Introduction: Gingival recession results from apical migration of the gingival margin leading to root exposure with esthetical and functional problems. Treatment of gingival recession occurs through variable techniques as laterally positioned flaps, coronally advanced flaps, connective tissue graft, tunnel technique and guided tissue regeneration. Acellular Dermal Matrix allograft (ADM) is a safe alternative to autogenous grafts allows the treatment of multiple adjacent recessions. The tunnel technique (Tun) provides good vascularity with absence of the vertical releasing incision. Modification of tunnel technique, vestibular incision subperiosteal tunnel access (VISTA) preserve the papillary integrity and enhances patient's compliance. Materials and Methods:A split mouth study design was done on ten patients having bilaterally symmetrical maxillary or mandibular two to three adjacent Miller Class I or II gingival recession defects on canine or premolars. In each patient, gingival recession will be treated with VISTA+ADM at the right side and TUN+ADM at the left side.Results: After 6 months follow-up period a statistical significant difference exists between (VISTA+ADM) and (Tun+ADM) sides regarding recession heights and clinical attachment level in favor of (VISTA+ADM) technique. Also a statistically significant difference exists between baseline and 6 months follow-up measurements within each group regarding recession height, clinical attachment level, width of keratinized gingiva and probing depth.Conclusion: Acellular Dermal Matrix allograft is recommended in treatment of multiple gingival recessions. The combination of VISTA+ADM technique found to be more efficient than Tun+ ADM in treatment of Miller class I and II gingival recessions and led to favorable root coverage.
Introduction: Management of gingival enlargement starts with conventional periodontal treatment and might be followed by surgical intervention to return the gingiva to its normal anatomical and physiological contour. Gingivectomy can be done by various techniques as laser and electrocautery. Diode laser as a semiconductor transfer electrical energy into light energy allowing easy manipulation of soft tissue. Electrocautery is a controlled, precise application of heat used with carefully designed electrodes. Materials and Methods:A split mouth study design was done on ten patients having bilaterally symmetrical gingival hyperplasia in lower anterior teeth due to chronic inflammatory gingival enlargement. In each patient, gingivectomy was done with diode laser at the right side and electrocautery at the left side.Results: Intraoperative parameters included haemostasis and duration of surgery which showed no significant difference between both sides while laser showed significant improvement over electrocautery regarding instrument sticking. Postoperative parameters included pain which showed statically significant difference between both sides at 72hs in favor of electrocautery side, and healing index (HI) which showed no significant difference between both sides at 72hs, one week and one month postoperatively. Conclusion:Both treatment modalities were efficient in performing gingivectomy however, Electrocautery was superior to diode laser regarding postoperative pain and diode laser has advantage over electrocautery regarding instrument performance and showed better improvement in healing process.
Background: Diabetes mellitus and smoking are considered as two major risk factors that influence the severity and progression of periodontal disease. Severity and prevalence of periodontitis varies in different countries of the world and there are indications that may be extensive in developing more than high developed countries. Objective: The present study was designed to evaluate the periodontal conditions and severity of chronic periodontitis patients in relation to smoking and diabetes at Holy Makkah city. Materials and Methods: Two hundred and fifty-four patient adult male chronic periodontitis patients were participated in this study, their age ranging from 24 to 60 years old with mean age of 37.50 ± 0.13 years. The patients were selected from enrolled individuals at screening unit in three dental centers at Makkah city. The selection of chronic periodontitis patients were based on two major risk factors in presence or absence of smoking and diabetes mellitus and they categorized into the following four groups G1: Non diabetic nonsmokers, G2: Diabetic nonsmokers, G3: Non diabetic smokers, G4: Diabetic smokers. The periodontal status was evaluated by four clinical parameters: Plaque Index (PI), Bleeding Index (BI), Probing Pocket Depth (PD) and Clinical Attachment Loss (CAL). Results: The results were revealed the comparisons between the mean values of clinical parameters; PI was highly significant in G2 compared to G1 and G3. BI was significant in G2 versus to G1, and highly significant in G4 contrast to G1and G3. PD was significantly increased in G2 than G1, and highly significant in G4 related to G1, G2 and G3. CAL was significant in G4 compared to G3, highly significantly increased in G4 than G1 and G2, whereas, high significant in G4 contrast to G3. Severity forms of periodontitis in each group categorized into; mild, moderate and severe;
Objectives:The aim of the present study was to evaluate the use of platelet rich fibrin and Nano-hydroxyapatite as a regenerative treatment in furcation class II defect. Material and methods: Eight young adult dogs was selected for the study; in each dog, class II furcation defects were surgically created in 4 premolars and were treated as follow: First was treated with Nano hydroxyapatite alone ; Second with PRF alone ; Third with Nano hydroxyapatite and PRF ; Fourth did not receive any additional treatment than debridement (controls). Results: histomorphometric analysis revealed that, the greatest amount of newly formed bone was observed in the (PRF+ NHA bone) group, followed by the PRF group, then the NHA group, with the least recorded in the control group. The difference was not statistically significant except in comparing (PRF+ NHA group) with control group (p=0.0035). Conclusion:The combined use of both PRF and Nano hydroxyapatite in treatment of furcation class II defects could accelerate healing processes, getting use of the synergic effect of the powerful inherent regenerative potential of PRF and Nano hydroxyapatite.
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