Regenerative periodontal surgery and orthodontic tooth movement in stage IV periodontitis: A retrospective practice-based cohort study.

AIM: Evaluation of the effectiveness of regenerative treatment of intra-bony defects in combination with consecutive orthodontic tooth movements in stage IV periodontitis. MATERIAL AND METHODS: A total of 526 intra-bony defects in 48 patients were analysed after regenerative therapy using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic tooth movement initiated 3 months after surgery. Changes in radiographic bone levels (BL) and probing pocket depths (PPD) were evaluated after 1 year and up to 4 years. RESULTS: Tooth loss amounted to 0.57%. Mean BL gain was 4.67 mm (±2.5 mm) after 1 year and 4.85 mm (±2.55 mm) after up to 4 years. Mean PPD was significantly reduced from 6.00 mm (±2.09 mm) at baseline to 3.45 mm (±1.2 mm) after 1 year, and to 3.12 mm (±1.36 mm) after 2-4 years. Pocket closure (PPD ≤4 mm) was accomplished in 87% of all defects. Adjunctive antibiotic therapy did not show any statistically significant impact on treatment outcomes. CONCLUSIONS: Within the limits of this retrospective study design, the findings suggest that the combination of regenerative treatment and consecutive orthodontic tooth movements resulted in favourable results up to 4 years.

Self-assembling peptide matrix for treatment of dentin hypersensitivity: A randomized controlled clinical trial.

BACKGROUND: Patient-reported dentin hypersensitivity [DHS] pain is a common finding linked with periodontal disease. This pilot clinical study investigates a novel therapeutic regimen using self-assembling peptide matrix [SAPM] gel (test) compared with use of an 8% arginine and calcium carbonate [ACC] toothpaste (control) for treatment of DHS. METHODS: A total of 50 patients with history of supportive periodontal therapy were enrolled in this prospective, randomized monocentric clinical study, of which 45 (test: n = 22; control: n = 23) fulfilled all the study visits. Test group patients performed ex-office application of SAPM gel over 1 week, while control group patients performed ex-office application of ACC toothpaste over 90 days. DHS was assessed in office by Visual Analog Scale [VAS], and patient's perception of pain relief was evaluated by questionnaire. In support of the clinical data, scanning electron microscopy images were recorded to investigate tubule occlusion of both control and test product. RESULTS: Both SAPM and ACC significantly reduced DHS in patients throughout the study, with the patient questionnaire indicating higher patient satisfaction at the earlier time points for the test group. CONCLUSIONS: Both SAPM gel and ACC toothpaste were successful in providing relief from DHS and showed similar outcomes on VAS and verbal response scale (VRS) throughout the study period of 90 days. The new therapeutic regimen using SAPM resulted in higher patient satisfaction at day 7, as indicated by the patient questionnaire and the higher number of pain-free patients at day 7 and day 90. This is a pilot study describing a novel therapy for DHS.

Long-term results of periodontal regenerative therapy: A retrospective practice-based cohort study.

AIM: Evaluation of the long-term effectiveness of regenerative treatment of intra-bony defects in periodontal practice. MATERIAL AND METHODS: A total of 1,008 intra-bony defects in 176 patients were analysed after using collagen-added deproteinized bovine bone mineral (DBBMc) with or without collagen membrane (CM) or enamel matrix derivative (EMD). Defects were classified as one- and two-wall and as shallow (≤6 mm), moderate (>6 and <11 mm) and deep (≥11 mm). Radiographic bone level changes were evaluated after 1 year, 2 to 4 years and 5 to 10 years. RESULTS: Mean radiographic defect fill was 3.8 mm after 1 year and remained stable up to 10 years. Deep and moderate defects showed a higher degree of fill than shallow defects (53.3%, 49.2%, 42.9%). Tooth loss amounted to 2.6%, was dependent on initial defect size (1.2% shallow, 1.4% moderate, 5.7% deep defects) and occurred mainly due to endodontic reasons. CONCLUSIONS: Within the limits of the retrospective study design, the findings indicate that periodontal treatment using DBBMc with or without CM or EMD can lead to long-term defect reduction and tooth survival for up to 10 years in the setting of a periodontal practice.

Patient-related evaluation after systematic periodontal therapy - a clinical study on periodontal health-related quality of life (PHQoL).

PURPOSE: To evaluate how periodontitis patients perceive the outcome after long-term supportive therapy. MATERIALS AND METHODS: 281 patients (150 women/131 men) with a mean age of 55 years (range: 45-86 years) were randomly selected and consecutively interviewed using a questionnaire designed for laypersons. All patients had shown high compliance with the recommended supportive periodontal therapy (SPT) for up to 16 years (mean observation period: 12.5 years). Statistical evaluation was performed using the 2-sided t-test. RESULTS: A very high degree of confidence in the periodontal treatment (mean: 9.24, range 0-10) was found. Women noticed a higher positive impact on their social environment (P < 0.05). Patients who underwent SPT < 3 years showed a higher positive perception of treatment success than patients with SPT > 3 years (P < 0.01) and reported a greater impact on appearance (P < 0.01). Regenerative treatment demonstrated advantages over resective open flap debridement (OFD) procedures (P < 0.05) and scaling and root planing (SRP) (P < 0.05). However, treatment costs (P < 0.001) and time required (P < 0.01) for regenerative procedures were perceived as a burden. Periodontal treatment by a specialised team led to a significant reduction in the patients' complaints (P < 0.01). The SPT interval did not influence patients' perception of treatment success. CONCLUSIONS: Systematic periodontal therapy with subsequent SPT met the patients' demand to preserve oral health. Regenerative procedures prompt the perception in patients of better remission of periodontitis symptoms. Further trials should investigate clinical results of periodontal therapy regarding patient expectations.

Enhanced periodontal response and esthetics of implant-supported bridge by the use of galvanoforming technique: case report.

BACKGROUND: Galvanoforming restorations have been placed over the past 15 years successfully. They offer several advantages over alloy restorations, including enhanced response to the periodontal tissues, biocompatibility, and superior esthetics. PURPOSE: The purpose of this report is to show the use of the galvanoforming process in dental implant restorations to transfer the benefits of this technique. MATERIALS AND METHODS: Two standard Brånemark fixtures were placed submerged in the lower mandible for the restoration of a three-unit bridge. The impression was taken at fixture level, and two cast individual telescope abutments were inserted. The galvanoforming restoration was seated conventionally without any screw retention. RESULTS: An implant-supported galvanoforming bridge is functioning successfully. The use of biocompatible materials does not compromise the stability of the restoration; instead, the effect on the periodontal tissues is excellent, resulting in less plaque accumulation and bleeding on probing. Microgaps were avoided by conventional seating on the individual telescope gold abutments, revealing superior occlusal esthetics. CONCLUSIONS: This case report demonstrates the practicability of the biocompatible galvanoforming procedure for implant-supported restorations enhancing periodontal response and esthetics.