فهرست مطالب
Journal of Advanced Periodontology and Implant Dentistry
Volume:11 Issue: 1, Jun 2019
- تاریخ انتشار: 1399/01/20
- تعداد عناوین: 7
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Pages 1-6Background
Several classifications have been proposed for gingival recession defects. Correct diagnosis of the type of gingival recession is necessary for proper treatment planning and assessment of the prognosis. Considering the existing uncertainty regarding the reliability of different classification systems available for gingival recession and their shortcomings, this study sought to assess the reproducibility and reliability of accuracy of three available classifications (Cairo, Mahajan and Miller’s classification systems) for gingival recession.
MethodsThis descriptive study was conducted on 32 patients presenting to the Department of Periodontics, who were selected using convenience sampling. The screening process entailed two sessions and those with a minimum of one site of gingival recession disclosing the cementoenamel junction (CEJ) of the tooth with no adjacent tooth loss at the site of recession were enrolled. Each patient was separately evaluated by three calibrated examiners twice with a minimum of one-week interval. Grading of the gingival recession defects was determined using the Cairo, Mahajan and Miller’s classification systems for gingival recession. The gradings of each examiner were separately recorded by a blinded examiner. A total of 120 single recession defects were examined and data were analyzed using intra-class correlation coefficient (ICC) and Spearman’s test. Level of agreement was evaluated according to Landis and Koch.
ResultsThe results showed that the reliability of all the three methods was almost perfect (P<0.05), and no significant difference was noted in reliability of the Cairo, Mahajan and Miller’s classifications for gingival recession (P=0.7).
ConclusionBased on the results of the study, the highest intra- and inter-observer agreement in the use of the three classifications belonged to the Cairo classification; however, all the three classifications showed high reliability
Keywords: Classification, gingival recession, periodontium -
Pages 7-11Background
Certain salivary biomarkers that are considered unique in relation to the physiological aspects of periodontitis can be helpful in the diagnosis of periodontitis by considering quantitative changes in such biomarkers. This study was undertaken to answer the question to what extent non-surgical periodontal treatment can affect concentrations of salivary biomarkers in patients suffering from chronic periodontitis.
MethodsEighteen patients with generalized moderate-to-severe chronic periodontitis were recruited for this study by considering periodontal parameters of gingival index (GI), probing pocket depths (PPD), clinical attachment levels (CAL) and a number of radiographic parameters. Salivary samples were analyzed at baseline and at one-month interval after non-surgical periodontal treatment consisting of scaling and root planing. Concentrations of salivary biomarkers, including cortisol, immunoglobulin A (Ig A), IL-6, interferon-γ, soluble intercellular adhesion molecule-1 (sICAM) and ALP, were determined with the use of an ELISA kit. Data were subjected to statistical analyses using paired t-test, with SPSS 15. Statistical significance was set at P<0.05.
ResultsMean levels of IgA and interferon-γ decreased significantly after treatment (P<0.05); however, cortisol concentrations increased significantly after treatment. In addition, the decrease in IL-6, sICAM-1 and ALP levels were not significant (P>0.05).
ConclusionThe results showed that the salivary levels of IgA and interferon-γ decreased and those of cortisol increased significantly subsequent to scaling and root planing.
Keywords: Biomarkers, chronic periodontitis, dental scaling, root planing, saliva -
Pages 12-20Background and aims
This study aimed to compare the clinical efficacy of vestibular incisional subperiosteal tunnel access (VISTA) with subepithelial connective tissue graft versus a coronally advanced flap (CAF) with subepithelial connective tissue graft for the treatment of gingival recession defects.
Materials and methodsThis randomized clinical trial was performed on 24 recession defects that were bilaterally Miller’s class I or II in the maxillary canine and premolar area. One quadrant in each patient was selected randomly to receive VISTA (test group) or CAF (control group) with connective tissue graft. Clinical parameters measured at baseline and at 3- and 6- month postoperative intervals included recession width (RW), recession depth (RD), keratinized tissue width (KTW), clinical attachment level (CAL) and probing depth (PD).
ResultsHealing was uneventful in both the test and control groups. At the 6-month follow-up, there was a significant decrease in RD, RW and CAL and an increase in KTW in both the test and control groups. The PD remained unchanged. At 3 and 6 months, no statistically significant differences were found between VISTA and CAF for root coverage and clinical attachment gain. Mean root coverage (MRC) was 70.69% and 67.22% in the test and control group, respectively. VISTA demonstrated higher frequency of complete root coverage (CRC) compared to CAF: 50% vs. 33% (P<0.05). The mean KTW was 2.4±0.7 mm at the test and 2.7±0.8 mm at the control sites (P>0.05)
ConclusionVISTA, as a minimally invasive approach, can enhance root coverage, KTW and clinical attachment gain; therefore, it can be used as a substitute for CAF with connective tissue graft as a gold standard for root coverage.
Keywords: Coronally advanced flap, Gingival recession, Root coverage, Subepithelial connective tissue graft, Vestibular incisional subperiosteal tunnel access -
Pages 21-27Background
In the course of periodontal diseases, polymorphonuclear leukocytes (PMNs) produce oxidative agents and free radicals, thus triggering oxidant-antioxidant disequilibrium in the saliva. Due to the reduction of antioxidant protective effect, oxidative stress is induced, destroying periodontal tissues. This study aimed to investigate the consequences of the non-surgical phase of periodontal therapy on the level ofsalivary antioxidantsin patients with generalized moderate-to-severe chronic periodontitis.
MethodsUn-stimulated salivary samples were collected from 43 patients with generalized moderate-to-severe chronic periodontitis for 5 minutes. Clinical parameters, including clinical attachment loss (CAL), bleeding on probing (BoP) and pocket depth (PD), were recorded in each tooth and subsequently, scaling and root planing (SRP) was carried out. After four weeks, salivary samples were collected once again, and the above-mentioned clinical parameters were recorded. Following centrifugation and freezing at a temperature of -80°C, salivary samples were examined simultaneously in a single day, and the level of their antioxidants was measured with ferric reducing ability of plasma (FRAP) method using a spectrophotometer.
ResultsThe concentration of salivary antioxidants significantly increased four weeks following the non-surgical periodontal therapy (P<0.0001). Moreover, the clinical parameters of CAL, BoP and PD showed a significant decrease in 4 weeks as well (P<0.0001).
ConclusionThe level of salivary antioxidants in patients with generalized moderate to severe chronic periodontitis significantly increased after etiotropic periodontal therapy, indicating the possible beneficial influence of periodontal therapy on the level of salivary antioxidants in patients suffering from periodontitis.
Keywords: Antioxidants, periodontitis, dental scaling, oxidants, root planing -
Pages 28-33Background
An inappropriate inflammatory response is the cause of many common diseases, especially periodontitis. Considering that no studies have been carried out to investigate the effect of IL-36γ on chronic periodontitis, this study aimed to investigate the inflammatory mechanism of IL-36γ by stimulating macrophage cells using NF-KB pathway.
MethodsThis experimental study was performed on 50 healthy individuals and 50 subjects with chronic periodontitis. In this study, macrophage cells were extracted first, and then RNA was isolated from all the samples using TRIzol method. Subsequently, the rate of IL-36γ gene expression was analyzed and compared using real-time PCR technique. Additionally, immunofluorescence (IF) technique was used to investigate the rate of inflammation. The rate of NF-Kb expression was also measured via western blot technique. Finally, statistical analysis of the samples was carried out using appropriate statistical methods with SPSS 17.
ResultsThe results showed that the rate of IL-36γ expression in subjects with periodontitis was higher compared to healthy subjects (P<0.05). Moreover, the results showed that following treatment of cells with TLR4, the rate of IL36γ expression increased significantly, especially during the 12-hour period after treatment.
ConclusionThis indicates that after stimulating the TLR pathways, the rate of IL-36γ expression will probably increase.
Keywords: Chronic periodontitis, Inflammation, TLR4, IL-36y, NF-KB -
Pages 34-38Background
The role of mast cells in periodontal tissue degradation has been established. These cells can be efficient in the etiology of periodontitis by participating in gingival homeostasis and releasing cytokines and enzymes, resulting in connective tissue matrix breakdown. Therefore, the aim of this study was to compare the mast cell counts between patients with moderate and severe periodontitis.
MethodsThis case‒control study was performed on 15 subjects with severe periodontitis and 15 subjects with moderate periodontitis, who needed periodontal surgical treatment. Incisional biopsies were provided during periodontal surgery. Afterward, the mean counts of mast cells were determined after toluidine blue staining of the samples. Finally, data were analyzed with SPSS.
ResultsThe results of this study showed that mast cell counts in severe periodontitis cases were lower than those in moderate periodontitis. However, there were no statistically significant differences between the two groups (P=0.611). In addition, the mean mast cell counts in males and females did not show a statistically significant difference (P=0.231), although the count was higher in female subjects.
ConclusionBased on the results, no statistically significant differences were found in mast cell counts between subjects with severe periodontitis and those with moderate periodontitis.
Keywords: Mast cells, moderate periodontitis, severe periodontitis, toluidine blue staining -
Pages 39-45
Chronic periodontitis is a progressive disease with loss of several teeth. Implant therapy in these patients can be a successful outcome as long as the tissues are kept healthy from a microbiologic viewpoint. Regular follow-up visits after complex reconstruction is the key for long-term success. In our report, recall visits were kept on short intervals for ten years. The results showed that implants were very good prosthetic replacements in chronic sufferers of the disease but regular followups are the gold standard.
Keywords: Biological complications, bone loss, dental implants, long-term survival, peri-implantitis, periodontitis, supportive periodontal therapy