Periodontal findings in diabetic and nondiabetic patients.

This study was conducted to determine the possible influence of diabetes on the pathogenesis of periodontal disease. A total of 148 patients, 120 females and 28 males, were surveyed. Their ages ranged between 9 and 50 years, with an average age of 30. The experimental group consisted of 83 diabetics and there was a control group of 65 nondiabetics. Both groups were divided into patients under and over the age of 30. The results showed: 1. Loss of attachment was higher in the over-30 diabetic group in the presence of similar local factors. 2. A higher Gingival Index was reported in diabetics of the combined age groups than in the controls (P less than 0.05). 3. The Plaque and Calculus Indices did not differ significantly between the diabetic and control subjects. 4. The correlation between the Plaque Index and loss of attachment in diabetics was the most relevant of the correlation analyses. The correlation between the gingival inflammation and loss of attachment indices in the combined diabetic group was also significant. 5. In both groups, diabetics and controls, periodontal destruction increased significantly with age. 6. Juvenile diabetics with severe periodontal disease, as well as others with normal periodontal structures, were found in the course of this study. These findings coincided with the presence or absence of local factors.

Current regenerative periodontal therapy.

Healing, after subgingival curettage, leads to the formation of a long junctional epithelium. This is a repair process and not one of regeneration. Flap procedures of themselves also seem to lead to the formation of a long junctional epithelium, notwithstanding some evidence of bone repair. Bone grafts favour osseus repair without creating new attachment, for the previous architecture and function of the tissues is not restored. Recently, use of porous hydroxyapatite implants in block or granular form has led to pocket depth reduction and attachment gain. Conditioning of the root surface, after planing, with citric acid, attachment proteins or tetracycline has been widely investigated. The use of citric acid has not led to significant periodontal regeneration but the local use of slow-release tetracycline may prove to be of value. Guided regeneration aims to re-populate the root surface with active periodontal ligament cells. In recent experiments substantial reductions in pocket depth have been achieved.

Effect of occlusal splints on TMJ symptomatology.

The clinical response of TMJ symptomatology to full-coverage occlusal splints, when used as the only means of treatment, was evaluated. The symptomatology recorded during the last postoperative visit was compared to the initial visit. The response of the different symptoms to the use of the occlusal splint was analyzed statistically using a chi-square test. A statistically significant difference (p = .03) was only found when comparing those groups having only pain or dysfunction symptomatology. The response favored the remission of pain. However, every symptom was improved with the use of an occlusal splint. It was concluded that: 1. Both pain and dysfunction symptomatology will benefit from the occlusal splint therapy. 2. The pain response will be significantly better than the dysfunction response when the patient is treated with an occlusal splint. 3. Eighty percent of the patients suffering from a TMJ syndrome will improve or be cured when the only form of treatment is the use of a full-coverage occlusal splint.

Intraoral cancellous bone autografts in the treatment of infrabony pockets.

One hundred infrabony pockets with one- and two-wall bony defects were treated for reattachment. Mucoperiosteal flaps were raised, the tooth surfaces were scaled and planed, and the defects curetted. Flaps were sutured tightly and the sites protected with a surgical dressing. Antibiotic coverage was used in each case. Pre- and postoperative measurements were taken by the same clinician from the cemento-enamel junction to the base of the pocket. In 56 defects cancellous bone from the same patient was placed in the defect, and in 44 defects the treatment consisted only of open curettage without bone grafts. The results showed a trend towards more favourable clinical results using bone grafts; especially in the two-wall bony defects.