The goal of the study was to evaluate marginal bone loss (MBL) after 1-year implant placement using a guided implant surgical (GIS) protocol in grafted sockets compared to non-grafted sites. We followed a parallel study design with patients divided into two groups: grafted group (Test group, n = 10) and non-grafted group (Control, n = 10). A bioactive glass bone graft was used for grafting. A single edentulous site with a minimum bone height ≥11 mm and bone width ≥6 mm confirmed by cone-beam computerized tomography (CBCT) was chosen for implant placement. Tapered hybrid implants that were sandblasted and acid-etched (HSA) were placed using the GIS protocol and immediately loaded with a provisional prosthesis. MBL and implant survival rates (ISR) were assessed based on standardized radiographs and clinical exams. Patients were followed up for 1-year post-loading. MBL after one year, in the control group, was −0.31 ± 0.11 mm (mesial) and −0.28 ± 0.09 mm (distal); and in the test group was −0.35 ± 0.11 mm (mesial) and −0.33 ± 0.13 mm (distal), with no statistical significance (p > 0.05). ISR was 100% in both groups after one year. ISR was similar between groups and the marginal bone changes were comparable one year after functional loading, without statistical significance, suggesting that bioactive glass permitted adequate bone formation. The GIS protocol avoided raising flaps and provided a better position to place implants, preserving the marginal bone around implants.
This study aimed at assessing the clinical outcomes of the Single Flap Approach (SFA) with the additional use of Low-level laser therapy (LLLT). The defects were treated as per the principles of SFA, whereby 20 defects received only SFA (control group) and 20 defects received additional LLLT for bio stimulation/bio modulation (test group). Stable primary closure of the flaps was obtained with vertical internal mattress sutures. Plaque indices (FMPS), clinical attachment levels (CAL), probing pocket depth (PPD), and gingival bleeding scores (FMBS) were calculated at baseline, and at the 3rd and 6th months in both groups. An EHI score of 1 was observed at all sites except for two, where a score of 2 in the control group at week 2 was observed. In the test group, the PPD reduction at 6 months was 3.60 ± 0.95 and in the control group it was 3.75 ± 0.91 mm. CAL gain at 6 months was 2.70 ± 1.36 mm and 3.45 ± 1.2 mm in the test group and showed no statistical significance. These data suggested the positive effect of LLLT over CAL gain; thus, LLLT may be combined with SFA to potentially enhance the early wound healing and higher clinical outcomes in terms of increase in CAL and decrease in PPD.
Matrix metalloproteinases (MMP)-8 is increased in smokers with chronic periodontitis (CP). The levels of MMP-9 have not been assessed in the periodontal tissues of smokers. Therefore, the aim of this study is to estimate the concentrations of MMP-8 and -9 in the gingival crevicular fluid (GCF) of smokers and non-smokers with CP. Plaque, bleeding on probing, probing pocket depth, and attachment level were assessed in 60 subjects who were equally divided into three groups. Group A consisted of smokers with CP, Group B - non-smokers with CP and Group C - periodontally healthy subjects. The concentrations of MMP-8 and -9 were determined from GCF samples by using enzyme-linked immunosorbent assay. A highly significant difference (P < 0.0001) was found in the MMP-9 concentration between the Groups A (27.56 ± 2.87 ng/ml) and B (17.16 ± 1.74 ng/ml) and between Groups A and C (14.13 ± 2.87 ng/ml). A significant difference (P < 0.002) was also found between the Groups B and C. A highly significant difference (P < 0.0001) in MMP-8 concentration was found between the A (68.96 ± 20.53 ng/ml) and C (7.05 ± 0.75 ng/ml) and also between Groups B (56.97 ± 12.70 ng/ml) and C. The difference in MMP-8 concentration between A and B was not statistically significant. Our findings of significantly elevated MMP-9 than MMP-8 from the diseased sites in smokers imply that MMP-9 is more significantly related to the increased periodontal destruction seen among smokers with CP.
Background and objectives: The study aimed to evaluate and compare the amount of papillary gain and black triangle height reduction after intervention with a microtunnelling technique with either Connective tissue graft (CTG) or Platelet-rich fibrin (PRF) as a biomatrix at 6 months using a microsurgical approach. Materials and Methods: Twenty-six patients with interdental papillary loss were included in the study. The patients were selected randomly for the study groups with thirteen patients in each group: a control group where CTG was utilised as a matrix, and a test group where PRF was utilised as a matrix, for interdental papillary reconstruction. A microtunnelling technique was performed for both the study groups under a surgical microscope. The primary parameters assessed were interdental Papillary height (PH) and Black triangle height (BTH) at baseline, with secondary parameters Visual analogue score by dentist (VAS-D) and patient (VAS-P) assessed at 6 months. Results: Both the control and test groups showed a significant reduction in BTH within their respective group at six months (p < 0.05). The gain in papillary height significantly improved only in the CTG group at 6 months. However, significant differences could not be demonstrated for any of the variables such as BTH (p value = 0.582) and PH (p-value = 0.892) between the study groups at 6 months. Conclusions: IDP reconstruction utilising a microtunnelling approach with CTG or PRF was successful without any significant differences between the groups for the parameters assessed at 6 months.
4 October 2021 in International Journal of Implant Dentistry
Purpose: The study aimed to compare clinical and radiographic parameters of peri-implant site of laser-microgrooved implants with either laser-microgrooved or regular machined prosthetic abutment post 3 years of early loading.Method: Twenty edentulous sites of systemically and periodontally healthy individuals were allocated into two groups in this prospective, two-armed, randomized double-blinded clinical trial in 1:1 ratio, wherein each site received laser-microgrooved implants with either laser-microgrooved or machined prosthetic abutments. Outcome measures included full-mouth plaque (FMPS%) and bleeding score (FMBS%), site-specific plaque (SPS%) and bleeding score (SBS%), peri-implant sulcus depth (PISD mm), and mean crestal bone loss (MCBL mm) evaluated at baseline (6 weeks), 1 and 3 years post-early loading. Mean and standard deviation of all parameters were estimated, between groups and at different time points using independent and pairedt-test, respectively, Normality was checked using Kolmogorov–Smirnov test and Shapiro–Wilk test,Pvalue ≤ 0.05 was considered as statistically significant.Results: Three-year follow-up of test group showed statistically significant reduction in SPS, SBS, PISD (Pvalue ≤ 0.001). The MCBL reduced from 1.93 mm to 0.61 mm (Pvalue ≤ 0.001); in other words, a bone gain of 0.15 mm was obtained in the test group.Conclusion: Within the limitations of the present study, laser-microgrooved implants loaded with laser-microgrooved prosthetic abutments showed superior results clinically and radiographically when compared to loading with machined abutments.
Background: Dental root coverage, crucial in managing gingival recessions, traditionally utilizes subepithelial connective tissue grafts. However, this approach has limitations such as donor site morbidity and graft availability. Recent studies have introduced platelet-rich fibrin (PRF) as an alternative, leveraging its regenerative potential and growth factors. Despite the promise, comparative assessments between PRF and conventional grafts remain limited. This research probes whether PRF, when used beneath a modified Ruben's mixed flap, could provide comparable or superior dental root coverage than a subepithelial connective tissue graft. Material/Methods: We enrolled 30 patients exhibiting Miller's class I and II recession in this comparative case series. Patients were randomly assigned to receive either a connective tissue graft (15 patients) or a PRF matrix (15 patients), both covered by a modified Ruben's mixed flap.Results: Clinical parameters, including full mouth plaque scores, bleeding scores, probing sulcus depth, clinical attachment level, gingival position assessment, width, and thickness of attached gingiva, were assessed in both the control and test groups at baseline, 6 months, and 12 months post-surgery. Significant differences were observed at all intervals. At the 12-month mark, the control group (connective tissue graft) achieved 91% complete root coverage, while the test group (PRF matrix) achieved 86%. However, this difference was not statistically significant.Conclusions: The study outcomes suggest comparable gains in root coverage and attached gingiva between the connective tissue graft and PRF matrix groups. Thus, the results support our hypothesis that a subepithelial PRF matrix can serve as a viable alternative to a subepithelial connective tissue graft for treating dental root coverage.