Do Intrabony Defects Have a Worse Clinical Response to Step 2 of Periodontal Therapy and Repeated Subgingival Instrumentation Compared with Suprabony Defects? A Systematic Review.

AIM: To assess the differential clinical response to step 2 of periodontal therapy and repeated subgingival instrumentation between teeth with suprabony and intrabony defects. METHODS: Electronic and manual search were performed to identify studies reporting the differential clinical outcomes of non-surgical periodontal therapy (NSPT) in presence or absence of intrabony defects. The Cochrane Risk of Bias 2 and the Newcastle Ottawa scale were used to assess the risk of bias. RESULTS: Two thousand three hundred forty-eight articles were initially screened, and a total of 5 articles were finally included. Regarding the primary outcome measure, two studies reported PPD reduction values at 6 months after step 2 of periodontal therapy, showing an opposite response of intrabony defects compared to suprabony defects (3.2 mm ± 1.9 versus 2.2 mm ± 1.7 and 0.48 mm ± 0.42 versus 0.72 mm ± 0.36, respectively), while one study reported no differences at 3 months. One study showed a negative association between the presence of intrabony defect and PPD reduction at 9 months after non-surgical step 3 (p < 0.05). CONCLUSION: Due to the limited number of studies and heterogeneity of the data, conflicting evidence emerged for the differential response to NSPT of intrabony and suprabony defects.

[The use of prostheses and traditional technics in the surgical treatment of laparocele. An experimental study]. / Impiego di protesi e tecniche tradizionali nel trattamento chirurgico del laparocele. Studio sperimentale.

The problem of surgical fixing for incisional hernia is still far from a final solution. Over the past few years, prostheses have been used in addition to traditional plastic surgery. The aim of this experimental study was to assess the efficacy of traditional techniques in comparison to modern methods using prostheses. For this purpose, two original experimental models were designed to assess parietal resistance. Ninety-six Wistar rats were subdivided into 4 group: 1) control; 2) "waistcoat" plastic surgery; 3) plastic surgery using a vicryl prosthesis. With the exception of rats in group 1, a lozenge-shaped section of abdominal wall was removed from all other rats and, subsequently, the wall was repaired using the above-mentioned methods. Rats were killed after 30-60-120-180 days and the abdominal walls were subjected to traction and pressure using specially designed experimental models. For the first 30 days, the walls with dacron and vicryl prostheses behaved in a similar way, and showed a greater resistance than the other two groups; but after day 120, the resistance of dacron prostheses was considerably greater than that of the other groups studied. In conclusion, plastic surgery based on the use of nonreabsorbable prostheses is now more efficacious than traditional plastic surgery in the surgical treatment of incision hernia.