Long-term predictability of allogenic dermal matrix for root coverage: Three years observation period on 15 consecutive cases.

Gingival recession is an apical migration of gingival margin that is a common finding on patients with meticulous oral hygiene and periodontitis patients. Several surgical treatment techniques of gingival recession have been described. The most challenging situation is the presence of multiple adjacent recession defects. 15 patients with total of 53 recession defects have been treated with Acellular Dermal Matrix (ADM). The following clinical parameters were evaluated recession depth (RD), probing depth (PD); and the width of the keratinized tissue (KT). Upon completion of the study; there was statistically significant (P-value = 0.00) reduction in recession depth from baseline, one and three years after the surgery (2.6 mm, 0.32 mm, and 0.17 mm, respectively). There was statistically significant (P-value = 0.00) increase in the width of keratinized tissue from baseline to one year and three years (3.47 mm, 5.02 mm, and 5.40 mm, respectively). Based on this study the use of ADM with the coronally advanced flap resulted in a significant increase in keratinized tissue and percentage of root surface coverage.

The Osteogenetic Potential of Chitosan Coated Implant: An In Vitro Study.

Objective: Chitosan is a promising polymer that has been used for coating dental implants. However, research concerning coatings with implant surfaces other than commercially pure titanium is limited. Therefore, this study aims to clarify the chitosan material's effect with two degrees of deacetylation (DDA) as coatings for laser surface microtopographic implants. Methods: Sixty-three Laser-Lok (LL) implant discs were divided into three groups (21 in each group), and two groups were coated with either 80 or 95 DDA chitosan. The groups were categorized as LL 95, LL 80, or LL control. Then, hMSC-TERT 20 cells were used to evaluate the cell morphology, viability, and osteogenic capacity of the chitosan material 7 and 14 days after culture. Two-way ANOVA followed by one-way analysis of variance (ANOVA) and Tukey's post hoc test were used. Results: All samples were biocompatible and allowed cell attachment. However, cell spreading and attachment were noticeably increased in the LL 95 group. There was a significant increase in the expression of osteogenic markers in chitosan-coated samples compared to the control group. The 95 DDA-coated group exhibited higher ALP, Runx2, osteocalcin, and osteonectin expression compared to the 80 DDA and control groups on days 7 and 14. Conclusion: A high DDA of chitosan promotes biomineralization and osteoblast formation. Therefore, this combination of laser surface and chitosan can enhance future dental implant healing processes and osseointegration.

Infected Mosquitoes Have Altered Behavior to Repellents: A Systematic Review and Meta-analysis.

Here we conducted a systematic review and meta-analysis to reach a consensus on whether infected and uninfected mosquitoes respond differently to repellents. After screening 2,316 published studies, theses, and conference abstracts, we identified 18 studies that tested whether infection status modulated the effectiveness of repellents. Thirteen of these studies had outcomes available for meta-analysis, and overall, seven repellents were tested (typically DEET with 62% of outcomes), six mosquito species had repellence behaviors measured (typically Aedes aegypti (L.) (Diptera: Culicidae) mosquitoes with 71% of outcomes), and a broad diversity of infections were tested including Sindbis virus (Togaviridae: Alphavirus) (33% of outcomes), Dengue (Flaviviridae: Flavivirus) (31%), malaria (Plasmodium berghei Vincke & Lips (Haemospororida: Plasmodiidae) or P. falciparum Welch (Haemospororida: Plasmodiidae); 25%), Zika (Flaviviridae: Flavivirus) (7%), and microsporidia (4%). Pooling all outcomes with meta-analysis, we found that repellents were less effective against infected mosquitoes-marking an average 62% reduction in protective efficacy relative to uninfected mosquitoes (pooled odds ratio = 0.38, 95% confidence interval = 0.22-0.66; k = 96). Older infected mosquitoes were also more likely to show altered responses and loss of sensitivity to repellents, emphasizing the challenge of distinguishing between age or incubation period effects. Plasmodium- or Dengue-infected mosquitoes also did not show altered responses to repellents; however, Dengue-mosquito systems used inoculation practices that can introduce variability in repellency responses. Given our findings that repellents offer less protection against infected mosquitoes and that these vectors are the most dangerous in terms of disease transmission, then trials on repellent effectiveness should incorporate infected mosquitoes to improve predictability in blocking vector-human contact.

Real-Time Assessment of Guided Bone Regeneration in Standardized Calvarial Defects in Rats Using Bio-Oss With and Without Collagen Membrane: An In Vivo Microcomputed Tomographic and Histologic Experiment.

In vivo microcomputed tomography (µCT) enables real-time assessment of bone regeneration. The aim of this µCT and histologic experiment was to assess guided bone regeneration (GBR) around standardized calvarial defects in rats using particulate graft material (Bio-Oss) with and without collagen membranes (CMs). Eighteen female Sprague-Dawley rats aged 6 weeks and weighing 300 g were used. With the rats under general anesthesia, calvaria were exposed and a full-thickness standardized defect was created on the parietal bone. For treatment, rats were randomly assigned to the following three groups: (1) CM group; (2) Bio-Oss group; and (3) Bio-Oss + CM group. Bone volume and bone mineral density (BMD) of newly formed bone (NFB) and remnant bone particles were measured at baseline and 2, 4, 6, and 10 weeks after the operations using real-time in vivo µCT. At 10 weeks, all animals were sacrificed and calvarial tissues were assessed histologically. In the CM group, a significant increase in mean ± standard deviation (SD) BMD of NFB was observed at 6 weeks (0.32 ± 0.02 g/mm(3)) (P < .01) compared with baseline. In the Bio-Oss group, mean ± SD volume (3.03 ± 0.14 mm(3)) (P < .05) and BMD (0.14 ± 0.01 g/mm(3)) of NFB significantly increased at 6 weeks compared with baseline (P < .01). In the Bio-Oss + CM group, mean ± SD volume (0.98 ± 0.19 mm(3)) and BMD (0.13 ± 0.01 g/mm(3)) of NFB significantly increased at 4 weeks compared with baseline (P < .01). In th Bio-Oss + CM group, mean ± SD volume (3.5 ± 0.7 mm(3)) and BMD (0.44 ± 0.03 g/mm(3)) of remnant bone particles were significantly reduced at 10 weeks compared with baseline values (5.8 ± 0.96 mm(3) and 1.3 ± 0.02 g/mm(3)) (P < .05). Although histologic analysis revealed NFB in all the study groups, the Bio-Oss + CM group exhibited the most. The results of this study revealed that, in real time, new bone formation starts as early as 4 weeks in standardized calvarial defects undergoing GBR with Bio-Oss + CM, compared with new bone formation at 6 weeks in defects undergoing GBR with Bio-Oss alone.

Guided Bone Regeneration in Standardized Calvarial Defects in Rats Using Bio-Oss and ß-Tricalcium Phosphate with Adjunct Platelet-Derived Growth Factor Therapy: A Real-Time In Vivo Microcomputed Tomographic, Biomechanical, and Histologic Analysis.

The objective of the present real-time in vivo experiment was to assess guided bone regeneration (GBR) in standardized calvarial defects using particulate graft material (Bio-Oss) and ß-tricalcium phosphate (ß-TCP) with adjunct recombinant human platelet-derived growth factor (rhPDGF) therapy. Eighteen female Sprague-Dawley rats with a mean age and weight of 8 ± 0.53 weeks and 250 ± 0.49 g, respectively, were used. Following surgical exposure, a full-thickness standardized calvarial defect was created on the parietal bone using a trephine drill with an outer diameter of 4.6 mm. For treatment, rats were randomly divided into three groups (six rats per group): (1) control; (2) rhPDGF + Bio-Oss, and (3) rhPDGF + ß-TCP. Volume of newly formed bone (NFB), bone mineral density (BMD) of NFB, volume of remnant bone particles, and BMD of remnant bone particles were assessed using in vivo microcomputed tomography. Measurements were made at baseline and at 2, 4, 6, and 10 weeks after the surgical procedures. At 10 weeks, all animals were sacrificed and calvarial tissues were assessed histologically. In the control group, a significant increase in BMD of NFB was observed at 6 weeks (mean ± standard deviation [SD], 0.32 ± 0.002 g/mm(3)) (P < .01) from baseline, and the defect did not regenerate completely. In the rhPDGF + Bio-Oss group, mean ± SD volume (2.40 ± 0.25 mm(3)) (P < .01) and BMD (0.13 ± 0.01 g/mm(3)) of NFB significantly increased at 4 weeks and 6 weeks, respectively, from baseline (P < .001). In the rhPDGF + ß-TCP group, mean ± SD volume (2.01 ± 0.7 mm(3)) and BMD (0.12 ± 0.02 g/mm(3)) of NFB significantly increased at 4 weeks from baseline (P < .01). In the rhPDGF + Bio-Oss and rhPDGF + ß-TCP groups, mean ± SD BMD of remnant bone particles (0.31 ± 0.11 g/mm(3) and 0.23 ± 0.01 g/mm(3)) showed significant reduction at 6 and 10 weeks, respectively, compared with baseline values (1.12 ± 0.06 g/mm(3) and 0.92 ± 0.01 g/mm(3), respectively) (P < .001). Histologic results at 10 weeks showed NBF in the rhPDGF + Bio-Oss and rhPDGF + ß-TCP groups. In real time assessment, when rhPDGF was added to ß-TCP, BMD and bone hardness significantly increased compared with the other two groups.

Histomorphometric analysis of bone regeneration using a dual layer of membranes (dPTFE placed over collagen) in fresh extraction sites: a canine model.

In untreated extraction sockets, buccal bone remodeling compromises the alveolar ridge width. The aim of this study was to histologically assess the efficacy of using a dual layer of membranes (high-density polytetrafluoroethylene [dPTFE] placed over collagen) for ridge preservation in fresh extraction sites. Eight beagle dogs were used. After endodontic treatment of mandibular bilateral second (P2), third (P3), and fourth (P4) premolars, mandibular bilateral first premolars and distal roots of P2, P3, and P4 were extracted atraumatically. Animals were randomly divided into 4 treatment groups. group 1, the control group, received no treatment; in group 2, allograft was placed in the alveolum and the socket covered with dPTFE membrane; in group 3, allograft was placed in the alveolum, the buccal plate was overbuilt with allograft, and the socket was covered with dPTFE membrane; in group 4, allograft was placed in the alveolum and covered with dual layer of membranes (dPTFE placed over collagen). No intent of primary closure was performed for all groups. After 16 weeks, the animals were sacrificed and mandibular blocks were assessed histologically for buccolingual width of alveolar ridge, percentage of bone formation and bone marrow spaces, and the remaining bone particles. The buccolingual width of the alveolar ridge was significantly higher among sockets in group 4 than in group 1 (P < .05). the amount of newly formed bone in each socket was higher in extraction sockets in group 4 than in groups 1, 2, and 3 (P < .001). A significant difference was found in the percentage of bone marrow spaces among all groups (P < .001). No significant difference was found in the number of nonresorbed bone particles among the groups. Using a dual layer of membrane was more effective in ridge preservation than conventional socket augmentation protocols.

Microcomputed tomographic analysis of the alveolar ridge alteration around extraction sites with and without immediate implants placement: in vivo study.

BACKGROUND: The aim was to assess the alveolar ridge alteration around extraction sites with and without immediate implants according to extraction socket classification (ESC) using microcomputed tomography (micro-CT). MATERIAL AND METHODS: Ten beagle dogs (mean age and weight: 24 ± 0.83 months and 13.8 ± 0.49 kg, respectively) were randomly divided into three groups according to the ESC. In Group 1 (ESC-I), bilateral first and third premolars were extracted and replaced with immediate implants. In Group 2 (ESC-II), two adjacent premolars were extracted with one immediate implant placement in the mesial socket in the maxilla and in the distal socket in the mandible. In Group 3 (ESC-III), three adjacent teeth were extracted and an immediate implant was placed in the central socket. Primary closure was achieved using resorbable sutures. Buccal sites with dehiscence defects were excluded. After 4 months, subjects were sacrificed and alveolar ridge widths were measured at 1 mm interval in axial and sagittal views, using micro-CT in sites with and without immediate implants. RESULTS: In sites without immediate implant placement, alveolar ridge width was significantly higher in Group 1(6.1 ± 1.35mm) than Group 3 (4.14 ± 1.53 mm) (p <.05). In sites with immediate implant placement, the alveolar ridge width was higher among sites in Group 1 (6.4 ± 3.8 mm) than Group 2 (4.8 ± 0.46 mm) (p < .05) and Group 3 (5.02 ± 0.84 mm) (p <.05). Overall, between each corresponding group in both sites with and without immediate implant placement at 1 mm thickness, there was no significant difference in the alveolar ridge widths. CONCLUSION: With the exception of Group 1 (ESC-I), immediate implant placement did not prevent or minimize bone remodeling in extraction sites according to ESC.

Efficacy of using PDGF and xenograft with or without collagen membrane for bone regeneration around immediate implants with induced dehiscence-type defects: a microcomputed tomographic study in dogs.

BACKGROUND: Use of collagen membrane (CM) with xenograft and recombinant human platelet-derived growth factor (rhPDGF) in guided bone regeneration (GBR) is debatable. The aim of this microcomputed tomographic experiment was to assess the efficacy of using PDGF and xenograft (with or without CM) for GBR around immediate implants with dehiscence defects. METHODS: Ten beagle dogs underwent atraumatic bilateral second and fourth premolar extractions from both arches. A standardized dehiscence defect (6 × 3 mm) was created on the buccal bone and immediate implants were placed in distal sockets in each site. Animals were randomly divided into three groups: 1) group 1, xenograft with rhPDGF was placed and covered with CM; 2) group 2, xenograft with rhPDGF was placed over the defects; and 3) group 3, four immediate implants were associated with dehiscence (controls). After 16 weeks, animals were sacrificed and jaw segments were assessed for buccal bone thickness (BBT), buccal bone volume (BBV), vertical bone height (VBH), and bone-to-implant contact (BIC) using microcomputed tomography. RESULTS: BBT was higher in group 2 (1.533 ± 0.89 mm) than group 1 (0.745 ± 0.322 mm) (P <0.001) and group 3 (0.257 ± 0.232 mm) (P <0.05). BBV was higher in group 2 (67.87 ± 19.83 mm(3)) than group 1 (42.47 ± 6.78 mm(3)) (P <0.05) and group 3 (19.12 ± 4.06 mm(3)) (P <0.001). VBH was higher in group 2 (6.36 ± 1.37 mm) than group 3 (0.00 ± 0.00 mm) (P <0.001). VBH was higher in group 1 (3.91 ± 2.68 mm) than group 3 (0.00 ± 0.00 mm) (P <0.05). BIC was higher in group 2 (67.25% ± 13.42%) than group 1 (36.25% ± 12.78%) (P <0.05) and group 3 (30.25% ± 7.27%) (P <0.01). CONCLUSION: GBR around immediate implants with dehiscence defects using PDGF and xenograft alone resulted in higher BBT, BBV, VBH, and BIC than when performed in combination with CM.

Efficacy of using a dual layer of membrane (dPTFE placed over collagen) for ridge preservation in fresh extraction sites: a micro-computed tomographic study in dogs.

OBJECTIVE: To assess if overbuilding the buccal plate or using a dual-layer socket grafting technique prevents alveolar bone resorption and enhances final ridge width, height, and volume after tooth loss in an animal model. MATERIAL AND METHODS: In eight beagle dogs bilateral second (P2)-, third (P3)-, and fourth (P4) premolars were endodontically treated. All bilateral mandibular first premolars and distal roots of P2, P3, and P4 were hemisectioned and atraumatically extracted. Animals were randomly divided into four groups: (i) Control-Socket alone, (ii) Particulate allograft in the alveolum, socket covered with high-density polytetrafluoroethylene (dPTFE) membrane and sutured over the alveolum, (iii) Particulate allograft in the alveolum and overbuilding the buccal plate, socket covered with dPTFE membrane and sutured over the alveolum, (iv) Particulate allograft in the alveolum and covered with dual layer (dPTFE placed over collagen membrane), and sutured over the alveolum. After 16 weeks, the animals were sacrificed. Mandibular blocks of the jaws were assessed for bone volume (BV), vertical bone height (VBH), alveolar ridge thickness, and bone mineral density (BMD) using micro-computed tomography. RESULTS: The BV in groups 1, 2, 3, and 4 was 169.5, 207.57, 242.4, and 306.1 mm(3) , respectively. The VBH in groups 1, 2, 3, and 4 was 4.2, 6.4, 6.2, and 7.3 mm, respectively. Ridge widths in groups 1, 2, 3, and 4 were 5.45 ± 0.75, 5.91 ± 0.86, 6.05 ± 0.63, and 6.28 ± 1.01 mm, respectively. There was no significant difference in BMD between the groups. CONCLUSIONS: The RP using a dual layer of membrane following tooth extraction results in more BV, VBH, and alveolar ridge width as compared to when a single layer of membrane is used.

Efficacy of acellular dermal matrix and coronally advanced flaps for the treatment of induced gingival recession defects: a histomorphometric study in dogs.

BACKGROUND: Gingival recession (GR) defects can be treated by various methods, including acellular dermal matrix (ADM) or coronally advanced flaps (CAFs). The aim of this histomorphometric experiment is to compare the efficacy of ADM and CAF for treating GR defects in dogs. METHODS: In eight beagle dogs, a critical-size labial GR defect was surgically induced on bilateral maxillary cuspids under general anesthesia. Test sites received ADM and CAF, and control sites underwent CAF treatment alone. Plaque index (PI), bleeding index (BI), and gingival index (GI) were measured at 4 weeks (baseline), 8 weeks, and 16 weeks. Width of keratinized gingiva (KG) was determined at baseline and at 16 weeks. Depth of recession and width of GR below the cemento-enamel junction (CEJ) was also determined. After 4 months, animals were sacrificed, and jaw blocks were histomorphometrically assessed for tissue thickness and distance from the stent to the gingival margin (GM) and to the CEJ. RESULTS: At 4-, 8-, and 16-week intervals, there was no significant difference in the BI, GI, and PI at the test and control sites. At 16 weeks, thickness of KG was significantly higher at the control sites than test sites (P <0.01). There was no difference in the midfacial recession depth and recession width at the test and control sites at baseline and before euthanasia (16 weeks). Histomorphometrically, there was no significant difference in tissue thicknesses and distances from the stent to the GM and CEJ in the test and control sites. CONCLUSION: ADM might yield similar results to a CAF alone and could decrease the amount of KG.

Effect of implant surface properties on peri-implant bone healing: implant stability and microcomputed tomographic analysis.

PURPOSE: The present study aimed to evaluate and compare two types of implants: grit-blasted and acidetched implants (SLActive) and nanometer-scale hydroxyapatite-modified implants (NanoTite). MATERIALS AND METHODS: Twenty-two SLActive and 22 NanoTite implants were inserted into the mandibles of 11 beagle dogs. The animals were divided into three groups according to healing time (group A, 2 weeks; group B, 4 weeks; group C, 8 weeks). Resonance frequency analysis (RFA) was performed immediately after implant placement and after 2, 4, and 8 weeks of healing. Two, 4, and 8 weeks after implantation, the animals were sacrificed and the amount of bone surrounding the implants was assessed using microcomputed tomography. RESULTS: For SLActive and NanoTite implants, the RFA values decreased after 2 weeks and increased after 4 and 8 weeks of healing. After 8 weeks, the mean RFA value for SLActive implants was significantly higher than the mean RFA value for NanoTite implants. For the different healing periods, no significant differences in bone volume were seen for SLActive and NanoTite implants. CONCLUSIONS: SLActive and NanoTite implants evoked a similar bone response after implantation for 2, 4, and 8 weeks in a nonsubmerged position in the mandibles of dogs. In addition, the data confirmed that RFA is a reliable and noninvasive method to determine dental implant stability and the bone formation process at the clinical level.

Surgical and implant-supported fixed prosthetic treatment of a patient with ectodermal dysplasia: a case report.

Ectodermal dysplasia (ED) is a hereditary disorder that affects ectodermal structures. The main clinical oral manifestations of ED include oligodontia and deficient alveolar ridges. This case report presents the oral rehabilitation of a 15-year-old female patient who never received an accurate diagnosis or appropriate dental care. Treatment included a combination of surgical intervention, a maxillary tooth-supported fixed detachable telescopic prosthesis, and an implant-supported mandibular fixed partial denture. The results showed a significant improvement in the esthetics, function, and psychological status of the patient. This article stresses the importance of appropriate care in providing an acceptable quality of life for patients with ED.

Effect of implant surface properties on peri-implant bone healing: a histological and histomorphometric study in dogs.

AIM: The present study aimed to evaluate and compare two types of implants, i.e. grit-blasted and acid-etched implants (SLActive(®)) with nano-meter-scale hydroxyapatite surface-modified implants (NanoTite™). MATERIAL AND METHODS: For histological and histomorphometrical evaluation, 22 SLActive(®) and 22 Nanotite™ implants were inserted in eleven Beagle dogs. The animals were divided into three groups of healing (A: 2 weeks; B: 4 weeks and C: 8 weeks). Two, 4 and 8 weeks after implantation, the animals were sacrificed and bone-to-implant contact (BIC %), first implant-bone contact (1st BIC) as well as amount of bone (BV) were assessed. RESULTS: For SLActive(®) and Nanotite™ implants, BIC% increased significantly over time. No statistically significant differences in BIC% were found between SLActive(®) and Nanotite™ at all the respective implantation times. Moreover, for the different healing periods, no significant differences for BV between SLActive(®) and Nanotite™ implants were found. CONCLUSIONS: The present study showed that SLActive(®) and NanoTite™ implants induce a similar bone response after implantation for 2, 4 and 8 weeks in a non-submerged position in the mandible of dogs.

Root caries and risk profiles using the Cariogram in different periodontal disease severity groups.

OBJECTIVES: To study root caries and risk profiles using the Cariogram in relation to periodontal disease severity and to analyse indicators associated with high caries risk. MATERIAL AND METHODS: A cross-sectional examination was carried out on 112 patients with periodontal disease from two government clinics in Saudi Arabia. The investigation comprised a questionnaire, bitewing radiographs, measurement of salivary secretion rate, buffering capacity and cariogenic microorganisms, and registration of periodontal status, plaque amount and coronal and root caries/fillings (DFT and RDFT). The data were then entered into the Cariogram pedagogic model to illustrate the caries risk profiles. RESULTS: Patients were grouped according to periodontal disease severity into one of three groups: (1) gingivitis (n = 44); (2) mild-to-moderate periodontitis (n = 33); and (3) severe periodontitis (n = 35). The prevalence of RDFT in the total sample was 17%. There were no statistically significant differences between the three groups in number of root lesions or mean 'Actual Chance to Avoid New Cavities' (Chance-AC) according to the Cariogram. Of the total sample, 22% displayed high caries risk (Chance-AC ≤ 40%). The most significant risk indicators in high caries risk patients were infrequent use of fluoride and unfavourable salivary and microbial parameters. CONCLUSIONS: Root surface lesions and high caries risk were present in about one-fifth of the patients referred for periodontal treatment. A combination of risk indicators rather than a single one contributed to the increased risk. Caries and risk profiles were not significantly correlated with periodontal disease severity.

Esthetic soft tissue ridge augmentation around dental implant: Case report.

The aim of this case report is to present a method to correct soft tissue ridge deformity around dental implant using acellular dermal matrix (ADM). A 25-year-old female patient presented with a missing maxillary first left premolar, which had class I soft tissue defect. The missing tooth was replaced with single implant supported prosthesis and the soft tissue defect was corrected using ADM utilizing the envelop technique. A 5-years follow-up is presented showing the long-term stability of this technique and the predictability of using the ADM as an alternative method to connective tissue graft to correct the soft tissue defect around dental implant.

Massive rectus sheath hematoma.

Rectus sheath hematoma is an uncommon cause of acute abdomen and is known to mimic various common surgical conditions. Although the management is essentially conservative, occasionally a surgical exploration is necessary.

Effect of white-colored mineral trioxide aggregate in different concentrations on Candida albicans in vitro.

The antifungal action of different concentrations of white-colored mineral trioxide aggregate (MTA) against Candida albicans was assessed in vitro. Fresh mix of MTA was prepared at concentrations varying from 0.78 mg/ml to 50 mg/ml by dilution with 10 ml molten agar at 45 degrees C. The MTA-agar compound was thoroughly mixed and the uniform mix was then poured into sterile Petri dishes and allowed to set. A total of 348 agar plates were prepared and divided into experimental groups of 11 plates each and control groups of 5 plates each. Plates of agar without MTA served as positive control and plates without C. albicans served as negative control. Fresh inoculate of C. albicans was prepared by growing an overnight culture from a stock culture. Aliquots of C. albicans were then taken from the stock culture and plated on the agar compound of the experimental and positive control groups. All plates were incubated at 37 degrees C for 1, 24, 48, and 72-h periods. At each time period, the presence of C. albicans colonies was assessed and recorded. A direct correlation was found between MTA concentration and its inhibition effect on C. albicans growth. Plates containing MTA in concentration of 50 mg/ml showed significantly better killing action against C. albicans in all of the time periods tested (p < 0.001). Plates containing MTA in concentration of 25 mg/ml showed antifungal activity only at 1 and 24-h time periods. Plates containing lower concentrations of MTA did not show any antifungal activity. It appears that under the conditions of this study, white-colored MTA in concentration of 50 mg/ml is effective in killing C. albicans for periods of up to 3 days. Lower MTA concentrations may not be effective.

Guided tissue regeneration-based root coverage: meta-analysis.

BACKGROUND: The goal of guided tissue regeneration-based root coverage (GTRC) is to repair gingival recession via new attachment formation. Numerous clinical trials have been conducted utilizing the concept of GTR to promote root coverage. Most GTRC studies have had relatively small sample sizes and have not utilized power calculations to determine appropriate sample size; therefore, it is difficult to draw strong conclusions from them. Hence, the purpose of this study is to combine data from currently available GTRC studies and to use meta-analysis to determine whether GTRC provides significantly improved clinical outcomes compared to conventional periodontal plastic surgical approaches for the treatment of marginal tissue recession. METHODS: Studies were identified that used GTR approaches to treat gingival recession from January 1990 to October 2001. Information from each study was entered into a database. Data were analyzed according to the following criteria: GTRC versus conventional mucogingival surgery (CMGS); membrane type; root conditioning; pretreatment recession depth; adjunctive use of bone replacement graft (BRG); and source of funding. Studies were ranked independently, and mean data from each were weighted accordingly. Meta-analysis was performed using the weighted means for each group. Paired t tests were used to determine statistical significance between each pair of groups. RESULTS: Forty papers were included for analysis. GTRC resulted in an average of 74% recession depth reduction, 41% complete root coverage, 3 mm AL gain, and 1 mm KG gain. Both GTRC and CMGS produced significant (P < 0.05) improvement compared to baseline measurements. Compared to GTRC, CMGS resulted in significantly (P < 0.05) increased KG (2.1 mm vs. 1.1 mm), root coverage (81% vs. 74%), and percentage of defects with complete root coverage (55% vs. 41 %). Use of absorbable membranes, root conditioning, shallow pretreatment recession (< 4 mm), and corporate sponsorship all resulted in significantly (P < 0.05) improved percentages of sites with complete root coverage but had no effect on other parameters. CONCLUSIONS: Based on this meta-analysis, guided tissue regeneration-based root coverage can be used successfully to repair gingival recession defects. Conventional mucogingival surgery, however, resulted in statistically better root coverage, width of keratinized gingiva, and complete root coverage.