Discovery of multiple foreign objects in the root canal is unusual and their removal is often difficult and challenging procedure. Entrapment of the foreign object in the pulp chamber or in root canal usually occur accidentally in children with the habit of chewing or placing various objects in the oral cavity. Clinically it was often encountered in tooth with wide carious lesion, exposed pulp chamber due to trauma or tooth left open for the drainage during root canal treatment. This impacted foreign body may act as a potential source of pain or infection. The attempt to retrieve such foreign object from the root canal with immature apex increases the risk of its displacement into periapical area. The present case report describes an unusual case of a patient with two metallic sewing needles inadvertently broken down in the root canal of the permanent maxillary left central incisor and it׳s successful retrieval by non-surgical endodontic treatment.
{"title":"Patient induced unusual metallic obturation of the root canal of permanent maxillary central incisor with an immature apex – A rare case report","authors":"Manoj Mahadeo Ramugade, Kishor Dattatray Sapkale , Sachin Shashikant Metkari","doi":"10.1016/j.sdj.2014.08.001","DOIUrl":"10.1016/j.sdj.2014.08.001","url":null,"abstract":"<div><p>Discovery of multiple foreign objects in the root canal is unusual and their removal is often difficult and challenging procedure. Entrapment of the foreign object in the pulp chamber or in root canal usually occur accidentally in children with the habit of chewing or placing various objects in the oral cavity. Clinically it was often encountered in tooth with wide carious lesion, exposed pulp chamber due to trauma or tooth left open for the drainage during root canal treatment. This impacted foreign body may act as a potential source of pain or infection. The attempt to retrieve such foreign object from the root canal with immature apex increases the risk of its displacement into periapical area. The present case report describes an unusual case of a patient with two metallic sewing needles inadvertently broken down in the root canal of the permanent maxillary left central incisor and it׳s successful retrieval by non-surgical endodontic treatment.</p></div>","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.sdj.2014.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32898830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1016/j.sdj.2013.11.001
Gunnar Bergenholtz, Susanna Axelsson, Thomas Davidson, Fredrik Frisk, Magnus Hakeberg, Thomas Kvist, Anders Norlund, Arne Petersson, Isabelle Portenier, Hans Sandberg, Sofia Tranæus, Ingegerd Mejare
Background
This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time.
Study design
An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. In addition, hand searches were carried out. Two reviewers independently evaluated abstracts and full-text articles. An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. Altogether, 161 articles were read in full text. Of these, 24 studies fulfilled established inclusion criteria. Based on studies of at least moderate quality, the quality of evidence of each procedure was rated in four levels according to GRADE.
Results
No study reached the high quality level. Twelve were of moderate quality. The overall evidence was insufficient to assess which of indirect pulp capping, stepwise excavation, direct excavation and pulp capping/partial pulpotomy, pulpotomy or pulpectomy is the most effective treatment approach for teeth with deep caries.
Conclusions
Because of the lack of good studies it is not possible to determine whether an injured pulp by deep caries can be maintained or whether it should be removed and replaced with a root canal filling. Both randomized studies and prospective observational studies are needed to investigate whether a pulp exposed to deep caries is best treated by measures intended to preserve it or by pulpectomy and root filling.
背景:本系统综述评估了深层龋齿病例中常用的牙髓治疗方法的效果,以及牙髓腔未感染的程度,以及牙髓或根尖周炎症病变和相关牙痛的程度。研究设计电子文献检索包括PubMed、EMBASE、Cochrane Central Register of Controlled Trials和Cochrane Reviews数据库,检索时间为1950年1月至2013年3月。此外,还进行了手部搜查。两名审稿人独立评估摘要和全文文章。如果两名审稿人中至少有一人认为文章摘要具有潜在的相关性,那么文章就会被全文阅读。全文共计161条。其中,24项研究符合既定的纳入标准。基于至少中等质量的研究,每个程序的证据质量根据GRADE分为四个等级。结果没有一项研究达到高质量水平。12个中等质量。整体证据不足以评估间接盖髓、逐步挖髓、直接挖髓盖髓/部分切髓、切髓或切髓哪一种是治疗深部龋最有效的方法。结论由于缺乏良好的研究,无法确定是否可以维持深龋损伤的牙髓,或者是否应该将其移除并更换根管充填物。需要随机研究和前瞻性观察研究来调查牙髓暴露于深部龋的最佳治疗方法是保留牙髓还是切除牙髓并进行牙根充填。
{"title":"Treatment of pulps in teeth affected by deep caries – A systematic review of the literature","authors":"Gunnar Bergenholtz, Susanna Axelsson, Thomas Davidson, Fredrik Frisk, Magnus Hakeberg, Thomas Kvist, Anders Norlund, Arne Petersson, Isabelle Portenier, Hans Sandberg, Sofia Tranæus, Ingegerd Mejare","doi":"10.1016/j.sdj.2013.11.001","DOIUrl":"10.1016/j.sdj.2013.11.001","url":null,"abstract":"<div><h3>Background</h3><p>This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time.</p></div><div><h3>Study design</h3><p>An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. In addition, hand searches were carried out. Two reviewers independently evaluated abstracts and full-text articles. An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. Altogether, 161 articles were read in full text. Of these, 24 studies fulfilled established inclusion criteria. Based on studies of at least moderate quality, the quality of evidence of each procedure was rated in four levels according to GRADE.</p></div><div><h3>Results</h3><p>No study reached the high quality level. Twelve were of moderate quality. The overall evidence was insufficient to assess which of indirect pulp capping, stepwise excavation, direct excavation and pulp capping/partial pulpotomy, pulpotomy or pulpectomy is the most effective treatment approach for teeth with deep caries.</p></div><div><h3>Conclusions</h3><p>Because of the lack of good studies it is not possible to determine whether an injured pulp by deep caries can be maintained or whether it should be removed and replaced with a root canal filling. Both randomized studies and prospective observational studies are needed to investigate whether a pulp exposed to deep caries is best treated by measures intended to preserve it or by pulpectomy and root filling.</p></div>","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.sdj.2013.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31974977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1016/j.sdj.2013.11.004
Chunhan Ngim , Allister Daquan Ngim
The rules governing the use of metallic mercury, a toxic and hazardous chemical, is in most jurisdictions identical to widely accepted standards and practices for handling the same chemical in industry for the protection of humans and their work environment. There cannot be exceptions solely for the practitioner dentists and their patients. Any workplace must be safe for both workers and visitors. The latter being dental patients waiting in the dentist's work environment. We reviewed the literature for toxic health effects of elemental mercury upon humans and present information about the Minimata Convention convened by the United Nations Environment Programme. A study conducted among dentists in Singapore and their personal work environment almost 30 years ago contributed to the workplace standard for elemental mercury, which was reduced, and is still currently enforced as a global standard. We recommend that dentists, with a large alternative battery of restorative materials today, make selection of a restorative material a more seriously considered choice, and not to make use of amalgam without the proper use of personal protective equipment for themselves (members of the dental operating team) and their patients, (amalgam traps and judicious monitoring of their workplace air quality). Mercury is ubiquitous in our presence due to human activities; any reduction in the dentists' workplace contributes to a global reduction.
{"title":"Health and safety in the dental clinic – Hygiene regulations for use of elemental mercury in the protection of rights, safety and well-being of the patients, workers and the environment","authors":"Chunhan Ngim , Allister Daquan Ngim","doi":"10.1016/j.sdj.2013.11.004","DOIUrl":"10.1016/j.sdj.2013.11.004","url":null,"abstract":"<div><p>The rules governing the use of metallic mercury, a toxic and hazardous chemical, is in most jurisdictions identical to widely accepted standards and practices for handling the same chemical in industry for the protection of humans and their work environment. There cannot be exceptions solely for the practitioner dentists and their patients. Any workplace must be safe for both workers and visitors. The latter being dental patients waiting in the dentist's work environment. We reviewed the literature for toxic health effects of elemental mercury upon humans and present information about the Minimata Convention convened by the United Nations Environment Programme. A study conducted among dentists in Singapore and their personal work environment almost 30 years ago contributed to the workplace standard for elemental mercury, which was reduced, and is still currently enforced as a global standard. We recommend that dentists, with a large alternative battery of restorative materials today, make selection of a restorative material a more seriously considered choice, and not to make use of amalgam without the proper use of personal protective equipment for themselves (members of the dental operating team) and their patients, (amalgam traps and judicious monitoring of their workplace air quality). Mercury is ubiquitous in our presence due to human activities; any reduction in the dentists' workplace contributes to a global reduction.</p></div>","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.sdj.2013.11.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31974979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1016/j.sdj.2013.11.005
Neetha J. Shetty
Root coverage is achieved by many procedures like free gingival autografts, connective tissue grafts and pedicle grafts. Several studies state that root coverage using connective tissue grafts have high success rates but have disadvantages like creation of second surgical site and post-operative color harmony is less. Although Cohen and Ross reported more than 85% success in covering denuded roots, the degree of success varies among other clinicians. The double papilla pedicle graft has limited usefulness. The double papillae pedicle graft is most appropriate in those cases where esthetics demand a close tissue color match and where the papillae are large and have shallow gingival grooves.
{"title":"Double papilla repositioned flap for the treatment of isolated recession – A case report","authors":"Neetha J. Shetty","doi":"10.1016/j.sdj.2013.11.005","DOIUrl":"10.1016/j.sdj.2013.11.005","url":null,"abstract":"<div><p>Root coverage is achieved by many procedures like free gingival autografts, connective tissue grafts and pedicle grafts. Several studies state that root coverage using connective tissue grafts have high success rates but have disadvantages like creation of second surgical site and post-operative color harmony is less. Although Cohen and Ross reported more than 85% success in covering denuded roots, the degree of success varies among other clinicians. The double papilla pedicle graft has limited usefulness. The double papillae pedicle graft is most appropriate in those cases where esthetics demand a close tissue color match and where the papillae are large and have shallow gingival grooves.</p></div>","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.sdj.2013.11.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31974980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1016/j.sdj.2013.11.003
Vinicius Rosa
Disinfection of root canals followed by the replacement of the infected or inflamed pulp tissues by inert materials is the foundation for treating irreversible damaged dental pulps. The management of pathological conditions of the periodontium is mainly based solely upon infection control via the reestablishment of oral hygiene, scaling and root planing to control inflammation which stops progressive bone loss. As one may see, the clinical management of endodontic and periodontal diseases has not changed drastically despite the development of new materials, techniques and medicaments. Tissue engineering is a multi-disciplinary field focused on the development of materials, techniques and strategies to improve or replace damaged or lost biological functions and tissues. As the tissue engineering field progresses, “scaffolds”, “suggest pathways” and “stem cells” abandoned their role as technical words exclusively used by scientists and slowly assume a part in the language of students, educators, clinicians and patients. However the unfamiliarity with some of the concepts can lead to misinterpretations of the current status and overexcitement about future applications of stem cells for dental-related tissue regeneration. This paper will present a panorama and the future challenges on the path to use of stem cells for endodontic and periodontal tissue regeneration.
{"title":"What and where are the stem cells for Dentistry?","authors":"Vinicius Rosa","doi":"10.1016/j.sdj.2013.11.003","DOIUrl":"10.1016/j.sdj.2013.11.003","url":null,"abstract":"<div><p>Disinfection of root canals followed by the replacement of the infected or inflamed pulp tissues by inert materials is the foundation for treating irreversible damaged dental pulps. The management of pathological conditions of the periodontium is mainly based solely upon infection control via the reestablishment of oral hygiene, scaling and root planing to control inflammation which stops progressive bone loss. As one may see, the clinical management of endodontic and periodontal diseases has not changed drastically despite the development of new materials, techniques and medicaments. Tissue engineering is a multi-disciplinary field focused on the development of materials, techniques and strategies to improve or replace damaged or lost biological functions and tissues. As the tissue engineering field progresses, “scaffolds”, “suggest pathways” and “stem cells” abandoned their role as technical words exclusively used by scientists and slowly assume a part in the language of students, educators, clinicians and patients. However the unfamiliarity with some of the concepts can lead to misinterpretations of the current status and overexcitement about future applications of stem cells for dental-related tissue regeneration. This paper will present a panorama and the future challenges on the path to use of stem cells for endodontic and periodontal tissue regeneration.</p></div>","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.sdj.2013.11.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31974978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1016/S0377-5291(13)00014-X
SUM Chee Peng (Editor)
{"title":"Letter from the Editor","authors":"SUM Chee Peng (Editor)","doi":"10.1016/S0377-5291(13)00014-X","DOIUrl":"10.1016/S0377-5291(13)00014-X","url":null,"abstract":"","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0377-5291(13)00014-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31974981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1016/j.sdj.2012.10.002
Gabriel Tse Feng Chong
This article quotes and discusses Jean-Anthelme Brillat-Savarin's musings on the mouth and ingestion as described in his book The Physiology of Taste. The book was first published in France in December 1825, and is still widely read as a key work in Gastronomy today. The mouth is intimately related to the acts of chewing, swallowing and eating and it would be interesting to report an early 19th century epicurean's views on the mouth.
Passages from Brillat-Savarin's book describing the functions of the teeth and tongue and the acts of tasting, chewing, and swallowing are quoted in full. Anecdotes also include one on the horrifying punishment of having one's tongue removed and another illustrating the poor oral health found among Europeans of that era.
His work offers a unique glimpse into how a 19th century gastronome viewed the oral cavity and its gastronomical functions. While some of his writings may appear archaic and antediluvian to the modern reader; others relating to, for example chewing and swallowing, are surprisingly accurate by contemporary standards. Nonetheless, the gastronomic savant seemed to know a lot right about modern stomatology!
{"title":"Jean-Anthelme Brillat-Savarin's 1825 treatise on the mouth and ingestion","authors":"Gabriel Tse Feng Chong","doi":"10.1016/j.sdj.2012.10.002","DOIUrl":"10.1016/j.sdj.2012.10.002","url":null,"abstract":"<div><p>This article quotes and discusses Jean-Anthelme Brillat-Savarin's musings on the mouth and ingestion as described in his book <em>The Physiology of Taste</em>. The book was first published in France in December 1825, and is still widely read as a key work in Gastronomy today. The mouth is intimately related to the acts of chewing, swallowing and eating and it would be interesting to report an early 19th century epicurean's views on the mouth.</p><p>Passages from Brillat-Savarin's book describing the functions of the teeth and tongue and the acts of tasting, chewing, and swallowing are quoted in full. Anecdotes also include one on the horrifying punishment of having one's tongue removed and another illustrating the poor oral health found among Europeans of that era.</p><p>His work offers a unique glimpse into how a 19th century gastronome viewed the oral cavity and its gastronomical functions. While some of his writings may appear archaic and antediluvian to the modern reader; others relating to, for example chewing and swallowing, are surprisingly accurate by contemporary standards. Nonetheless, the gastronomic savant seemed to know a lot right about modern stomatology!</p></div>","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.sdj.2012.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31484865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1016/S0377-5291(12)00024-7
Tan Peng Hui (Editor-in-Chief)
{"title":"Letter from the Editor","authors":"Tan Peng Hui (Editor-in-Chief)","doi":"10.1016/S0377-5291(12)00024-7","DOIUrl":"10.1016/S0377-5291(12)00024-7","url":null,"abstract":"","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0377-5291(12)00024-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31484866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1016/j.sdj.2012.10.004
{"title":"Evidence‐based guidelines for dental implants in edentulism","authors":"","doi":"10.1016/j.sdj.2012.10.004","DOIUrl":"https://doi.org/10.1016/j.sdj.2012.10.004","url":null,"abstract":"","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.sdj.2012.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137386860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2012-12-01DOI: 10.1016/j.sdj.2012.10.003
V. Rosamma Joseph , Arun Raghunath , Nitin Sharma
Background
This interventional controlled clinical trial with split mouth design compares the clinical effectiveness of autologous platelet rich fibrin with open flap debridement in the management of infrabony periodontal defects.
Methods
Fifteen patients with paired contralateral infrabony defects were treated with open flap debridement and autologous platelet rich fibrin (experimental group) or open flap debridement alone (control group). The changes in probing pocket depth, clinical attachment level, and radiographic defect depth were evaluated. Patient perception regarding pain and discomfort following the procedures and early soft tissue healing responses were assessed by visual analog scales, scored 7 days after the surgical procedures. Final reevaluation was done 1 year after surgery.
Results
Baseline clinical and radiographic measurements were comparable between the groups. Reevaluation at 1 year revealed that both treatment modalities resulted in a significant decrease in probing pocket depth, gain in clinical attachment and radiographic bone fill of the defects compared to baseline. Postoperative differences observed between the two groups were 2.27±0.29 mm (P<0.001) for probing pocket depth, 3.33±0.35 mm (P<0.001) for clinical attachment level and 1.29±0.32 mm (P<0.001) for radiographic infrabony defect depth reduction, all in favor of the experimental group. Patient preference was greater and early healing response better for the experimental group as assessed by the visual analog scores.
Conclusion
Within the limitations of this study it can be concluded that use of platelet rich fibrin is more effective than open flap debridement alone in the management of infrabony periodontal defects.
本研究采用裂口设计,比较了自体富血小板纤维蛋白与开瓣清创治疗骨下牙周缺损的临床效果。方法对15例双侧对侧骨下缺损患者分别采用开放皮瓣清创联合自体富血小板纤维蛋白治疗(实验组)和单独开放皮瓣清创治疗(对照组)。评估探查袋深度、临床附着水平和影像学缺损深度的变化。手术后7天,通过视觉模拟量表评估患者对手术后疼痛和不适的感觉以及早期软组织愈合反应。术后1年复查。结果两组之间的基线临床和放射学测量具有可比性。1年后的重新评估显示,与基线相比,两种治疗方式都显著降低了探测袋深度,增加了临床附着和x线片上的骨填充缺损。两组术后探查袋深度差异为2.27±0.29 mm (P<0.001),临床附着水平差异为3.33±0.35 mm (P<0.001),影像学下骨缺损复位深度差异为1.29±0.32 mm (P<0.001),均优于实验组。通过视觉模拟评分评估,实验组患者的偏好更大,早期愈合反应更好。结论在本研究的局限性下,应用富血小板纤维蛋白治疗骨下牙周缺损比单纯开瓣清创更有效。
{"title":"Clinical effectiveness of autologous platelet rich fibrin in the management of infrabony periodontal defects","authors":"V. Rosamma Joseph , Arun Raghunath , Nitin Sharma","doi":"10.1016/j.sdj.2012.10.003","DOIUrl":"10.1016/j.sdj.2012.10.003","url":null,"abstract":"<div><h3>Background</h3><p>This interventional controlled clinical trial with split mouth design compares the clinical effectiveness of autologous platelet rich fibrin with open flap debridement in the management of infrabony periodontal defects.</p></div><div><h3>Methods</h3><p>Fifteen patients with paired contralateral infrabony defects were treated with open flap debridement and autologous platelet rich fibrin (experimental group) or open flap debridement alone (control group). The changes in probing pocket depth, clinical attachment level, and radiographic defect depth were evaluated. Patient perception regarding pain and discomfort following the procedures and early soft tissue healing responses were assessed by visual analog scales, scored 7 days after the surgical procedures. Final reevaluation was done 1 year after surgery.</p></div><div><h3>Results</h3><p>Baseline clinical and radiographic measurements were comparable between the groups. Reevaluation at 1 year revealed that both treatment modalities resulted in a significant decrease in probing pocket depth, gain in clinical attachment and radiographic bone fill of the defects compared to baseline. Postoperative differences observed between the two groups were 2.27±0.29<!--> <!-->mm (<em>P</em><0.001) for probing pocket depth, 3.33±0.35<!--> <!-->mm (<em>P</em><0.001) for clinical attachment level and 1.29±0.32<!--> <!-->mm (<em>P</em><0.001) for radiographic infrabony defect depth reduction, all in favor of the experimental group. Patient preference was greater and early healing response better for the experimental group as assessed by the visual analog scores.</p></div><div><h3>Conclusion</h3><p>Within the limitations of this study it can be concluded that use of platelet rich fibrin is more effective than open flap debridement alone in the management of infrabony periodontal defects.</p></div>","PeriodicalId":35891,"journal":{"name":"Singapore Dental Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.sdj.2012.10.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31483409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}