scholarly journals A Novel Treatment of Gingival Recession using a Botanical Topical Gingival Patch and Mouthrinse

2013 ◽  
Vol 14 (5) ◽  
pp. 948-953 ◽  
Author(s):  
William Z Levine ◽  
Noah Samuels ◽  
Meytal Elia Bar Sheshet ◽  
John T Grbic
Keyword(s):  
Treatment Period ◽  
Conservative Therapy ◽  
Case Series ◽  
Gingival Recession ◽  
Current Treatment ◽  
Scaling And Root Planing ◽  
Gingival Thickness ◽  
Novel Treatment ◽  
Oral Hygiene Instruction ◽  
Miller Classification

ABSTRACT Background and aim Current treatment of gingival recession (GR) is limited to surgical procedures. We describe a case series of 18 patients with GR who were treated with a botanical patch and rinse following standard conservative therapy. Case series description A total of 22 sites with GR > 1 mm were studied. Following scaling and root planing (SRP) and oral hygiene instruction, patients received two courses of patch treatment (3 days each) and botanical rinse administered twice daily throughout the treatment period. Outcome measures (GR, gingival index (GI) and gingival thickness (GT) were taken at baseline; at 1 to 2 weeks; 2 to 4 weeks; and at 6 to 8 weeks. Miller classification and plaque index (PI) were measured at baseline and at 6 to 8 weeks. At the end of the treatment period, mean GR decreased from 4.18 ± 1.74 mm to 3.31 ± 1.51 mm (20.8%); Miller grade from 1.86 ± 0.56 to 1.06 ± 0.43; GI scores from 1.45 ± 0.63 to 0.17 ± 0.38 (88.3%); and PI scores from 1.33 ± 0.59 to 0.78 ± 0.94. GT increased from 0.74 mm ± 0.40 to 1.21 ± 0.39 (63.5%). No adverse effects were reported with either the patch or rinse treatments Conclusion We observed a decrease in GR and GI scores in 18 patients (22 sites) treated with the study patch and rinse, with increased GT. How to cite this article Levine WZ, Samuels N, Sheshet MEB, Grbic JT. A Novel Treatment of Gingival Recession using a Botanical Topical Gingival Patch and Mouthrinse. J Contemp Dent Pract 2013;14(5):948-953.

scholarly journals Xenogeneic collagen matrix for the treatment of multiple gingival recessions in esthetics areas: a case series with 24-month follow-up

2021 ◽  
Vol 10 (10) ◽  
pp. e349101018776
Author(s):  
Raphaella Coelho Michel ◽  
Rafael Ferreira ◽  
Erika Beatriz Spada de Carvalho ◽  
Talyta Sasaki Jurkevicz ◽  
Carla Andreotti Damante ◽  
...  
Keyword(s):  
Case Series ◽  
Collagen Matrix ◽  
Gingival Recession ◽  
Health Impact ◽  
Anterior Maxilla ◽  
Gingival Thickness ◽  
Coronally Advanced Flap ◽  
Keratinized Tissue ◽  
Surgical Pain

Introduction: Multiple gingival recessions (GR) are often associated with high hypersensitivity and esthetics concerns due to exposed roots. The collagen matrix (CM) associated with coronally advanced flap (CAF) may be a suitable treatment for multiple GR in esthetic areas. However, there is a lack of long term follow up investigations. Objective: To evaluate a 24-month follow-up of the CM + CAF treatment for multiple RT1 GRs in esthetics areas. Materials and Methods: Six patients presenting 6 adjacent Cairo’s gingival recessions type 1 (RT1) in the anterior maxilla were treated with CM + CAF, and based on these patients a brief statistical analysis was conduct. The evaluated parameters included gingival recession depth (GRD), gingival recession width (GRW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), gingival thickness (GT), and mean root coverage (MRC). Patient-related outcomes measurements (PROMs) were assessed using an oral health impact profile (OHIP-14) questionnaire and visual analogue scale (VAS).  Results: There was significant improvement in GRD, GRW, and CAL measurements at 3 months postoperatively (p<0.05). Besides, CAL also increased from 12 months to 24 months’ follow-up (p=0.0023). The MRC percentage was 82%. PD, GT, and KTW presented no statistical difference. PROMs revealed a high score for esthetics (82.2%) and a significant reduction in hypersensitivity and surgical pain/discomfort. Conclusions: Considering the limitations of a case series, the use of CM + CAF on RT1 multiple gingival recessions in esthetic areas demonstrated positive outcomes after 24 months.

scholarly journals Dynamics of Matrix Metalloproteinase-1 and -8 Secretion in Gingival Crevicular Fluid after Gingival Recession Therapy via MCAT with Either Subepithelial Connective Tissue Graft or Collagen Matrix

Biomolecules ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 731
Author(s):  
Anna Skurska ◽  
Violetta Dymicka-Piekarska ◽  
Robert Milewski ◽  
Małgorzata Pietruska
Keyword(s):  
Connective Tissue ◽  
Gingival Crevicular Fluid ◽  
Collagen Matrix ◽  
Gingival Recession ◽  
Gingival Thickness ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Keratinized Tissue ◽  
Matrix Metalloproteinase 1 ◽  
Crevicular Fluid

Objectives: The objective of this study was to determine and estimate the changing levels of matrix metalloproteinases 1 and 8 (MMP-1 and MMP-8) in GCF at consecutive stages of healing after root coverage procedure via modified coronally advanced tunnel (MCAT) combined with either sub-epithelial connective tissue graft (SCTG) or collagen matrix (CM) and also to relate those changes to clinical outcomes of both therapeutic approaches. Materials and methods: The study involved 20 patients with a total of 91 recessions. Those on one side of the mandible received MCAT plus CM while the contralateral ones MCAT plus SCTG. The evaluation of MMP-1 and MMP-8 concentrations in Gingival Crevicular Fluid (GCF) took place at baseline, then at 1, 2, and 4 weeks, and finally at 3 months after surgery. Elisa protocol was applied to determine the levels of MMP-1 and MMP-8 in GCF. Results: Three-month observation revealed statistically significant changes in MMP-1, MMP-8 and Sulcus Fluid Flow Rate (SFFR) values after implementation of both techniques. A correlation was found between a difference in MMP-1 concentrations and gain in Keratinized Tissue (KT) after SCTG and CM. MMP-8 levels and a Gingival Thickness (GT) gain observed after CM was also correlated. Conclusions: A type of augmentative material does appear to determine the dynamics of MMP-1 secretion.

scholarly journals Management of Spontaneous Isolated Mesenteric Artery Dissection: A Systematic Review

2021 ◽  
pp. 145749692110005
Author(s):  
S. Acosta ◽  
F. B. Gonçalves
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Conservative Therapy ◽  
Case Series ◽  
Celiac Artery ◽  
Artery Dissection ◽  
Covered Stents ◽  
Bowel Infarction

Background and Aims: There are increasing reports on case series on spontaneous isolated mesenteric artery dissection, that is, dissections of the superior mesenteric artery and celiac artery, mainly due to improved diagnostic capacity of high-resolution computed tomography angiography performed around the clock. A few case–control studies are now available, while randomized controlled trials are awaited. Material and Methods: The present systematic review based on 97 original studies offers a comprehensive overview on risk factors, management, conservative therapy, morphological modeling of dissection, and prognosis. Results and Conclusions: Male gender, hypertension, and smoking are risk factors for isolated mesenteric artery dissection, while the frequency of diabetes mellitus is reported to be low. Large aortomesenteric angle has also been considered to be a factor for superior mesenteric artery dissection. The overwhelming majority of patients can be conservatively treated without the need of endovascular or open operations. Conservative therapy consists of blood pressure lowering therapy, analgesics, and initial bowel rest, whereas there is no support for antithrombotic agents. Complete remodeling of the dissection after conservative therapy was found in 43% at mid-term follow-up. One absolute indication for surgery and endovascular stenting of the superior mesenteric artery is development of peritonitis due to bowel infarction, which occurs in 2.1% of superior mesenteric artery dissections and none in celiac artery dissections. The most documented end-organ infarction in celiac artery dissections is splenic infarctions, which occurs in 11.2%, and is a condition that should be treated conservatively. The frequency of ruptured pseudoaneurysm in the superior mesenteric artery and celiac artery dissection is very rare, 0.4%, and none of these patients were in shock at presentation. Endovascular therapy with covered stents should be considered in these patients.

scholarly journals Unique Genomic Landscape of High-Grade Neuroendocrine Cervical Carcinoma: Implications for Rethinking Current Treatment Paradigms

2020 ◽  
pp. 972-987
Author(s):  
Ramez N. Eskander ◽  
Julia Elvin ◽  
Laurie Gay ◽  
Jeffrey S. Ross ◽  
Vincent A. Miller ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Current Treatment ◽  
High Grade ◽  
Novel Treatment ◽  
Sample Average ◽  
Genomic Landscape ◽  
Comprehensive Genomic Profiling ◽  
Tumor Mutational Burden ◽  
Sample Range ◽  
Novel Treatment Strategies

PURPOSE High-grade neuroendocrine cervical cancer (HGNECC) is an uncommon malignancy with limited therapeutic options; treatment is patterned after the histologically similar small-cell lung cancer (SCLC). To better understand HGNECC biology, we report its genomic landscape. PATIENTS AND METHODS Ninety-seven patients with HGNECC underwent comprehensive genomic profiling (182-315 genes). These results were subsequently compared with a cohort of 1,800 SCLCs. RESULTS The median age of patients with HGNECC was 40.5 years; 83 patients (85.6%) harbored high-risk human papillomavirus (HPV). Overall, 294 genomic alterations (GAs) were identified (median, 2 GAs/sample; average, 3.0 GAs/sample, range, 0-25 GAs/sample) in 109 distinct genes. The most frequently altered genes were PIK3CA (19.6% of cohort), MYC (15.5%), TP53 (15.5%), and PTEN (14.4%). RB1 GAs occurred in 4% versus 32% of HPV-positive versus HPV-negative tumors ( P < .0001). GAs in HGNECC involved the following pathways: PI3K/AKT/mTOR (41.2%); RAS/MEK (11.3%); homologous recombination (9.3%); and ERBB (7.2%). Two tumors (2.1%) had high tumor mutational burden (TMB; both with MSH2 alterations); 16 (16.5%) had intermediate TMB. Seventy-one patients (73%) had ≥ 1 alteration that was theoretically druggable. Comparing HGNECC with SCLC, significant differences in TMB, microsatellite instability, HPV-positive status, and in PIK3CA, MYC, PTEN, TP53, ARID1A, and RB1 alteration rates were found. CONCLUSION This large cohort of patients with HGNECC demonstrated a genomic landscape distinct from SCLC, calling into question the biologic and therapeutic relevance of the histologic similarities between the entities. Furthermore, 73% of HGNECC tumors had potentially actionable alterations, suggesting novel treatment strategies for this aggressive malignancy.

scholarly journals Palatal Harvesting Technique Modification for Better Control of the Connective Tissue Graft Dimensions

2013 ◽  
Vol 24 (6) ◽  
pp. 565-568 ◽  
Author(s):  
Danilo Maeda Reino ◽  
Arthur Belem Novaes Jr. ◽  
Marcio Fernando de Moraes Grisi ◽  
Luciana Prado Maia ◽  
Sergio Luis Scombatti de Souza
Keyword(s):  
Connective Tissue ◽  
Donor Site ◽  
Case Series ◽  
Gingival Recession ◽  
Connective Tissue Graft ◽  
Tissue Graft ◽  
Partial Thickness ◽  
Harvesting Technique ◽  
Subepithelial Connective Tissue Graft ◽  
Graft Thickness

Subepithelial connective tissue graft (SCTG) has been extensively used for a variety of clinical applications. However, the surgical procedure may not allow control of graft thickness. The purpose of this case series is to illustrate a modification to the single incision palatal harvesting technique in order to control the SCTG thickness without increasing patient discomfort. Fifty cases from thirty systemically and periodontally healthy patients with at least one multiple gingival recession were treated with coronally advanced flaps combined with a SCTG. The palatal area served as the donor site, from where a single perpendicular incision was made to obtain a full thickness flap. Next, 1-2 mm of the flap was elevated and dissected to obtain a partial thickness flap. The graft remained attached to the full-partial thickness flap. After determining the desired SCTG thickness, the graft was harvested from the palatal flap. The patients healed uneventfully at 7 days postoperatively and primary closure was obtained for all palatal donor sites. The SCTG length and width varied depending on the needs of each case, but the SCTG thickness was well controlled with only 0.24 mm standard deviation. The suggested modification granted control of the SCTG dimensions and achieved complete wound closure within a week.

scholarly journals Lingual bonded retainers: A case series of complications and resolutions

2020 ◽  
Vol 10 ◽  
pp. 3-11
Author(s):  
Tae-Kyung Kim ◽  
Seung-Hak Baek
Keyword(s):  
Case Series ◽  
Gingival Recession ◽  
Black Triangle ◽  
Anterior Teeth ◽  
Combined Use ◽  
Management Of Complications ◽  
Bonding Failure ◽  
Transfer Method ◽  
Transverse Position ◽  
Bonded Retainers

Objective: The objective of the study was to describe the types, causes, and recommendations for the prevention/ management of complications related with lingual bonded retainers (LBRs) during the retention period. Materials and Methods: The retention protocol was a combined use of the LBRs made from 0.0175 multistrand wire and bonded on the maxillary and mandibular anterior teeth by DuraLay resin transfer method and a removable retainer at both arches for nighttime wear. Nine cases, which did not show bonding failure or fracture of LBR, were described to explain the complications including unexpected tooth movements and gingival problems. Results: The types of complications were spacing, loss of alignment, change in transverse position, angulation or torque of the crown, gingival recession, and black triangle. There are three possible causes for these complications: (1) Active force generated by LBR, which was not passively fabricated or bonded, (2) deformation of LBR induced by heavy biting force or traumatic occlusion, and (3) untwisting force of strand in round flexible multistrand wire. These complications can be prevented or managed by (1) fabrication of LBR on a working model to make it passive, (2) use of a jig to position LBR during bonding to avoid deformation by finger pressure, (3) supplemental use of a removable retainer for nighttime wear, (4) early detection of bonding failure, deformation, or fracture of LBR, and (5) immediate removal of LBR and use of a new removable retainer for resolution of complications. Conclusion: Clinicians should check the existence of these complications from the start of retention and inform the patient of the possibility of retreatment.

scholarly journals PFKFB3: A Potential Key to Ocular Angiogenesis

2021 ◽  
Vol 9 ◽  
Author(s):  
Zi-Yi Zhou ◽  
Lin Wang ◽  
Yu-Sheng Wang ◽  
Guo-Rui Dou
Keyword(s):  
Cell Metabolism ◽  
Current Treatment ◽  
Potential Treatment ◽  
Ocular Angiogenesis ◽  
Pathological Angiogenesis ◽  
Novel Treatment ◽  
Promising Target ◽  
Long Time ◽  
New Evidence ◽  
Endothelial Cell Metabolism

The current treatment for ocular pathological angiogenesis mainly focuses on anti-VEGF signals. This treatment has been confirmed as effective despite the unfavorable side effects and unsatisfactory efficiency. Recently, endothelial cell metabolism, especially glycolysis, has been attracting attention as a potential treatment by an increasing number of researchers. Emerging evidence has shown that regulation of endothelial glycolysis can influence vessel sprouting. This new evidence has raised the potential for novel treatment targets that have been overlooked for a long time. In this review, we discuss the process of endothelial glycolysis as a promising target and consider regulation of the enzyme 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase as treatment for ocular pathological angiogenesis.

scholarly journals Low-dose subcutaneous immunoglobulin is an effective treatment for autoimmune bullous skin disorders: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X1990107 ◽  
Author(s):  
Erin Streu ◽  
Marni C Wiseman ◽  
James B Johnston
Keyword(s):  
Low Dose ◽  
Treatment Approach ◽  
Subcutaneous Tissue ◽  
Hospital Setting ◽  
Case Series ◽  
Novel Treatment ◽  
Autoimmune Bullous Diseases ◽  
Serum Trough ◽  
Bullous Diseases ◽  
High Doses

Intravenous immunoglobulin is a recognized treatment in recalcitrant autoimmune bullous diseases. Infusions are administered monthly over 1–5 days in the hospital setting and associated with mild to severe infusion-related systemic effects, in part due to the high doses necessary to induce and achieve remission. We present a case series of four patients with bullous diseases treated successfully with low-dose subcutaneous IgG who achieved remission with maintenance therapy. Patient-administered smaller, more frequent doses of IgG into subcutaneous tissue more closely mimics the body’s own antibody production and produces a more stable serum trough level. Subcutaneous IgG is a novel treatment approach in bullous diseases which can induce a state remission.

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