bromochloroacetic-acid and Tooth-Mobility

The aim of this study was to assess soft-tissue re-growth following Fibre Retention Osseous Resective Surgery (FibReORS) or Osseous Resective Surgery (ORS) over a 12-month healing period.. Thirty patients with chronic periodontitis showing persistent periodontal pockets at posterior natural teeth after cause-related therapy were enroled. Periodontal pockets were associated with infrabony defect ≤3 mm; 15 patients were randomly assigned to FibReORS (test group) and 15 to ORS (control group). Measurements were performed by a blind and calibrated examiner. Soft-tissue rebound after flap suture was monitored by changes in gingival recession at 1-, 3-, 6-, and 12- month follow-up. Multilevel analysis considering patient, site, and time levels was performed.. Greater osseous resection during surgery and higher post surgical gingival recession was observed in the ORS group. The mean amount of soft-tissue rebound following surgery was 2.5 mm for ORS-treated sites and 2.2 mm for FibReORS-treated sites. Approximately 90% of the coronal re-growth was detectable after 6 months for both procedures. The interaction between ORS and time of observation showed a higher soft-tissue rebound after 12 months (p = 0.0233) for ORS-treated sites.. Both procedures showed a similar coronal soft-tissue re-growth with a significant higher recession reduction for ORS-treated sites. Significant clinical stability of the gingival margin is obtained 6 months after surgery for both procedures.

Topics: Adult; Alveolar Bone Loss; Alveolar Process; Alveolectomy; Chronic Periodontitis; Dental Plaque Index; Female; Follow-Up Studies; Gingiva; Gingival Recession; Gingivoplasty; Humans; Keratins; Male; Middle Aged; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Single-Blind Method; Surgical Flaps; Tooth Cervix; Tooth Mobility; Treatment Outcome; Wound Healing

The primary aim of this randomized, controlled, blinded clinical pilot study was to compare the percentage of recession defect coverage obtained with a coronally positioned tunnel (CPT) plus an acellular dermal matrix allograft (ADM) to that of a CPT plus ADM and platelet-rich plasma (CPT/PRP) 4 months post-surgically.. Eighteen patients with Miller Class I or II recession >or=3 mm at one site were treated and followed for 4 months. Nine patients received a CPT plus ADM and were considered the positive control group. The test group consisted of nine patients treated with a CPT plus ADM and PRP. Patients were randomly selected by a coin toss to receive the test or positive control treatment.. The mean recession at the initial examination for the CPT group was 3.6 +/- 1.0 mm, which was reduced to 1.0 +/- 1.0 mm at the 4-month examination for a gain of 2.6 +/- 1.5 mm or 70% defect coverage (P <0.05). The mean recession at the initial examination for the CPT/PRP group was 3.3 +/- 0.7 mm, which was reduced to 0.4 +/- 0.7 mm at the 4-month examination for a gain of 2.9 +/- 0.5 mm or 90% defect coverage (P <0.05). There were no statistically significant differences between the groups (P >0.05).. The CPT plus ADM and PRP produced defect coverage of 90%, whereas the CPT with ADM produced only 70% defect coverage. This difference was not statistically significant, but it may be clinically significant.

Topics: Adult; Aged; Collagen; Dental Plaque Index; Female; Follow-Up Studies; Gingiva; Gingival Recession; Gingivoplasty; Humans; Keratins; Male; Middle Aged; Periodontal Attachment Loss; Periodontal Index; Periodontal Pocket; Pilot Projects; Platelet-Rich Plasma; Single-Blind Method; Skin, Artificial; Surgical Flaps; Tooth Mobility; Tooth Root; Young Adult

Gingival recession in its localized or generalized form is an undesirable condition resulting in root exposure. Sites exhibiting Miller Class IV gingival recession are not suitable for treatment with surgical root coverage techniques, and their prognoses are very poor with current techniques. The aim of this case report is to establish a new technique for the root coverage of severe gingival recession defects (Miller Class IV) by providing a new source of enough tissue with good blood supply using the pedicled buccal fat pad (PBFP).. The PBFP was mobilized through an incision in the base of the buccal flap at the level of the upper second molar; the vascularized flap was secured to the buccal surface of the upper first molar tooth and premolar teeth and sutured with the wound margins.. A clinically significant amount of keratinized gingiva that covered the root recession defect was obtained. Epithelialization of the buccal fat pad was completed after 6 weeks, with formation of healthy-looking keratinized mucosa in the anatomic site of the keratinized gingiva.. The PBFP technique is simple and easy to handle. It may also be considered a novel application with promising results for the root coverage of severe gingival recession defects (Miller Class IV) that may provide a considerable amount of keratinized tissue used for root coverage of the upper posterior molar teeth.

Topics: Adipose Tissue; Adult; Alveolar Bone Loss; Epithelium; Female; Furcation Defects; Gingival Recession; Gingivoplasty; Humans; Keratins; Maxilla; Molar; Mouth Mucosa; Surgical Flaps; Tooth Mobility; Tooth Root; Wound Healing

Topics: Gingivectomy; Gingivoplasty; Granuloma; Humans; Keratins; Periodontitis; Postoperative Complications; Recurrence; Subgingival Curettage; Suppuration; Surgical Wound Infection; Tooth Mobility; Wound Healing