A radiological study method of vertical alveolar resorptions using immediate dental implants

Dental extraction is followed by decreases in alveolar volume, vertically and horizontally. This retrospective study measured vertical alveolar resorption after insertion of immediate implants, using OPG, without CBCT or additional radiographs. Patients were randomly split in two groups A (57 implants) and B (47 implants). Measurements were made by two independent observers. The types of implants were: Exacta (Biaggini Medical Devices), Nova, Dentix Millenium and Surcam. The method was based on the size of the implant and another common element of the two radiographs. It used an optimal radiologic exposure. It can be generalized to other studies. Similar results measured in the two groups showed that alveolar remodeling does not depend on the type of the implant. Half of the alveoli did not have any resorption. Another quarter showed barely perceptible clinical resorption (1-2 mm). In the last quarter were registered all the notable resorptions that were associated with various factors (temporary mobile prosthesis, surgical flap, medication and some health problems, smoking, etc.) showing real situations, not ideal conditions. Maximum resorption was unique (7.63 mm).

Assessment of the changes in the stress related salivary cortisols levels induced during different Dental procedures

Aims and objective: Anxiety ,fear and pain assessment is essential in day to day Dental practice .The present study evaluated the stress related salivary cortisols levels induced during scaling,tooth preparation and surgical flap elevation in Periodontally compromised subjects Methodology: The salivary cortisol level were assessed in 80 patients ,out of which 40 patients were healthy patient who do not require any Dental treatment and 40 patients who underwent Scaling , tooth preparation and surgical flap elevation in Periodontally compromised subjects The groups divided were as follows . Group 1: control group with no treatment and just the saliva sample was taken. Group 2; The patients underwent scaling Group 3; The patients underwent tooth preparation for fixed prosthesis Group 4; The patients underwent surgical flap elevation in Periodontally compromised situation .The salivary cortisol levels were assessed using Salivary Cortisol Enzyme Immunoassay Kit. Results: The salivary cortisol level was highest in Group 4 followed by Group 2, Group 3 and least in Group 1. Conclusion: The stress level was lowest in healthy patient and highest when patient underwent surgical flap elevation in Periodontally compromised subjects .Dentist should try to minimize subject anxiety and stress to great extent .

The Effect of Platelet Rich Fibrin (PRF) and Bone Graft (Carbonate Apatite) Applications on Platelet Derived Growth Factor-BB Post Flap Surgery in Patients with Chronic Periodontitis

Chronic periodontitis characterized by a periodontal pocket over 5 mm, alveolar bone resorption accompanied by tooth mobility, requires periodontal surgical treatment. Conventional surgical treatment can not achieve the regeneration of periodontal tissue and thus requires regenerative procedures, such as with the addition of PRF. PDGF-BB is a growth factor that plays an important role in wound healing. Developments in additional bioactive ingredients in surgical procedures are used to regulate inflammation and increase the speed of the healing process. The purpose of this study was to determine the effect of PRF and bone graft (carbonate apatite) on PDGF-BB levels post-surgical flap in patients with chronic periodontitis. The experimental study with open label and consecutive sampling was conducted on 10 subjects of chronic periodontitis who received surgical flap treatment with bone graft and PRF; and 10 subjects without PRF. GCF samples were collected immediately before surgery and 7 days post flap surgery for examination of PDGF-BB levels by ELISA method. The data were calculated statistically by Mann-Whitney test (p <0.05). The results showed that the mean difference of PDGF-BB level in PRF group was 9.44 pg/ml (-1.20 – 37.79 pg/ml) with p value (0.013) and Non-PRF group was 7.97 pg/ml (-6.62 - 44.42 pg/ml) with p value (0.059). The p value in the PRF group > 0.05 means a significant increase in PDGF-BB levels on the 7th day post flap surgery. Examination of PDGF levels, especially PDGF-BB, should be done in each healing phase of the wound from the inflammatory phase to the maturation and remodeling phase, for example on the 3rd, 7th, 14th and 28th days when PDGF levels approach zero and the healing process it's almost over, referring to the results of Alzahrani's research (2018) and also Matsuoka and Grotendorst (1989) which showed higher levels of PDGF-BB and VEGF in GCF on days 1, 3, 7 and 14 after surgery with minimally invasive surgery (MIS) technique. The conclusions of this study showed that the application of Platelet Rich Fibrin (PRF) and bone graft had an effect on the level of Platelet Derived Growth Factor (PDGF-BB) post-surgical flap in patients with chronic periodontitis, and elevated levels of PDGF-BB post-surgical flap with PRF application higher than surgical flap without the PRF application. Increased levels of PGDF-BB in the group applied to the PRF were higher than those that were not applied PRF, although statistically significant differences were not found, there was a tendency for the healing process of the PRF group to be better than the Non PRF group.

Mechanical Tooth Depuration and Pocket Depth: A Correlative Clinical Study

Background and aims. Previous researches, conducted mostly on extracted teeth, have shown that efficacy of calculus removal decreases with increasing pocket depth, but there is still a lack of clinical studies concerning the correlation between residual calculus and varying pocket depths. The objective of the present clinical study was to assess the efficiency of mechanical tooth depuration by closed approach in terms of pocket depth, tooth type and tooth surface. Materials and methods. Fifty subjects with chronic periodontitis underwent scaling and root planing by closed approach. After instrumentation, 225 teeth (92 single-rooted and 133 multi-rooted) with pocket depths of 4 mm and 5‒8 mm were evaluated for calculus-positive surfaces by surgical flap elevation. Residual calculus was assigned a score from 1 to 3 based on the distance in mm from CEJ or furcation. Results. 11.4% of surfaces were calculus-positive. On inter-pocket depth comparison, calculus-positive surfaces were present in both single- and multi-rooted teeth, with no significant differences. Residual calculus score 1 was significantly associated with a pocket depth of 4 mm and scores 2 and 3 with pocket depths 5‒8 mm in overall distribution and for multi-rooted teeth. Conclusion. During mechanical tooth depuration by closed approach, no significant correlation was found between percentages of calculus-positive surfaces and increasing pocket depth.