Measurement of the Clinical Effects of a Marine Fish Extract on Periodontal Healing—A Preliminary Clinical Interventional Study

The aim of the study was to assess the clinical effects of periodontal healing using a Romanian pharmaceutical compound of marine fish extract (Alflutop®). Adults with periodontal disease were included in the study group. Gingival inflammation, the degree of tooth mobility, and probing depth (PD) were recorded for each patient before and after therapy. Patients were divided into two groups: group I—after scaling and root planing (SRP), patients followed therapy with marine fish extract, Alflutop®, group II—SRP therapy alone. Statistically significant differences between groups in terms of gingival inflammation reduction (p = 0.045) were found. Tooth mobility reduction, as well as PD improvement, were also noticed after the therapy (p = 0.001), but no statistically significant differences among PD reduction rates were found (p = 0.356). Alflutop® has proven a certain therapeutic efficiency in the treatment of periodontitis in terms of reduction in the clinical signs of inflammation and tooth mobility.

Antimicrobial Impact of Different Air-Polishing Powders in a Subgingival Biofilm Model

Subgingival air-polishing devices (SAPD) can reduce bacterial biofilms and thus support periodontal healing. The authors of this study evaluated the effectiveness of the glycine-based and trehalose-based air-polishing powders in removing pathogenic bacteria in a subgingival biofilm model. We treated 56 subgingival pockets in porcine jaws with SAPD. Subgingival air polishing was performed in three groups of 13 pockets each: I, glycine-based powder; II, trehalose-based powder; and III, water alone. Another group (IV) served as untreated controls. Prior to air polishing, inoculated titanium bars were inserted into the pockets containing periopathogenic bacteria such as Porphyromonas gingivalis and Tannerella forsythia. Remaining bacteria were evaluated using real-time PCR. The numbers of remaining bacteria depended on the treatment procedure, with the lowest number of total bacteria in group I (median: 1.96 × 106 CFU; min: 1.46 × 105; max: 9.30 × 106). Both polishing powders in groups I and II (median: 1.36 × 107 CFU; min: 5.22 × 105; max: 7.50 × 107) showed a statistically significantly lower total bacterial load in comparison to both group IV (median: 2.02 × 108 CFU; min: 5.14 × 107; max: 4.51 × 108; p < 0.05) and group III (median: 4.58 × 107 CFU; min: 2.00 × 106; max: 3.06 × 108; p < 0.05). Both subgingival air-polishing powders investigated can reduce periopathogenic bacteria and thus support antimicrobial therapy approaches in periodontal treatment regimens.

Improved Healing after Non-Surgical Periodontal Therapy Is Associated with Higher Protein Intake in Patients Who Are Non-Smokers

The aim of this study was to determine whether a relationship between periodontal healing and protein intake exists in patients undergoing non-surgical treatment for periodontitis. Dietary protein intake was assessed using the 2005 Block food frequency questionnaire in patients with chronic generalized periodontitis undergoing scaling and root planing (n = 63 for non-smokers, n = 22 for smokers). Protein intake was correlated to post-treatment probing depth using multiple linear regression. Non-smoking patients who consumed ≥1 g protein/kg body weight/day had fewer sites with probing depth ≥ 4 mm after scaling and root planing compared to patients with intakes <1 g protein/kg body weight/day (11 ± 2 versus 16 ± 2, p = 0.05). This relationship was strengthened after controlling for baseline probing depth, hygienist and time between treatment and follow-up (10 ± 2 versus 16 ± 1, p = 0.018) and further strengthened after controlling for potential confounders including age, sex, body mass index, flossing frequency, and bleeding on probing (8 ± 2 versus 18 ± 2, p < 0.001). No associations were seen in patients who smoked. Consuming ≥1 g protein/kg body weight/day was associated with reductions in periodontal disease burden following scaling and root planing in patients who were non-smokers. Further studies are needed to differentiate between animal and plant proteins.

Accidental avulsion of a recently traumatised maxillary anterior tooth during rubber dam application

Avulsion injuries are usually seen in the anterior maxillary teeth as a result of trauma. Avulsion as an endodontic mishap is extremely rare. This report highlights an unusual instance of exarticulation of a recently traumatised maxillary central incisor tooth when the rubber dam was applied during a routine non-surgical endodontic procedure. The tooth was immediately repositioned and stabilised with wire composite splint. Endodontic treatment was initiated after rubber dam isolation with a modified technique. Calcium hydroxide was used as intracanal medicament dressing, and obturation was done after 2 weeks. The treatment was successful with uneventful periodontal healing at 24-month follow-up. The presence of well-demarcated periodontal ligament space and absence of any resorptive area on the radiograph could be defined as a successful outcome for the present case.

Successful management of mandibular first molars with endodontic-periodontal lesions – Two case reports

The interrelationship between pulpal and periodontal disease primarily occurs through the intimate anatomic and vascular connections between the pulp and the periodontium. The purpose of this case report is to present the treatment of two cases of mandibular first molars displaying endodontic-periodontal lesions with and without the use of regenerative bone techniques. The endodontic treatments were performed under an operating microscope in two appointments. Later, periodontal therapy was performed with a non-surgical approach in one case and with guided bone regeneration in the other. A 12-month radiographic and clinical follow-up showed periapical and periodontal healing in both cases. The present case report demonstrates that an interdisciplinary approach can help improve the prognosis and maintain natural dentition. Moreover, periodontal regenerative therapy can be performed to guide the wound healing towards the regeneration of lost periodontal structures.

Effect of tetracyclines on pulpal and periodontal healing after tooth replantation: a systematic review of human and animal studies

Background Pulpal and periodontal healing are two main concerns of delayed replantation of avulsed teeth. The objective of this review was to evaluate the effectiveness of topical and systemic application of tetracyclines on pulpal and periodontal healing after tooth replantation. Methods A comprehensive electronic search was conducted in six databases. This systematic review was carried out according to Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results After exclusion of 246 irrelevant papers, 14 animal studies and one human study were included in this review. The human study showed that avulsed permanent teeth treated with doxycycline did not show a better clinical outcome for pulp and periodontal healing compared with treatment with normal saline. As for animal studies, significant more pulpal healing was observed in immature teeth treated with topical doxycycline in two researches, while another one study showed that there is no difference between teeth treated with normal saline and teeth treated with doxycycline. Systemic doxycycline exerted no significant effect on pulpal revascularization illustrated by one research. Only one out of four articles illustrated the positive effect of systemic tetracyclines on periodontal healing. One paper reported that intracanal application of demeclocycline promoted favorable periodontal healing. Two articles showed topical doxycycline contributed to favorable periodontal healing, while five studies showed no significant effect of topical tetracyclines on periodontal healing. Conclusions As a result of data heterogeneity and limitations of the studies, the effect of topical or systemic application of tetracyclines on pulpal and periodontal healing is inconclusive. More studies are required to get more clinically significant conclusions.

COMPARATIVE EVALUATION OF THE BENEFITS OF ADJUNCTIVE USE OF LYCOPENE AND VITAMIN E IN NON-SURGICAL TREATMENT OF PERIODONTITIS : A RANDOMISED CLINICALAND MICROBIOLOGICAL STUDY

Background-This study was aimed to compare and evaluate the benefits of adjunctive use of lycopene and vitamin E in the non-surgical treatment of periodontal diseases and effect of this treatment on the periodontal microflora. Methodology-Systemically healthy 30 chronic periodontitis patients were included in the study. periodontal examination was performed and BANA test score were obtained. patients were randomly divided into group-I, group-II and group-III. scaling and root planing was performed for all three groups. group-II and group-III were supplimented with lycopene (Lycostar) and Vit E(Evion 400mg)respectively for 1 month. PI, BOP, PPD, CAL and BANA test score were re-evaluated after 1 month. Result-Periodontal parameters and BANA test score were significantly reduced in both group-II and group-III as compared to group-I. Conclusion-Systemic administration of antioxidants improved periodontal healing and significantly reduced microbial load and can be used as an adjunct to non-surgical periodontal therapy.

Aesthetic rehabilitation in a patient with skeletal mandibular deficiency and open bite: journey from splinted metalloceramic prosthesis to all-ceramic crowns

This case report is of a 31-year-old female who presented with splinted and faulty metalloceramic prosthesis on maxillary anterior teeth, which was responsible for localised periodontal disease and poor aesthetics. At multiple sites the ceramic had chipped off and the prosthesis colour did not match with the adjacent healthy teeth. A multidisciplinary approach of endodontics, periodontics and prosthodontics was employed for this case. The treatment plan consisted of removing the faulty prosthesis, endodontic retreatment of inadequately root-treated teeth and endodontics in the other coronally prepared abutment teeth. Crown lengthening surgery was performed for the correction of periodontal pockets and high smile line and maintenance of an adequate biological width. After periodontal healing, all-ceramic individual crowns were placed on the maxillary anterior teeth along with a three-unit all-ceramic bridge for the replacement of the left upper maxillary first premolar. Continuous...