressings. Variables with regard to patient comfort also yielded results in favor of the test pack. Incorporation of antibacterial agents with high retention and slow release properties in the mouth in surgical dressings seems advantageous.

Comparación de los efectos cicatrizantes de dos cementos quirúrgicos periodontales; uno a base de óxido de zinc con eugenol y otro sin eugenol, mediante evaluación de la resistencia a la tensión en ratones de raza Swiss / Compartive effects cicatrtizant of two surgical cements periodontis; one base zinc oxide with eugenol without eugenol, inteverning, evaluation resistence at the tension in mouse of swiss crack

En el presente estudio se compararon los efectos cicatrizantes de 2 cementos quirúrgicos periodontales. Uno a base de óxido de zinc con eugenol y otro sin eugenol, mediante evaluación de la resistencia a la tensión en tejidos en proceso de cicatrización. Con este propósito se produjo una herida de 1cm. en la piel de la superficie dorsal del ratón y se le colocó cada uno de los cementos quirúrgicos periodontales. Los animales fueron sacrificados a las 48 y 72 horas e inmediatamente se les midió la resistencia a la tensión. Los resultados mostraron que a las 48 y 72 horas, la mayor resistencia a la tensión fue para el grupo con eugenol, luego para el grupo sin eugenol y por último el grupo control. Compararon la resistencia a la tensión de las 48 a las 72 horas para cada grupo, se encontró que existe diferencia muy significativa para el grupo control, no existe diferencia estadística para el grupo con eugenol y diferencia altamente significativa para el grupo sin eugenol

Labial veneers in the management of desquamative gingivitis.

Desquamative gingivitis is an unsightly condition characterized by erythema and desquamation of the attached gingivae. The use of acrylic labial veneers as a vehicle for delivering medication and as a way to improve the esthetics is described.