Giuseppe Cardaropoli

Healing following ultrasonic debridement and PVP-iodine in individuals with severe chronic periodontal disease: A randomized, controlled clinical study

Objective. Antiseptics and antibiotics delivered either locally or systemically have been used as an adjunct to scaling and root planing procedures in order to control the subgingival biofilm and thereby enhancing the treatment outcome. The results presented in the literature are, however, inconclusive. Povidone-iodine (PVP-iodine) has a bactericidal effect and is effective against most bacteria, including putative periodontal pathogens. The aim of the present study was to evaluate the clinical effect of PVP-iodine as an adjunct to ultrasonic scaling in the treatment of severe chronic periodontitis. Material and Methods. Twenty patients were recruited to the study. Each test site and the related quadrant were randomly assigned to one of four different treatment modalities: ultrasonic scaling + subgingival irrigation with 0.5% PVP-iodine for 5 min/tooth, ultrasonic scaling + subgingival irrigation with sterile saline solution for 5 min/tooth, subgingival irrigation with sterile saline solution for 5 min/tooth, and subgingival irrigation with 0.5% PVP-iodine for 5 min/tooth. The individuals were followed longitudinally for 6 months. Results. The present study showed that non-surgical periodontal therapy by means of an ultrasonic device was effective in attaining a healthy periodontal status in patients with severe periodontal lesions. No additive effect was found when PVP-iodine was included. Conclusions. Ultrasonic debridement using Odontogain® is effective in controlling infection in patients with severe chronic periodontitis. PVP-iodine does not add any clinical benefit to the ultrasonic debridement alone under these circumstances.

Vertical ridge augmentation with a collagen membrane, bovine bone mineral and fibrin sealer: clinical and histologic findings.

This study evaluated the treatment of alveolar bone deficiencies combined with dental implant placement. Thirty-five endosseous implants were inserted into 20 patients. After implant placement, the mean height of the supracrestal bone defects measured 4.25 ± 1.34 mm. Bone regeneration procedures were performed using a combination of a bovine bone-derived mineral stabilized with a fibrin-fibronectin sealing system and covered with a bilayered porcine collagen membrane. Healing was uneventful in all instances with maintenance of primary closure throughout the healing period. Stage-two surgery was performed after 6 months, and a hard bonelike tissue was detectable at the defect sites. Histologic examination confirmed the presence of newly formed bone with residual particles of xenograft. The mean bone gain was 3.95 ± 1.47 mm. The positive outcomes in terms of bone regeneration and low complication rate demonstrated the potential of this technique for the treatment of supracrestal ridge deficiencies. Bovine bone mineral combined with a fibrin sealer and protected by a collagen membrane should be considered as an alternative in the treatment of vertical peri-implant bone defects.

Soft tissue contour changes at immediate implants: a randomized controlled clinical study.

In 52 patients, single anterior teeth were extracted and replaced by immediate implants. The peri-implant gap was left either untreated (control) or was grafted and covered with a membrane (test group). After 12 months the horizontal bone resorption was significantly lower in the test group (test sites: 0.69 ± 0.68 mm, 8.13%; control sites: 1.92 ± 1.02 mm, 21.62%; P = .001), and there was less reduction in ridge height (test sites: 0.58 ± 0.77 mm; control sites: 1.69 ± 1.74 mm;P = .004). Ridge preservation considerably limited the amount of horizontal and vertical soft tissue alterations when compared with implant placement alone.