The purpose of this study was to compare probing depth resolution achieved by gingivectomy and periodontal flap techniques in the treatment of cyclosporine A- and nifedipine-induced gingival enlargement. Ten kidney transplant patients who were receiving cyclosporine A and nifedipine for at least 6 months participated in the study. Five patients were randomly assigned to the gingivectomy group and 5 patients to the periodontal flap group. Only anterior segments of the oral cavity (canine to canine) were surgically treated. Clinical measurements, including probing depths, plaque index, and gingival sulcus index, were taken at baseline, 6 weeks, 6 months, and 1 year. Results showed that probing depths, while similar for both groups in the first 6 weeks of the study, were significantly shallower for the periodontal flap group when compared to the gingivectomy group at 6 months (2.48 +/- 0.34 mm versus 4.87 +/- 0.79 mm, respectively) and 1 year (322 +/- 0.65 mm versus 6.40 +/- 1.02 mm, respectively). Within its limitations, this study suggests that the pocket reduction achieved by the periodontal flap may be sustained for longer periods of time than by the gingivectomy technique in the treatment of cyclosporine A- and nifedipine-induced gingival enlargement.

Background: Polynucleotides (PN) and hyaluronic acid (HA) have been effective in stimulating the growth of primary gingival fibroblasts and promoting wound healing. The aim of this study was to investigate the clinical efficacy of a gel containing PN and HA used in association with subgingival re-instrumentation in the treatment of residual periodontal pockets. Methods: Fifty patients were enrolled in a randomized, split-mouth, singleblind, clinical trial. For each patient, two teeth with similar residual pockets with probing depth (PD) ≥5 mm were selected to receive re-instrumentation with (test group) or without (control group) the adjunctive use of a PN and HA-based gel. Differences in changes of PD, gingival recession, clinical attachment level (CAL), modified sulcular bleeding index (mSBI), plaque index (PI) from baseline to 6, 8, 24, 36, and 48 weeks were analyzed and the frequencies of sites with PD ≤4 mm at 48 weeks were compared.Results: At 48 weeks, the test group showed better results in terms of PD reduction (2.08 ± 1.24 vs. 1.94 ± 1.19, p = 0.533) and sites with PD ≤4 mm (38/50 vs. 35/50, p = 0.499), although not statistically significant. Similarly, CAL gain was comparable between groups (test: 0.50 ± 1.85 vs. control: 0.36 ± 1.80, p = 0.700). Significantly higher reduction in mSBI was recorded in the test group only in sites with baseline PD ≥6 mm (p = 0.004). Conclusions:The adjunctive use of a PN and HA-based gel could help to ensure a greater reduction of clinical parameters of inflammation in deep residual pockets.

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The purpose of this study was to evaluate the clinical efficacy of a non-surgical periodontal treatment using a piezoelectric power-driven device with a novel insert. Plaque index (PlI), bleeding on probing (BoP), probing depth (PD), recession depth (Rec) and clinical attachment level (CAL) were assessed at 6 weeks, 3 months and 6 months. Furthermore, tooth mobility and furcation involvement were recorded and chewing discomfort and dental hypersensitivity were evaluated. Eighteen stage I to IV periodontitis patients providing 437 teeth and 2622 sites in total were analyzed. At six weeks, CAL gain (0.4; p < 0.0001), PD reduction (0.4; p < 0.0001) and Rec increase (0.1; p = 0.0029) were statistically significant. Similarly, the mean number of sites with PD > 4 mm and absence of BoP significantly decreased between baseline and 6 weeks (−12.7; p < 0.0001). At this time point, the patient’s chewing discomfort was also significantly diminished (1.4; p = 0.0172). Conversely, no statistically significant changes were observed between 6 weeks and 3 months and between 3 months and 6 months for any of the clinical variables evaluated. In conclusion, within the limitation of this study, mechanical piezo-assisted non-surgical periodontal treatment in conjunction with an innovative tip resulted significantly efficacious to reduce pathological periodontal pockets, to gain clinical attachment and to reduce gingival inflammation.