A clinical comparison of nano-crystalline hydroxyapatite (Ostim) and autogenous bone graft in the treatment of periodontal intrabony defects.

OBJECTIVES: The aim of the present study was to evaluate the efficacy of autogenous bone graft (ABG) and nano-crystalline hydroxyapatite (Ostim) in the management of human intrabony periodontal defects. STUDY DESIGN: Twenty-four similar two and three wall intrabony periodontal defects with ≥5 mm probing depths and ≥3 mm depths of intrabony component in 12 healthy patients were selected. One defect in each subject was treated with ABG (ABG group) and the contralateral one with ABG and Ostim (Ostim group). Plaque index (GI), gingival index (PI), clinical probing depth (CPD), clinical attachment level (CAL), gingival margin level, bone fill, crestal resorption and defect resolution were measured at baseline and during reentry surgery after 6 months. Wilcoxon signed-rank test and Mann-Whitney U test were used to analyze the data. RESULTS: Groups showed statistically significant improvements in soft and hard tissue parameters after 6 months except in gingival margin level and crestal level. However, the between-group differences after 6 months were not statistically significant with regard to soft and hard tissue measurements. CONCLUSION: Within the limits of this study, both treatments resulted in marked clinical improvement, and Ostim treatment seemed to be effective in the treatment of two & three-wall intrabony defects as well as autogenous bone graft.

Detection of enterococcus faecalis in subgingival biofilm of patients with chronic refractory periodontitis.

OBJECTIVES: Refractory periodontitis is the occurrence of additional clinical attachment loss after repeated attempts to control the infection with conventional periodontal therapy. Some microorganisms seem to be involved in the pathogenesis of chronic refractory periodontitis. The prevalence of Enterococcus faecalis in the oral cavity seems to be higher in individuals with periodontitis. Therefore, the present study investigated the presence of E. faecalis in subgingival biofilm of patients with chronic refractory periodontal disease. STUDY DESIGN: Periodontal treatment was instituted for 100 patients suffering from chronic periodontitis. Then samples were obtained from 27 successfully treated and 27 chronic refractory periodontitis subjects and then cultured. Statistical evaluation was performed for descriptive purposes. RESULTS: 27% of the patients had chronic refractory periodontitis. The difference in the presence of E. faecalis in the pockets between the successfully treated (11.1%) and chronic refractory (51.8%) groups by culture methods was statistically significant (p<0.05). CONCLUSION: Data showed that E. faecalis is probably involved in the pathogenesis of refractory periodontitis. Accurate knowledge about the pathogen and its role in the pathogenesis of refractory infections helps develop effective treating strategies.

Determination of vertical interproximal bone loss topography: correlation between indirect digital radiographic measurement and clinical measurement.

BACKGROUND: Diagnosis and accuracy in determining the exact location, extent and configuration of bony defects of the jaw are of utmost importance to determine prognosis, treatment planning and long-term preservation of teeth. If relatively accurate diagnosis can be established by radiography, proper treatment planning prior to treatment procedures will be possible. OBJECTIVES: The aim of the present study was to assess the correlation between indirect digital radiographic measurements and clinical measurements in determining the topography of interproximal bony defects. PATIENTS AND METHODS: Twenty interproximal bony defects, preferably in the mandibular and maxillary 5↔5 area were selected and radiographed using the parallel periapical technique. The radiographs were corrected and digitized on a computer using "Linear Measurement" software; then the three parameters of the base of defect (BD), alveolar crest (AC) and cementoenamel junction (CEJ) were determined using a software. Subsequent to radiographic measurements, clinical measurements were carried out meticulously during flap procedures. Then linear measurements were carried out using a periodontal probe to determine the defect depth and its mesiodistal width. Then the amount of correlation between these two measurements was assessed by Pearson's correlation coefficient. RESULTS: The correlation between clinical and radiographic measurements in defect depth determination, in the evaluation of defect angle and in determination of defect width were 88%, 98% and 90%, respectively. CONCLUSIONS: Indirect digital radiographic technique can be used to diagnose intra-osseous defects, providing a better opportunity to treat bony defects.

A clinical evaluation of anatomic features of gingiva in dental students in tabriz, iran.

BACKGROUND AND AIMS: The anatomical features of gingiva are important in appropriate periodontal treatment planning. This study was designed to determine the anatomic features of gingival in a group of dental students in Tabriz, Iran. MATERIALS AND METHODS: One-hundred healthy subjects (aged 20-24 years old) with no history of periodontal or orthodontic treatment and a gingival index of zero or one were included. The following measurements were made using a periodontal probe: the distance between the gingival margin and base of gingival sulcus (depth of sulcus); the distance between the gingival margin and mucogingival junction (keratinized gingiva); and the distance between base of gingival sulcus and mucogingival junction (attached gingiva). Existence of free gingival groove was also recorded by observation. Mean values of collected data were calculated. RESULTS: The widest attached gingiva and keratin-ized gingiva on the buccal aspect was seen in upper lateral incisor and their minimum in lower premo-lars. The maximum depth of sulcus on the buccal surface was recorded in upper right molar and its minimum on the buccal surface was found in lower left canine. All of the studied students had free gin-gival groove on the buccal or oral aspect of at least one tooth. CONCLUSION: The anatomic features found in this study were similar to those of the previous studies. However, mild variations with regard to race differ-ences were observed.