Coronally advanced flap and envelope type of flap plus acellular dermal matrix graft for the treatment of thin phenotype multiple recession defects. A randomized clinical trial.

INTRODUCTION: The aim of this randomized clinical trial was to assess the aesthetical and clinical outcomes of acellular dermal matrix graft (ADMG) plus coronally advanced flap (CAF) with vertical incisions or the envelope flap in the treatment of thin phenotype, multiple-recession defects. MATERIAL AND METHODS: Twenty-two participants with 55 class recession type 1 (RT1) with a depth of ≥3 mm were investigated. Control group was treated with ADMG plus conventional CAF with vertical releasing incisions, whereas test group received the envelope flap with ADMG. Primary outcome variables were complete root coverage (CRC), root coverage aesthetic score and patient satisfaction. RESULTS: Tooth-based CRC was observed in 23 of the 28 recession defects in mCAF + ADMG group (82.1%), whereas in 19 of the 27 recession defects in CAF + ADMG group (70.37%), with no inter-group difference (p > .05). CRC was observed in 9 of the 11 patients in mCAF + ADMG group (81.8%). On the other hand, in CAF + ADMG group, CRC was achieved in 8 of the 11 patients (72.7%). Results were similar between the groups (p > .05). CONCLUSIONS: Both techniques were successful in the management of multiple recessions; however, superior results regarding patient's satisfaction were achieved with mCAF + ADMG.

Clinical and microbiological effects of probiotic lozenges in the treatment of chronic periodontitis: a 1-year follow-up study.

AIM: The objective of this study was to evaluate the effects of lozenges containing L. reuteri as an adjuvant treatment to initial periodontal therapy for chronic periodontitis patients and to detect the level of L. reuteri colonization in the periodontal pockets of treated patients. MATERIAL AND METHODS: A total of 40 patients were selected and randomly divided into two groups. Each patient had at least two teeth with one approximal site each with a probing depth (PD) of 5-7 mm and gingival index (GI) of ≥2 in each quadrant. Group I received scaling and root planing (SRP) plus L. reuteri-containing lozenges, and Group II received SRP plus placebo. The plaque index (PI), GI, bleeding on probing (BoP), PD and relative attachment level were measured. Microbiological sampling was performed at baseline and on days 21, 90, 180 and 360 and were analysed by culturing. The Bonferroni-corrected paired sample t-test, Bonferroni-corrected Wilcoxon signed rank test and paired sample t-test were used to evaluate intra-group differences. The Bonferroni-corrected Student's t-test and the Mann-Whitney U-tests were used to evaluate inter-group differences. RESULTS: After treatment, the measured PI, GI, BoP and PD were significantly (p < 0.05) lower in Group I compared with Group II at all time points. Similar observations were made for the total viable cell counts and the proportions of obligate anaerobes with the exception of day 360. In Group I, significantly fewer patients required surgery on ≥3 sites. CONCLUSION: L. reuteri-containing lozenges may be a useful adjuvant agent to slow re-colonization and improve clinical outcomes of chronic periodontitis. Further studies are required to clarify the optimal dose of the lozenges.

Comparison of two different xenografts in bilateral sinus augmentation: radiographic and histologic findings.

OBJECTIVE: The aim of this study was to evaluate the radiographic and histomorphometric results of two different xenografts in bilateral sinus augmentation in patients with posterior maxillary atrophy. METHOD AND MATERIALS: Eight patients with less than 5 mm residual alveolar bone height were included in this study. One side was augmented with bovine bone graft-1 and the other side with bovine bone graft-2. Radiographic analyses were performed before and after augmentation, and before the implant placement. After 8 months of healing period, bone biopsies were obtained during implant placement. RESULTS: No statistically significant difference was found between the groups, based on post-augmentation and pre-implantation graft heights (P > .05). Histomorphometric evaluation demonstrated 24.63% and 29.13% newly formed bone in the graft-1 and graft-2 groups, respectively. Intergroup differences were not significant for the mean percentage of new bone formation (P > .05). CONCLUSION: Within the limitations of this study, it can be concluded that xenograft materials resulted in satisfactory bone height and trabecular new bone formation, and they could be used for the rehabilitation of atrophic maxillae.