Clinical and Histological Manifestations of Chronic Coca Leaf Chewing in a Peruvian Population: A Cross-sectional Study.

AIMS: This study aimed to determine the possible clinical and histological periodontal effects of long-term coca leaf chewing habit in habitants of the highland region of Peru. MATERIALS AND METHODS: A total of 100 residents, were recruited for the study. Fifty individuals were habitual coca leaf chewers and 50 were non-users. Eligibility criteria were: 60-80 years old, ≥20 teeth present (excluding third molars), systemically healthy (controlled systemic disease), not using medication affecting the gingiva. Chronic tobacco smokers were excluded. All participants completed questionnaires, received clinical periodontal examination, and had gingival biopsies harvested for histopathological assessment. RESULTS: Most coca leaf chewers reported several oral changes resulting from the habit, such as bitterness, numbness and mouth dryness, while none of the non-chewers reported experiencing such changes. Within the clinical periodontal parameters, it was found that there was a significant difference in terms of clinical attachment level loss, with a p value of 0.014 in those who chewed coca leaves, who appeared to have less clinical attachment loss. CONCLUSIONS: Chewing coca leaf produce bitterness, numbness and mouth dryness, and clinical attachment loss. Histologically higher number of inflammatory cells in the stratum spinosum, with more acanthosis, clear cell, and higher number of blood vessels.

Alveolar Ridge Preservation Using a Bovine derived Bone Graft in Association with Titanium Foil - A Prospective Case Series.

AIMS: To estimate the change in the alveolar ridge by means of a new alveolar ridge preservation (ARP) approach, using an anodized titanium foil (Tseal) associated with a bovine bone graft (BBG) by cone-beam computerized tomography. MATERIALS AND METHODS: Sixteen patients, each presenting one hopeless tooth, were selected and these teeth were carefully extracted. The alveolar socket was filled with BBG and the Tseal was trimmed and adapted to the bone crest. The primary outcome variable was the change in the alveolar dimension (AD) measurements between baseline (T1) and 6 months (T2) 1mm below the palatal bone. RESULTS: Imaging assessment of AD demonstrated a decreased value in all subjects. The absolute rate and percentage of absorption between T1 and T2 time point showed statistically significant differences. The mean AD varied from 9.88 ± 2.04 mm (T1) to 8.85 ± 1.92 mm (T2). On average, this ARP procedure maintained 89.55% ± 6.11% of the distance of between the buccal and palatal wall. No differences were observed between the maxilla and mandible (p greater than 0.05). CONCLUSION: The application of a bovine bone graft covered with Tseal resulted in clinically important horizontal preservation of the alveolar ridge at 6 months after extraction.