Lavin Flores-de-Jacoby

Bioabsorbable Membrane and Bioactive Glass in the Treatment of Intrabony Defects in Patients With Generalized Aggressive Periodontitis: Results of a 5-Year Clinical and Radiological Study

BACKGROUND The aim of this clinical and radiological prospective 5-year study was to compare the long-term effectiveness of a bioabsorbable membrane and a bioactive glass in the treatment of intrabony defects in patients with generalized aggressive periodontitis. METHODS Sixteen patients (11 women and five men) with generalized aggressive periodontitis were enrolled in the study. The investigations were confined to 1- to 3-walled intrabony defects with a depth >/=4 mm and with preoperative probing depths (PDs) >/=7 mm. Teeth with furcation involvement were excluded. Twenty-two of the defects were treated with the membrane (RXT group) and 20 with the bioactive glass (PG group). Allocation to the two groups was randomized. The clinical parameters plaque index (PI), gingival index (GI), PD, bleeding on probing (BOP), gingival recession (GR), clinical attachment level (CAL), and tooth mobility were recorded before surgery and at 6 months and every year for 5 years after surgery. Intraoral radiographs were taken using a standardized paralleling technique at baseline and every year for 5 years. Statistical analysis was based on Kolmogorov-Smirnov and Wilcoxon signed-rank tests, analysis of covariance, and Spearmans bivariate correlation analysis. RESULTS After 5 years, a reduction in PD of 3.6 +/- 0.8 mm (P = 0.016) and a gain in CAL of 3.0 +/- 2.0 mm (P = 0.01) were registered in the RXT group. There was a slight increase in GR by 0.6 +/- 1.4 mm (P = 0.334). In the PG group, a reduction in PD of 3.5 +/- 1.4 mm (P = 0.01) and a gain in CAL of 3.3 +/- 2.1 mm (P = 0.01) were recorded, whereas GR increased by 0.2 +/- 1.7 mm (P = 0.525). The 1-, 2-, 3-, and 4-year results did not differ significantly from the 5-year results. Radiographically, the defects (the point on the proximal surface of the defective tooth at which the projected alveolar crest intersected the root surface [xCA] to the most coronally located point at the proximal surface of the tooth on the defect side up to which the periodontal ligament space still displayed a uniform width [xBD]) were found to be filled by 47.5% +/- 38.3% (P = 0.001) in the RXT group and by 65.0% +/- 50.5% (P = 0.001) in the PG group. Crestal resorption (the most apical point of the enamel at the proximal surface of the tooth on the defect side [xCEJ] to the xCA) was 19.0% +/- 30.2% (P = 0.374) in the RXT group and 12.3% +/- 38.6% (P = 0.647) in the PG group. The xCEJ to the xBD was significantly more in the PG group (28.4 +/- 24.6 versus 7.3 +/- 21.8, P = 0.048). A good standard of oral hygiene and inflammation-free periodontal tissue in the postoperative phase improved the treatment outcome. No dependence of attachment gain was found on the tooth type, number of walls involved in the defects (r = 0.075; P = 0.319), or intraoperative depth (r = 0.114; P = 0.307). CONCLUSIONS Highly significant improvements in the parameters PD and CAL were recorded after 5 years with both regenerative materials. Radiographically, the defects (the xCED to the xBD) were found to be filled significantly more in the bioactive glass group. A good standard of oral hygiene and inflammation-free periodontal tissue in the postoperative phase improved the treatment outcome.

Comparison of two full-mouth approaches in the treatment of peri-implant mucositis: a pilot study.

OBJECTIVES The aim of the present study was to test the hypothesis that an additional full-mouth disinfection results in a greater clinical and microbiological improvement compared with sole mechanical debridement within one session in patients with peri-implant mucositis and treated chronic periodontitis. MATERIAL AND METHODS The study included 13 partially edentulous patients (mean age 51.5 years) with treated chronic periodontitis and 36 dental implants with mucositis (bleeding on probing and/or a gingival index > or =1 at least at one site at baseline, absence of peri-implant bone loss during the last 2 years before baseline). After randomized assignment to a test and a control group, patients received a one-stage full-mouth scaling with or without chlorhexidine. Clinical and microbiological examination was performed at baseline, after 1, 2, 4 and 8 months. Additional microbial samples were taken 24 h after treatment. Microbiological analysis was performed by real-time polymerase chain reaction. RESULTS Both treatment modalities resulted in significant reductions of probing depth at implant sites after 8 months, with no significant group differences. The bacteria at implants and teeth could be reduced in every group 24 h after treatment; however, this reduction was not significant after 8 months. CONCLUSIONS Both treatment modalities led to an improvement of the clinical parameters and a temporary reduction of the microflora at implants with mucositis, but without significant inter-group differences after 8 months.

One‐stage full‐mouth disinfection versus quadrant and full‐mouth root planing

OBJECTIVE The aim of this study was to test the hypothesis that the one-stage full-mouth disinfection (FMD) provides greater clinical and microbiological improvement compared with full-mouth scaling and root planing (FM-SRP) within 24 h and quadrant scaling and root planing (Q-SRP) in patients with generalized chronic periodontitis. MATERIAL & METHODS Twenty-eight patients were randomized into three groups. 25 patients completed the study and were the basis for analysis. The Q-SRP group was scaled quadrant-wise at 1-week intervals. The other groups received a one-stage full-mouth scaling with (FMD) and without (FM-SRP) chlorhexidine. At baseline, after 1, 2, 4 and 8 months clinical parameters were recorded and microbiological analysis was performed. RESULTS All three treatment modalities resulted in significant clinical improvement at any time. There were only group differences after 1 and 2 months: in the FM-SRP group was a significantly higher reduction of probing depth and bleeding on probing compared with the other two groups. The bacteria could be reduced in every group although this reduction was only significant for Prevotella intermedia in the FMD group 8 months after treatment. CONCLUSION All three treatment modalities lead to an improvement of the clinical and microbiological parameters, however, without significant group differences after 8 months.

Effect of Age on Gingival Crevicular Fluid Concentrations of MIF and PGE2

We used an experimental gingivitis study design to compare crevicular fluid concentrations of Migration Inhibitory Factor (MIF) and Prostaglandin E2 (PGE2) in younger (18 to 30 yrs) and older (46 to 77 yrs) healthy adults. PGE2 increased after 1 wk in younger participants, whereas it decreased in older individuals after 1 wk of plaque accumulation. A significant interaction between age and time was observed for PGE2 (p = 0.04). High concentrations of MIF were identified in both age groups at baseline. MIF increased in the younger participants, whereas in the older individuals a decrease over time was observed. MIF concentration was positively correlated with plaque index and gingival index in the older age group. Total counts of bacteria, Parvimonas micra and Prevotella intermedia, were significantly correlated with MIF concentration in older participants. In conclusion, MIF and PGE2 production in response to bacterial accumulation seems to be modified by age.