A novel soft tissue thickness measuring method using cone beam computed tomography.

OBJECTIVE: The aim of this study was to introduce a novel soft tissue thickness measurement method using cone beam computed tomography (CBCT) and to compare the new method with ultrasonic device applications and transgingival probing measurements. METHODS: Twenty-five participants (12 female, 13 male, age range, 25-51 years) were included the study. Soft tissue thickness in lateral incisor, canine, premolar, and molar regions were measured using transgingival probing (group T), ultrasonic device (group U), and CBCT scan measurements (group C). Differences and correlations between groups and agreement between measurement methods were evaluated. RESULTS: Soft tissue thickness was significantly lower in group U in premolar region, but was significantly higher in molar region compared with group C and group T (P < .05). There were significant positive correlations in lateral incisor and canine region, between group U and group C, in premolar region between group T and group C, and in molar region between group U and group C, and between group C and group T (P < .05). The highest agreement between measurement methods was evident between group T and group C. CONCLUSION: Soft tissue thickness values in maxilla may differ depending on the measurement method and location of the measurement. Ultrasonic device, transgingival probing, and CBCT measures may not necessarily correlate in all locations. The high agreement between CBCT measurements and transgingival probing may suggest the newly introduced method as a promising technique for soft tissue thickness evaluation. CLINICAL SIGNIFICANCE: This study evaluated the relation between different soft tissue thickness measurement methods and demonstrated a novel method which can be used in any part of the mouth. The outcome also suggested that the measurement method and the location might affect the soft tissue thickness value obtained, and therefore might be important in clinical decision making.

Micro- and macrosurgical techniques in the coverage of gingival recession using connective tissue graft: 2 years follow-up.

OBJECTIVE: The aim was to evaluate the clinical results of micro- and macrosurgical approaches in the coverage of gingival recession using connective tissue graft. MATERIAL AND METHODS: Twenty-one teeth in microsurgical group (test group) and 21 in macrosurgical group (control group) were treated using coronally positioned flap and subgingival connective tissue graft. Recession depth (RD), recession width (RW), root surface area (RSA), keratinized tissue width (KTW), probing depth, clinical attachment level, pain level during healing, and aesthetic results were evaluated for 24 months. RESULTS: RD, RW, and RSA were significantly lower at 1, 3, 6, and 24th months compared with baseline in both groups. RD was also significantly lower in the 1st month compared with 24th month in control group. RD and RSA at 24th month were significantly lower in microsurgical group. KTW significantly and similarly increased by 6th month in both groups. The pain levels in the donor and the recipient area decreased earlier in the microsurgical group, and aesthetic scores improved similarly in both groups. CONCLUSION: A microsurgical approach to root coverage with gingival recession is likely to preserve the clinical outcomes longer than macrosurgical approach, at least for 24 months. Healing appears to be faster using microsurgery, but aesthetic outcomes are similar. CLINICAL SIGNIFICANCE: This study evaluated the clinical results of microsurgical versus macrosurgical approaches to root coverage in cases of gingival recession. Based on the results of the study, pain levels in the donor and the recipient areas decreased earlier in the microsurgical group, and microsurgical approach resulted in significantly greater amount of root coverage at 24 months.

Effect of human platelet-derived growth factor-BB on attachment of periodontal ligament cells on root surfaces.

OBJECTIVE: To evaluate the effects of platelet-derived growth factor-BB (PDGF-BB) on the attachment of human periodontal ligament cells (HPLCs) on the root surfaces demineralized with different agents. METHODS: We performed this study at Ege University, Izmir, Turkey between 2005 and 2006. Eighty root slices were subjected to one of following treatments after root planing: 1) only root planing, 2) Platelet derived growth factor-BB (PDGF-BB), 3) citric acid demineralization, 4) citric acid demineralization + PDGF-BB, 5) tetracycline hydrochloric acid (T-HCl) demineralization, 6) T-HCl demineralization + PDGF-BB, 7) ethylenediamine tetra-acetic acid (EDTA) demineralization, and 8) EDTA demineralization + PDGF-BB. Human periodontal ligament cells were seeded on the root surfaces. Following the 2-hour incubation period, the number of cells was calculated by the colorimetric assay. Three slices from each group were processed for scanning electron microscopy. The number of attached cells was tested by analysis of variance (p=0.050). RESULTS: There were no significant differences among the groups with regard to the mean number of attached cells (p=0.843), which was highest in the fourth group, and lowest in the sixth group. CONCLUSION: Root planing is the most important treatment to make the diseased root surfaces biocompatible to HPLCs adherence. Application of PDGF-BB to root surfaces demineralized with citric acid may be advocated to enhance periodontal regeneration.

5-year longitudinal study of survival rate and periodontal parameter changes at sites of maxillary canine autotransplantation.

BACKGROUND: Although dental transplantation is an accepted treatment modality, few studies have evaluated the prognosis for autotransplantation of maxillary canines, and changes in clinical periodontal parameters still need to be demonstrated. The objectives of this long-term study were to evaluate the prognosis and changes in clinical attachment level (CAL), probing depth (PD), soft tissue recession (REC), and radiographic bone level changes between years 1 and 5 for autotransplanted maxillary canines. METHODS: Thirty subjects with 32 impacted canines were scheduled for transplantation. Transplanted teeth were splinted for 4 weeks, and endodontic treatments were performed within 1 year after the operation. Radiographs were taken, and PD and CAL were measured for up to 5 years. Progressive root resorption was observed in two teeth, and one tooth was extracted during year 4. RESULTS: The survival rate was 93.5%. CAL and PD tended to increase slightly at all sites, especially at palatal sites after transplantation, whereas the greatest CAL and PD were found at approximal sites, and REC was the same as natural teeth. CONCLUSIONS: Maxillary canine transplantation can be a reliable treatment alternative. Clinical measurements demonstrated long-term stability. Based on the literature and the present findings, maxillary canine transplantation can be suggested as a promising treatment modality.

Effect of platelet-rich plasma on gingival and periodontal ligament fibroblasts: new in-vitro growth assay

The use of platelet-rich plasma (PRP) as a source of growth factors is reported to be beneficial for periodontal regeneration. The aim of this study was to evaluate its effect on gingival and periodontal ligament fibroblast healing on a special growth assay designed by the working group. A wound with a 5 mm of diameter has been performed on periodontal ligament (PDL) and gingival fibroblast (GF) cell cultures. The cell wells were divided into five groups. The control group received only DulbeccoÆs modified EagleÆs medium/ HamÆs (DMEM) and the test groups received 0.5% PRP with 1/3 or 1/2 thrombin; 0.1% PRP with 1/3 or 1/2 thrombin. All of the groups were stained with haemotoxylene-eosine on days 2, 5, 7, 9 and 11. Digital screenings were performed on each time stop and the results were interpreted by means of % surface area covered by the cells. The results showed that 0.1% PRP with 1/3 thrombin group have closed up the wound circle in GF group at day 9 and in PDL group at days 9 and 11 with a significant difference when compared with other groups. GF response was significantly better than PDL cell response starting from day 5. Concluding, PRP favored wound closure in PDL and GF cell cultures and the developed growth assay may be utilized in future investigations of the biological basis of periodontal wound healing.

Reattachment of subgingivally fractured central incisor with an open apex.

A case report of a 6-year-old girl with a fractured maxillary left central incisor with an open apex is presented. The procedure used to repair the fracture included flap surgery with an intrasulcular incision and endodontic treatment. The patient was called for 3 months regular follow-up to check the root formation. At the end of 32 months just before the root was obturated by guttaperka, she fractured the same tooth. Flap surgery was repeated and the tooth was restored. The root canal was obturated with a root filling paste and guttaperka as the apex was closed. Examination 10 months after treatment revealed good periodontal health, aesthetics and normal function.

The effect of bee propolis on oral pathogens and human gingival fibroblasts.

Propolis is one of the few natural remedies that have maintained its popularity over a long period of time. The aim of this study is to investigate the antimicrobial properties of six propolis solutions and evaluate their cytotoxicity on gingival fibroblasts at different dilutions. Two different solutions of powder propolis (Sigma) and Turkish propolis were prepared and propylene glycol (PG) and alcohol were used as solvents for each propolis sample. In addition to the four propolis solutions, two other propolis samples of far geographic regions (USA and Australia) were included in the study. The antibacterial effects of six solutions on oral pathogen microorganisms were tested and their cytotoxic effects on human gingival fibroblasts were evaluated by MTT assay. The effective dilutions of the six propolis samples on periodontopathogen microorganisms were found to be cytotoxic to gingival fibroblasts. All solutions had strong antifungal activity and the effective dilutions were safe for gingival fibroblasts. Propolis could have a promising role in the future medicine, if appropriate solutions can be prepared being strongly antibacterial and non-cytotoxic as well.

Quantitative evaluation of the vasculature and fibronectin localization in gingival connective tissue of smokers and non-smokers.

BACKGROUND: It has been shown that tobacco is a significant risk factor for periodontal disease. The reason for decreased gingival bleeding in smokers is not known. The aim of the present study was to demonstrate the localization of fibronectin in the extracellular matrix of the inflamed gingiva of smokers and non-smokers and to evaluate the chronic effect of smoking on the gingival microvessel number (NVES) and vascular surface density (VSD). METHODS: Seventy-four (74) adult patients with periodontitis were included in this investigation. Of these patients, 38 were smokers and 36 were non-smokers. Probing depths (PD), papillary bleeding index (PBI) of both groups, and the smoking habits of the smokers were recorded. Biopsy specimens obtained during periodontal surgery were prepared to evaluate fibronectin distribution and to quantitate the vasculature. RESULTS: The mean VSD values of smokers and non-smokers were 6.721 +/- 1.845 and 5.721 +/- 3.118 (mean +/- SD), and the mean NVES of smokers and non-smokers was 31.582 +/- 11.810 and 30.145 +/- 15.442, respectively. The difference between the mean PD and PBI values of the 2 groups was not statistically significant. The location of the biopsy specimen, whether in the anterior or posterior area of the mouth, did not lead to any statistically significant differences between the groups. In addition, the number of years smoked and the tobacco brand used did not result in statistically significant differences. The most intense staining of fibronectin was observed beneath the epithelium around the blood vessels of the uppermost region of the connective tissue, showing a fibrillar and diffuse distribution; however, there was no significant difference between smokers and non-smokers. CONCLUSION: The results of the present study indicate that smoking does not affect the vascular surface density, number of vessels per mm2 stroma, or fibronectin distribution in subepithelial gingival connective tissue.