Platelet-rich plasma. A review.

Platelet-rich plasma has been used in periodontal therapy because of its biologic characteristics in promoting wound healing and regeneration. Platelet-rich plasma, growth factors in platelet-rich plasma, their mechanism of action, probable role in wound healing, preparation of platelet-rich plasma and its activation are reviewed to provide insights into the role of this entity in wound healing and regeneration.

An evaluation of platelet-rich plasma without thrombin activation with or without anorganic bone mineral in the treatment of human periodontal intrabony defects.

The efficacy of platelet-rich plasma (PRP) in periodontal regeneration is not well understood and the definite clinical viability of blood derived platelets lacks clarity. Also, the use of thrombin for platelet activation is disputed. Hence, the purpose of this study was to evaluate the efficacy of blood derived platelets without thrombin activation, alone or in combination with bovine anorganic bone mineral (ABM), in the treatment of human periodontal intrabony defects. PRP was prepared using a simple tabletop centrifuge and activated using calcium chloride without the addition of thrombin. This PRP was used alone (in Group A) and in combination with bovine ABM (in Group B) in the treatment of human periodontal angular defects. Both the control and the test groups showed definite improvement in clinical parameters. On comparison, however, there was a statistically significant improvement in the probing pocket depths and relative attachment level in Group B over Group A at 3 and 6 months intervals, whereas at the end of 9 months this difference was not statistically significant. There was no statistically significant difference between the groups with respect to the relative defect depth. Within the limitations of this study and the type of PRP used, i.e. without thrombin mediated activation, it can be concluded that both PRP and PRP combined with bovine ABM results in significant clinical improvement. Albeit statistically insignificant, there is a preponderance of better clinical results with the addition of ABM to PRP. Further studies need to be carried out on a larger sample size to confirm the results of the present study.

The effect of indocyanine green-mediated photodynamic therapy as an adjunct to scaling and root planing in the treatment of chronic periodontitis: A comparative split-mouth randomized clinical trial.

OBJECTIVE: The aim of this study was to assess the effect of adjunctive photodynamic therapy (PDT) (using 810 nm diode laser and Indocyanine green as photosensitizer) in chronic periodontitis. MATERIALS AND METHODS: Patients with untreated chronic periodontitis were included. Treatment was done according to a split mouth design. All sites received periodontal treatment comprising scaling and root-planing (SRP). Test group were additionally treated with PDT. Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD) and Relative Attachment Level (RAL) were evaluated at baseline, 1 month and 3 months. RESULTS: Mean baseline values for PI, GI, PPD and RAL were not different in the test group and control group. Statistical significant difference in PPD and RAL, 3 months after treatment was seen in test group as compared to the control group. CONCLUSIONS: In patients with chronic periodontitis, clinical outcomes of conventional SRP can be improved by adjunctive PDT.

Implants in adolescents.

Implants have gained tremendous popularity as a treatment modality for replacement of missing teeth in adults. There is extensive research present on the use of implants in adults, but there is a dearth of data available on the same in adolescents. The treatment planning and execution of implant placement in adolescents is still in its infancy. This review article is an attempt to bring together available literature.

The antiplaque efficacy of pomegranate mouthrinse.

OBJECTIVE: to evaluate the effect of a pomegranate-containing mouthrinse on plaque, determine whether it has any adverse effects, and evaluate its antibacterial properties against selected periodontopathogens in vitro. METHOD AND MATERIALS: thirty periodontally healthy volunteers, randomly divided into three groups, refrained from all mechanical oral hygiene measures for 4 days and used one of the randomly assigned mouthrinses (A, pomegranate; B, chlorhexidine; or C, distilled water [placebo]) twice daily. The Plaque Index (PI) was assessed at days 0 and 5. Adverse effects were also evaluated. Pomegranate extract was tested against Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), and Prevotella intermedia (P.i.). RESULTS: in all groups, the PI significantly increased from the baseline to day 5 (P < .1). The pomegranate mouthrinse created no adverse effects. There was a statistically significant difference (P < .05) between the chlorhexidine and placebo rinse and the pomegranate and placebo rinse, but no statistically significant difference was found between the chlorhexidine and pomegranate rinse with respect to the PI. Pomegranate extract showed inhibition of all three strains of periodontopathogens at various concentrations. CONCLUSION: these results indicate that the pomegranate mouthrinse has an antiplaque effect. Pomegranate extract is efficacious against A.a., P.g., and P.i. strains in vitro. Pomegranate mouthrinse should be explored as a long-term antiplaque rinse with prophylactic benefits.

Anterior middle superior alveolar injection is effective in providing anesthesia extending to the last standing molar in maxillary periodontal surgery.

BACKGROUND: Multiple injections are required to anesthetize the maxilla for periodontal surgery that involves a quadrant or multiple teeth across the midline. The anterior middle superior alveolar (AMSA) field block was reported to effectively anesthetize the central incisors to the mesial aspect of the first molar of the maxilla with one or two injections. To our knowledge, the extent of anesthesia has not been reported beyond first molars in the literature. METHODS: Fifty subjects who were indicated for periodontal surgery were provided maxillary anesthesia with an AMSA injection through a conventional syringe with a 27-gauge needle. All subjects were given an AMSA injection, and after surgery, they were assigned to group 1 (requiring only the AMSA injection), group 2 (requiring one supplemental buccal infiltration), or group 3 (requiring two supplemental buccal infiltrations). Subjective and objective signs and symptoms were used to confirm the extent and profoundness of the anesthesia at 90, 120, and 180 minutes. RESULTS: Statistical significance for groups 1 and 2 was observed for anesthesia at different time intervals during the course of periodontal surgery. Pairwise comparisons of groups showed no statistical significance. The profoundness of the anesthesia extended to the last standing molar. CONCLUSIONS: The AMSA injection provided excellent, wide-spread anesthesia in all groups for the required time of surgery, and there was no significant implication among groups. The AMSA injection can be used as an effective technique to anesthetize teeth distal to the first molar up to the last standing molar in maxillary periodontal surgery.