Clinical and histological comparison of healing by steel scalpel, diode laser, and radiofrequency in palatal wound: An animal study.

Background: Wound healing following periodontal soft tissue procedures can differ owing to different techniques, the feasibility of which can be determined through detailed macroscopic and microscopic observations. Aims: This study aimed to clinically and histologically evaluate palatal wound healing in rats by secondary intention after excision using a steel scalpel, diode laser, and radiofrequency. Materials and Methods: An excision was made in the edentulous anterior maxilla of 42 4-month-old male Wistar rats weighing 289-428 g. Part of the connective tissue was left in the surgical area to observe the dynamics of secondary intention wound healing. Three experimental groups were established: the steel scalpel, an 810-nm diode laser at a power output of 1.5 W in continuous mode, and a monopolar radiofrequency in a fully rectified waveform at 15 W. Clinical and histological analyses were performed on days 2, 4, and 7. Hemostasis, changes in body weight, defect size, epithelial gap, and inflammatory infiltration were evaluated. Results: The epithelial gap closed completely in all groups on day 7. Bleeding occurred significantly more in the scalpel group (P < 0.001). No significant changes were observed in body weight between the groups. Macroscopically, the mean wound area decreased over time in all groups. Wound healing was significantly slower in the laser group on day 2 and in the radiofrequency group on days 4 and 7 (P < 0.001). Microscopically, the laser created the cleanest wound area, with minimal inflammatory infiltration and no thermal injury. More damage occurred in the connective tissue of the radiofrequency group. Wound healing was observed on day 7 in all groups. Conclusions: Palatal wound healing with secondary intention yielded different outcomes in a rat model when different techniques were used. However, almost complete healing was observed in all wounds, which highlights the importance of the soft tissue left in the surgical area. Wound healing in periodontal soft tissue procedures is not compromised by different techniques, as long as the clinician has sufficient knowledge and experience.

Periodontal disease severity, tooth loss, and periodontal stability in private practice.

Background: Periodontal disease diagnosis and its stability after treatment are still a field of interest for both researchers and clinicians. Aims: First aim of this study was to implement the new periodontal classification for the reflection of periodontitis severity in private practice. Second, periodontal stability and tooth loss were observed in patients who attended supportive periodontal therapy (SPT). Patients and Methods: A total of 454 patients were classified according to the new classification. To define periodontitis, patients were staged according to the clinical attachment level, and tooth and bone loss. Grading was also assessed by bone loss to age ratio, smoking, and/or presence of diabetes. Associations between periodontitis and age, gender, presence of diabetes, and smoking were also analyzed. Additionally, periodontal stability, tooth loss, and adherence to oral hygiene were recorded for those who attended SPT. Results: One hundred five patients were diagnosed as generalized gingivitis and 349 patients as periodontitis. Among them, 166 suffered from severe periodontitis (stage 3 or 4). Most of the patients had stage 3 grade C periodontitis (40.4%). Out of the 344 patients who attended SPT at least once, no treatment was needed in 57 (16.6%) patients who were accepted periodontally stable. Twenty-nine patients lost at least one tooth due to periodontal reason. Conclusions: According to the new periodontal classification, 47.6% of the patients had severe periodontitis (stage 3 or 4). Periodontal stability was observed in 16.6% of patients who attended SPT.

Plasma tissue factor levels and salivary tissue factor activities of periodontitis patients with and without cardiovascular disease.

The association between periodontal and cardiovascular disease has received considerable attention. Studies have demonstrated a higher incidence of atherosclerotic complications in patients with periodontal disease. Tissue factor (TF) has been known as a key initiator of the coagulation cascade, and the TF pathway is the primary physiological mechanism of initiation of blood coagulation. Recently, it has been shown that the circulating pool of TF in blood is associated with increased blood thrombogenicity in patients with coronary artery disease (CAD). Various tissues and saliva have been known to have TF activity. Consequently, the aim of this study was to investigate plasma TF levels and TF activity of saliva in periodontitis patients with and without diagnosed CAD. Twenty-six patients with a diagnosis of CAD and 26 systemically healthy patients were examined in the dental clinic, and the Community Periodontal Index Treatment Needs (CPITN) scores were recorded. Plasma TF levels were determined using commercially available ELISA kit. Salivary TF activities were determined according to Quick's one-stage method. Plasma TF levels were significantly increased in patients with CAD when compared with the control group. There was no difference in salivary TF activities between the 2 groups, but there was a strong and negative correlation between salivary TF activities and CPITN indexes in both groups. In order to determine the possible role of TF activity as a salivary marker in CAD and periodontitis and to fully understand the negative correlation between salivary TF activities and CPITN, TF activity of gingival crevicular fluid that may also affect saliva can be evaluated.