Treatment of Reticular Oral Lichen Planus with Photodynamic Therapy: A Case Series.

OBJECTIVES: The aim of the study was to clinically evaluate the efficacy of photodynamic therapy in treatment of the reticular form of oral lichen planus (OLP). MATERIALS AND METHODS: Twenty patients aged 40-76, with 40 confirmed OLP lesions in total, underwent photodynamic therapy (PDT) following the authors' own protocol, which used 5% 5-aminolevulinic acid as a photosensitizer applied two hours prior to illumination with a diode lamp emitting light at 630 nm and 300 mW. The therapy comprised of 10 weekly illumination sessions and was clinically evaluated between its completion and the end of a 12-month follow-up. RESULTS: While the baseline mean size of all 40 lesions was 2.74 ± 3.03 cm2, it was 2.97 ± 3.4 cm2 for the 30 lesions on the buccal mucosa and 2.02 ± 1.32 cm2 for the remaining 10 on the gingiva and tongue. On completion of the therapy, 37 sites improved, including 14 showing complete remission. From that point, the mean size reduction of 56.2% (1.2 ± 1.4 cm2) rose to 67.88% (0.88 ± 1.3 cm2) 12 months later. CONCLUSIONS: The results suggest that ALA-mediated photodynamic therapy was effective for the reticular form of OLP and may become an optional or complementary treatment.

Long-Term Assessment of Periodontal Tissues after Corticotomy-Assisted Orthodontic Arch Expansion.

OBJECTIVES: The aim of the study was the long-term assessment of the condition of periodontal tissues after corticotomy-assisted orthodontic expansion in patients with transverse maxillary deficiency. MATERIALS AND METHODS: The study included a group of 18 adults (9 women, 9 men) aged between 24 and 40 years who were at least 5 years post treatment. The following parameters were assessed: the full mouth plaque index (FMPI), full mouth bleeding on probing (FMBOP), probing depth (PD), clinical attachment level (CAL), gingival recession height (GR), recession width (RW), papilla height (PH), papilla width (PW), bone sounding (BS), phenotype, and KT. RESULTS: During examination performed at least 5 years after the completion of orthodontic treatment, the values of PD and CAL were found to be considerably decreased compared to the examination one year post treatment (PD: -0.23; 95% Cl: -0.29, -0.16) (CAL: -0.04; 95% Cl: -0.17, 0.10). The other parameters-FMPI, FMBOP, GR, RW, PH, PW, BS, phenotype, and KT-did not change significantly. CONCLUSIONS: Corticotomy-assisted orthodontic arch expansion does not have a negative effect on the periodontium in long-term observations. CLINICAL RELEVANCE: Orthodontic arch expansion can lead to bone dehiscence and gingival recession. Long-term observations revealed that corticotomy-assisted orthodontic expansion of the upper arch is not followed by negative changes in periodontal status.

A clinical evaluation of efficacy of photodynamic therapy in treatment of reticular oral lichen planus: A case series.

Background The aim of the study was to clinically evaluate the efficacy of photodynamic therapy in treatment of reticular oral lichen planus (OLP). Methods Fifty patients aged 26-84, with 124 OLP lesions in total, underwent photodynamic therapy (PDT) mediated with topically applied 5% 5-aminolevulinic acid. ALA was activated by a custom-made diode lamp with a high-power LED emitting light at 630 nm and 300 mW delivered through an optical fiber probe. A light exposure dose was 150 J/cm2. The therapy comprised of 10 weekly illumination sessions. The lesions' response was macroscopically measured in millimeters with a periodontal probe and clinically evaluated at each session, then on completion of the series and throughout the 12-month follow-up. Results The baseline mean size of lesions was 3.99 cm2±3.73. The lesions on the buccal mucosa and lips (lining mucosa) were larger than those on the gingiva and tongue (masticatory mucosa) - 4.58 cm2±4.01 and 2.93 cm2±2.91 respectively. On completion of the therapy 109 sites improved, including 46 in complete remission. The mean reduction in size was 62.91% (p = 0.000000). 12-month after therapy mean reduction of the lesions was 78.7% (p = 0.000000), specifically 79.48% (p = 0.000000) within the lining mucosa and 76.11% on the masticatory mucosa. Conclusions The results proved that ALA-mediated photodynamic therapy with a 630 nm light was effective and as such it can be used as an optional treatment for symptomatic OLP.

Clinical evaluation of Miller class I and II recessions treatment with the use of modified coronally advanced tunnel technique with either collagen matrix or subepithelial connective tissue graft: A randomized clinical study.

AIM: To compare outcomes of modified coronally advanced tunnel technique (MCAT) combined with either collagen matrix (CM) or subepithelial connective tissue graft (SCTG) in the treatment of Miller class I and II multiple gingival recessions in the mandible. MATERIALS AND METHODS: The study encompassed 91 recessions in 29 patients for whom MCAT was combined with CM on one side of the mandible and SCTG on the contralateral one. The following clinical parameters were measured: gingival recession height (GR) and width (RW), probing depth (PD), clinical attachment level (CAL), width of keratinized tissue (KT), gingival thickness (GT), mean (MRC) and complete root coverage (CRC) and Root Coverage Esthetic Score (RES). RESULTS: The MRC proportions on the CM- and SCTG-treated sides were 53.20% and 83.10%, respectively. CRC was achieved in 9 out of 45 (20%) gingival defects treated with CM and 31 out of 46 (67%) treated with SCTG. There were statistically significant differences in MRC, CRC, GR, RW, KT, GT and RES between CM- and CTG-treated sides. CONCLUSIONS: Modified coronally advanced tunnel technique leads to reduction in gingival recession both when combined CM and SCTG, of which the latter is more efficient as far as root coverage and aesthetic parameters are concerned.

Assessment of the effect of the corticotomy-assisted orthodontic treatment on the maxillary periodontal tissue in patients with malocclusions with transverse maxillary deficiency: a case series.

BACKGROUND: The aim of the study was to assess the effect of corticotomy-assisted orthodontic treatment on soft tissue clinical parameters in patients with malocclusions with transverse maxillary deficiency. METHODS: The study included 20 generally healthy adult individuals with malocclusion, who underwent a corticotomy-assisted orthodontic treatment in maxilla. During the corticotomy performed after full-thickness flap elevation, only the buccal cortical plate was cut with the use of OTS-7, OTS7-4, OTS7-3 ultrasound tips of the piezosurgery device (Mectron s. p. a., Italy). A clinical examination was performed prior to the corticotomy procedure, then repeated - 3, 6, 9 and 12 months after the procedure. The following parameters were assessed: FMPI (full mouth plaque index), FMBOP (full mouth bleading on probing), PD (probing depth), CAL (clinical attachment level), GR (gingival recession height), RW (recession width), PH (papilla height), PW (papilla width), BS (bone sounding), biotype and KT. RESULTS: There was a statistically significant reduction in PD (mean difference: 0.06; 95% Cl: - 0.33, - 0.18), CAL (mean difference: 0.07; 95% Cl: - 0.33, - 0.19), PH (mean difference: 0.26; 95% Cl: - 0.47, 0.05) and BS (mean difference: 0.13; 95% Cl: - 0.41, - 0.14) after the treatment. Statistically significant changes were also noted in relation to KT (mean difference: 0.17; 95% Cl: - 0.07, 0.27) and biotype (mean difference: 0.07; 95% Cl: 0.26, 0.39), which thickness increased significantly after the treatment. No statistically significant differences were observed in GR, RW and PW. CONCLUSIONS: The corticotomy-assisted orthodontic treatment did not jeopardize the periodontal clinical status in maxilla. There is a need for further studies on a larger number of patient to compare the clinical findings with a control group as well as in patients with conventional orthodontic treatment in a longer follow-up time to find out more about the post-treatment periodontal tissue changes and stability.

Evaluation of concordance between CAD/CAM and clinical positions of abutment shoulder against mucosal margin: an observational study.

BACKGROUND: While working on CAD/CAM-customized abutments, the use of standard impression copings with a circular diameter produces inconsistency within the emergence profile. It may begin with a collapse of the supra-implant mucosa during impression taking, then lead to a computer-generated mismatch of the position and outline of the abutment shoulder, and consequently result in a compromised outcome of anticipated treatment. The aim of the study was to compare the virtual and clinical positions of the abutment shoulder in relation to the mucosal margin after the abutment delivery. METHODS: Conventional open-tray impression takings followed uncovering surgery. Master casts were scanned with a desktop scanner. Clinical examinations took place after abutment's insertion and temporization (T1) and prior to cementation of the definitive crown (T2). The distances between the abutment shoulder and marginal soft tissue were measured intraorally in four aspects and juxtaposed with those on the virtual model. RESULTS: The study evaluated 257 dental implants and CAD/CAM-customized abutments. As T1 and T2 showed, there was a positive correlation between the virtually designed abutment shoulder position and matching clinical location relative to the mucosal margin. In 42.1% of cases, the distance between the mucosal margin and the abutment shoulder did not change. It increased in 36.3% of cases while a decrease occurred in 21.6% of them. CONCLUSIONS: Computer-set position of the abutment shoulder in relation to the mucosal margin can be predictably implemented in clinical practice.

The Effect of Nonsurgical Periodontal Therapy on the Level of Human Neutrophil Peptides 1-3 in Patients with Aggressive Periodontitis.

PURPOSE: To assess the presence of HNP1-3 in the gingival crevicular fluid (GCF) of patients suffering from aggressive periodontitis before and after nonsurgical periodontal therapy. MATERIALS AND METHODS: Twenty patients, each with generalised aggressive periodontitis (GAP) were included in the study. After periodontal examination, one site with a probing depth (PD) ≥ 4 mm was selected. Patients received nonsurgical treatment (scaling and root planing [SRP]) with additional administration of systemic antibiotic therapy (amoxicillin 375 mg three times daily + metronidazole 250 mg three times daily for 7 days). Prior to therapy and 3 and 6 months after, the following parameters were evaluated from the same site: PD, gingival recession (GR), clinical attachment level (CAL), plaque index (PI), bleeding on probing (BOP), sulcus fluid flow rate (SFFR). The level of HNP1-3 in GCF was determined by means of a commercially available ELISA kit. RESULTS: Compared to baseline, the level of HNP 1-3 did not show statistically significant differences at 3 and 6 months. The evaluated clinical parameters and SFFR showed statistically significant decreases compared to baseline. At 6 months, PD (median) decreased from 7 to 3.5 and CAL (median) decreased from 7 to 4. CONCLUSION: In patients with GAP, nonsurgical periodontal therapy in conjunction with systemic administration of amoxicillin and metronidazole had no effect on the level of HNP1-3 in GCF.

The Effect of Nonsurgical Periodontal Therapy on HNP1-3 Level in Gingival Crevicular Fluid of Chronic Periodontitis Patients.

The rich bacterial flora of oral cavity is controlled by innate immune response, including antibacterial peptides and among them human neutrophil peptides 1-3 (HNP1-3). The knowledge of the involvement of HNPs in innate and acquired immunity of the periodontium is fragmentary. The aim of the study was to assess alterations in HNP1-3 levels in the gingival crevicular fluid (GCF) of chronic periodontitis patients before and after nonsurgical periodontal therapy. Nineteen patients with chronic periodontitis were qualified to the study. After periodontal examination, one site with pocket depth (PD) ≥4 mm was selected. All the patients received periodontal treatment involving scaling and root planing with additional systemic antibiotic therapy (Amoxicillin 375 mg three times daily and Metronidazole 250 mg three times daily for 7 days). Prior to therapy, 3 and 6 months after it, clinical periodontal parameters were measured and GCF was collected from previously chosen site. The level of HNP1-3 in GCF was determined by means of a commercially available enzyme-linked immunoassay kit. The periodontal therapy caused a statistically significant (p < 0.001) decrease in all the assessed clinical parameters at the sites of sample collection except for bleeding on probing. The level of HNP1-3 per measure point showed a statistically significant increase (baseline-3 months: p = 0.05, baseline-6 months: p = 0.007). Within the limits of the study, it can be stated that nonsurgical periodontal therapy with additional systemic administration of Amoxicillin and Metronidazole increases the level of HNP1-3 in GCF.

A clinical evaluation of the efficacy of photodynamic therapy in the treatment of erosive oral lichen planus: A case series.

BACKGROUND: Erosive oral lichen planus (EOLP) poses a substantial risk of malignant transformation into squamous cell cancer. The absence of established treatment gives way to alternative therapeutic strategies, including photodynamic therapy. The aim of the study was to evaluate the efficacy of PDT in the treatment of EOLP. METHODS: Twelve female patients aged 63-80 with 22 OLP lesions (16 on the buccal mucosa, 6 on gingiva and tongue), underwent authors' own PDT scheme with the use of 5% solution of 5-aminolevulinic acid (ALA) as photosensitizer. An ALA-saturated occlusive dressing was applied directly onto a lesion and surrounding mucosa 2h prior to illumination with a custom-made diode lamp (light of 630nm, dose of 300mW). After a series of 10 weekly illumination sessions the patients were monitored for 12 months. RESULTS: The mean size of lesions before treatment was 1.46cm2±1.44. The lesions on the buccal mucosa were smaller (1.06cm2±0.98) than those on the gingiva and tongue (2.63cm2±1.93). Post-treatment improvement encompassed 16 lesions, 5 of which were in remission. The mean reduction in size after 10-session therapy was 8,05%. The healing continued and further reduction in size (by 69.13%) took place during the 12-month observation: 39.62% of lesions within the buccal mucosa and full remission of all lesions on the gingiva and tongue. CONCLUSIONS: The results suggest that PDT offers non-invasive treatment of lesions in oral mucosa and may become an alternative and complementary method to those currently in use. Further studies involving larger groups of patients should be undertaken before it becomes routine practice.

Incidence of undetected cement on CAD/CAM monolithic zirconia crowns and customized CAD/CAM implant abutments. A prospective case series.

OBJECTIVE: The aim of this study was to assess the frequency of cement residues after cementation of CAD/CAM monolithic zirconia crowns on customized CAD/CAM titanium abutments. MATERIALS AND METHODS: Sixty premolars and molars were restored on Astra Tech Osseospeed TX™ implants using single monolithic zirconia crowns fixed on two types of custom-made abutments: Atlantis™ titanium or Atlantis™ Gold Hue. Occlusal openings providing access to the abutment screws were designed for retrievability of the crown/abutment connection. After fixation with glass ionomer cement, the crown/abutment units were unscrewed to evaluate the presence of residual cement. Dichotomous assessment of the presence or absence of cement at the crown/abutment unit and peri-implant tissues was performed. RESULTS: Clinically undetected cement excess was visible on 44 of 60 restorations (73.3%). There was no interdependency between residual cement presence and implant location or diameter. However, a dependency between the presence of residual cement and the aspect of the abutment/crown connection could be noted. The majority of the residues were observed on the distal (17.9%) and mesial (15%) aspects. While on the palatal/lingual aspect, the cement was visible in 8.8%; only 3.4% of all surfaces displayed cement residues. CONCLUSIONS: Within the limitations of the study, it can be concluded that the use of customized CAD/CAM abutments do not guarantee avoidance of subgingival cement residues after crown cementation.

The assessment of the influence of vertical incisions on the aesthetic outcome of the Miller class I and II recession treatment: a split-mouth study.

AIM: The aim of this study was to compare the clinical and aesthetic parameters following a connective tissue graft (CTG) combined with the modified coronally advanced flap (MCAF), or the coronally advanced flap combined with vertical incisions (CAF) in the treatment of Miller class I and II recessions. MATERIALS AND METHODS: Twenty patients with 99 recessions were treated in a split-mouth study model. The MCAF with CTG was used on the right side, while the CAF with CTG was applied on the left side. The clinical and aesthetic evaluation was executed. RESULTS: The mean root coverage on the MCAF side was 90.52% 1 year post-operatively, whereas on the CAF side was 91.77%. A complete root coverage (CRC) was achieved in 78.43% of gingival defects treated with the MCAF and 83.33% defects treated with the CAF. The average RES after the MCAF was 7.98 ± 1.88 and after the CAF was 8.37 ± 1.81. There was no significant difference in the CRC and RES values or their variables between the two techniques. CONCLUSIONS: MCAF with CTG and CAF with CTG allow obtaining satisfactory and comparable root coverage as well as an aesthetic outcome without the negative effect of vertical incisions on the appearance of soft tissue.

Effect of nonsurgical periodontal treatment in conjunction with either systemic administration of amoxicillin and metronidazole or additional photodynamic therapy on the concentration of matrix metalloproteinases 8 and 9 in gingival crevicular fluid in patients with aggressive periodontitis.

BACKGROUND: To evaluate in patients with aggressive periodontitis (AgP) the effect of nonsurgical periodontal treatment in conjunction with either additional administration of systemic antibiotics (AB) or application of photodynamic therapy (PDT) on the gingival crevicular fluid (GCF) concentration of matrix metalloproteinases 8 and 9 (MMP-8 and -9). METHODS: Thirty-six patients with AgP were included in the study. Patients were randomly assigned to treatment with either scaling and root planing (SRP) followed by systemic administration of AB (e.g. Amoxicillin + Metronidazole) or SRP + PDT. The analysis of MMP-8 and -9 GCF concentrations was performed at baseline and at 3 and 6 months after treatment. Nonparametric U-Mann-Whitney test was used for comparison between groups. Changes from baseline to 3 and 6 months were analyzed with the Friedman's ANOVA test with Kendall's index of consistency. RESULTS: In the AB group, patients showed a statistically significant (p = 0.01) decrease of MMP-8 GCF level at both 3 and 6 months post treatment. In the PDT group, the change of MMP-8 GCF level was not statistically significant. Both groups showed at 3 and 6 months a decrease in MMP-9 levels. However, this change did not reach statistical significance. CONCLUSIONS: Within the limits of the present study, it may be suggested that in patients with AgP, nonsurgical periodontal therapy in conjunction with adjunctive systemic administration of amoxicilin and metronidazole is more effective in reducing GCF MMP-8 levels compared to the adjunctive use of PDT.

Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole.

OBJECTIVE: The use of antibacterial photodynamic therapy (aPDT) additionally to scaling and root planing (SRP) has been shown to positively influence the clinical outcomes. However, at present, it is unknown to what extent aPDT may represent a potential alternative to the use of systemic antibiotics in nonsurgical periodontal therapy in patients with aggressive periodontitis (AP). The aim of this study was to evaluate the outcomes following nonsurgical periodontal therapy and additional use of either aPDT or amoxicillin and metronidazole (AB) in patients with AP. MATERIAL AND METHODS: Thirty-six patients with AP displaying at least three sites with pocket depth (PD) ≥6 mm were treated with SRP and either systemic administration of AB for 7 days or with two episodes of aPDT. The following clinical parameters were evaluated at baseline and at 6 months: plaque index (PI), bleeding on probing (BOP), PD, gingival recession (GR) and clinical attachment level (CAL). RESULTS: Thirty-five patients have completed the 6-month evaluation. At 6 months, mean PD was statistically significantly reduced in both groups (from 5.0 ± 0.8 to 3.0 ± 0.6 mm with AB and from 5.1 ± 0.5 to 3.9 ± 0.8 mm with aPDT (p < 0.001)). AB yielded statistically significantly higher improvements in the primary outcome parameter PD (p < 0.001) when compared to aPDT. The number of pockets ≥7 mm was reduced from 141 to 3 after AB (p < 0.001) and from 137 to 45 after aPDT (p = 0.03). Both therapies resulted in statistically significant reductions in all parameters compared to baseline. CONCLUSION: While both treatments resulted in statistically significant clinical improvements, AB showed statistically significantly higher PD reduction and lower number of pockets ≥7 mm compared to aPDT. CLINICAL RELEVANCE: In patients with AP, the two times application of aPDT in conjunction with nonsurgical periodontal therapy cannot be considered an alternative to the systemic use of amoxicillin and metronidazole.

Clinical evaluation of photodynamic therapy efficacy in the treatment of oral leukoplakia.

BACKGROUND: The aim of the study was clinical evaluation of photodynamic therapy efficacy in the treatment of oral leukoplakia lesions. METHODS: Twenty-three consecutive patients aged 21-79 were included to the study. In all patients 44 homogeneous, flat leukoplakia lesions were clinically diagnosed and confirmed histopathologically. Photodynamic therapy was performed with the use of Photolon(®) photosensitizer, containing 20% Chlorine-e6 and 10% dimethyl sulfoxide and a semiconductor laser, with power up to 300mW and a wavelength of 660nm. Ten illumination sessions were conducted with the use of superficial light energy density of 90J/cm(2). RESULTS: At baseline the mean size of leukoplakia lesion was 6.5±5.10cm(2) while after photodynamic therapy 3±2.99cm(2). Significant reduction (on average by 53.8%) of leukoplakia lesions sizes was observed after therapy. Twelve (27.27%) lesions had been completely cured, 22 (50%) partially cured, although 10 (22.73%) lasted unchanged. The efficacy of PTD was comparable in women and men irrespective of age. There have been no adverse site effects during therapy noted. CONCLUSIONS: Within the limits of the study it can be concluded that photodynamic therapy with the use of Chlorine-e6 can lead to considerable reduction of oral leukoplakia lesions size thus may be useful in clinical practice. However there is a need of further studies on larger number of cases and longer follow-up time.

Retention force assessment in conical crowns in different material combinations.

The puprose of this study was to evaluate retention force of conical double crowns in two material connections: gold casting alloy/gold casting alloy and gold casting alloy/gold electroforming alloy. 12 crown pairs of both material connections with the cone angles of 2°, 4° and 6° were made. Experiment of 10.000 in-and-out cycles was performed using a new device which allows the retentive force to be measured in continuous way without necessity of moving the samples to another device. It has been found that the higher the retentive force values, the lower the cone angle. Dispersion of the retention value was similar in both groups, but when cone angle was 2° or 4°, stability of retention force with the passage of time was higher in combinations with electroformed copings. The optimum solution was the cast alloy/cast alloy connection but only with cone angle 6°. However, retentive values seem to be too low to achieve proper retention of dentures.

Nonsurgical treatment of aggressive periodontitis with photodynamic therapy or systemic antibiotics. Three-month results of a randomized, prospective, controlled clinical study.

The aim of this randomized, controlled clinical study was to compare the short-term effects of nonsurgical periodontal therapy with the additional administration of systemic antibiotics (AB) and the same therapy with additional photodynamic therapy (PDT) in the treatment of patients with aggressive periodontitis (AP). Thirty-six patients with AP received full-mouth nonsurgical periodontal treatment (SRP) and were then randomly divided into two groups of 18 subjects each. Group AB received amoxicillin and metronidazole three times a day for 7 days. Group PDT received two applications of PDT on the day of SRP as well as at follow-up after 7 days. The following clinical parameters were measured at baseline and 3 months after therapy: plaque index (PLI), bleeding on probing (BOP), probing depth (PD), gingival recession (GR), and clinical attachment level (CAL). After 3 months, PD was significantly reduced in both groups (from 5.0±0.8 mm to 3.2±0.4 mm with AB, and 5.1±0.5 mm to 4.0±0.8 mm with PDT; both p<0.001), while AB revealed significantly lower values compared to PDT (p = 0.001). In both groups, GR was not significantly changed. CAL was significantly reduced in both groups (PDT: 5.7±0.8 mm to 4.7±1.1 mm; p=0.011; AB: 5.5±1.1 mm to 3.9±1.0 mm; p<0.001) and differed significantly between the groups (p=0.025). The number of residual pockets (PD ≥4 mm) and positive BOP was reduced by AB from 961 to 377, and by PDT from 628 to 394. Pockets with PD ≥7 mm were reduced by AB from 141 to 7, and by PDT from 137 to 61. After 3 months, both treatments led to statistically significant clinical improvements. The systemic administration of antibiotics, however, resulted in significantly higher reduction of PD and a lower number of deep pockets compared to PDT.

Clinical assessment of the efficacy of photodynamic therapy in the treatment of oral lichen planus.

The study objective was clinical assessment of the efficacy of photodynamic therapy (PDT) in the treatment of oral lichen planus (OLP). There were 23 patients aged 31-82 included in the study with oral lichen planus diagnosed clinically and histopathologically. In all patients photodynamic therapy was performed with the use of chlorin e6 (Photolon(®)), containing 20 % chlorin e6 and 10 % dimethyl sulfoxide as a photosensitizer. PDT was performed using a semiconductor laser, with power up to 300 mW and a wavelength of 660 nm. A series of illumination sessions was conducted with the use of superficial light energy density of 90 J/cm(2). Changes of lesion size were monitored at one, two, five, and ten PDT appointments from the series of ten according to the authors' own method. The sizes of clinical OLP lesions exposed to PDT were reduced significantly (on average by 55 %). The best effects were observed for the lesions on the lining mucosa (57.6 %). The therapy was statistically significantly less effective when masticatory mucosa was affected (reduction, 30.0 %). Due to substantial efficacy and noninvasiveness, PDT can be useful in the treatment of OLP lesions.

Clinical and radiographic evaluation of intrabony periodontal defect treatment by open flap debridement alone or in combination with nanocrystalline hydroxyapatite bone substitute.

The aim of this study has been to compare the clinical and radiographic outcome of periodontal intrabony defect treatment by open flap debridement alone or in combination with nanocrystalline hydroxyapatite bone substitute application. Thirty patients diagnosed with advanced periodontits were divided into two groups: the control group (OFD), in which an open flap debridement procedure was performed and the test group (OFD+NHA), in which defects were additionally filled with nanocrystalline hydroxyapatite bone substitute material. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), pocket depth (PD), gingival recession (GR) and clinical attachment level (CAL) were measured prior to, then 6 and 12months following treatment. Radiographic depth and width of defects were also evaluated. There were no differences in any clinical and radiographic parameters between the examined groups prior to treatment. After treatment, BOP, GI, PD, CAL, radiographic depth and width parameter values improved statistically significantly in both groups. The PI value did not change, but the GR value increased significantly after treatment. There were no statistical differences in evaluated parameters between OFD and OFD+NHA groups 6 and 12months after treatment. Within the limits of the study, it can be concluded that the additional use of nanocrystalline hydroxyapatite bone substitute material after open flap procedure does not improve clinical and radiographic treatment outcome.

Long-term follow-up of conical crown-retained dentures fabricated using different technologies.

This study presents the results of a long-term clinical evaluation of conical crown-retained dentures fabricated using different technologies. Four different material connections between the outer and inner crowns were used: cast gold/cast gold, cast gold/electroforming, nonprecious alloy/electroforming, and titanium abutment/electroforming. Technical failures and retention values were assessed. The best clinical outcome was found with dentures in which both crowns were cast from gold alloy. The most frequent technical failures were observed in restorations with electroformed outer crowns. Better clinical outcomes were noted when the electroformed outer crowns were used in dentures retained by implants as compared to dentures on natural dentition.

Cholesteatoma-associated pathogenicity: potential role of lysosomal exoglycosidases.

UNLABELLED: The enzymatic profile of lysosomal exoglycosidases in middle ear cholesteatoma has not been well known. The assessment of glycoconjugate catabolism may contribute to a better understanding of cholesteatoma pathogenesis. OBJECTIVE: The study aim was to evaluate catabolic processes of glycoproteins, glycolipids, and proteoglycans in cholesteatoma through outlining the concentration of N-acetyl-ß-hexosaminidase (HEX), ß-glucuronidase (GLUC), and ß-galactosidase (GAL) activity as well as in serum of cholesteatoma patients and healthy volunteers. STUDY DESIGN: Acquired cholesteatomas (n = 25) and normal retroauricular skin specimens (n = 25) were taken during surgery as well as serum from cholesteatoma patients and healthy volunteers. HEX, GAL, and GLUC activity was assessed on basis of p-nitrophenol release from derivatives of the substrate (HEX: N-acetylglucosamine i N-acetylgalactosamine, GAL from galactose, and GLUC from glucuronide). RESULTS: The mean concentration of activity of HEX 1142.39 pKat/ml, GAL 8.90 pKat/ml, and GLUC 14.06 pKat/ml was significantly higher compared with the concentration of enzyme activity in normal tissue: HEX 267.65 pKat/ml, GAL 3.44 pKat/ml, and GLUC 3.90 pKat/ml. In the serum of cholesteatoma patients, the mean concentration of enzyme activities were as follows: HEX 641.62 pKat/ml, GAL 4.55 pKat/ml, and GLUC 12.80 pKat/ml and were significantly higher compared with the concentration of HEX activity (215.75 pKat/ml), GAL (1.89 pKat/ml), and GLUC (5.51 pKat/ml) in the serum of the healthy control group. In cholesteatoma compared with the normal tissue, there is an increase of the glycoconjugate catabolism due to significantly higher concentration of HEX, GAL, and GLUC activity in cholesteatoma. Cholesteatoma causes systemic reaction due to the increase of HEX, GAL, and GLUC activity in patient serum.