This pilot study suggests that LDD in combination with AFS may improve the response of surgical therapy in reducing probing depth in severe chronic periodontal disease. LDD administration also tends to reduce local periodontal bone resorption during drug administration. The use of LDD did not appear to contribute to any significant shifts in the microbiota beyond that of surgery alone.

Factors associated with apoptosis were detected in GCF in patients with CP.

The prevalence of gingival recession has been estimated at around 22.5% in people aged older than 29 years. Classic treatment approaches include the use of connective tissue grafts in combination with coronally advanced flaps (CAFs). To reduce morbidity and the need for a secondary surgical site, allograft materials are currently being used. Nevertheless, long-term randomized studies testing the efficacy of these materials are lacking. Hence, the aim of the present randomized controlled clinical trial was to compare two acellular dermal matrix (ADM) materials produced by different processing techniques, freeze-dried (FDADM) and solvent-dehydrated ADM (SDADM). At 12 months, both groups showed significant improvement in attachment level, recession depth, and recession width. A mean improvement in attachment level of 2.0 ± 1.08 mm for FDADM and 2.0 ± 0.70 mm for both SDADM was achieved (P = .002). Root coverage after 12 months was 80.66 ± 22.90% for FDADM and 80.97 ± 18.08% for SDADM. Hence, it was concluded that both FDADM and SDADM grafting materials can successfully achieve root coverage in Miller Class I and II recession defects for up to 12 months when used in combination with CAFs.

BackgroundThe mechanisms responsible for periodontal disease progression remain unclear. However, recent studies suggest that apoptosis may be one mechanism underlying the pathophysiology of periodontal disease progression. This pilot study is the 3 month follow-up of our published baseline study on the presence of apoptotic factors in serum, saliva, and gingival crevicular fluid (GCF) and their association with periodontal disease severity and activity.MethodsGCF samples were obtained from 37 adult patients with chronic periodontitis (CP) and 7 healthy controls. Clinical measurements, including probing depth (PD), clinical attachment level (CAL), and radiographs, were used to evaluate data by sites and to classify patients into healthy, mild, and moderate/severe CP groups. Enzyme-linked immunosorbent assays were used to measure apoptosis or DNA fragmentation levels in GCF. Western immunoblotting was used to detect several apoptotic proteins, Fas, FasL, sFasL, and caspase-3 expression and its cleavage products in GCF.ResultsAt the patient level clinical and apoptotic measurements change minimally over time. At the site level, DNA fragmentation levels increase with increasing PDs at 3 months and baseline. Apoptotic protein expression exhibits increasing trends with increasing PDs at baseline and 3 months. FasL and Active FasL show a high specificity and PPV; low sensitivity and NPV. Caspase-3 products (ProCas35K and Active Cas) show a high PPV with moderate to high specificity; low sensitivity and NPV. ProCas70K shows a high PPV with moderate to high sensitivity; low specificity and NPV.ConclusionFactors associated with apoptosis show minimal changes in expression in periodontitis groups in comparison to a healthy group over a short time interval (3 months). However, at the site level, apoptotic factors (DNA fragmentation and apoptotic proteins) exhibit significant increases or increasing trends with increasing PDs at any time point examined (baseline or 3 months). Several of these apoptotic factors also exhibit a high sensitivity and high positive predictive value. Thus, apoptotic molecules may be helpful biomarkers of disease status at any point in time.