Journal of Advanced Periodontology and Implant Dentistry
Volume:3 Issue: 1, Jun 2011

Background and aims. Tricalcium Phosphate (TCP), Bovine-Derived Hydroxyapatite (BioOss™), Demineralised Freeze-dried Bone Allograft (DFDBA) and Calcium Sulphate (CaS) were compared in vitro for osteoblast cytotoxicity and in rabbit’s calvaria to measure the bone histopathologic response.Materials and methods. 34 critical size defects in the calvaria of 12 male Australian rabbits were randomly filled with the materials and 2 empty defects were used as controls. After one month, histologicalal evaluation was performed on the samples to record regenerated bone type and volume, material absorption and the amount of inflammation. Saos-2 cell line was exposed to the materials and the cell line vitality was tested with Methyl Tetrazolium Test (MTT) to determine material’s osteoblast cell cytotoxicity.Results. The type of regenerated bone did not show a significant difference between the groups (p=1.0) while the amount of bone inflammation was significantly different (p=0.021), where BioOss caused the least and DFDBA had the highest. Bone formation was also similar between the groups (p=0.428). DFDBA group showed the highest material absorption while TCP group had the lowest (p=0.028). DFDBA was associated with significantly higher Saos-2 cell line viability than TCP and BioOss that were significantly less cytotoxic comparing to Cas (p< 0.0001).Conclusion. DFDBA group had the highest amount of material absorption and was associated with more inflammation than other materials in the rabbit calvaria. BioOss exhibited lowest amount of inflammation and TCP had the lowest amount of material absorption. Results of cytotoxicity test might be affected by different solubility constants of the test materials.

Background and aims. Scaling and root planing is one of the most commonly performed procedures in a dental clinic. Most patients consider the procedure annoying and some experience pain. Understanding the factors which relate to experience of pain during the procedure is important for the treatment of periodontal diseases. The present study made an attempt to find factors which are correlated with pain during periodontal instrumentation.Materials and methods. The data for the present study was collected from the control group of a double-blind split mouth study comparing the effect of intrasulcularly applied 20% Benzocaine with a placebo in reducing pain during scaling and root planing. Heft Parker Visual Analog Scale was used to record the level of pain experienced by the 16 control participants during instrumentation. Pearson’s correlation was used to find factors related to pain.Results. Subgingival calculus was negatively correlated with experience of pain while age, gender, severity of periodontitis, and supragingival calculus were found to have no correlation.Conclusions. Severity of periodontitis, age and gender do not affect the experience of pain due to periodontal instrumentation.

Background and aims. Psoriasis and periodontitis are characterized by an exaggerated host immune response to epithelial cell surface microbiota. Thus, mediators produced as part of host response orchestrate the inflammatory cascade and cause tissue destruction. The aim this study was to investigate the prevalence of periodontitis in psoriasis patients, and to find whether any correlation exists between them.Materials and methods. This hospital-based cross-sectional study included 100 age- and gender-matched subjects divided into two groups: group 1: psoriasis (test) and group 2: chronic periodontitis (CP) (control). Both groups were evaluated for periodontal clinical parameters (gingival index (GI), plaque index (PI), probing depth (PD), periodontal attachment level (PAL) and tooth loss (1-3 or ≥4). Furthermore, subgingival microbial analysis of dental plaque was carried out to estimate the levels of periodontopathic organisms, using polymerase chain reaction (PCR). ANOVA, independent sample t-test and chi-squared test were used for statistical analysis.Results. Psoriasis patients showed significantly higher GI, PI, PD, PAL and tooth loss (≥4) compared to controls. Furthermore, their microbiological analysis showed significantly greater number of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis positive samples. However, no difference was found in Tannerella forsythia positive samples.Conclusions. The prevalence of periodontitis is higher in psoriasis subjects as compared to age- and gender-matched periodontitis controls. We hypothesized that this assumption is valid as periodontitis shares several important common pathways with psoriasis. Further studies with larger sample sizes are warranted to substantiate this association.

Background and aims. Dental implant education is inevitable in dental educational programs of dental schools. The aim of the present study was to determine and evaluate the curricula and teaching methods for dental implants in specialty courses of periodontics, maxillofacial surgery and prosthodontics in Iran.Materials and methods. In the present study, 6 dental faculties were evaluated. Data was collected through discussions in small groups with authorities, academic staff and post-graduate students. A special questionnaire was used for quantitative variables. Descriptive statistical methods (means, medians, and ranges) were used when necessary.Results. All the dental faculties had dental implant educational programs in their curricula. However, the details were unspecified and the programs were presented differently in different faculties. A total of 82.3% of the academic staff of the departments involved participated in the programs. Lack of funds and facilities were reported as the most important factors limiting implant educational programs. Forty-five articles by the academic staff of dental faculties in Iran have been cited in Pubmed.Conclusions. The details of dental implant educational programs are different in different dental faculties in Iran; however, the content of the programs are similar to a great degree.

Background and aims. The aim of the present study was to estimate the prevalence of dentin hypersensitivity in an adult population in Greece.Materials and methods. Eight hundred patients participated in the present study, including 380 males and 420 females with an age range of 18‒64 years. All the subjects answered questions regarding gender, age, educational level, teeth affected and any factor that initiated dentin hypersensitivity. This was followed by a clinical examination involving assessment of sensitive teeth per patient and any buccal gingival recession associated with sensitive teeth. Data were analyzed using descriptive statistics and chi-squared test.Results. Our findings showed that 13.5% of the patients had dentine hypersensitivity. Prevalence of hypersensitivity in females (15%) was not significantly higher (p=0.465) than males (11.8%). The mean number of sensitive teeth per patient showed a peak in the 35‒44 age group and then reduced slowly in the older and younger cohorts. The teeth most commonly affected by dentin hypersensitivity were the first and second premolars of both jaws followed by the canines of both jaws. The majority (82.5%) of sensitive teeth had at least 1-3 mm of gingival recession. Pain-initiating stimuli frequently observed were the consumption of cold drinks followed by consumption of hot drinks and tooth-brushing. A statistically significant difference was recorded between dentin hypersensitivity and educational level (p=0.045).Conclusions. The prevalence of dentin hypersensitivity in an adult population sample in Greece was 13.5% and the mean number of sensitive teeth per patient was observed to increase with age.

This clinical report describes a case of maxillary dental rehabilitation using five implants placed simultaneously in three cortico-cancellous iliac bone blocks and rigidly fixed to the residual bone with titanium mini-screws 2-mm in diameter and mini-plates. All “empty spaces” between the bone segments were filled with iliac bone chips harvested from the diploe of iliac bone mixed by Bio-oss. The second surgery was performed 5 months later, when all five implants were integrated, and one cover screw was exposed to oral cavity. Two months after the second surgery, abutments were connected to the implants and loaded with a fixed partial denture.

This clinical report describes the successful use of lip repositioning technique for the reduction of excessive gingival display. A 34-year-old female patient reported with a chief complaint of gummy smile. The lip repositioning technique was performed under local anesthesia with the main objective of reducing gummy smile by limiting the retraction of elevator muscles (e.g. zygomaticus minor, levator anguli, orbicularis oris and levator labii superioris). The technique is fulfilled by removing a strip of mucosa from the maxillary buccal vestibule, creating a partial-thickness flap between mucogingival junction and upper lip musculature, and suturing the lip mucosa with mucogingival junction, resulting in a narrow vestibule and restricted muscle pull, thereby reducing gingival display. A scalpel surgery was planned for depigmentation. The entire procedure was explained to the patient and written consent was obtained. A Bard Parker handle with a No.15 blade was used to remove the pigmented layer. When a crown lengthening procedure is planned to increase the length of the available tooth, the biological width needs to be considered and not encroached upon, as this may lead to periodontal breakdown.

Lack of sufficient bone to place an implant at the most functionally and esthetically appropriate position is a common problem, especially in the maxillary anterior esthetic zone region. A surgical bone spreading technique is proposed to augment the alveolar ridge for horizontal defects through a localized alveolar osteotomy and interpositional bone graft. Bone spreading technique (BST) is horizontal augmentation with minimal trauma for simultaneous implant placement. The foremost advantage of this method is that the buccal wall expands after the medullar bone is compressed against the cortical bone. The lateral dilation and compaction of the medullar bone enhances primary stability.