RESUMO
AIM AND OBJECTIVE: To compare the mucosal thickness, width of attached gingiva, and extent of coverage achieved with the usage of connective tissue graft, platelet-rich fibrin (PRF) membrane and buccally advanced flap along with bone grafts in the closure of immediate implant site. MATERIALS AND METHODS: Twenty-one sites requiring immediate implants were randomly divided into three groups of seven samples each. The techniques comprised bone grafting in jumping space along with either buccally advanced flap (group A), PRF membrane (group B), or connective tissue graft (group C) to cover the socket. In each group, the extent of socket coverage, mucosal phenotype, and width of attached mucosa achieved were assessed after 3 months and intercompared with initial measurements to identify the best technique in achieving primary tissue closure of immediate implant sites. RESULTS: Comparative assessment of gain in attached mucosal width had a remarkable difference in all the groups but exhibited no statistical significance among the groups compared. Also, comparative assessment of mucosal thickness and the extent of socket coverage equally indicated a clinical significance among all groups, but failed to achieve any statistical significance. CONCLUSION: All the three techniques were found to be equally effective in achieving additional width of attached mucosa around implants, coverage of mucosa at osteotomy sites, and a thicker mucosal phenotype at implant sites. In comparison with one another, no single technique was found to be advantageous over the other. CLINICAL SIGNIFICANCE: The commonly used three techniques for socket coverage following the immediate implant placement has been proven to be equally effective. Thus, the selection of the technique to meet the objective of complete closure of an extraction socket along with implant platform is left open to operator skill and operation site, which should consider least traumatic and most feasible technique.
Assuntos
Implantação Dentária Endóssea , Fibrina Rica em Plaquetas , Transplante Ósseo , Estudos de Coortes , Implantação Dentária Endóssea/métodos , Humanos , Extração DentáriaRESUMO
BACKGROUND: A split-mouth longitudinal study was conducted to compare and evaluate the effect of ozonated water and photodynamic therapy (PDT) in nonsurgical management of chronic periodontitis, along with mechanical debridement procedure. MATERIALS AND METHODS: Twenty-two patients diagnosed with chronic generalized periodontitis were subjected to the study. Following the assessment of gingival index, periodontal pocket depth, and clinical attachment loss, all patients underwent full-mouth scaling and root planing. Upper right and left quadrants of each patient were considered as sample sites in the study. Among these split-mouth sites, upper right quadrant of each patient was subjected to ozonated water irrigation with a 22-gauge needle and left upper quadrant was treated with PDT, which involved sulcus irrigation with indocyanine green dye (0.05 mg/ml) followed by low-level diode laser light application at 0.5 W and 810 nm (AMD Picasso) through a fiber-optic tip of 10 mm length, default angle of 60°, and fiber core diameter of 400 µm in noncontact continuous wave mode. Patients were recalled at the 2nd and 4th months regularly, and the therapy was repeated at the same sites in the same manner. Clinical parameters recorded before the study were assessed again at the end of the 2nd- and 6th-month period. RESULTS: A statistically significant reduction (P < 0.05) was observed in gingival index scores within both the study groups at all intervals of the study. In Ozone therapy (OT) group, a statistically significant difference was noted for total periodontal pocket depth values between baseline and 2nd month (P = 0.000), baseline and 6th month (P = 0.000), and between 2nd month and 6th month (P = 0.029). In the PDT group, on contrary, a statistically significant difference was noticed in total periodontal pocket probing depth values between baseline and 2nd month (P = 0.000) and baseline to 6th month (P = 0.000), but a similar significant difference was not noticed between 2nd-month and 6th-month periods (P = 0.269). In group OT, a statistically significant difference was noted for total clinical attachment loss between baseline and 2nd month (P = 0.000), baseline and 6 months (P = 0.000), and 2nd month and 6th month (P = 0.019). In group PDT, a statistically significant difference in terms of its improvement was noted at intervals between baseline and 2 months (P = 0.000) and from baseline to 6 months (P = 0.000) but not between 2nd month and 6th month (P = 0.129). CONCLUSION: Results of the study showed that sub-gingival OT and PDT equally improved the clinical outcomes of treatment drastically following mechanical debridement at the end of first 2 months. Thereafter, it was shown to improve steadily throughout the study period, with slightly better results with OT compared with PDT.
RESUMO
BACKGROUND: A split-mouth longitudinal study was designed here to evaluate the effect of ozonated water delivered subgingivally through a jet device (Kent Ozone dental TY 820 jet) in controlling gingival inflammation of patients undergoing fixed orthodontic therapy. MATERIALS AND METHODS: Twenty-eight patients undergoing fixed orthodontic treatment following thorough oral prophylaxis were recalled after 2 weeks, and baseline gingival inflammation was estimated. This study was conducted as split-mouth technique with the upper left quadrant (Control side) was irrigated by jetting saline into sulcus by air-water syringe with gauge 22 needle tip and upper right quadrant (Test side) irrigated with ozonated water by a jet device using similar delivery tip. The patients were recalled at the end of 1st, 2nd, 3rd, and 4th month and the irrigations as well as gingival inflammation estimation were repeated. A biochemical assessment of gingival inflammation (estimation of aspartate aminotransferase [AST] in gingival crevicular fluid [GCF]) and clinical assessment (gingival index scoring) was done at each visit. RESULTS: At the test side, the AST level in the GCF was found to be maintained almost the same value as baseline till the end of 4th month, indicating not much of change in inflammatory status. Statistically significant difference in GCF-AST and gingival index score between test and control sites were found at the end of 3rd and 4th month with a significance of P < 0.05. CONCLUSION: The patient undergoing fixed orthodontic treatment showed a consistent improvement in gingival inflammation on frequent irrigation with ozone jet irrigation as compared with saline irrigation delivered with same jetting force.