Treatment of infrabony periodontal defects using a resorbable biopolymer of hyaluronic acid: a randomized clinical trial.

OBJECTIVE: This randomized clinical study examined the use of hyaluronic acid to treat infrabony periodontal defects over a period of 24 months. METHOD AND MATERIALS: Forty subjects with a two-wall infrabony defect (probing depth [PD] >= 7 mm; clinical attachment level [CAL] >= 7 mm) were selected. The defects were randomly divided into two groups: sites treated with hyaluronic acid (test group) and those treated with open flap debridement (control group). RESULTS: The 12- and 24-month evaluations were based on clinical and radiographic parameters. The primary outcome variable was CAL. Test defects shows a mean CAL gain of 1.9 ± 1.8 mm, while the control defects yielded a significantly lower gain of 1.1 ± 0.7 mm. PD reduction was also significantly higher in the test group (1.6 ± 1.2 mm) than in the control group (0.8 ± 0.5 mm). Frequency distribution analysis of the study outcomes indicated that hyaluronic acid increased the predictability of clinically significant results (CAL gains >= 2 mm and PD reduction >= 2 mm) in the test group compared with the controls. CONCLUSIONS: The treatment of infrabony defects with hyaluronic acid offered an additional benefit in terms of CAL gain, PD reduction, and predictability compared to treatment with open flap debridement.

Complications in surgical removal of impacted mandibular third molars in relation to flap design: clinical and statistical evaluations.

OBJECTIVE: The extraction of an impacted mandibular third molar may result in periodontal complications on the distal surface of the adjacent second molar. The purpose of this study was to compare the influence of three full-thickness flaps on the periodontal healing of the adjacent second molar after extraction of impacted mandibular third molars. METHOD AND MATERIALS: Forty-five volunteers with bilateral impaction of the mandibular third molars were selected. Each patient was randomly assigned to one of three groups: group A (envelope flap modified by Thibauld and Parant), group B (Laskin triangular flap), and group C (envelope flap modified by Laskin). The periodontal health of the second molars was evaluated at 3, 6, 12, and 24 months after surgery via clinical measurements. RESULTS: After 21 days, there was no correlation between postoperative complications (such as edema and alveolitis) and flap design. However, there was a statistically significant reduction of pocket probing depth (PPD) and increase of clinical attachment level (CAL) in group B compared to the other groups (P<.05) 24 months after surgery. CONCLUSION: The effect of the type of flap used for mandibular third molar surgery on the periodontal status of the second molars as well as the factors that influence this outcome remains uncertain. Regardless of the flap design, the periodontal conditions of the adjacent second molar deteriorated after 12 and 24 months. The decision to use a certain type of flap should be based on the surgeon's preference.

Rapid maxillary expansion in growing patients. Hyrax versus transverse sagittal maxillary expander: a cephalometric investigation.

The aim of this retrospective study was to cephalometrically evaluate and compare the skeletal and dental effects of a transverse sagittal maxillary expander (TSME) and a Hyrax-type expander (RME) in children with maxillary hypoplasia. Fifty subjects (26 males and 24 females), aged from 6 to 15 years, with a maxillary crossbite caused by basal apical narrowness, were divided into two equal groups. Twenty-five were treated with a TSME and the other 25 with a RME. For each patient, a lateral cephalogram was obtained before treatment (T0) and at the end of the retention period (T1). Changes in the two groups during the observation period were calculated, compared, and statistically analysed with a paired samples t -test. In the TSME group, SNP-A, I SN, and I FH and in the RME group SN-SNP.SNA, N-Me, and U6.PP displayed a statistically significant increase (P < 0.05). The increase in SNP-A, I SN, and I FH in the TSME group was significantly greater following treatment than in the RME group. The results support the use of the TSME to produce skeletal changes and dentoalveolar modification and to correct maxillary hypoplasia. It was also demonstrated that in patients with an anterior open bite, the use of the TSME is not contraindicated as the anterior vertical dimension did not increase significantly.

Effects of Hypericum Perforatum, in a rodent model of periodontitis.

BACKGROUND: Hypericum perforatum is a medicinal plant species containing many polyphenolic compounds, namely flavonoids and phenolic acids. In this study we evaluate the effect of Hypericum perforatum in animal model of periodontitis. METHODS: Periodontitis was induced in adult male Sprague-Dawley rats by placing a nylon thread ligature around the lower 1st molars. Hypericum perforatum was administered at the dose of 2 mg/kg os, daily for eight days. At day 8, the gingivomucosal tissue encircling the mandibular first molar was removed. RESULTS: Periodontitis in rats resulted in an inflammatory process characterized by edema, neutrophil infiltration and cytokine production that was followed by the recruitment of other inflammatory cells, production of a range of inflammatory mediators such as NF-κB and iNOS expression, the nitration of tyrosine residues and activation of the nuclear enzyme poly (ADP-ribose) polymerase; apoptosis and the degree of gingivomucosal tissues injury. We report here that Hypericum perforatum exerts potent anti-inflammatory effects significantly reducing all of the parameters of inflammation as described above. CONCLUSIONS: Taken together, our results clearly demonstrate that treatment with Hypericum reduces the development of inflammation and tissue injury, events associated with periodontitis.

WY-14643, a Potent Peroxisome Proliferator Activator Receptor-α PPAR-α Agonist Ameliorates the Inflammatory Process Associated to Experimental Periodontitis.

We have investigated the effects of WY14643, a potent peroxisome proliferator activator receptor-α (PPAR-α) agonist, in a rat model of ligature-induced periodontitis. Male Sprague-Dawley rats were lightly anaesthetized with pentobarbitone (35 mg/kg). Sterile, 2-0 black braided silk thread was placed around the cervix of the lower left first molar and knotted medially. Animals received WY14643 (1 mg/kg i.p, daily for eight days). Eighths days after placement of the ligature, we evaluated several markers of inflammation such us (1) myeloperoxidase activity, (2) a cytokines and adhesion molecules expression, (3) NF-κB expression, (4) iNOS expression, (5) the nitration of tyrosine residues, (6) activation of the nuclear enzyme poly(ADP-ribose) polymerase, (7) apoptosis, and (8) the degree of gingivomucosal tissues injury. Administration of WY14643 significantly decreased all of the parameters of inflammation as described above. These results demonstrate that WY14643 exerts an anti-inflammatory role during experimental periodontitis and is able to ameliorate the tissue damage.