Journal of the International Academy of Periodontology最新文献

This study aimed to evaluate the bone response around titanium implants in osteoporotic rabbits receiving oral alendronate (ALN) for one month either simultaneously with implant placement (IP) or stopped immediately before surgery. Six weeks before IP, 34 adult female New Zealand white rabbits were submitted to intramuscular injections of dexamethasone (3 mg/kg twice a week) to induce osteoporosis-like conditions. Two animals were sacrificed and histological examinations of their leg bones were performed to confirm the osteoporosis-like condition, as compared to a healthy animal. The remaining 32 rabbits were then divided into four equal groups. Group I represented osteoporosis-like animals receiving implants. For Groups II, III and IV, osteoporosis-like animals received calcium phosphate cement before IP. Animals in Group II received implants without any systemic treatment for osteoporosis. In Group III, ALN was simultaneously started with IFP. In Group IV, ALN was stopped immediately before surgery. At 12 weeks post-surgery all animals were sacrificed. Both bone-implant interface and mineralized bone area percentage (MBA%) were microscopically evaluated. Group IV showed a significant gain in MBA% (p < 0.05), along with the most favorable implant integration outcome. Our results suggest that finishing an ALN course before implant placement could enhance the healing capacity around implants.

Aim: The aim of the present study was to evaluate the effect of simvastatin, a potent antiinflammatory drug, on the progression of alveolar bone loss in an experimental model of periodontitis in rats.

Material and methods: A cotton ligature was used around the lower right first molar in a submarginal position in order to induce experimental periodontitis. Sixty rats were divided into 12 groups consisting of three control groups, three simvastatin groups, three ligature groups, and three ligature plus simvastatin groups. The distance between the cemento-enamel junction and the alveolar crest was determined at the mesial root surfaces of the lower right first molars by radiographic as well as profilometric analyses.

Results: In rats of the experimental periodontitis group (ligature), alveolar bone loss was higher compared to the control groups. However, simvastatin was associated with decreased alveolar bone loss in all treatment groups with experimental periodontitis (p < 0.01).

Conclusion: Simvastatin treatment seems to be a beneficial and supporting therapeutic that favors protection against alveolar bone loss in a model of experimental periodontitis in rats.

Objective: The aim of the present double-blind, randomized, controlled study was to evaluate and compare the efficacy of amnion allograft and connective tissue graft in covering denuded root surfaces.

Methods: Seventy-one teeth in 22 patients with gingival recession were treated randomly with coronally displaced flap plus connective tissue graft (control group, n = 29 recessions in 10 patients) or coronally displaced flap plus amnion allograft (test group, n = 42 recessions in 12 patients). The amount of root coverage and clinical parameters (probing depth, recession depth, clinical attachment level, recession width, gingival width, and papilla dimensions) were measured at baseline and at 3 and 6 months postoperatively.

Results: Average root coverage percentages after 6 months in the test and control groups were 67% (2.3 +/- 0.289 mm) and 54% (2.24 +/- 0.519 mm), respectively, with no statistically significant differences (p = 0.054). The changes in depth and width of recessions and in gingival width were significant 3 and 6 months after surgery compared to baseline (p = 0.000). Variations in the level of attachment and probing depths after 6 months were statistically significant in the test group compared to the control group (p = 0.002). Papilla dimensions were significantly correlated with root coverage (p = 0.00).

Conclusions: Amnion allograft might be a suitable alternative to connective tissue graft in procedures to cover denuded root surfaces and can reduce recession depth.

Objective: The aim of this report was to clinically and radiographically evaluate changes to the hard and soft tissues around implants placed in extraction sockets grafted with medical grade calcium sulfate hemihydrate (MGCSH) mixed with platelet-rich plasma (PRP) and a collagen resorbable plug after one year of function.

Methods: This evaluation was part of a previous study conducted to evaluate extraction socket grafts. Fourteen subjects out of 16 were evaluated. After tooth extraction, eight subjects received MGCSH mixed with PRP in the extraction sockets (test group), and six subjects received collagen resorbable plug dressing material (control group). After three months of bone healing, dental implants were placed. Three months after implant installation, provisional restorations were placed and implants were loaded in function for one month followed by definitive restorations. Follow-up examinations and intraoral digital radiographs were made at baseline and one year after definitive restorations to evaluate the marginal bone level in each subject.

Results: At the one-year follow-up, the survival and success rate was 100% for all implants. There was no statistically significant difference in the amount of vertical bone loss between groups after 1 year (p > 0.05). For the test group, there was a mean mesial bone loss of -0.8 +/- 0.6mm and a mean distal bone loss of -0.5 +/- 0.4mm. For the control group, there was a mean mesial bone loss of -1.1 +/- 0.7mm and a mean distal bone loss of -0.6 +/- 0.6mm.

Conclusions: At the one-year follow-up, the implant placement in grafted sockets was not affected by the type of the graft material. Implants placed in sockets grafted with MGCSH mixed with PRP showed less marginal bone loss after one year in comparison to those with collagen resorbable grafts.

Objective: The aim of this clinical trial was to assess the performance of a full-mouth ultrasonic debridement protocol in the treatment of severe chronic periodontitis in comparison with scaling and root planing in a quadrant-wise procedure in smokers.

Materials and methods: The trial consisted of 30 participants presenting with periodontitis divided into 3 groups: Group FMUD - full-mouth ultrasonic debridement, i.e., one session of 45 minutes of ultrasonic instrumentation for smokers (n = 10), Group SRP- scaling and root planing performed in a quadrant-wise manner for smokers (n = 10), and Group Control - SRP for nonsmokers (n = 10), treated following the same protocol as the SRP group. The parameters evaluated were: plaque/bleeding on probing indices, probing pocket depth, relative recession, and relative probing attachment level at baseline, 45, 90 and 180 days after therapy.

Results: Full-mouth ultrasonic debridement and scaling and root planing resulted in comparable gain of attachment 6 months after therapy. Both groups exhibited probing pocket depth reduction at all experimental periods as compared to baseline. Smokers, however, had less probing pocket depth reduction and relative probing attachment level gain compared to non-smokers, despite the mechanical protocol used (p < 0.05). Moreover, at 180 days, nonsmokers presented with fewer sites requiring re-treatment (probing pocket depth > 5 mm and bleeding on probing) than smokers (p < 0.05).

Conclusions: Full-mouth ultrasonic debridement and scaling and root planing result in comparable clinical outcomes for the treatment of smokers with severe chronic periodontitis. Despite the non-surgical technique used, smokers had a less favorable clinical response than non-smokers.

Background: Periodontitis and immune dysfunction are often reported in alcohol-dependent patients. Our objectives were to investigate the effects of alcohol exposure on neutrophil function and the associated consequential effects on the periodontium in a group of African American (AA) males with documented history of alcohol use without medical complications.

Methods: Thirty-three AA males with documented history of alcohol use were included in this analysis. All subjects were free from systemic illness. Blood levels of gamma-glutamyl transpeptidase (GGTP) were determined and used as a measure of alcohol consumption. Periodontal evaluations including attachment levels (AL) were recorded on 6 sites per tooth. Enumerative and functional neutrophil measures were obtained.

Results: GGTP blood levels inversely associated with neutrophil bacterial killing (NBK) (p = 0.04). Regression analysis, adjusting for risk factors associated with periodontitis, showed an inverse association between NBK and percent of sites with AL > or = 5 mm (p <0.05) and a direct significant interaction between GGTP (> 51 international units) and increasing NBK activity on percent of sites with AL > or = 5 mm (p < 0.05).

Conclusions: In AA males with excessive alcohol use, neutrophils show depressed NBK. Depressed NBK was not associated with loss of periodontal attachment in this population. Furthermore, AA males with excessive alcohol use and uncompromised neutrophil function are at greater risk of periodontal tissue damage.

Objective: The aim was to assess the thickness of Schneiderian membranes (SM) in patients with advanced periodontal disease.

Methods: 17 dentate patients (DG) scheduled for periodontal surgery on maxillary molars were consecutively recruited and cone beam computed tomographies performed for preoperative diagnosis. Twenty-one patients (EG) requiring cone beam computed tomography-based planning of implant placement in the edentulous posterior maxilla served as controls.

Results: Schneiderian membrane thickness measured from cone beam computed tomography was significantly greater in the dentate group compared to the edentulous group, both in the first (p = 0.028) and second (p < 0.001) molar position. In the dentate group, clinical signs of periodontal destruction (increased probing pocket depth or furcation involvement) were not associated with Schneiderian membrane thickness. Additional findings, such as periapical lesions (p = 0.008), and the distance between root tips and maxillary sinus revealed a significant association (p = 0.036) with Schneiderian membrane thickness.

Conclusion: In molar regions with periodontal destruction, Schneiderian membrane thickening occurred, particularly in combination with small bone layers above the root tips or periapical lesions.

Purpose: The purpose of this study was to histologically evaluate newly generated vital bone using porous granules of bioactive and resorbable silica-calcium phosphate nanocomposite (SCPC) in extraction sockets.

Material and methods: Six patients with a non-restorable maxillary central incisor requiring extraction followed by implant placement participated in the study. Extraction sockets were grafted with granules of SCPC. After 6 months, a bone core sample was retrieved from the center of the healed socket for histologic analysis, and dental implants were placed. Alveolar bone width was clinically assessed immediately after tooth extraction and 6 months after bone grafting, at the time of implant placement. Alveolar bone height was radiographically assessed immediately after tooth extraction and 6 months after extraction.

Results: Histomorphometric analyses of sockets grafted with SCPC for 6 months revealed 46.8% +/- 14% new vital bone and 2.5% +/- 1.5% graft material remnants. In these sockets, the mean bone height resorption over the 6-month period of healing was 1.6 mm +/- 1.5 mm. The mean bone width resorption of 2 mm +/- 0.7 mm was found at the bone crest.

Conclusion: The results of this study suggest that SCPC graft material reduces the amount of change in alveolar ridge dimensions after tooth extraction and facilitates the regeneration of new vital bone.

Objective: The short-term clinical and microbiological effects of patient-applied subgingival root brushing were assessed on untreated deep human periodontal pockets.

Methods: Assessments of plaque, bleeding on probing, probing depth, total cultivable subgingival counts, and cultivable counts and proportions of six putative periodontal pathogens were carried out at baseline and after 14 days on two contralateral > or = 6 mm bleeding interproximal posterior sites in each of 11 adults with untreated chronic periodontitis. One of the sites was randomly assigned to daily patient-applied subgingival root brushing for 14 days, and the other to remain with the patient's pre-existing tooth brushing and flossing regimen. No other periodontal therapy was performed during the 14 test days.

Results: Significant reductions in plaque, bleeding on probing, probing depth, total subgingival counts, and levels of putative periodontal pathogens were found after 14 days of subgingival root brushing. Subgingival root brushing nearly eliminated bleeding on probing at test sites, reduced probing depths by a mean of 1.8 mm, and reduced cultivable subgingival proportions of six evaluated putative periodontal pathogens from a cumulative total of 14.1% to 0.8%. In comparison, no significant clinical or microbiological changes were detected after 14 days where the patient's pre-existing oral hygiene regimen remained unaltered.

Conclusions: Subgingival root brushing over 14 days, in properly trained patients, induced favorable clinical and microbiological changes in deep periodontal pockets > or = 6 mm even in the absence of professional subgingival debridement.