A novel approach in root coverage - Coronally repositioned flap with GTR membrane and frenotomy.

This case report describes a guided tissue regeneration (GTR) based root coverage procedure over maxillary central incisor using coronally advanced flap with simultaneously performed frenotomy. The patient was a 32-year-old female with chief complaint of gingival enlargement in relation to 11. Based on overall findings it was diagnosed as a case of inflammatory gingival enlargement. Vertical osseous defect along with Millers class I gingival recession was seen after initial therapy. GTR-based root coverage procedure using coronally advanced flap with simultaneously performed frenotomy was planned. Complete root coverage was achieved over the maxillary central incisor that initially presented with Miller's class I gingival recession along with radiographic bone fill of the osseous defect. This case report shows the possibility of applying GTR-based root coverage procedure using coronally advanced flap combined with frenotomy to treat Millers class I gingival recession.

Periodontal status in subjects with hyperlipidemia and determination of association between hyperlipidemia and periodontal health: a clinicobiochemical study.

AIM: The aim of this study was to assess the periodontal status in subjects with hyperlipidemia and to determine whether there is any association between hyperlipidemia and periodontitis. MATERIALS AND METHODS: Sixty subjects with hyperlipidemia and 60 normolipidemic subjects participated in the study. Biochemical parameters assessed included plasma triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) levels. Periodontal parameters assessed included plaque index (PI), probing depth (PD), clinical attachment level (CAL) and percentage of sites with bleeding on probing (BOP). RESULTS: Hyperlipidemic patients showed signifcantly higher values across the four periodontal parameters. Plasma triglycerides, total cholesterol, LDL-C were signifcantly and positively associated with PD, BOP and CAL (p = 0.05). Whereas HDL-C levels were signifcantly and negatively associated with PD, BOP and CAL (p = 0.05). CONCLUSION: Patients with hyperlipidemia manifested higher values of periodontal parameters compared to control group. Poorly controlled hyperlipidemia had a destructive impact on periodontium. A cyclic relationship exists between serum lipids, periodontitis and systemic health. Clinical signifcance: The relationship between periodontium and systemic factors is bidirectional and interlinked. Therefore, dentists and physicians should take this into account while treating patients, aiming for the overall betterment of the patient.

A Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure.

Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans. Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement. Methods and Material. Twenty (20) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent sites: Plaque and Gingival Indices (PI) & (GI), Position of Gingival Margin from reference Stent (PGMRS), Probing depth (PD), and Biologic Width (BW). Statistical Analysis Used. Student "t" Test. Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group) and 1.95 mm (Ostectomy procedure B2 Group) and after surgical procedure the values were 1.15 mm and 1.25 mm. Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.