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Healing response of gingival recession defects following guided tissue regeneration procedures in smokers and non-smokers
No full textThis retrospective study evaluated healing response in gingival recession defects following guided tissue regeneration (GTR) in smokers. 22 systemically healthy patients who had been treated for deep (> or = 4 mm), buccal, Miller's class I or II gingival recession defects with ePTFE membranes were included. Patients were regarded as smokers if they smoked more than 10 cigarettes/day at the time of surgical procedure. Occasional and former smokers were excluded. 9 patients (6 male, mean age 29 years) were smokers, while 13 patients (4 male, mean age 35 years) were non-smokers. Clinical parameters, recorded presurgery and at 6 months postsurgery, included defect-specific plaque (DP1) and bleeding on probing (BoP) scores, recession depth (RD), probing depth (PD), clinical attachment level (CAL), and keratinized tissue width (KG). Extent of membrane exposure (ME) and newly formed tissue (NFT) gain were assessed at membrane removal. Statistical analysis revealed no significant differences between smokers and non-smokers in demographic and presurgery defect characteristics. DP1 and BoP scores were similar presurgery and remained almost unchanged throughout the observation interval in both groups. ME was significantly greater in smokers (2.6 +/- 1.4 mm) than in non-smokers (1.3 +/- 0.6 mm). NFT gain was 2.8 +/- 1.0 mm in smokers and 3.6 +/- 1.4 mm in non-smokers, the difference being not statistically significant. Smokers showed significantly less RD reduction and root coverage (2.5 +/- 1.2 mm and 57%, respectively) compared to non-smokers (3.6 +/- 1.1 mm and 78%, respectively). In conclusion, the results indicate that treatment outcome following GTR in gingival recession defects is impaired in cigarette smokers
Long-term stability of the mucogingival complex following guided tissue regeneration in gingival recession defects
No full textThe purpose of the present study was to evaluate the stability of soft tissue conditions in gingival recession defects treated with guided tissue regeneration (GTR). The study population was selected among those patients who had been treated with GTR procedures for Miller's class I or II, deep (> or =3 mm), buccal gingival recession defects. Defects were included only when they had revealed recession depth reduction > or =2 mm and root coverage > or =60% at 6 months following GTR treatment. These defects were regarded as successfully treated and scheduled for further monitoring. 20 patients, 11 male and 9 female, aged 23 to 57 years (mean age: 33.2 years), each contributing 1 defect, were selected. 9 patients were smokers (> or =10 cigarette per day). Recession depth (RD), probing depth (PD), clinical attachment level (CAL), and width of keratinized gingiva (KG) were assessed immediately before surgery, at 6 months post-surgery (baseline examination), and at 4 years post-surgery (4-year examination). At baseline examination, RD reduction was 3.6+/-0.9 mm (mean root coverage: 80%). CAL gain amounted to 4.2+/-1.3 mm, 60% of the defects showing CAL gain > or =4 mm. KG increased from 1.9+/-1.2 mm at presurgery examination to 3.1+/-0.9 mm at baseline examination. At 4-year examination, no significant changes from baseline RD, CAL and KG recordings were observed. Differences in baseline-4 year changes between smokers and non-smokers were not statistically significant. The results of the present study demonstrate that clinical outcome achieved following GTR procedure in gingival recession defects can be maintained over periods up to 4 years
Impaired treatment outcome following GTR in gingival recession defects in cigarette smokers
No full textThis retrospective study evaluated healing response in gingival recession defects following GTR in smokers. Twenty-two systemically healthy patients who had been treated for deep ( 3 4 mm), buccal, Miller’s Class I or II gingival recession defects with e-PTFE membranes were included. Patients were regarded as smokers if they smoked more than 10 cigarettes/day at the time of surgical procedure. Occasional and former smokers were excluded. Nine patients (6 males, mean age: 29 years) were smokers, while 13 patients (4 males, mean age: 35 years) were non-smokers. Clinical parameters, recorded presurgery and at 6 months postsurgery, included defect-specific plaque (DPl) and bleeding on probing (BoP) scores, recession depth (RD), probing depth (PD), clinical attachment level (PAL), and keratinized tissue width (KT). Extent of membrane exposure (ME) and newly formed tissue (NFT) gain were assessed at membrane removal. Statistical analysis revealed no significant differences between smokers and non-smokers in demographic and presurgery defect characteristics. DPl and BoP scores were similar presurgery and remained almost unchanged thoroughout the observation interval in both groups. ME was significantly greater in smokers (2.6 ± 1.4 mm) than in non-smokers (1.3 ± 0.6 mm). NFT gain was 2.8 ± 1.0 mm in smokers and 3.6 ± 1.4 mm in non-smokers, the difference being not statistically significant. Smokers showed significantly less RD reduction and root coverage (2.5 ± 1.2 mm and 57%, respectively) compared to non-smokers (3.6 ± 1.1 mm and 78%, respectively). In conclusion, the results indicate that treatment outcome following GTR in gingival recession defects is impaired in cigarette smokers. This study was partly supported by MURST grant #95/60/06/1
Action du chlorhydrate de tetracycline sur le cement et la dentine d'une racine saine. Etude au microscope electronique a balayage de l'effet obtenu en fonction de la concentration de la solution et de la duree d'application.
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Effect of topical application of a fibrin-fibronectin sealing system on healing response following periodontal surgical procedures
No full textThe purpose of these controlled clinical trials was to evaluate the effect of a fibrin-fibronectin sealing system (FFSS) application on periodontal wound healing. Treatment outcomes following periodontal surgery were investigated by selecting different surgical procedures where wound stability was affected by defect anatomy, surface treatment, flap management and adjunctive application of wound-stabilising devices. In each patient, treatment modalities were randomly assigned according to a split-mouth design. In the first trial, 11 patients presenting with a pair of moderate to severe supra-alveolar defects were treated with flap debridement surgery with or without tetracycline HCl (TTC) root conditioning and FFSS application. In the second trial, 11 patients presenting with a pair of buccal gingival recession defects were treated with coronally positioned flap procedure and TTC root conditioning with and without FFSS application. In the third trial, 8 patients presenting with a pair of buccal gingival recession defects were treated with coronally positioned flap procedure, TTC root conditioning and teflon membrane with and without FFSS application. Conventional probing recordings, including probing depth, clinical attachment level and recession depth, were made immediately before surgery and 6 months postsurgery. Overall, the results indicated that periodontal healing following surgery resulted in a clinically and statistically significant improvement in the defect, and that the adjunctive application of FFSS produced limited to no enhancement of treatment outcome
Nondiseased cementum and dentin root surface following tetracycline hydrochloride conditioning: Sem study of the effects of solution concentration and application time
No full textTetracycline hydrochloride treatment of cementum and dentin surfaces derived from human teeth not affected by periodontitis resulted in the removal of the smear layer and uncovered a fibrillar collagen substrate. In cementum specimens, the amount of exposure of the organic matrix appeared to be more related to morphologic structure of the cementum and mechanical instrumentation of the root surface rather than to concentration and time of application of tetracycline solution. Time-dependent changes were observed in dentin surfaces, the intertubular "matted" collagen matrix being evident only in the 4-minute specimens
A comparative study on the use of a HA/collagen/chondroitin sulphate biomaterial (Biostite®) and a bovine‐derived HA xenograft (Bio‐Oss®) in the treatment of deep intra‐osseous defects
No full textOBJECTIVES: This parallel-group, randomized, clinical trial was designed to evaluate the clinical outcome of deep intra-osseous defects following reconstructive surgery with the use of a synthetic hydroxyapatite/equine Type I collagen/chondroitin sulphate biomaterial (Biostite), as compared to a bovine-derived hydroxyapatite xenograft (Bio-Oss). MATERIAL AND METHODS: Twenty-four systemically healthy subjects with moderate to advanced periodontitis, 11 females and 13 males, aged 30-64 years, seven smokers, were selected. Patients presented with one interproximal deep intra-osseous defect (intra-osseous component >or=4 mm) as clinically and radiographically evaluated. Immediately before surgery and 12 months after surgery, pocket probing depth (PPD), clinical attachment level (CAL) and radiographic depth of the defect (DEPTH) were evaluated. RESULTS: Thirteen defects were treated with Biostite (test) and 11 defects with Bio-Oss (control). In the test group, PPD amounted to 7.8+/-1.3 mm before surgery, and decreased significantly to 3.6+/-1.6 mm 12 months following surgery, while in the control group PPD significantly decreased from 7.5+/-2.0 mm pre-surgery to 3.1+/-1.0 mm post-surgery. At 1 year, CAL gain and DEPTH gain were 2.9+/-1.9 and 2.5+/-1.4 mm, respectively, in the test group, and 4.0+/-2.4 mm and 3.1+/-1.8 mm, respectively, in the control group. No statistically significant differences for PPD reduction, CAL gain and DEPTH gain were detected between the groups. CONCLUSIONS: The results of the present study indicate that both Biostite and Bio-Oss grafting biomaterials have determined a clinically and statistically significant improvement in terms of CAL gain, PPD reduction and radiographic DEPTH gain when used for the treatment of deep intra-osseous defects
Impaired healing response of periodontal furcation defects following flap debridement surgery in smokers - A controlled clinical trial
No full textOBJECTIVES: The purpose of the present parallel-design, controlled clinical trial was to evaluate the treatment outcome of periodontal furcation defects following flap debridement surgery (FDS) procedure in cigarette smokers compared to non-smokers. MATERIALS AND METHODS: After initial therapy, 31 systemically healthy subjects with moderate to advanced periodontitis, who presented at least one Class I or II molar furcation defect, were selected. Nineteen patients (mean age: 40.3 years, 15 males) were smokers (>or=10 cigarettes/day) and 12 patients (mean age: 44.8 years, 3 males) were non-smokers. Full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS), probing pocket depth (PPD), vertical clinical attachment level (v-CAL), and horizontal clinical attachment level (h-CAL) were assessed immediately before and 6 months following surgery. RESULTS: Overall, statistically significant v-CAL gain was observed in smokers (1.0 +/- 1.3 mm) and non-smokers (1.3+/-1.1 mm), the difference between groups being statistically significant (p=0.0003). In proximal furcation defects, v-CAL gain amounted to 2.3+/-0.7 mm in non-smokers as compared to 1.0+/-1.1 mm in smokers (p=0.0013). At 6 months postsurgery, non-smokers presented a greater h-CAL gain (1.3+/-1.1 mm) than smokers (0.6+/-1.0 mm), with a statistically significant difference between groups (p=0.0089). This trend was confirmed in both facial/lingual (1.4+/-1.0 versus 0.8+/-0.8 mm) and proximal furcation defects (1.2+/-1.3 versus 0.5+/-1.2 mm). The proportion of Class II furcations showing improvement to postsurgery Class I was 27.6% in smokers and 38.5% in non-smokers. After 6 months, 3.4% of presurgery Class I furcation defects in smokers showed complete closure, as compared to 27.8% in non-smokers. CONCLUSIONS: The results of the present study indicated that (1) FDS produced clinically and statistically significant PPD reduction, v-CAL gain, and h-CAL gain in Class I/II molar furcation defects, and (2) cigarette smokers exhibited a less favorable healing outcome following surgery in terms of both v-CAL and h-CAL gain
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