No abstract

Oral lichen planus (OLP) could be a doubtless malignant autoimmune disease, characterized by burning and pain that reduces the standard of patient's life. Treatment of OLP remains a significant challenge despite the recent advances in understanding the immunopathogenesis.The properties of Platelet-rich plasma suggested its application in clinical practice for treatment of OLP patients that do not respond to conventional therapy. This study aims to evaluate the effectiveness of intralesional Platelet rich Plasma (PRP) in treatment of Erosive lichen planus. Materials and methods:The study sample consisted of 10 patients of erosive OLP among which were given intralesional PRP. All the patients were given weekly injections for 4 weeks. The two fundamentals variables used for assessment of the patient is pain control and healing of the lesion. Each visit consists of measuring the target lesion size and pain evaluation by visual analogue scale (VAS) .Results: No serious adverse reaction was obtained in patients during the 4 weeks of treatment.The result was satisfactory with a significant reduction in patient symptoms. Reduction in terms of size and inflammation was observed. Conclusion:This methodology of using intralesional PRP showed to be effective in decreasing the symptoms and improvement in clinical signs of OLP, which was resistant to conventional therapy.

Background. This study aimed to compare the use of the platelet-rich fibrin membrane (PRF) versus the free gingival graft (FGG) during the second stage of the dental implant to increase the amount of keratinized mucosa around dental implants. Methods. Fifteen patients with bilaterally missing teeth and deficient width of the keratinized mucosa (KM) were recruited for a spit-mouth randomized controlled trial. After implant placement on the control sides, onlay FGG was used, whereas, on the other side (study side), onlay PRF membranes were applied to augment the KM. One month and three months after augmentation, the increase in keratinized mucosa width, bone level around the implants, and soft tissue health were evaluated and compared. The shrinkage percentage was also calculated for both grafts. Results. There was a significant increase in the width of KM in the FGG and PRF groups; however, it was observed that FFG resulted in significantly better results than PRF, with no significant difference in peri-implant soft tissue health or bone level. Conclusion. Within the limitations of this study, it was concluded that the onlay PRF membrane could increase the keratinized mucosa width around dental implants with the advantages of a lower surgical time and less postoperative discomfort and pain for the patients in comparison to the FGG. However, FGG had a significantly higher ability to augment and increase keratinized mucosa around dental implants.

Background. The present study aimed to assess the clinical and radiographic effect of strontium ranelate and metal-substituted hydroxyapatite as bone graft materials on treating chronic periodontitis among diabetes mellitus patients. Methods. A randomized split-mouth study was conducted on 20 sites in 10 controlled type II diabetic patients suffering from chronic periodontitis. After phase I therapy, the sites were randomly allocated by a computer-generated table into two groups. Group 1: A mucoperiosteal flap was elevated in 10 sites, followed by the placement of strontium ranelate mixed with Gengigel. Group 2: A mucoperiosteal flap was elevated in 10 opposite sites, followed by the placement of metal-substituted hydroxyapatite mixed with Gengigel. Clinical parameters were assessed at baseline and 3- and 6-month intervals. Cone-beam computed tomography (CBCT) was used at baseline and after six months to assess bone gain. Results. The two treatment modalities resulted in a statistically significant reduction in clinical parameters at the 3- and 6-month intervals compared to the mean baseline value. Intergroup comparison showed a significant reduction in probing pocket depth and clinical attachment loss in group 1 compared to group 2. Comparison of the two sides by CBCT showed a significant increase in the alveolar bone height in the SR group than the metal-substituted hydroxyapatite group. Conclusion. Clinical and radiographic results showed a significant improvement in the two groups and provided evidence that strontium ranelate is promising in treating periodontal diseases.

BackgroundThe use of Cone Beam Computed Tomography (CBCT) in dentistry started in the maxillofacial field, where it was used for complex and comprehensive treatment planning. Due to the reduced radiation dose compared to a Computed Tomography (CT) scan, CBCT has become a frequently used diagnostic tool in dental practice. However, published data on the accuracy of CBCT in the diagnosis of the buccal bone level is lacking. The aim of this study was to compare the accuracy of intra-oral radiography (IOR) as well as CBCT in the diagnosis of the extent of buccal bone loss.MethodsA dry skull was used to create a buccal bone defect at the most coronal level of a first premolar; the defect was enlarged apically in steps of 1 mm. After each step, IOR and CBCT were taken. Based on CBCT data 2 observers jointly selected 3 axial slices at different levels of the buccal bone, as well as one transverse slice. Six dentists participated in radiographic observations. First, all observers received the 10 intra-oral radiographs and each observer was asked to rank the intra-oral radiographs on the extent of the buccal bone defect. Afterwards, the procedure was repeated with the CBCTs based on a combination of axial and transverse information. For the second part of the study, each observer was asked to evaluate axial as well as transverse CBCT slices on the presence or absence of a buccal bone defect. ResultsThe percentage of buccal bone defect progression rankings that were within 1 of the true rank was 32% for IOR and 42% for CBCT. On average, kappa values were increased by 0.384 for CBCT compared with intra-oral radiography. The overall sensitivity and specificity of CBCT in the diagnosis of the presence or absence of a buccal bone defect was 0.89 and 0.85, respectively. The average area under the curve (AUC) of the ROC was 0.892 for all observers.ConclusionWhen CBCT images are available for justified indications, other than bone level assessment, such 3D images are more accurate and thus preferred to 2D images to assess periodontal buccal bone. For other clinical applications, intra-oral radiography remains the standard method for radiographic evaluation.